Choosing an OB-GYN or Midwife

What Should I Look for in a Provider?

Finding a qualified provider whom you trust and feel comfortable with is of utmost importance. Whether it is an OB-GYN or a CNM, he or she should be happy to answer your questions and encourage your input.

You can increase your chances of a great partnership with the provider by letting him or her know, early on, what is important to you. For many women, pain medication is a pivotal point. If you hope to labor without pain medication, make sure your provider is supportive. Ask about familiarity with other, nonmedical forms of pain management. Alternatively, if you are planning on an epidural, avoid the practitioner who tries to talk you out of it.

Here are some other things to consider:

• Credentials/References: He or she should have reputable and current credentials. Find out how long he has been in practice. Does she come recommended by friends, family, or other professionals?
• Birth Philosophy: What are her views on pain medication during delivery? How about breastfeeding? Does she encourage you to trust your instincts and your body's natural birthing ability? Are you comfortable with her use of medical technology and intervention?
• Procedures: A great way to get many procedural questions answered is to ask your obstetric provider to describe a typical birth. Ask her to begin with the first phone call from a laboring woman, through the birth and subsequent hospital stay.

Find out when the provider meets patients at the hospital or birth center, whether he will be present during the majority of the birth, and his use of Pitocin (a synthetic form of Oxytocin used to induce or quicken labor), forceps, or vacuum extractions. Are episiotomies (an incision to increase the vaginal opening for birth), enemas, fetal monitoring, and IVs mandatory or elective? When can you expect to see the OB-GYN or CNM after delivery?

• C-Section Rate: If you are seeing an OB-GYN, find out his or her C-section rate. According to Dr. Phelan, between 15 and 30 percent is about average (keeping in mind that doctors handling higher risk cases may have higher percentages). Ask under what conditions a doctor would opt to do a C-section.