Interview questions for an OB-GYN?

[rreiko]

It seems like there is a great community here~

Background: So I've taken 3 home pregnancy tests (1 digital and 2 "regular") and they all came up positive (2 bright blue plus signs and 1 "pregnant" ). I'm about 5 days past my period due date.

I guess I'm technically high risk because I'll be 36 when I deliver. We only tried for 2 months and it seemed to work, so I don't think I'm looking at infertility issues at this point.

I assume I should just go straight to an ob-gyn rather than go to my GP for a "real" test. Does that sound right?

This might sound odd, but has anyone else ever "interviewed" ob-gyns? I had a bad experience with an orthopaedist after an ACL reconstruction, so I'm wary of taking anything that medical professionals say at face value. I've read some of the posts on this forum about different practices which have been helpful.

Do you have any recommendations on questions you should ask a prospective? How many doctors should I talk to? All of the pregnancy books I've read so far are so "it's so wonderful and special" about pregnancy and seem to be more concerned with the "what happens to your body" stuff.

Of course, I'm excited about possibly being pregnant, but I also want to make sure that I start this experience with a realistic rather than romanticized view.

Thanks so much for your help and advice.

[Anonymous]

First, you're not just "possibly" pregnant -- if you are five days late and have had three positive pregnant tests, you're definitely pregnant. Congratulations.

Second, yes, you should just go straight to an OB at this point. No need to see your GP in the meantime.

Third, before you think about interviewing OBs, you might want to think about what kind of birth experience you want to have. How important is a natural birth to you? What kind of medical interventions do you feel comfortable with/want to avoid? At what hospital would you like to deliver? (And if you want a home birth, maybe you want to head straight to looking for a midwife instead.) How do you feel about the food safety guidelines that go along with pregnancy -- i.e., do you think a glass of wine is probably okay later in pregnancy? Do you think you'll feel okay about eating lunch meat? Or do you feel strongly that you should abstain from all things that are potentially harmful including caffeine, etc.? Some OBs are really strict on these issues; some are much more laid-back. You probably want one whose views align with yours in this regard as they will likely see eye-to-eye with you on other issues, too.

Good luck!

[rreiko]

Thanks for your advice-these are all great questions. I'm just starting to determine natural birth v medical birth; organic vs. non-organic pregnancy,etc...

It's almost like you are "dating" your doctor-you want to have the same values since you are going to be having a 9 month relationship with them~

Thanks again!

[Anonymous]

I don't have much to add to what the PP already said, I just want to point out that as far as I know, just being 36 does not put you in a high-risk pregnancy category. I think the "medical" term is advanced maternal age, but again, that in and of itself does not mean that your pregnancy is higher risk. Some of the risks are slightly higher for older moms (such as Down's), and you will probably be advised to do an amnio/CVS instead of other screening tests, but you shouldn't have any issues otherwise just because of your age.

There have been numerous threads on different hospitals, practices, specific doctors etc. Some of the questions can probably be answered right there.

Congrats on your pregnancy and wishing you a very healthy 9 months.

[Anonymous]

Congratulations!!! If you have done a home pregnancy test you are definitely pregnant!!! YAY!

This forum has lots of information about OBs in the area, so do a quick search and I am sure you will find someone you like. Once you do, remember they are unlikely to see you until around week 8 as most wait until then to ensure the pregnancy is still viable.

As the PP said, you need to think about what kind of birth you want. Read up. I am currently reading - The Thinking Woman's Guide to birth by Henci Goer & it is great - lots of information (it is very pro-natural birth) but does a good job of listing the pros & cons of intervention. Once you have an idea in your head about how you want to proceed, you find an OB (or midwife) from there.

[Anonymous]

FYI, I've not heard of people "interviewing" obs in the sense that they do with prospective pediatricians, who often have procedures and set times to meet with expecting parents. Obviously you can use a first visit to 'interview' but also recognize that a lot of doctors won't see you until you're at least 8w. (Mine did a confirmation test for me this time around, but not on a previous pregnancy.) You can probably get a reasonably good feel from the archives about the general ways of some of the more popular practices, or if you're considering particular ones post questions here and you'll get lots of feedback. Books and websites can also give you a sense of the issues that you might want to consider as well. "Advanced maternal age" means an elevated risk factor, but other than giving you more coverage for prenatal testing if you want it, I don't think an AMA pregnancy is followed much differently than one in a younger woman (at least not in my experience) - especially here in DC where there are so many women over 35 who have babies. There are high-risk specialists, but I believe they are mainly for women with medical conditions that warrant closer attention.

[Anonymous]

Congrats on your pregnancy!

I'd strongly recommend seeing an OB ASAP--even if it is not someone you stay with through the pregnancy.

Not to be a bummer, but I had a miscarriage myself last Dec. Do you know what blood type you are? If you are a - (I'm B-), you'll probably need a shot in the case of miscarriage--or even an intervention like CVS--because failure to get that shot can cause your immune system to attack the baby or prevent a future pregnancy.

That said, I'm pregnant again and in the process of switching to a CNM myself, as I want a more natural birth.

Good luck!

[Anonymous]

My husband and I did in fact interview a few different practices before choosing one . . . and then wound up switching early in the third trimester to yet another practice (not because we didn't like the practice we chose but because we wanted one that would more fully support our decision to go the natural childbirth route). Beyond just asking the MD/midwife questions--like, your thoughts on me drinking wine? caffeine? eating sushi? doing natural childbirth?, etc.--we also got a feel for how the practice operated simply by sitting in the waiting room. We hightailed it out of one downtown practice after waiting a very long time to meet with someone, witnessing the conduct of the admin staff, and then ultimately not meeting with one of the MDs but with one of the PAs (who was very nice but couldn't answer a lot of our questions). We were also drawn to a practice that proactively provided stats on the number of c-sections, epidurals, etc. that are done in their practice, and were similarly unimpressed with another practice that could not give us these kinds of numbers.

[Anonymous]

Anonymous wrote:My husband and I did in fact interview a few different practices before choosing one . . . and then wound up switching early in the third trimester to yet another practice (not because we didn't like the practice we chose but because we wanted one that would more fully support our decision to go the natural childbirth route). Beyond just asking the MD/midwife questions--like, your thoughts on me drinking wine? caffeine? eating sushi? doing natural childbirth?, etc.--we also got a feel for how the practice operated simply by sitting in the waiting room. We hightailed it out of one downtown practice after waiting a very long time to meet with someone, witnessing the conduct of the admin staff, and then ultimately not meeting with one of the MDs but with one of the PAs (who was very nice but couldn't answer a lot of our questions). We were also drawn to a practice that proactively provided stats on the number of c-sections, epidurals, etc. that are done in their practice, and were similarly unimpressed with another practice that could not give us these kinds of numbers.

What practice did you end up chosing?

[rreiko]

"Not to be a bummer, but I had a miscarriage myself last Dec. Do you know what blood type you are? If you are a - (I'm B-), you'll probably need a shot in the case of miscarriage--or even an intervention like CVS--because failure to get that shot can cause your immune system to attack the baby or prevent a future pregnancy."

Thanks so much for the above advice. I'm sorry to hear about your miscarriage.

I am actually a B- as well and haven't even thought about that as a factor although I have read about it happening.

Sounds like I have a ton of reading to do beyond "From the Hips" and "Organic Pregnancy" !

Thanks to all for your wonderful guidance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My husband and I did in fact interview a few different practices before choosing one . . . and then wound up switching early in the third trimester to yet another practice (not because we didn't like the practice we chose but because we wanted one that would more fully support our decision to go the natural childbirth route). Beyond just asking the MD/midwife questions--like, your thoughts on me drinking wine? caffeine? eating sushi? doing natural childbirth?, etc.--we also got a feel for how the practice operated simply by sitting in the waiting room. We hightailed it out of one downtown practice after waiting a very long time to meet with someone, witnessing the conduct of the admin staff, and then ultimately not meeting with one of the MDs but with one of the PAs (who was very nice but couldn't answer a lot of our questions). We were also drawn to a practice that proactively provided stats on the number of c-sections, epidurals, etc. that are done in their practice, and were similarly unimpressed with another practice that could not give us these kinds of numbers.

What practice did you end up chosing?

DC Birth Center.

[Anonymous]

While it is important to find a physician you like, you may want to pay more attention to the kind of practice you are looking for and what hospital you want to deliver at.

Are you looking for a university practice that can do all your testing (labs, ultrasounds, etc) right there?
Or would you prefer more of a private practice which will send you elsewhere for testing but which may have better customer service?
Do you want to deliver at a community hospital or a university hospital? The community hospital may have better creature comforts, but the university setting may be better able to respond to unexpected things that can go wrong (for example, I chose the Georgetown practice because they have the best NICU in town, just in case!)

I have been seeing Megan Breen at Georgetown, and have been very happy with her. The visits feel somewhat rushed at times, but that is because there really isn't much to do at each visit. She is always very warm, pleasant and caring, and she seems like she has a pretty laid back attitude about things (encourages good exercise, pretty reasonable about dietary restrictions). Not the most efficiently run office in the world, but it hasn't really been a problem. I imagine that some of the private practices out there are probably a bit friendlier and more efficient, though.

Good luck and congratulations!