...keeps the doctor away!
Or so the saying goes.
My mother’s group of girlfriends used to add that if the doctor is handsome, keep the apple away.
I took some time to write this post. Reason? I have too many thoughts and opinions when it comes to this topic. I realise that as a doula, I have a responsibility to write my articles with an unbiased tone. Hence, I wanted to come into this entry ‘clean’ so that it isn’t skewed otherwise, I’d just come off as another piece of unsolicited advice.
So, deep breaths now...and here we go:
You’ve peed on a stick and it’s official - you’re pregnant!
Chances are, you’d be thinking of a visit to the good doc soon to confirm the news. Some may choose to go to their family doctor while most women will pay a visit to their gynae or OBGYN. Where your friendly, neighbourhood GP is concerned, there really isn’t much of a choice to make because you may already be comfortable with him or her.
But which gynae or OBGYN do you go to if you don’t really have one or if you’d like to start your pregnancy journey with one?
To share my personal experience, when we were pregnant with our first, we sought the advice and recommendations of friends. My first thought was that I wanted my husband to be comfortable with the good doc because of how pregnancy can possibly be a whole ‘fish out of water’ affair for men. The doc I chose had to have experience, bedside manners and be patient enough to answer questions. Lastly (and I had NO IDEA at the time how important this was and what it entailed till I was pregnant with our second child), I wanted a doctor who would listen to my needs, acknowledge my boundaries and just work WITH me for the truly free-spirited and independent person who I am.
Our appointments went really well at first. I mean, the man had pictures of babies and lovely Thank You notes of all colours, shapes and modes of art form stuck ALL OVER the office walls and ceilings.
He was so approachable when we asked our questions and he really took the time to answer them. When my hubs had doubts, the doc assured him that things were fine and took the time to explain. He even threw in a joke or two during our visits!
Bedside manners ☑️
Answers questions ☑️
If you’ve read some of the articles which I’ve shared, you’d then be familiar with how my lovely, ‘too good to be true’ gynae didn’t give my birth plan a second look when it was presented.
He didn’t discuss it with me or go through it with me. To be fair, I was ill-informed too of the choices I had and the pros as well as possible cons of those choices. So i figured, “He’s the doctor so he should know better.”
Does that sound familiar to you?
The answer to that is a resounding “NO”. While it is fact that a doctor has more medical knowledge and is an expert in his or her field of study, they do not know you better than yourself. Every woman’s body is different. We possess an innate instinct regarding what feels right for us, where our boundaries lie, what’s uncomfortable and what going too far entails. We know our bodies best and that is something no one can possibly know better than you, even after a thorough interview. Evidence of this lies in the doctor still having to ask how you’re feeling, where the pain is, etc, when you’re being examined. They need your input to make their diagnosis and an accurate one at that. This, therefore, makes you a team. Your gynae or OBGYN, in the same light, is a part of your birth team. Without you, there’s a possibility that wrong decisions can be made. A doctor without a physical assessment of the patient is blind. If you choose not to communicate your concerns, doubts, fears, considerations, this teammate in your birth team will not know or understand how to support you.
At this point, I feel it’s important to note that everything I have written so far is fact. I need all parents to know how important your voice is when it comes to choosing your doctor and that the birth story you wish to write, the gynae or OBGYN you choose and your choice of hospital are all intertwined - beginning with how you want to go through pregnancy and how you want to birth.
Okay okay, so this entry is a little long I admit, but let’s get on with the important bit: gynae or OBGYN shopping!!!
Or more seriously - how to chose your gynae or OBGYN. Not because you’re nitpicking or choosey or any of that. It’s because YOU matter. YOU deserve to have the birth you hope for. This is one of life’s most vulnerable times and you need those who fan your flames to support you. You can do this via PSA!
No, I don’t mean go to the local shipping magnate for advice -
Start with the birth you see for yourself - is it a vaginal delivery with minimal interventions? An elective C-section? A VBAC? Are you open to an episiotomy or is that a hard limit for you? If you’re birthing vaginally, do you think you’d like to birth in any position that’s comfortable for you or would you be okay if you could only lie on your back?
While I get that attending a birth class may mean you’d be further along in your pregnancy, having a rough outline of the important things would help to get you started when choosing your gynae or OBGYN. There are no rules that state you have to stick to the same doc from the first appointment. Making a skeletal plan in the early stages and doing some reading up means you have more of a buffer if you find that you need to switch gynae.
With this first draft of your birth plan, SCOUT for your gynae. I have intentionally used the term "scout" to point out that you are, just like a sports scout, looking to recruit a new member of your team - your birth team. If you’re looking for someone to replace an attack position in a sport, you would not start looking at defenders (unless the person is versatile but you get my drift). This process may begin with a bevy of choices as you scour the internet for RECENT reviews, posts and profiles. Use that plan of yours to guide your selection process and then narrow it down to perhaps the best three or two, depending on how much time you have. Once you’re down to a few, ask the questions that matter in a face-to-face conversation. This may include:
How many patient appointments do you schedule in a day and how long is the duration of each appointment?
How do you feel/what are your thoughts on birth plans?
Do you perform episiotomies? What are your thoughts on this procedure?
What are your views on natural childbirth?
What is your C-section rate?
Do you perform VBACs? What’s the success rate?
Which birthing positions are you most comfortable with/what position would you recommend when delivering a baby?
I realise at this point that cost will be a factor for most. The idea of paying for the consult just to choose a gynae (and you don’t even know if you’re going to make a choice) will be a deterrent and rationally so. I’d like to suggest using the initial ‘selection interview’ as one or your routine gynae visits before making payment for a package. Essentially, try not to lock yourself in with the full payment of an antenatal package without having asked all the questions you need to make your decision. I’d also like to add that I know of parents who have changed their doctors in the later part of their third trimester. It would be good to find out if there would be a possibility of reimbursement should you choose to change doctors after having paid for the antenatal package in full.
Lastly, reflect on your experience and the responses you were given. Does it all add up for you and does the good doctor check all or most of the important boxes for you? If so, then hurray! We have a match!
Once you’ve arrived at Step 3, you would probably be thinking about choosing the hospital you’d prefer to birth at. I am inclined to think that most doctors prefer working at hospitals aligned to their own values and working styles. Even if the institution falls a little short, the hospital (or hospitals) at which your gynae operates would not be too far off the mark from what matters on your list. If there is a choice to be made though, you could read the article on choosing a hospital which I posted earlier together with the relevant links before making your choice.
I’d also like to add that while some may not have the luxury of choosing a gynae, you can still exercise and make your informed choice by doing your own homework on the hospitals you can choose from. Discuss your birth plan with your partner so that he can speak up and ask the questions that matter as well during antenatal visits and even when you are in labour in the delivery suite. There is nothing more formidable than a couple who constantly communicates with one another and is on the same page with each other.
My sincere hope is that all mothers attain that positive birth they envision for themselves and I hope this little guide helps you with your pregnancy journey when you form your birth team. Sorry it was such a long post! I promise this won’t be a habit.
Oh! And in case you’re wondering - I still eat my apples🙂
PS: Need more? Here’s a well-written related article from The Birth Hour which you may be interested in too: