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 Post subject: finding a good obgyn and ? to ask
PostPosted: Tue Apr 12, 2011 4:29 pm 
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So I'm hoping to get pregnant this summer or coming fall, and am starting to do my homework. Okay truth be told I started getting information 3 years ago - I'm just type A like that. I like my current OB/GYN well enough, and assume she'll be fine once I'm pregnant, but I picked her randomly based on what my insurance covered and the fact that her first language was English (yes I'm being racist, but I'm not good with accents and have trouble understanding some of the Indian doctors in the area) but is there something I should look for and questions I should ask her now? I do know her practice makes you see all 5 doctors in the group (I'm okay with that in theory-unless I hate one of the doctors that I meet there). A friend of mine also mentioned to look into bringing a midwife along for the journey so I know who will be around the whole time, since you spend more time with nurses than with the doctor anyways. I'll have to investigate that one too.

Other than googling for reviews, anyone know how to get feedback on doctors and hospitals? All my co-workers that are/were pregnant live closer to other hospitals so their advice doesn't really help. I'm not traveling 45+ minutes to a doctor unless I end up with some high risk pregnancy. Not to mention it's a bit of an odd topic to bring up at work so I don't want to ask those I'm not close with (yet I feel comfortable asking people I've never met in person via internet). My sister-in-law liked her doctor, but I feel weird switching to a doctor 3 towns away based on only her experience if my doctor would've been great. Of course I might just be super over reacting just because the chicagoland area has so many medical groups and hospitals to choose from.

Sorry for those that just think I'm crazy and spending way too much energy worrying about this before I am even preggers


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Tue Apr 12, 2011 5:12 pm 
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I would do some research and consider ALL your options. After becoming frustrated with the care I was receiving at a hospital (the l&d ward was mostly run by CNMs as primary caregivers) I ultimately decided to go with a group of CNMs that run an independent birth center and do home births (the choice between the birth center and home was not a dealbreaking one for me, but are ultimately opting for a home birth. Our proximity to hospitals and highways and the portability of the midwives' equipment were factors in this decision).

Also be aware that there are different types of midwives (CNMs, CPMs, lay-midwives).. and that hospitals have different policies. I assume from the handle you're in Chicago? I have a friend there who interviewed one or two of them and did some of her nursing training assisting births in another hospital. (She ultimately decided to have a home birth with a CNM as well, but isn't anti-medicine or anti-hospital, she's a nurse, it was just her personal decision after being fairly well informed of her options.) If you want to PM me with contact info I could ask her to email you with her general findings.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Tue Apr 12, 2011 8:51 pm 
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I don't know if maybe it's just a west coast thing, but most doctors around here have reviews up on Yelp. So you might look there.

My OB/GYN was a totally random choice and turned out to be a wonderful lady... I feel really lucky about that.

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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Tue Apr 12, 2011 9:13 pm 
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chiveggie wrote:
I picked her randomly based on what my insurance covered and the fact that her first language was English (yes I'm being racist, but I'm not good with accents and have trouble understanding some of the Indian doctors in the area)


I am South Asian and don't have an accent, and I have South Asian friends and family who were raised in this country, with English as their first language who went to great medical schools.

I got reviews from friends and was recommended a really great MD. You could also go on a site like Mothering.com and ask there - there are generally people looking and recommending in your area.

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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Tue Apr 12, 2011 9:44 pm 
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chiveggie, I don't think it's cool to say "yeah, I'm being racist" so casually. If you really believe you are being racist you should take a step back and look at your thoughts and actions about people from other countries. If what you meant was just that you'd prefer to see someone who spoke English clearly, I can understand that especially if you have trouble understanding accents, but that in itself isn't racist. Not all people from India or with Indian names necessarily have accents and it's a little hard to tell what you're basing your knowledge of their accent on. Anyway, I just want to point out that you could probably think of a better way to say what you're saying.

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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Wed Apr 13, 2011 9:10 am 
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ijustdiedinside wrote:
chiveggie, I don't think it's cool to say "yeah, I'm being racist" so casually. If you really believe you are being racist you should take a step back and look at your thoughts and actions about people from other countries. If what you meant was just that you'd prefer to see someone who spoke English clearly, I can understand that especially if you have trouble understanding accents, but that in itself isn't racist. Not all people from India or with Indian names necessarily have accents and it's a little hard to tell what you're basing your knowledge of their accent on. Anyway, I just want to point out that you could probably think of a better way to say what you're saying.


I apologize. Racist was the incorrect word. I was not making a decision based on race (My doctor is actually half Korean) I meant to say that I was being prejudiced (as I was pre- judging somebody before meeting them based on what my insurance website listed as their primary languages).

Thanks for the suggestions. Couldn't find reviews on YELP, but will try Mothering.com. Most people don't write reviews if nothing was out of the ordinary, so I know that skews review sites.

Yikes-I haven't even conceived yet, and I'm already "that mom". I'll keep looking around, and annak, I'll PM you to see if your friend has any info in the areas I'm looking.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Wed Apr 13, 2011 5:19 pm 
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I'm about in your shoes -- we're hoping to conceive late summer/early fall. I picked my ob/gyn office (where I see a midwife) based on the hospital I wanted to deliver at. There's only one group that serves that hospital (though they have about a half dozen locations in the area), and it's the hospital with the lowest rate of c-sections/interventions, so the decision was pretty much made for me there. (as a sidebar -- ismloveyoubobbybrown had Milo there, and did great, so she was my guinea pig!) The other hospitals in the area have varying rates of suckiness ranging from an 8 hr labor policy (you get 8 hrs to labor before they csection) to other that are just more medical-ly than I'd like. I'm also going to look into some midwives for a homebirth when I'm actually pregnant and probably concurrently plan since I hate hospitals period!

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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Wed Apr 13, 2011 5:29 pm 
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rabidchild wrote:
I'm about in your shoes -- we're hoping to conceive late summer/early fall. I picked my ob/gyn office (where I see a midwife) based on the hospital I wanted to deliver at. There's only one group that serves that hospital (though they have about a half dozen locations in the area), and it's the hospital with the lowest rate of c-sections/interventions, so the decision was pretty much made for me there. (as a sidebar -- ismloveyoubobbybrown had Milo there, and did great, so she was my guinea pig!) The other hospitals in the area have varying rates of suckiness ranging from an 8 hr labor policy (you get 8 hrs to labor before they csection) to other that are just more medical-ly than I'd like. I'm also going to look into some midwives for a homebirth when I'm actually pregnant and probably concurrently plan since I hate hospitals period!



One thing I learned while looking at hospitals around me (and through personal experience of talking to nurses etc) was that sometimes the lowest c section rates don't always mean the best hospitals.. if one hospital has a high level NICU and the other has none, it's hard to compare intervention rates because the former will be seeing far riskier patients. I was encouraged by the hospital I was originally seeing having a 25% primary csection rate (I know, but that's the lowest around by far), but eventually learned that it was mostly because they were referring out any risky cases to another area hospital. These numbers can be very useful and can raise some red flags, but don't tell the whole story. An interesting rate, if you can get it, to look at, because it tells you a lot about their philosophy of breastfeeding support (if that's of interest): what percentage of newborns are given bottles with formula supplements.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Thu Apr 14, 2011 2:38 pm 
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http://www.babyfriendlyusa.org/eng/index.html
best experience ever birthing in a baby friendly hospital. I would start there.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Sun Apr 17, 2011 9:00 am 
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Thanks Aliks for the link, but unfortunately no babyfriendusa endorsed hospitals near Chicago.

For anyone else in my shoes, and wants to do their research, I found http://www.babycenter.com/0_choosing-a-hospital_1148.bc to be a great article and links to research doctors and hospitals. I also am rationalizing my obsessing by realizing I have so far spent less time researching this than my husband spent researching the last car he bought.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Sun Apr 17, 2011 4:12 pm 
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chiveggie wrote:
I also am rationalizing my obsessing by realizing I have so far spent less time researching this than my husband spent researching the last car he bought.


I think too often women don't spend enough time thinking about quality healthcare, absolutely. I see nothing odd about you doing your research now. After my daughter was born (via c-section due to breech presentation) and was between 6-12 months old, I started interviewing potential new docs for my next baby, even though I wasn't planning on getting preggers for another year. I have decided beliefs about labor/birth and how I want to be treated and I needed to find someone who would be for me and establish a patient/doc relationship. That way, once I was pregnant, I couldn't be turned-down from their practice. It took me 5 interviews before I found someone. And over a year later, I found myself unexpected pregnant. Now, at 25 weeks, I'm very glad I chose the provider I did (even if I'm still not thrilled with having an MD as a primary caregiver--I would have preferred a midwife, but that's a different story).

Anyway, lots of words to say I think you're being responsible, not obsessive. Do the legwork/research/interviewing now, before it's "go time."


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Sun Apr 17, 2011 4:31 pm 
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Crantastic wrote:
chiveggie wrote:
I also am rationalizing my obsessing by realizing I have so far spent less time researching this than my husband spent researching the last car he bought.


I think too often women don't spend enough time thinking about quality healthcare, absolutely. I see nothing odd about you doing your research now. After my daughter was born (via c-section due to breech presentation) and was between 6-12 months old, I started interviewing potential new docs for my next baby, even though I wasn't planning on getting preggers for another year. I have decided beliefs about labor/birth and how I want to be treated and I needed to find someone who would be for me and establish a patient/doc relationship. That way, once I was pregnant, I couldn't be turned-down from their practice. It took me 5 interviews before I found someone. And over a year later, I found myself unexpected pregnant. Now, at 25 weeks, I'm very glad I chose the provider I did (even if I'm still not thrilled with having an MD as a primary caregiver--I would have preferred a midwife, but that's a different story).

Anyway, lots of words to say I think you're being responsible, not obsessive. Do the legwork/research/interviewing now, before it's "go time."


Absolutely - it's really great even just to know what options are out there. I didn't do much research until I was pregnant, but am lucky to have learned quickly that my original choice wasn't a good fit. It's not just about numbers like statistics or insurance coverage, either; while these are important, you'll be happiest with someone on board with your own decision-making philosophies. And fundamentally, respectful informed consent is important, but during labor chances are even the most rational mother-to-be might be too physically wiped out or emotionally on edge to evaluate things logically, so it's really important to have a provider whose opinions and advice you trust. You may not have the energy to disagree or the time to get a second opinion. Of course, plenty of doctors and midwives flat out lie about what they'd do in a given situation or what options you'll be given, so that's extra frustrating and makes the whole search process more difficult.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Sun Apr 17, 2011 11:18 pm 
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annak wrote:
Of course, plenty of doctors and midwives flat out lie about what they'd do in a given situation or what options you'll be given, so that's extra frustrating and makes the whole search process more difficult.


Could you elaborate? That sounds very frustrating.

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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Mon Apr 18, 2011 7:39 am 
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Tofulish wrote:
Could you elaborate? That sounds very frustrating.



This is more anecdotal than anything else (and not my own experience; I haven't given birth yet so who knows how things will play out!) but from reading a few birth-related blogs.. The Unnecesarean, My OB said what.. and some books and whatnot (I recommend "Pushed" - it's biased, but very interesting).. I have heard too many stories of women being told their options and then suddenly things change when they're actually in labor, even without any new negative information or whatever. Not saying it's typical, just that it's important to keep in mind that caregivers are stakeholders in the outcome of your birth as well but with slightly different experience, goals, and motivations. I don't understand giving women incorrect info because you'd think everyone would be happiest if doctors gave their patients a more realistic outlook on what to expect. If I were planning to give birth in a hospital, I'd find out if any friends had given birth there before and how their experiences of hospital and staff policies matched up with what the providers were promising.

I definitely think that obstetric interventions have their place - sometimes I think the more hardline natural birth advocates/people who are convinced of things like "a woman's body is built for birth and knows what to do" should spend a few weeks volunteering in a fistula clinic in Africa for perspective. (and conversely, obs should maybe attend some home births as part of their training!) But I also think women have the right to weigh the consequences and make their own choices and for various reasons, those choices are often taken away.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Mon Apr 18, 2011 8:31 am 
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i think it's more along the lines of OBs just nodding their heads when women come into their offices with lovely detailed birth plans printed on patchouli scented paper that their doula gave them, but without a whole lot of research or conviction behind it and then those women being disappointed when their birth doesn't go as expected. medical practitioners definitely have their own agendas, but they also have rules and guidelines that they are expected to follow based on where they practice. AND, they may agree with you on what constitutes a "good" birthing experience, but either not know how to let that happen or have different ideas on timelines, safety, etc. i think most OBs would agree that the best birthing experience involves a calm, peaceful environment, no pain meds/IVs, no intervention in delivery (C/S, episiotomy etc), BUT they might not agree with you about when that scenario is possible. so when you say to an OB, "i don't want an epidural, is that possible?" she's going to say "yes, of course," but when you are actually in labour, her ideas about when an epidural is necessary are probably going to differ vastly from yours, or perhaps she's not going to have the tools to help you manage without one, so you end up feeling it's necessary.

if you go to an OB and give birth in a hospital, you need to expect that you are going to receive the type of care that they typically provide to everyone. same for midwives. you have to have an understanding of the pressures and guidelines they face, and ask questions in a way that allow you to really judge their practice.

anyway, chiveggie, your original post made me want to respond. i gave birth with midwives whose primary language is french, in a primarily french hospital. i think it's very understandable to want to be able to communicate very well with your health providers. these women had quite good english, if i'd met them outside of a clinic i wouldn't have thought twice about communicating with them. but, we really did have problems communicating sometimes, and that is much more stressful when you are actually in a crisis situation. however, being that you're in the US, i'd expect that the doctors you're looking at have to be at a certain level of fluency to practice, so i wouldn't rule them out. in the end, i preferred giving birth with women whose language wasn't my own but who had the same birth philosophies as me.


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Mon Apr 18, 2011 9:55 am 
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That is really interesting, and fits with the stories I've heard from friends of going in with a birth plan and having that pretty much disregarded and having a pit drip put in which led to stronger contractions etc etc. I think its pretty easy to have your autonomy taken away in a crisis situation where you are in pain and not able to argue with your caregivers who also have a great deal more experience than you do.

I know NJ has the highest rate of c-sections in the US - Its just over 40% and the hospital the midwife we chose practices at has a 43% c-section rate (its about the middle for NJ - Hackensack, the worst has a 53% c-section rate and they don't even accept VBAC patients). The midwife assured us however that her c-section rate is much lower and that she wouldn't be pushing to induce etc and was committed to assisting us with a vaginal birth as far as possible. The hospital we picked also has a specialist group for high risk pregnancies and a NICU Level III, so we felt comfortable with the level of the amenities.

We're also going to be hiring a doula, just to have a second person in the room advocating for us. I love my husband, but in a crisis, he generally just would go along with the doctors, which makes sense because he'd be worried about me.

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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Mon Apr 18, 2011 10:47 am 
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Tofulish wrote:
We're also going to be hiring a doula, just to have a second person in the room advocating for us. I love my husband, but in a crisis, he generally just would go along with the doctors, which makes sense because he'd be worried about me.


It sounds like you've found a great ob, tofulish! I'm a huge advocate for doulas. Next time around, we will definitely hire one. I was on the fence on getting one for the first birth, and my husband convinced me that we didn't need to spend the money. I knew he was going to be a great birth partner, and he was... until we were at the hospital and the needles and monitors came out, and he was puking in the bathroom. Birth is crazy, and the more advocates you can have, the better!


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 Post subject: Re: finding a good obgyn and ? to ask
PostPosted: Mon Apr 18, 2011 10:58 am 
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Hahaha! My husband would definitely be overwhelmed and freaked out, and that is a good thing. I can't imagine its easy for someone you love to see you having a hard time or struggling. A friend of mine said she had her MIL, a labor and delivery nurse with her, but even that didn't work bc her MIL wasn't able to act as an advocate because she was so close to my friend.

We went with a midwife (recommended by JENNA) rather than an OB and she is amazing. My husband was upset that we didn't go with an OB because "why not have a proper doctor if insurance is paying for it. I don't want you at any risk at all." But for me a midwife is someone who is trained to treat the patient and the birth process holistically and not to fragment it into medical issues. I also know that my OB had a tendency to tell me everything including the worst case scenario in such a way that I was often left feeling pretty anxious. I wanted someone with a ton of experience who would be calming and easy to work with and who would always have time to answer questions etc. Our first consultation, she took so much time with us, answering all our questions and just generally being really sweet, and she left me feeling really encouraged and excited that I would be able to do a vaginal birth, where my OB had been less encouraging. At the end of the day, you just want someone where you feel like you are in good hands, and I feel that way about our midwife.

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