Finding the Best Childbirth Care for You
With all the choices that are available, how do you decide what kind of care and which person will be most appropriate for you? You can start by asking questions to help determine whether the caregiver you are considering provides the kind of care that you need or want.
Begin by shopping over the phone and talking with the office nurse or, in some cases, speaking directly to the caregiver.
- Ask about the background and training of the caregiver and how long he or she has been in practice.
- Ask about any limitations on the scope of practice of your caregiver. Midwives, for example, do not provide prenatal testing and some do not provide prenatal care.
- Ask in which hospitals the caregiver has privileges.
- Ask how much time is scheduled for each prenatal appointment. Your caregiver should allow at least 30 minutes for each appointment -- longer if you are undergoing a procedure such as an ultrasound. You should also expect to wait since the caregiver may be called away at any moment to deliver a baby.
- Find out who sees you for your prenatal appointment if your caregiver is called away during office hours. Sometimes a colleague or the office nurse sees you. Some doctors employ nurse practitioners or midwives to do checkups or even perform uncomplicated deliveries. If this is the case, be sure you understand and are comfortable with the arrangement. In both instances, the substitute caregiver may not be willing or able to answer questions about policies, philosophies, and usual practices. Sometimes, in a busy practice, a woman comes in several times without seeing her own caregiver. This can be very frustrating, especially if she has questions that only the caregiver who will be present at the delivery can answer.
- If the caregiver is involved in a group practice, find out how likely it is that your own caregiver will see you during your prenatal appointments. In some group practices, you meet all members of the group. In others, you may see only one, but one of the others may attend your birth.
- If the caregiver is in a group practice, the members probably take turns being on call at night. If you go into labor on a night when your caregiver is not on call, ask whether your caregiver will come in or will the partner on call perform the delivery? If one of the partners may deliver your baby, you will need to make sure you are comfortable with the other members of the group and they have the same attitudes toward childbirth as your doctor. Otherwise, the delivery you've so carefully planned may change at the last minute. Some groups are so large that the chances of a woman having her own caregiver during the birth are really quite small. If you do not like that, and there are no other overriding reasons for choosing such a group, you might decide to look for a smaller group or an individual practitioner.
- Ask if your partner is welcome to attend prenatal appointments with you.
- Before you make an appointment, inquire about finances. Be sure your insurance will cover the caregiver's charges, and find out how and when payment is expected. Find out what happens to the charges if there are any complications.
If your phone conversation with the office nurse or caregiver gives you a positive impression, make an appointment with the caregiver. (You do pay for these appointments.) Plan to use this appointment as an interview rather than a first prenatal visit. (The latter includes an extensive physical examination and many costly laboratory tests.)
Make it clear when setting up the appointment that you are in the process of choosing a caregiver and would like the opportunity to meet with this person and ask questions. The charge for such an appointment is usually less than an initial prenatal appointment. It is a good idea for the baby's father to accompany you so that he can ask questions and form an opinion about the caregiver as well.
See the next page to learn what questions you should ask during the interview with the caregiver.