What the hell? No interviews?

Allright doctors, listen up! Obstetrics is a competitive, consumer driven field. Allow yourselves to be interviewed. As a mom, I want to know that we'll get along, you will after all be looking at my girly parts and providing a service to me. As a childbirth educator, I encourage my clients to interview all potential health care providers. You as an OB, encourage your patients to interview prospective pediatricians, don't you? Then why can't I interview you? Oh and why are you charging me for a consult? You have the potential to make thousands of dollars off of me, provided you pass my quiz. I would think you would want interviews/consults, after all it would give you, the obstetrician, the chance to weed out the mothers you don't want to work with (You know us, whiney, natural childbirth obsessed mothers?)'
I'm only a week into knowing I'm pregnant, and already, I'm ready to give up on the obstetrics profession.
Please, someone send me an angel.

March 18, 2009

So today I had the fun task of calling every Family Doctor in the area that's covered by my insurance. I must say that the majority of receptionists didn't even know that a Family Doctor could catch a baby. Ugh. I called 10, and all were a no go. Finally at physicians office #10, they gave me the phone number for the SE Missouri Medical Association (I wonder if I can research individual doctors statistics through them), and THEY gave me the number for a Family Doc who catches babies. I also set up an interview with the Doctor who my client delivered with. I'll probably also set up an interview with the OB who I let check my girly parts. I liked his candor, and that he didn't talk to me like I was a moron.

Oh and double UGH...
http://www.cdc.gov/media/pressrel/2009/r090318.htm

"The cesarean delivery rate rose 2 percent in 2007, to 31.8 percent, marking the 11th consecutive year of increase and another record high for the United States."

To quote The Price is Right, "THAT'S TOO MUCH".

Let the Adventure begin!

So, I find myself in need of a midwife, or a NCB friendly prac that'll let me labor/birth the way I need to. I hate that I even need to say "let me". I'm the one pushing a baby out my vagina, they're working for me, but I digress.

So I'm compiling a list of questions to ask my prospective docs...provided I don't find a midwife willing to travel.

Some of these questions come from here and there are more questions there than are listed here (there'$s even a cool print out).

1) What are your philosophies and beliefs about birth?
Answer I'm looking for: Birth is an awe inspiring force of nature, that I am happy to be a part of. I like to let things unfold as they will. Not the answer I'm likely to get, but if I get it, you'll be able to knock me over with a feather.

2)I am firm proponent of informed consent and refusal. How much choice do you feel I should have in the decision making process?
Answer I'm looking for: We'll work together as a team. I will tell you everything I know about whatever decision needs to be made.

3) I'll roughly outline my wishes for birth (i'm not so big on birth plans, unless you're going to a hospital that actually reads them), and see what's negotiable up front... I'll probably ask about management of third stage as well.
Answer I'm looking for: Doc supports my wishes for an as un-intervened birth as possible, ie, hep lock in place of IV, laboring/birthing in positions that suit me, NO EPISIOTOMY, etc. I don't know how I'm going to get around the insane requirement of constant electronic fetal monitoring.

4)What is your induction rate, and when do you feel induction of labor is necessary?
Answer I'm looking for: A very low induction/augment rate, similar to that suggested by the WHO, induction for medical reasons such as PIH, post-dates of 10 days or more, toxemia (but even then doc should be offering nutritional counseling well before toxemia sets in), etc.

5) What is your preferred method of induction?
Answer I'm looking for: Anything but Cytotec!

6) What is your Caesarean rate? And in what situations do you recommend a C-section?
I'm naturally looking for a very low answer, but honestly don't think I'm going to find anyone with a rate lower than 30-40% here. I'm actually going to interview a couple of nurses from each of the hospitals before I settle on a doctor.

7) How do you feel about vaginal births for breech presentations or twins?
I don't know what answer I'm looking for there, honestly if doc's never attended either, I don't want to be his guinea pig. I'll go to the Farm for that!

8) I am hiring a doula for my birth. Do you work with doulas?
If the answer is no, then he/she is not the doctor for me. I am a doula and a natural childbirth educator. And because there is a distinct possibility of birthing in a hospital, I will most definitely hire a doula.

I know I've got some pie in the sky answers I'm looking for, and I'll probably settle for answers that are less than what I'm looking for if the doc will look the other way when it comes to my stubborness.
There are tons more questions you should ask of your HCP if this is a first baby for you, or you are not a birth junkie, like I am. I suggest looking for a practitioner that meets the definition of Mother-friendly as outlined by the Coalition for Improving Maternity Services. Believe it or not
BabyCenter has a great print-out as does BabyFit.