Photo by James Willcox CC BY SA
This article is not meant to diagnose or provide medical advice—that responsibility lies with physicians. The author is not a licensed medical professional.
Becoming a parent for the first time comes with an avalanche of emotions, late-night Googling of random questions, incessant reading of baby equipment reviews, and unsolicited advice. Lots of it. But the one piece of advice you should take to heart is this: make sure you’ve done the leg work to find the right medical specialist for you.
The labor and delivery of your bundle of joy is an extremely personal and intimate moment. Not to mention life-altering. You wouldn’t want just anyone doing it. So how do you find the right person?
If you go the route of delivering with an obstetrician, there are some vital questions you should ask before committing to one, as their answers can make or break your experience—and your baby’s. Delivery Day should be an emotionally charged time that’s full of positive moments. Ensure your delivery goes as smoothly as possible and becomes one your family’s best memories by asking the following questions before deciding on an OB.
1. What’s Your Cesarean Section Rate? What is the Hospital’s Rate?
If the doctor’s rate of performing cesarean sections, or c-sections, is higher than the national average of 32 percent, that is cause for alarm. The United States has notoriously averaged higher than most developed countries (the global average of c-sections is 19 percent), which adds more risks to full-term pregnancies.
A cesarean section is a major surgery that involves incisions in the abdomen and uterus. Even though obstetricians are highly trained in this procedure, surgeries come with their own share of complications from blood transfusions and anesthesia, which can lead to infections and more. While there are several medically sound reasons that they are mandated (including breech positioning and placental problems), oftentimes c-sections are performed as elective surgery.
There are several reasons why that may be the case. One main reason is timing. Babies arrive when they arrive, on their own time. Delivering a full-term baby vaginally can take minutes or several hours, sometimes leading into the next day. That can put a damper on a person’s (i.e., physician’s) schedule. C-sections can expedite what would have been a long labor, unnecessarily putting a mother and baby at risk. Putting it simply, the operation can be “convenient” for a physician’s schedule. But the flipside is a major operation that may lead to complications.
If you know the hospital where the physician has privileges, ask what its c-section rate is. There might be a financial motivation to perform c-sections. In many cases, the financial incentives for c-sections over natural births includes a few hundred dollars for physicians and a few thousand dollars for hospitals.
2. Do You Do Episiotomies?
If the OB responds, “Yes,” then be sure to press for more details. Episiotomies, essentially making an incision at the vagina to avoid tearing the perineum, were once considered routine. Back in the 1950s. Just like with c-sections, there’s a time and place for episiotomies, including abnormal positioning of the fetus and the possibility of extensive vaginal tearing.
However, the recovery is tough and the pain is often unbearable. It can even lead to tears in the anus and uncomfortable infections. Not exactly what you want after hours spent pushing a human out of our body.
If a physician frequently practices episiotomies, be sure to ask why. It could be a red flag—a sign that he or she might be a bit more old school than modern practitioners, defaulting to an antiquated technique that could cause immense amounts of postpartum pain.
3. Will You Personally Be Delivering My Baby?
Average gestation periods are 40 weeks, which is a long time to build a relationship with your OB. You set your birth plan with him or her, laugh together, and talk about family life, maybe even baby names. A relationship has been established, one that you’ll be happy to have come delivery, and afterward as well. So what if the person who you’ve spent nearly 40 weeks visiting and birth planning with isn’t the one there on Delivery Day? It’s a little like spending years getting to know someone, but having someone else show up in their place on your wedding day (OK, not exactly, but you get the point).
That happens more often than one expects (not just to Seth Rogen and Katherine Heigl in Knocked Up). Doctors in group practices can cover for each other when one physician goes on vacation or something unexpected comes up in their schedules. While you’d like to think the covering physician is completely capable—and he or she likely is—the rapport and comfort needed for as calm a delivery as possible just isn’t as in tact as it is with your regular OB.
When interviewing OBs, ask if he or she is guaranteed to be your delivering physician. Make sure his or her schedule is completely cleared not just during your expected delivery date, but a few weeks before and after it in the event your little one doesn’t arrive on time. After all, labor and delivery is stressful enough, so seeing a familiar face at the end of the bed is always a comforting sight.
Nila Do Simon is a freelance writer and editor, and full-time adventure seeker based in Florida with a taste for travel, health and sports.