Choosing Your Health Care Provider: OB/GYNs

Thinking about adding an OB/GYN to your team of health care providers? What type of prenatal care can you expect to receive with an OB/GYN? What exactly is their role during the labor and delivery process? And how can you find an OB/GYN that best fits your goals outlined in your birth plan?

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Preggie Pals
Choosing Your Health Care Provider: OB / GYNs

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Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]

ABBY LACEY: You’re pregnant or trying to conceive and you’re considering receiving care from an obstetrician. How do you know who to go to when there’s so many obstetricians to choose from? What questions should you ask? I’m ABBY LACEY:, founder of the Doula Initiative, and today we’re discussing how to choose an obstetrician that’s right for you. This is Preggie Pals.

[Theme Music/Intro]

STEPHANIE GLOVER: Welcome to Preggie Pals, we are broadcasting from the birth education centre of San Diego. Preggie Pals is your online on-the-go support group for expecting parents and those hoping to become pregnant. I’m your host, Stephanie Glover. A special thanks to all of our Preggie Pals club members.

Our members get special episodes, bonus content after each new show plus special giveaways and discounts. See our website for more information. Another way for you to stay connected is by downloading our free Preggie Pals app available on Android, iTunes and Windows market place. Sunny our producer is now going to give us some information about our virtual panelist program.

SUNNY GAULT: Yeah so if you guys are listening and you want to be part of the show but you’re not here in San Diego for some reason, you can make it to our taping today. You can participate through our virtual panellist program. You can like us on Facebook, follow us on Twitter. We are going to be using #preggiepalsvp, of course the VP stands for virtual panellist. And we’re going to be asking you guys some questions that we’re asking the panellist right here in the studio. If you guys want to ask our expert some questions that’s a great way to do it as well and just participate in the conversation and help out some other momma’s to be. So if you are participating, you can even win some great prices. So please do.

STEPHANIE GLOVER: Great. Thank you Sunny

SUNNY GAULT: Yep

STEPHANIE GLOVER: So, we’re going to go ahead and go around the table here and introduce our panellist, introduce ourselves. I’ll go ahead and get start started, my name is Stephanie Glover, I’m 32 years old. I am a stay-at-home mom and host of Preggie Pals. No due date but I’ve have two little girls. Gretchen is almost three and she was my C-section baby. And Lydia is eleven months and I had her via VBAC

ANNIE LAIRD: Hi my name is Annie. I’m 36. I’m a labour doula. I have three little girls, a nine year old, a two year old and an eight month old, Clara, Lucy and Stella. Clara was a vaginal birth in the hospital. And Lucy was a transfer homebirth to the hospital. And Stella was my homebirth.

STACEY SPENSLEY: Hi I’m Stacey Spensley. I’m 31 years old. I’m a certified holistic health coach. And I am not due yet with anything but I have one son Iver who is seventeen months old. And I had an un-medicated vaginal, natural childbirth

STEPHANIE GLOVER: Great

STACEY SPENSLEY: Thank you

SUNNY GAULT: And I’m Sunny, I am filling in for Samantha as producer on today’s show. But you guys know me, I’ve been around the block a couple of times on these shows. I’ve got four children currently under the age of four. My oldest is about to turn four so I can’t use that expression for too much longer. My middle guy’s two and I have identical twin girls who are eight months old. My first was vaginal and then I had two caesarean births.

STEPHANIE GLOVER: Alright. Thank you Sunny

[Theme Music]

STEPHANIE GLOVER: So before we get started here we’re reviewing a pregnancy app called Full Term Labour Contraction Timer and it’s available on iPhone and iPad. And this app could time contractions which can be very helpful when you’re in labour. It also provides basic guidelines for the different faces of labour which you can refer to when using the app and kind of compare it to your labour pattern. And if you forget to say hit the stop button after a contraction, then you can actually go in and edit your input and your entries to I guess show an accurate account of your contraction patterns. And also you’re able to email your contraction times with a doula or someone else that you would like to communicate your labour to. So we’ll go around the room and just kind of discuss this app and get some opinions on it

ABBY LACEY: Okay as a doula I have to say, big love on this app. Not only is it free which, who doesn’t like the F word

ANNIE LAIRD: I love the F word

ABBY LACEY: So not only is it free but it, you know as your doula if I’m at home, or you know at work or doing something and you’re calling me and say ‘hey we’re in labour and I have questions?’ and you don’t have the answers. Great! You know what? If you’re comfortable and you don’t mind tracking your labour for the next thirty to sixty minutes, track it for me. Send me an email from the app directly that shows me what your progress is and what things look like. You know as experienced doula I can often look at that pattern and have a pretty good idea of what’s going on with your, with your labour. It’s fantastic as a doula.

SUNNY GAULT: Question? So when, how easy is that to send to your doula? Because I’m thinking, okay I’m having contractions, I might be in some pain, the last thing I want to do is hunt for an extra button to send. Is it literally like, right there?

ABBY LACEY: Yeah. If you’re under the details section, there’s a big envelope in the top right hand corner. You hit that envelope, you type in my email address and off it goes directly from the app

SUNNY GAULT: So is it just what’s listed there like the contractions that you’ve experienced so far that’s what it sends? Or can you isolate it more?

ABBY LACEY: It will send the entire history

SUNNY GAULT: Oh okay. Okay

ABBY LACEY: So, but it will list it typically with the most recent pattern at the top of the email and then they can go back and see you know historically what was your pattern, how has your pattern been developing. You know generally speaking I don’t like my families later on in labour to be too focused on my contractions are every two and a half minutes and they’re thirty five seconds long. And you know, I, at some point yeah, we don’t want you to kind of obsessed over having your phone in your hand and tracking when your contractions are starting and stopping. But when you’re getting the hang of it and trying to figure out if you’re even in labour, is there a pattern? Fantastic app and it doesn’t cost you a dime.

SUNNY GAULT: Love it. And you’ve used this right?

ANNIE LAIRD: Yes. It is funny because Abby and I are back up doulas for each other and I had no idea that we both use this app. But it’s not something that we talk about I just also as a labour doula I felt that this is a very effective app. It’s very easy and I like the edit function on it because everybody in labour you think once starting but oh it’s not or you forget to hit stop button and then it’s thirty seconds later and then showing that your contractions are two minutes long which they are not.
But yeah that edit function is great and it has a graphing function on it so. And it’s hard, we we’re talking about this in previous episode where it tell you, you know, wait to come in the hospital before you know, wait until you’re contractions are four to five minutes apart. Well it’s not like it goes ‘oh okay, well now it’s five minutes, five minutes, five minutes, four minutes, four minutes, four minutes’ it doesn’t work like that.

It goes like, four minutes and twenty seconds and then six minutes and ten seconds and it’s all over the board. But what you’re looking for is the average. And so, the next thing with this app is it already calculates that average for you. And you can see it either in a table format or you can see it graphically in a chart

ABBY LACEY: And you don’t have to remember, is it four minutes from the start to the start of the next one. Is it four minutes from the end to the start of the next one?

SUNNY GAULT: Right

ANNIE LAIRD: All you have to worry is the start button which turns in to a stop button, that’s it

ABBY LACEY: Yeah.

ANNIE LAIRD: It has mom not thinking so much during her labour so

SUNNY GAULT: Yeah. I like the fact that this app that’s all this app does because you know there’s a bunch of different pregnancy apps out there and this is one of the functions. So it’s an upgraded option or something. And for some people that may be good but it’s been my experience that if you can do one thing and do it really well, then there might be a better option than trying to be all things to every pregnant women out there

ABBY LACEY: Right

SUNNY GAULT: And I also know that when you know when you’re in labour and you may not be thinking as clearly, it’s a little lot easier for me to find just ‘where’s that contraction app?’ Then again, going ‘oh here’s my favourite pregnancy app’ and then scroll here and hit the

ANNIE LAIRD: Through five sub menus

SUNNY GAULT: Exactly. Exactly

ANNIE LAIRD: And Abby I think you’re saying this was developed by a, expecting dad right?

ABBY LACEY: Yeah. That’s my understanding is he developed this, from my understanding he’s not a developer and he couldn’t find something that he likes so he decided to write his own and use it in his own, life saver

SUNNY GAULT: Alright so thumbs up?

ANNIE LAIRD: Thumbs Up

ABBY LACEY: Big thumbs up

[Theme Music]

STEPHANIE GLOVER: Today on Preggie Pals we’re continuing our series on hiring your care provider. This week we’re discussing how to choose an obstetrician or OB that’s right for you. Joining us today is Abby Lacey, founder of the Doula Initiative, a non-profit organization that provides subsidies and resources to families and doulas. Welcome to Preggie Pals Abby, thanks for joining us

ABBY LACEY: Thanks for having me

STEPHANIE GLOVER: So before we get started can you explain what an obstetrician is? And how they differ from a midwife?

ABBY LACEY: Yeah. An obstetrician is a medically trained care provider. Not to say that a midwife isn’t but an obstetrician is an MD who has gone all the way through medical school and has chosen to specialize in pregnancy care and birth. A midwife, so there are couple of different types of midwives, at least in California, there’s a certified professional midwife who goes through an entire training program.

Maybe doesn’t have any previous medical experience but decides to become a midwife. And there’s a certified nurse midwife. And a CNM is required to actually be an RN before going through their midwifery training. Midwifery training in that case is an advanced degree. It’s a masters and with the option of extending into a doctorate. So it’s different training, its different schooling. And obstetricians are the typical choice of delivering women in the United States.

STEPHANIE GLOVER: Okay. And we often hear the term OBGYN. So what’s the difference between obstetrician and a gynaecologist? And are obstetricians usually both?

ABBY LACEY: You know an obstetrician doesn’t have to be both. An obstetrician does specialize the maternity care and labour and birth. A gynaecologist specializes in women’s reproductive health. They do tend to go very well together so you will see a lot of obstetricians who are also gynaecologists.

You also may see gynaecologists who are not obstetricians. Typically if you’re an OB adding gynaecology to your practice isn’t quite as cumbersome. And can of course help grow your patient base. However, if you’re just the gynaecologist, some of them don’t want to take on the additional liability of working with pregnancy and birth

STEPHANIE GLOVER: Okay

ANNIE LAIRD: I imagine the time restraint as well you know with gynaecology there’s you know well women care from puberty to you know old ladies basically. Yeah but birth work, you know having that obstetrician hat on as well as gynaecology. You know you’re getting calls from the middle of the night and generally with genealogical this, I can’t think of any gynaecological emergency you’d pretty much any woman would wait for office hours the next day. You schedule surgeries if they’re needed

ABBY LACEY: Yeah more often than not

ANNIE LAIRD: Yeah

STEPHANIE GLOVER: Where do OB’s typically practice? And where do they deliver?

ABBY LACEY: So OB’s more often than not currently are practicing in large group practices. You’ll see anywhere from three to twelve obstetricians group together in a practice. That’s in private care. If you’re on the HMO side, your doctor’s also maybe in a practice environment. But one of the big difference is for example between Kaizer and Sharp, is if you’re in a OB practice at Sharp, you’re more than likely going to wind up with one of the OB’s from your groups.

So there’s a chance you’ve met the provider before versus a practice with Kaizer. You may be seeing your obstetrician and then show up at the hospital and no one from that office is currently in the hospital. And you see an obstetrician who happens to be on call for that shift

STEPHANIE GLOVER: Okay. And are there patients that are better suited to receive care from an obstetrician? Versus a midwife or?

ABBY LACEY: Well absolutely. If you’re considered a high risk pregnancy, then an obstetrician is where you need to be. Usually that means that there are conditions that are present in your pregnancy that need a more managed care as opposed to, you know a little bit more hands off approach that you’re going to get from a majority of midwives.
So particularly high risk, I also tell my clients really if you’re just more comfortable under obstetric care because the one of the biggest keys to birth is trusting that you’re in safe hands, feeling good with your provider. And going in to the birth itself full of confidence

STEPHANIE GLOVER: Okay. And now did, Stacey or Annie, did either of you have obstetric care?

STACEY SPENSLEY: I actually, because I had a low risk pregnancy, I did see midwives for my prenatal care. An OB showed up just in time for the baby to arrive and since I didn’t push very long almost missed them like gotcha

ANNIE LAIRD: Let’s see, I have three to three, three different pregnancies. So I had obstetrician care at different points of the pregnancy with baby number one and number two

STEPHANIE GLOVER: Okay

ANNIE LAIRD: So yeah with number one it was basically who’s covered by my insurance and I really felt comfortable with a woman rather than a man. So I chose, basically the only female obstetrician that was covered by my insurance. That was my decision making process on that one.

So, yeah, and she did all my prenatal care, yeah, she was there just a little bit in the hospital checking on me and then she was there right before the birth. So yeah, and then with the second baby I had midwifery care, hospital midwifery care and homebirth midwifery care, a doula care. So one was covered by my insurance, one was not. And then when it was time for me to have the baby I transferred with my homebirth but the hospital, the insurance where to midwifery care is not available twenty four seven.

So an obstetrician came in basically to catch the baby and then do the perennial repair. And I’ve never met him before. So yeah, it was kind of funny because he was a new obstetrician just finishing his residency, it’s kind of a quiet night, I don’t think they were expecting you know me to show up and I was all on fours and so he was like ‘woah, what’s this?’ you know like, it’s just you know a different way of practicing you know most women have epidurals on their backs and that’s the way the babies were born you know here I come and you know cur son up the storm and knock it off my hands and knees and so yeah. So it worked out okay. He was a young guy but he throw all the punches pretty good so yeah

STEPHANIE GLOVER: Within obstetrics are there different specialties or are there different types of OB’s

ABBY LACEY: Absolutely! So you have some OB’s that prefer the low risk pregnancies and that’s typically what they will work with. You will also have OB’s who specialize in the high risk groups. They’re typically referred to as perinatologist as opposed to just obstetricians. It’s not uncommon if you’re having multiples or if you have other significant contributing health factors to see a perinatologist. If you have a history of seizures if you have any heart conditions, occasionally if you have gestational diabetes, you will be transferred over to care for with a perinatologist versus an obstetric office because they feel like you’re in better hands

STEPHANIE GLOVER: Okay. You each reference sort of the OB showing up to catch your babies and baby catchers. So what’s the model of care like for an obstetrician? Like how, how involved are they with prenatal with like labour and delivery and postpartum?

ABBY LACEY: Good question. So, the interesting thing about obstetric care is just that we find more and more that it is really kind of guided by what insurance companies will allow obstetricians to do. Oftentimes insurance companies that a minimum or a maximum amount of time that an OB is allowed to spend with you per office visit.

So, you might not get as much one on one time with your OB during an office visit. So the other part of it is that you may find that the office practices itself is so busy. That they can all thing get behind and you wind up spending a decent amount of time sitting in the waiting room to be seen for you know, maybe five, ten minutes at most. You’re brought back into the office by a nurse or a nurse practitioner, who takes your vitals, has a chat with you. You sit; you wait for your OB to come in.

They whisk in and talk to you for five minutes and then they’re gone. And you’ve just spent three hours in the office and for five minutes with your care provider. So it’s not necessarily if you want a lot of face time with your doctor to go to. If you are totally comfortable with that model of care and if that’s all your insurance will provide for you which is really a deciding factor for a lot of women then it’s just good to be aware that obstetricians oftentimes aren’t able to provide the one on one care.

Outside of your office visits when it comes time for labour and delivery again, if you’re in a group practice, they often have a rotation for who is taking births in the office that day. So you may wind up with your doctor, you may not. You may wind up with someone in their practice who you have met previously. I will say there are exceptions to this rule. And we have a handful of them here in San Diego County. And if you are dead set on having your provider at your birth, you need to seek out that provider and not find a group care situation.

ANNIE LAIRD: Well it’s definitely something in the interview process. I feel that women have to do their homework and you know, don’t do what I did for my first birth. I’m like well I want a female, and I want my kids insurance covered. You know I really, was my birth fine? Yeah. Could have been better? Yeah. Definitely in a lot of ways.

You know and that wasn’t just my obstetrician that was a lot of choices that I made or you know, chose not to make with regard to childbirth education. But yeah that’s definitely something and it’s so much easier to do at early on in a woman’s pregnancy. Going through that interview process and going well am I, do I really click with this person or and as you refer to Abby, okay great I click with them. What’s the likelihood that they’re going to end up as the person who is there at the birth?

ABBY LACEY: Exactly. And the other thing to note too is just that, if you feel like you need to be very specific about your provider being at your birth, understand that really the obstetrician is with you not a significant amount of time during the labour and birth itself. Your nurse is the person who spends the most amount of time with you while they are on shift. That is the person who is going to be really kind of actively involved to managing your care while you’re in the hospital.

ANNIE LAIRD: That’s what you bring the brownies for

ABBY LACEY: Exactly

SUNNY GAULT: One thing I was going to say, one thing that I did, this is with my first so I hadn’t had a child before. And I was with a care provider that they could not guarantee that the person that have been seeing me was actually going to deliver the baby and this was a vaginal birth so they don’t whose and when I was going to go on labour and who is going to be on call. And so I took the advice of a friend who is in you know similar position and decided that for all of her prenatal appointments she was going to try to see a different provider each time

ABBY LACEY: Absolutely

SUNNY GAULT: And that’s kind of what, what I ended up doing every time that I could I’d see. Now it may felt kind of a weird prenatal appointment each time because either checking in and they’re pretty intimate and you’re not able to really establish a rapport with them. It’s kind of a little awkward if you didn’t get past that phase. But I did meet a bunch of different people. It did so happened that when I went in to labour, one of the people that I saw one time ended up you know being there. And I was comforted by that so that may be an option for people that don’t have that ability if you’re an HMO or whatever. And you know can’t really make that choice that that may be an option for you for your prenatal appointments

ABBY LACEY: Absolutely and it’s a great opportunity to have conversations with each of the doctors in the office. And ask them about the things that are important to you. So you know is it that really important to you not to have an episiotomy. Well they’re not standard anyway, but if that’s the one thing that’s really important to you

ANNIE LAIRD: If that’s the hell you’re going to die on

ABBY LACEY: Yeah

ANNIE LAIRD: Yeah

ABBY LACEY: Ask the doctor every visit that you have. You know, ask each doctor if there’s something that’s just really important to you, ask them.

ANNIE LAIRD: Well I know here locally in San Diego there’s a birth centre that they do that as a standard of practice where you see a different midwife every time because you don’t know who’s going to be on call. I imagined there’d be groups of obstetricians that you know they can’t force that on you of course but maybe they could be encouraged to that and say look, we don’t know who’s going to be there so why don’t you see a different provider every time

SUNNY GAULT: You know what for my situation the receptionist is giving me a weird look every time I try to schedule

ANNIE LAIRD: Really?

SUNNY GAULT: I said, why? I don’t understand, why, what, you know, you’ve been assigned to this person , I’m like No, like I don’t know who’s going to be there. But they didn’t get it

ANNIE LAIRD: Yeah

SUNNY GAULT: And every time I saw a new obstetrician the next week, you didn’t like your last one? I don’t, I don’t know why, you know and they would go through it each time. I’m like don’t you understand, like this is a personal experience and I want to know who is staring at my vagina for four or five hours whatever, you know

STACEY SPENSLEY: I had the same thing and when, and actually it was one of the first midwives, I saw a nurse practitioner from my original appointment and they don’t deliver babies anyway. So, then I, when I was seeing the midwife the first time, then in her own words, well it doesn’t matter who you see for your prenatal care because it has no bearing on who’s here, who’s going to be there when you deliver.

And I didn’t like her anyway. That’s why, that’s why I called back. And I only caught cried three times when I was pregnant and that was the first time. And in the car in the way home I was like hysterical because I’m like, honey I’m going to cross my legs and never have the baby if she’s the one who’s there. So I called back and I was like when are you going to change my appointment? They’re like, okay, different time or that, and I’m like just a different provider.

They’re like, do you have somebody on your mind? I said, anybody but her. And they were like uhh, okay. And of course, so I went through I think four other care providers just as again I rotated through. When I found what I liked and so I did stick with her for the last like three appointments. And of course, who was there when I delivered? One I didn’t like

SUNNY GAULT: Oh NO!

STACEY SPENSLEY: Luckily I chose an excellent doula and I was only there for two and a half hours it didn’t matter. But, still

STEPHANIE GLOVER: Great segway, so when we come back we’ll discuss how to find an obstetrician that matches your care preferences. We’ll be right back

[Theme Music]

STEPHANIE GLOVER: Welcome back. Today we’re discussing how to find an obstetrician for your prenatal care and delivery. Labour doula Abby Lacey is our expert. So for a first time mom where do you even begin when you’re trying to find an obstetrician?

ABBY LACEY: So, I always tell families who are newly pregnant, the first thing is to decide what kind of birth to have and really because your care provider is going to make or break your experience. And when you’re deciding what kind of experience you want to have, that’s going to help point you in the direction of the obstetrician who’s going to really feel more comfortable for you.

So start with deciding, do I want really un medicated hands off care? Or do I want epidural in the parking lot? You know, that kind of thing. And then once you have established what kind of birth experience you think you want to have, then I encourage you, start talking to people. Start talking to other people who’ve had babies recently because let me tell you practices change in a matter of a couple of years. So if its five or more years old probably don’t, it’s great to consider their opinion but obstetric practice changes very very rapidly. If you try and keep up with ACOG and their position changes

STEPHANIE GLOVER: And what is ACOG?

ABBY LACEY: ACOG is the American College of Obstetrics and Gynecology, they’re the ruling body for obstetricians. And they put out position papers like it’s going out of styles. So, you know even for an obstetrician to keep up with the changes and practice, it can take a little while for them to implement changes. But you know obstetric practice can change fairly quickly even though you would think we’ve been having babies for how many thousands of years.

So, anyone who’s had a baby, you know five years or recent, more recently, I would maybe talk to them, find out what kind of birth they had, what their experience was with their provider? What they were looking for? Because you would be surprised when you talk to your girlfriends how varied the idea of a perfect birth is. So definitely ask around, talk to your friends who’ve recently had babies and what their experience was, what their preferences were?

If that provider was accommodating to those things you know, get online, do Google searches, research your doctor. You know one of the things that always surprises me, people do more homework on what car they’re going to buy than they do on the doctor who’s going to help bring their child into the world. So, do a little bit of homework on your doctor.

Don’t just look at whether or not that doctor’s covered by your insurance. Absolutely that’s important, see what providers are available underneath your coverage, and then go to town. Do some homework on this person because they’re going to be in your personal business and they’re going to create memories that you’re going to have for the rest of your life that they may remember for a week.

It’s, I mean, it’s a tough truth but it really is the reality. They see how many patients in a year, they’ve seen birth over and over and over again. This is what? A one, two, three four time experience in your life and you know, make sure that this is someone that you really absolutely adore. And that you want to go back to

ANNIE LAIRD: Well that’s something to bring up too. We’re talking about you know making sure that you and your doctor that you chose are on the same page. But if you find out later on, kind of tagging on to what’s Sunny is saying, if you’re finding out later in your pregnancy that you know what this isn’t a good fit anymore, women should not be afraid to change that care practitioner to someone that they feel is more in line with what they want for their birth, what they want for their child.

Because you know what, and I, you know, I understand, I totally get it like you feel like you have a relationship with this doctor. You don’t want to hurt their feelings. But you know what, trust me, you’re not hurting their feelings you know, you are may be preventing you know something, you know, I don’t want to say bad from happening but you’re looking for the best outcome for you and your baby. And if you’re feeling in your gut, that that’s not going to happen with this person, you’re not going to hurt their feelings. You’re just changing someone else

ABBY LACEY: Yep. No, trust your mommy intuition

ANNIE LAIRD: Yeah

STEPHANIE GLOVER: You know we were talking about, Annie brought up changing health care providers. But when you’re trying to make that decision and finding really the one that’s right for you, are you able to meet with them like have interviews with them. And is that, what are those called, is that covered by insurance, are they free, to get a good feel for if you want to continue your care?

ABBY LACEY: So most obstetricians won’t necessarily do what they would, what you would consider traditional interview. They will want you to come in for an initial visit. So you get an experience of what their care is typically like by going in for that initial visit. They do get a little bit more time on your first visit for some of that intake so that they will ask a little bit more about your medical history about what you’re looking for about all of those kinds of things.

But I would expect to go in and pay your co-pay for what you would typically pay for an office visit. And if that first office visit doesn’t go well and something doesn’t sit right for you, move on, go. Don’t schedule another visit with the practice if they call you to remind you that you need to make an appointment say, you know what thank you so much but I have decided to take care with someone else

STEPHANIE GLOVER: What are some key characteristics, I mean, I know you talked about asking yourself the type of birth that you want. Are there any other questions that you think are just imperative to ask potential obstetrician?

ABBY LACEY: One hundred percent. So we’d know nationally that our C section rate is approaching forty percent and it’s climbing every year. So if you’re really concerned about C-sections, you need to know what your obstetrician c-section rate is. If you’re in a group practice, you need to know what the group practices c-section rate is. You also need to know what that c-section rate is at the hospital that you plan to deliver at, because if it just so happens that nobody from that practice is available, they may post someone from a different practice.

And all of the, all of the care providers together who have privileges at a hospital contribute to making that hospital c-section rate. So always, always, always ask what the C-section rate is at your office. Ask the office staff, what’s the wait time? How long am I going to have to wait to be seen when I come in? Does the doctor run late often? Does the doctor deliver all their own babies? If you wind up in a practice where the obstetrician does deliver all of their own patients, you’re going to have a wait time I guarantee you, it’s just going to happen. Or you may have to reschedule your appointment.

So if you’re someone who is extremely busy, has a very rigid schedule and you know that you need to be seen on time on a specific day, your group practice, a large group practice might be better for you. But if you’re adamant that you want your care provider be the person who delivers too, expect to have a wait time.

You may want to ask in the case that you’re with a provider who delivers all their babies, how many patients to they accept around your due date? Are they really super busy? Is it going to be difficult? Will they vaginally deliver breach babies? Isn’t it very important question because that is not a standard of care? And most obstetricians won’t and you know it’s good to know. Is your obstetrician one of them?

STACEY SPENSLEY: And how long they go before they considered an induction?

ANNIE LAIRD: That’s a good one too.

STACEY SPENSLEY: My friend’s sister just had a baby in Tennessee and they we’re talking it like thirty eight weeks and we’re all just like ‘what?!’

STEPHANIE GLOVER: Yeah. Awesome! Thank you so much for joining us today Abby

ABBY LACEY: Absolutely!

STEPHANIE GLOVER: For more information about Abby Lacey and the Doula Initiatives as well as information about any of our panellists visit the episode page on our website. This conversation continues for members of the Preggie Pals club. After the show, Abby’s going to be discussing changing obstetricians mid pregnancy. To join our club, visit our website, www.newmommymedia.com

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ANNIE LAIRD: We’ve got a question form one of our listeners for one of our experts: Hello my name is Andy. And I’m currently twenty three weeks pregnant with my first child due this August. I had a question regarding going through a miscarriage, the similarities to giving birth. I’m wondering because I previously miscarried around ten weeks, though the baby had no heartbeat around eight weeks.

I experienced menstrual like cramping that over a couple of days got more and more painful and the blood flow that followed the same pattern. Eventually the pain was constant; I could no longer talk through it. I was at the friend’s house that evening. I went up to her bathroom and just tried to make it through the weights of pain that were coming back to back.

I started to wonder how long it was going to last and then I began to cry a little, mostly about the unknown of when it would stop. After about half an hour I felt relief and I immediately felt better. So now I’m pregnant with a healthy girl and wondering how similar the experience will be to my daughter’s birth. I’m hoping for a med free delivery which is why I’m thinking of this. Thank you for your time. Andy

NICOLAS CAPETANAKIS: Hi Andy my name is Doctor Nicolas Capetanakis, I’m a Board Certified OBGYN in San Diego California. Thank you for your question. I’m sorry that your first pregnancy ended in a loss but I’m excited for you that things seem to be going well with your baby this time. To answer your question, is it difficult to say exactly how intense having a miscarriage is with how intense delivering a full term baby is.

I will tell you that the process is very similar as you describe having the cramps for several days is very common. The only thing I will tell you what delivery of a full time baby or full term baby is that those ways that you felt may last longer as far as hours. And also as far as time and minutes, meaning that most first time mommas, their labour and delivery might be around twenty four hours.

Now that doesn’t mean that the intensity is always there but that frequency will build so about every four minutes. The contractions will last about a minute until you deliver. Obviously after your water breaks you will feel more intensity but I would say the experience is similar.

I do recommend if you’re planning an un-medicated delivery to take extra courses whether that’s you know birthing from within or hypnobirthing or Bradley these courses will help prepare you. Also consider hiring a doula. Doulas are excellent help and can help you through that process. Hope that answers your question. Good luck, I know you can do it and congratulations again. Thanks. Bye-bye

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STEPHANIE GLOVER: That wraps up our show for today. We appreciate you listening to Preggie Pals.
Don’t forget to check out our sister shows
• Parent Savers for parents with new born, infants and toddlers
• Twin Talks for parents of multiples
• Our show The Boob Group for moms who breastfeed their babies

This Preggie Pals; “Your Pregnancy Your Way”

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: New Mommy Media is expanding our line up of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or organization interested in joining our network of shows through a co-branded podcast, visit www.NewMommyMedia.com .

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