How Do You Pick An Obstetrician?

It’s important that you find an obstetrician that has similar viewpoints to you in regards to your birth plan, what interventions you are and are not okay with and where you are willing to be flexible. I like to think of your first meeting as a kind of job interview, you are both interviewing each other to make sure that it is a good fit. So here are some questions that you can ask to help establish whether this relationship is the right one for you and your baby. 

1.How many clients with conflicting due dates do you take on at one time? Who do you use for backup and will I meet them prior to my due date?

Finding out how many other patients your OB will be caring for during your due date period is important as the more patients they have the less likely they will be available for your birth due to having to attend other births. You can also ask if they will balck out times and dates for you specifically so they prioritise you over other patients. All obstetricians will have back up options so chat to them about this and find out if there is any opportunity for you to build a relationship with that backup just in case they end up being the one attending your birth.  

2.How often will you check in on me during my labour and at what point do you take over as my main carer?

During your labour you will have a midwife or sometimes a team of midwives caring for you and your baby, your OB should come and check in on you intermittently throughout your labour and be present for the pushing stage and birth of your baby. 

3.Do you offer intermittent monitoring instead of consistent monitoring?

It is common practice in hospitals to continuously monitor the baby’s heart rate during labour, some women find this method can be distracting and can cause them to be uncomfortable as it is harder to move around while hooked up to the monitor machines, you are also unable to use hydrotherapy (bath and shower) for help with pain relief with this type of monitoring. Check in with your OB to see if they offer the option to monitor at intermittent periods. 

4.Which hospitals do you work at?

Not all private OBs work at all private hospitals, it is important to know which hospital your OB has privileges in so you know if they are available at a hospital that is accessible and suitable for you. 

5. If I need to schedule a c-section will I be able to have “gentle C-section” ?

Some OBs and hospitals allow for gentle c sections, which refers to a c section that is designed to feel less surgical and offer a calmer and more enjoyable environment for you baby to be born. Some gentle c section techniques are playing nice music, allowing the birth partner to be involved, allowing a doula in the operating theatre, having a clear sheet instead of surgical drapes so you can see your baby the moment they are born, delayed cord clamping, skin to skin contact, allowing the parents to announce the sex.

6.Do you conduct routine episiotomies?

Some OBs routinely use episiotomy as a means to try and prevent tearing during delivery. It has been shown that this method is not necessarily beneficial and is something you should discuss. 

7.Do you support water births?

Many women are interested in birthing in a birthing pool, most hospitals will allow you to use a birthing pool, bathtub or shower for alternative pain relief but then will need you to exit the birthing pool for the pushing and birthing phase of labour. Ask you OB what they do and don’t support in regards to this. 

8.What is your belief and philosophy surrounding birth?

It can be thought that all OBs have a “get baby out no matter what” philosophy, we have to remember that OBs are human too and therefore will have their own beliefs and philosophy surrounding birth. Some OBs may take this approach but others may be more inclined to follow a “wellness” model of care, it is important to have a good chat about this so that you can find out if you are both on the same page. 

9.Do I have to give birth on the bed?

Many women find the flexibility of being able to find their optimal birthing position very beneficial during the pushing and birthing stage of labour. Ask your OB if they support the decision for you to birth in a position of your choice which may be on or off the bed. 

10.Do you support the use of a doula?

Doula’s have become increasingly more popular over the last 10 years as women have taken a strong interest in their birthing rights and power. It’s a good idea to chat to your OB about their views on having a doula present at your birth and find out if they have experience with this kind of dynamic during delivery with prior patients. 

11.C section rate vs vaginal delivery rate?

Ask your OB what their rates of c section are compared to vaginal delivery, if they have a higher or equal rate of c section births this is a pretty good indicator that your OB may prefer c section delivery over physiological labour and delivery.  

12.Do you routinely use intervention during stage 3 of labour? If so, do you use ergot derivatives? 

Stage 3 of labour is where you will deliver the placenta, some care providers will want to use medication to help your body dislodge and expel your placenta. Ergot is a type of fungus and some medicines used during this stage are derivative from this fungus, which can have bad side effects for some people depending on the person and the dosage. 

13.Thoughts on delayed cord clamping, would you be supportive if i want to delay my cord clamp until the chord has stopped pulsating? 

Delayed cord clamping has grown more popular over the last few years as more information about the benefits of this practice have become clear, many OBs and hospitals are happy for you to delay you cord clamp up to 3 mins, however some women like to wait for the cord to stop pulsating with blood before they clamp which could take up to 10 mins.  

14.What are the main reasons you would want to induce, if I need to have a scheduled   c section would you be happy for me to experience some level of  labour beforehand?  

Labour brings with it many beneficial physiological processes, having a chat with you OB about their stance on induction and also if they support labour before c section will give you a better understanding of how they view birth and how they feel about trying to keep things as natural and undisturbed as possible. 

There are many questions you can ask your obstetrician and of course this will depend on your views and circumstances. I hope that this list has given you some ideas about what questions would be best suited for you and your birth. Good luck and if you have any questions feel free to contact me via the details below.