From: ff76@vaxb.acs.unt.edu (Jhinuk Chowdhury)
Subject: SUMMARY: OB/Gyn Interview questions (Repost)
Organization: University of North Texas
Date: Wed, 15 Apr 1992 18:22:59 GMT

  Dear Networkers:
  
  COMPILATION: Questions for the OB/GYN in the first interview  (837 lines).
  --------------------------------------------------------------------------
  (This is a "rerun"; first appeared in misc.kids in October 1991.) 
   
          Here is a compilation of responses to my query regarding the 
  questions one should ask in an initial interview with OB/Gynecologists, 
  before one has made up one's mind regarding which OB/Gyn to adopt during 
  pregancy and birth and afterwards.   The query had been posted in misc.kids, 
  misc.consumers, and sci.med.
  
          I begin with a reproduction (unintented pun!) of the actual text of 
  my original query, followed by excerpts from the resposes (edited for the 
  sake of brevity).
  
          My sincere thanks to all of you who have responded and provided my 
  wife and myself with tons of useful information and support.  The messages 
  were informative, caring and very friendly. 

  
           -*-*-*-*-*- TEXT OF ORIGINAL QUERY BEGINS -*-*-*-*-*-
  
          Having recently learned that my wife is pregnant (for the first 
  time), both of us (well, me actually) are duly anxious (panic-stricken?).  
  Evidently, we need to establish a long-term relationship with a competent 
  OB/Gyn, with whom both of us will be comfortable.  I suppose it is time to 
  go out and interview those that are listed on my company's health plan. 
  
          (1) WHAT QUESTIONS DO YOU THINK ARE APPROPRIATE AND USEFUL FOR THE 
  PURPOSE OF EVALUATING AN OB/GYN during the first interview?  We would like 
  to be able to make the best possible choice based on the responses to those 
  questions (and other intangible aspects of the interview, I am sure).  
          Since, I suppose that I will be paying fees for every visit, 
  including the initial interview, I'd like to know from those of you who may 
  have gone through this, how many interviews would you consider to be a 
  "reasonable" number? 
          (2) What other kinds of preparation (books, seminars, exercises, 
  financial planning, reservation of facilities <whatever they may be>) do you 
  think we should consider at this time? 
          (3)  This being the end of the first month of the pregnancy, when 
  would be a good time (in terms of which month of pregnancy it is) to begin 
  interviewing pediatricians? 
  
  Jhinuk Chowdhury
  
  University of North Texas 
  (Internet: FF76@VAXB.ACS.UNT.EDU, Bitnet: FF76@UNTVAX)
  
       --*--*--*--   END OF TEXT OF THE ORIGINAL QUERY  -*--*--*--
  
          The following section contains excerpts from the responses I 
  received: 
  
  From: tiff@CS.UCLA.EDU (Tiffany Frazier)
  
  The best thing to do (I think) is to locate "The Maternity Sourcebook" 
  (author?).   The book is large, question-answer oriented, provides lots of 
  references and tries to be as unbiased as possible.  I believe it treats 
  selecting an OB/gyn in great detail.  It provides many more details than any 
  net response can give. 
  
  This book - in combination with "What to expect when your expecting" - 
  should provide you with an excellent starting base. (Personally I found 
  Penelope Leach's books to be very biased. Too often she says "Never/always 
  do X" or only gives one solution to a problem/situation - she's not always 
  right!). 
  
  These two books cover pregnancy and childbirth only and should be available 
  in any bookstore. 
  
  ---------------------------------------------------------------
  From: speedy!ssh@att.att.com (Syed Shehryar Haider (ssh@speedy.att.com))
  
  As far as I know, the obstetrician charges a fixed amount ( ~ $2500)
  that includes all visits prior to delivery, the delivery itself, and
  probably one follow-up visit afterwards.
  
  Questions I recall asking:
  
  1)  What is your record on C-sections (i.e., as a percentage of total 
      deliveries).  I believe the national average is 25% !!
  
  2)  How often will you see my wife?  The frequency is usually once/month 
      for the first 7 months, then twice/month for a month, finally once/week 
      for the final month. 
  
  3)  How accessible are you;  who is the backup (covering) physician?
  
  4)  What places offer classes - we found ours very useful.
  
  5)  Ask your ob. to explain the whole procedure to you including what course 
      s/he follows for unusual circumstances/emergencies, what type of 
      anasthesia is used and what the cutoff time is for this: 
      Once labor progresses beyond a certain point, they will refuse to 
      administer anesthesis.  It is this "point of no return" that your wife 
      should clarify. 
  
  Start your search for a pediatrician now.  There's no harm.  You should be 
  able to ask prospective candidates to give you 10 minutes of their time to 
  answer questions without charging a fee.  If they have any sense, they will 
  agree;  the payoff to them of having an additional client is large enough 
  since you'll be paying the one you select through the nose for years. 
  
  Since this will be your first child, I can empathize with you.  Just try to 
  take everything in stride. 
  
  ------------------------------------------------------------------------
  From: lstowell@pyrnova.pyramid.com (Lon Stowell)
      
      Obviously your wife needs to be comfortable with the
      person...but in addition you may want to query about their
      attitudes on anesthesia, family members in the delivery,
      midwifery, or any other "alternative" birth methods...as well as
      circumcision policies.  Too many folks don't ask and end up with
      a doctor whose views on "proper" childbirth don't agree with
      their personal prejudices.
  
  ------------------------------------------------------------------------
  From: Carolyn (jimpt@tekig6.pen.tek.com (James R Peterson))
  
  I would suggest getting recommendations from friends for an OB.  Also have 
  them state WHY they are recommending this OB and what little things they 
  don't like about the doctor (no one is perfect).  I think it's hard to know 
  what to ask doctors and difficult to evaluate their answers. Other things 
  you might consider checking on include a) will their office handle the 
  insurance forms - that saves you a night mare in paper work b) how easily 
  can you contact them at 2 a.m.  c)who do they trade calls with - how many 
  are in the group  d) do they do many c-sections  -- what do they do with 
  patients that had had a previous c-section (avoid a doctor that 
  automatically schedules repeat c-sections). 
  
  You might also see how well your wife likes the NURSE.  In my first 
  pregancy, I made a lot of nervous calls to the OB's office about routine 
  matters.  The nurse is usually the one to handle these calls. 
  
  If you don't know any new or recently new parents, you might try posting a 
  request for recommendations to misc.kids.  Restrict the distribution of the 
  article to your own city. 
  
  Our OB charged a flat fee that included the prenatal care, delivery and post 
  partum care.  If the pregancy required a few extra office calls, there was 
  no additional charge. 
  
  Your OB will probably have information about child birth classes in your 
  area.  You might check with the local swimming pools for pregancy fitness 
  classes (aqua aerobics).  Your wife will get to meet other pregant women 
  here, also.  The experienced moms can also help out with pediatrician 
  selections. 
  
  If you have never taken care of children, check with the local American Red 
  Cross chapter for classes for new parents.  We took their class and found it 
  to be very good. 
  
  If your wife is having a normal pregancy, I would recommend checking out the 
  doctors around the 7th month.  If she might deliver early, get busy earlier.  
  We got recommendations from friends, my OB, other participants in the 
  pregancy fitness class and some neighbors.  In our case, the same 2 doctors 
  names kept coming up, so we interviewed both of them. (There was a charge 
  for the interviews.)  We liked both doctors.  We made our final choice based 
  on the following "bonuses" one doctor offered over the other.  1) The 
  waiting room was pleasant and had toys to play with and fish for observation  
  2)The doctor's office handled the insurance billing  3)Doctor's office had 
  SATURDAY and SUNDAY morning office hours for sick kids and for phone calls 
  about sick kids  4)Plenty of other doctors in the practice, so there is no 
  problem getting someone quickly in the evening for questions about 
  emergencies  5)I wanted to breast feed and the clinic had a specialist that 
  could give assistance --don't assume it comes "naturally".  Items 3 & 2 are 
  probably the most important ones to look for.  Our doctor also has 
  registered pediatric nurses in the office.  Some had people in "nurse" 
  uniforms that were not nurses. 
  
  ----------------------------------------------------------------------
  From: mtunf!reg@att.att.com (regina mackiewicz)
  
  i can't help you with questions for a obg/gyn but i have one question for 
  your wife.  why did she wait until pregnant to visit a gyn??? a woman should 
  visit her gyno. once a year for regular checkups.  if she is taking birth 
  control pills she should go twice a year.  not to scare you but in a way i 
  am, cervical cancer is one of the most deadly of cancers affecting women.  
  the primary reason is that it is a silent killer and you don't know you have 
  it until you are too far gone.  the only way to get early detection is have 
  a pap smear done regularly. 
  
  i would hope for the health of your wife that you suggest she begin a 
  routine of regular checkups after she has recovered from the baby. 
  
  -----------------------------------------------------------------------
  From: maureen@research.att.com  (Maureen McGee)
  
    Find out who will deliver the baby.  My first ob/gyn was part
    of group practice.  About 16 weeks into the pregnancy I realized
    that one of seven doctors could deliver the baby.  I felt
    I was going to a clinic, so I changed doctors.  My second
    doctor assured me she would deliver the baby.
  
    With one or two doctors you can establish a long-term relationship,
    but I don't think its possible with a large practice.
  ------------------------------------------------------------------------
  From: esther@verdix.com (Esther Lumsdon)
  
  You don't necessarily have to choose an OB/GYN doctor, and then a 
  pediatrician. You can choose a Family Practise doctor. They deliver babies, 
  treat adults and children. I am very happy with my FP doctor (although I 
  don't intend to have babies anytime soon). An FP doctor can handle ~ 80% of 
  all pregnancies, and will not hesitate to refer you to a specialist if a 
  problem is over their head. Getting referred to a specialist like this 
  generally does not expose you to the "we aren't taking new patients" 
  problem, and you can have the FP doctor override the "we aren't taking new 
  patients" verbage. 
  
  Start looking for a doctor for the pregnancy now. The last 2 places that I 
  lived had a shortage of OB/GYN doctors, and a doctor will only accept as 
  many pregnant women as they can handle. After the limit, they turn away 
  pregnant women and do not accept them as patients. It isn't a nice feature 
  of doctors, but I don't know of a way to change it. 
  
  Disclaimer:  I'm not a doctor. One of my ex-roommates is a Family Practise 
  doctor (in South Carolina), and she has convinced me that FP doctors are a 
  good thing. 
  
  -----------------------------------------------------------------------
  From: Chakra.Srivatsa@Eng.Sun.COM (Chakra Srivatsa)
  
  Also interview the obgyn's partner, who will take over if the obgyn is not 
  available.  Ask how often this happens. 
  
  Ask for his c-section rate (% of c-sections to total deliveries). I believe 
  20% or so is average.  Lower the better IMO. 
  
  Some obgyns have favorite hospitals.  Check that they will come to the 
  hospital where you want to have the baby (ie whichever your insurance 
  covers). 
  
  How many ultrasounds does he/she do? 
  
  Epidurol during delivery - does he approve of it? (It's a drug to make 
  delivering women feel less pain.) 
  
  You can wait on pediatricians until the 7th month or so.  You should have 
  visited your hospital by then, and booked your Lamaze class. 
  
  ------------------------------------------------------------------------
  From: ausnit@software.org (Christine Ausnit)
  
    I'll summarize based on my own experiences...hope it helps...
  
  Ask how they define normal vs high risk pregnancy
  
  Ask about how they monitor a normal pregnancy
  
  -- frequency of visits (typically, it's once a month for the first 6 or so 
     months, then twice a month, then once a week during the last month) 
  
  -- when does the doctor start doing internal exams (usually not till late in 
     the pregnancy) 
  
  -- philosophy about childbirth:
    
     under what circumstances do they perform a Caesarian-section? 
       on what percentage of childbirths do they do a Caesarian (more than 15 
       to 20% would strike me as high...find out why) 
  
     what painkillers/drugs do they use during childbirth? what are the 
       potential side effects of these drugs? who decides whether drugs will 
       be used/are necessary? 
  
     how long do they allow labor to progress before performing a Caesarian 
       section? 
    
     which doctor attends the birth (the primary ob/gyn? a backup who may be 
       on call on The Day?) 
  
  -- what type of tests do they usually run during pregnancy and why? 
       
     sonogram?  (optional from my point of view, unless high risk pregnancy)
     glucose tolerance? 
     amniocentesis?
  
     They should run blood tests to find out whether your wife is immune to 
       measles/mumps/rubella (I hope she is--she does not want to come down 
       with any one of these during pregnancy as it could harm the baby).  
       They need to check your and your wife's blood type.  If you are Rh+ and 
       she is Rh-, then she should get a Rhogam shot at about 28 weeks.  If 
       the baby is Rh+ then she should get another Rhogam shot within one or 
       two days of delivery.  Rhogam prevents the Rh- mother from building 
       antibodies to the fetus' Rh+ blood.  Real danger is not with first 
       pregnancy, but with later pregnancies.  AFP (alfa-fetal-protein)?  
       Beware, this test does give false positives, which can be VERY scary (a 
       true positive would mean spina bifida, i.e. baby will have problems).  
       This test is very sensitive to mother's weight and how far along she is 
       in the pregnancy (if one or the other is off, or if your wife is 
       carrying twins, she may get a false positive).  
       
  -- what diet/vitamin supplements does the doctor recommend?
  
  -- what recommendations does the doctor have for morning sickness?  
  
  -- what restrictions should your wife observe during pregnancy (probably none)
  
  -- what exercise program(s) do they recommend?
  
  -- what constitute "emergencies" for which you should promptly call the 
     doctor (e.g., any kind of spotting, pre-term labor)
  
  Ask about miscarriages (risks, how to cope, causes, etc.)
  
  I found that the entire pregnancy (including delivery) was just one fee, but 
  then again, I already had an OB/GYN.  If your wife does not currently have a 
  doctor, then expect to be charged a first-time visit charge (if you're using 
  a doctor in private practice, I think there is an insurance code for a 
  prenatal visit).  If your wife has not had a Pap smear within the last year, 
  a doctor may/may not recommend one.  Fees vary from area to area. Northern 
  Virginia is probably more expensive than most--Fees ranged from $2500 to 
  $3000, depending on complications (e.g., Caesarian being more expensive than 
  vaginal delivery).  A private practice may require you deposit 20% of the 
  fee around the 4th or 5th month.  If this is your situation, make this 
  payment in early 1992 rather than late 1991 so that it falls into the next 
  "insurance" year and counts towards deductible, etc. 
  
  An important factor for me in choosing a doctor is how willing the doctor is 
  to spend time with me to answer my questions. If you feel the doctor rushes 
  you to get to the next patient, consider changing doctors. IMHO, a doctor 
  should be willing to share information, to explain things in layman's terms. 
  
  Find out what hospital(s) the doctor is affiliated with.  If you don't like 
  the hospital where the doctor delivers, you may want to change. 
  
  Books--read as much as you can.  Go to your local library/bookstore.  Don't 
  expect the pregnancy to follow what any one book says; each pregnancy is 
  different.  Ditto for books about babies.  Some good ones are "What to 
  Expect the First Year," plus books by Brazelton and Leach (I've forgotten 
  the titles) 
  
  Seminars--take with a grain of salt.  They're probably trying to sell you on 
  a particular method, not give you an overview of options.  Most doctors 
  recommend you take a 6 to 8 week "childbirth" course starting around the 
  seventh month.  These courses are offered by hospitals and private 
  organizations.  Your mileage may vary :-) 
  
  Do visit the hospital where your wife will deliver ahead of time.  Know 
  where to go (i.e., where is the maternity ward, whether you have to go 
  through admissions before going to the maternity ward, which hospital 
  entrance to use [it usually depends on whether you arrive during normal 
  working hours or after hours]).  Ideally, the hospital will have modernized 
  the maternity wing and your wife will stay in the same room for labor, 
  delivery, and recovery. 
  
  Find out what neonatal facilities the hospital has; what newborn conditions 
  do they handle locally, and when do they have to transport babies to other 
  hospitals with specialized equipment. 
  
  Exercises--YES!!!  There are prenatal aerobics classes (this is very 
  different from even a low-impact aerobics), and they make a big difference 
  come delivery time.  The exercises are pretty easy (nonstrenuous), but worth 
  it.  If nothing else, walk regularly (every day). Your wife should do Kegel 
  exercises (they're described in many pamphlets and books.)  A good prenatal 
  exercise class will require a note from the OB and should follow guidelines 
  set by the American College of Obstetrics and Gynecology. 
  
  >      . . .  when would be a good time (in terms of which month of 
  > pregnancy it is) to begin >interviewing pediatricians? 
  
  Around the 8th or 9th month.
  
  Remember, pregnancy is normal! It is NOT a disease!  
  
  -------------------------------------------------------------------------
  From: cnorman@weber.ucsd.edu (Cyndi Norman)
  
  I would do as much interviewing by phone as possible.  It's free.  That way 
  you can screen out the people who have obvious problems (don't take your 
  insurance, even though they're on your list, insist on a delivery proceedure 
  your wife doesn't want, don't do a delievery proceedure your wife wants, 
  will be out of town the month before and after the due date,etc) and save 
  your in-person consultations for getting to know a medical person 
  personally. 
  
  Keep in mind that some places match you up with a person who will do pre-
  natal care *and* deliver the baby.  Others will do pre-natal care and then 
  you get delievered by whoever is on duty.  If it is the latter (which is not 
  so bad), be sure the *place* is somewhere your wife feels comfortable. 
  
  I keep saying "medical person" instead of "doctor" because you should 
  explore options of midwives as well (they will refer to an MD if a problem 
  develops during pregnancy and--assuming you deliver in a hospital or a 
  birthing center within or next to a hospital--will turn you over to expert 
  medical care if a problem develops during delivery.  Midwives give better 
  pre-natal care in general too. 
  
  -------------------------------------------------------------------------
  From: samsung!asuvax.eas.asu.edu!anasaz!qip.tama@uunet.UU.NET (Tama McBride)
  
  Some doctor's don't charge for an "introduction" visit.  Check with the 
  office first.  I also got recommendations from my regular doctor, others in 
  the office (on the same health plan), and was very comfortable with my 
  choice because of the extra input. 
  
  Well, my husband and I considered ourselves sort of on the funny side,
  since we got pregnant and felt we had to get books to learn how to "do it
  right".  :-)
  
  Seriously, about the only thing I really used/needed/enjoyed during my 
  pregnancy (Ian's 14mo old now), is the book "What to expect when you're 
  expecting", a pregnancy exercise program sponsored by the hospital, and a 
  lot of sleep. 
  
  We thought that getting the room ready a month ahead of time would be fine.  
  We're still finishing it!  I didn't and still don't realize how much you can 
  really NOT get done when you're at the end of your pregnancy or when you 
  finally have your little one at home!  It's amazing - and I wouldn't trade a 
  minute of it! 
  
  The big issue for me was finding daycare, which I also started looking for 
  when I was five months pregnant.  It was such a relief to me to know that my 
  daycare was set up when I was at the end of my pregnancy - one thing less to 
  do! 
  
  ---------------------------------------------------------------------------
  From: tls@Rational.COM (Tracy Sconyers)
  
  I recently had to select a gynecologist for a medical problem, and not a 
  pregnancy, and I was very suprised that I disliked the first 3 that I talked 
  to.  I had a lot of questions pertaining to my problem, but the first 3 were 
  reluctant to spend time answering them in depth, or even at all!  I would 
  suggest that the most important thing is how comfortable you feel with the 
  doctor's answers, his/her approach to medicine, etc.  Don't be afraid to 
  find another one if you are not happy or comfortable.  I learned this the 
  hard way -- I was not happy with doc #3, but figured that after 3 it must be 
  me and not him.  I ended up letting him perform an unecessary surgery on me 
  before I realized that my first impressesions of him were, after all, 
  accurate. Doc #4, though, was (actually is) a vey good ob/gyn, so I have a 
  happy ending. 
  
  But enough icky stories -- this is a happy time for the both of you! I would 
  suggest that you read a lot of books on pregnancy, and write them down to 
  bring in to the first visit.  Tell the receptionist that you want a LOT of 
  time for discussions when you make the appointment (my first list had over 
  60 questions!!)  If the doc doesn't have time, then find another doc. 
  
  Just off the top of my head, I would ask about:
  
  - what to expect during the pregnancy - morning sickness, swollen joints, 
      when can you first feel the baby, when do you start to show, what 
      happens to your breasts, uterus, joints, etc. 
  
  - how does the baby develop during the 3 trimesters (my gyn has lots of 
      really neat posters on his wall on this one) 
  
  - what are the stages of labor
  
  - what hospital will be used, and what are their rules (can you keep your
  
  - when to start attending lamaze or other childbirth preperation classes
  
  - what tests are normally done to make sure the baby is developing
  
  - what common things can go wrong, and what are the symptoms
  
  - what painkillers are used during labor
  
  - what can be done to prepare for breastfeeding
  
  I would also suggest that both of you go in for some of the visits together, 
  so the doc can get to know you both.  I brought in my SO in before my 
  surgery, and he asked a few questions that I hadn't thought about. 
  
  I would also recommend reading the misc.kids group  . . . 
  
  -------------------------------------------------------------------------
  From: ctopp@cup.portal.com (Carol)
  
  Do you have access to misc.kids? There is a set of people who are keeping 
  FAQ (frequently asked question) information on selected topics. I don't know 
  if your question is covered, but I think you and your wife might find the 
  wisdom of the group useful. 
  
  When I was pregnant, I refered to a few different books. Most of them cover 
  questions and concerns for choosing your doctor. The books I used the most 
  are "the well pregnancy book" and "what to expect when you're expecting". I 
  have been going to the same ob/gyn for years, so I didn't need to make a 
  choice early on- I wanted to stay with her and her group. 
  
  I packed the books away along with the maternity clothes, but I remember the 
  books spending several pages on the topic. You should note that most OBs are 
  members of a 3-4 group. Pregnant patients see all the members so they know 
  all of them. The one on call when you deliver is the one you work with for 
  the delivery so you should really be evaluating the group. 
  
  A friend of mine had to find an OB after she learned she was pregnant. She 
  made the appointment and went there with her husband. She say the doctor for 
  5 minutes, expecting him or the nurse to say James should come in now. 
  Instead that was the end of the appointment except that he mumbled something 
  and said she should have an ultrasound. 
  
  Very discouraged she decided she should try again with another group. She 
  found a winner on the second try - they couldn't figure out why the 
  ultrasound was ordered. 
  
  My point in relaying this is to be sure that you like the way they treat you 
  and your wife on your initial visit and don't hesitate to change if you 
  don't like the interaction you are getting. My doctor said that my husband 
  is welcome at any of my appointments and he was encouraged to ask questions. 
  He came to several appointments and I think it helped when I started to have 
  some problems with my pregnancy. 
  
  In response to question 2, it depends on how comfortable you are with kids. 
  In addition to the birth preparation classes, I've heard of people taking 
  several other classes on care, dressing, understanding of infants. I know 
  some people on Kaiser health plan which take the classes through there. My 
  OB had a list of reccomendations for birth classes and pediatricians. I 
  expect that an OB group would also have sources for other classes - or you 
  could ask the pediatrician when you interview him/her. 
  
  You don't need to rush these steps. Sometime after the 32nd week is the time 
  to start getting ready and figuring out what you are going to do when that 
  amazing new life comes into your home. 
  
  The maternity ward had a set of video tapes on some of the basic steps-
  bathing a newborn, tips on dressing, breast feeding, (I don't remember the 
  rest, but there were 6-8). 
  
   . . .again I reccomend misc.kids  (the internet newsgroup) if you have 
  access to it. 
  
  ------------------------------------------------------------------------
  From: jeana@sco.COM (jeana)
  
   we weren't charged for our initial interviews for either the OB or
   the pediatrician...
  
  Questions to ask? Here are a few that I can think of...
  
   - do you have more than 1 hospital in your area?  does the OB/GYN deliver 
     at both?  if not, do you have a preference on hospital birthing policies? 
  
   - do you want to go with an OB or a Family Practioner that also does OB?  
     If you go with the Family Practioner ... do they seem flexible enough to 
     refer you to a specialist if a complication develops which is outside 
     their scope?  If you go with a family practioner then they could be 
     considered for the pediatrican too. 
  
   - does your wife have a preference for a woman OB ?
  
   - what are the odds of getting your OB for the delivery.  does it matter to 
     you?  what are the chances of getting other doctors in the practice and 
     can you interview them too? 
  
   - does the doctor seem open to answering questions?  or are they brusque.  
     does s/he answers questions at a level you can understand? are you 
     comfortable asking this person questions? 
  
   - what is their typical plan for pregnant women (barring complications) 
     i.e....what tests do they do, how frequently do they want to see you, do 
     they test for gestational diabetes, do they do ultrasounds and stress 
     tests and how frequently..., 
  
   - what is their c-section rate and how does it compare to other doctors in 
     your area... 
  
   - ask for references, check with the hospital delivery nurses.... what do 
     they think of this doctor 
  
   - what classes does the doctor recommend you take 
  
   - are you planning on nursing... is your doctor supportive of this?
  
   - ask other people in your area who they would recommend...
  
   - i would recommend looking for classes on: childbirth preparation,  
     nursing (if you are planning on doing so), infant care, and infant cpr 
  
   - you can usually register at the hospital you are going to in advance (not 
     for awhile yet .... :} )... so that when you do go into labor you don't 
     have to fill out paperwork, do insurance, etc... 
  
   - your wife may want to look into low-impact exercise classes for pregnant 
     women or swimming (swimming is great when you are pregnant!). 
  
   - books - i would recommend (1) the 1st 12 months of life which is a child 
     development book which describes what to expect after birth.  i don't 
     really remember the names of the pregnancy books i had...  (2) there is a 
     great book on nursing published by the nursing mothers council.. 
  
   - financial planning - depends on your insurance?
  
   - I started interviewing pediatricians around the 5-6th month
  
  -------------------------------------------------------------------------
  From: judy@locus.com (Judy Leedom Tyrer) 
  
  Congratulations!  Now, go to the nearest bookstore and buy "What to Expect 
  When You're Expecting" and ignore the section called "The Best Odds Diet". 
  The book is great about everything except nutrition.  I used it constantly 
  during both pregnancies - more than any other book on my well stocked shelf. 
  
  I think the OB depends on who your wife feels most comfortable with.  I know 
  this sounds sexist, but she is going to have to depend on the OB more than 
  you will.  So her comfort (now and for the next 9 months) is of utmost 
  consideration.  
  
  What type of doctor do you want?  Do you want one who handles everything for 
  you and shelters you from worry?  Do you want one that speaks in scientific 
  lingo?  Do you want the latest in technology or great bedside manner?  These 
  are the important questions you have to ask yourself.  Then choose a doctor 
  based on what type of doctor you want. 
  
  Basically, I got recommendations from friends and went to the doctor.  The 
  doctor I had for my first two pregnancies (both with bad results) was a Dr. 
  Kildaire type.  He was nice and wonderful, but a "there there, nothing to 
  worry about" type.  I knew someone else who went to him and he told her not 
  to read pregnancy books because it would just upset her.  So, when I was in 
  an HMO and had to change doctors, I found one who talked to me in scientific 
  terms and told me everything she thought could be wrong, including that I'd 
  tested positive for Lupus and needed more tests to see if I had it (I didn't 
  - but I really like the fact that she had told me about it right away and 
  let me worry until the final test results were in.  The first doctor would 
  have just drawn the blood without telling my why so I wouldn't worry 
  needlessly). 
  
  Other than "What to Expect When You're Expecting", I enjoyed "Pregnancy for 
  Today's Woman" which is all about medical procedures and terms and written 
  by an OB for his own patients.  It was refreshing since most of the books on 
  the market are very anti-doctors and pro-natural birth regardless of 
  extenuating circumstances.  I would use this for nutritional advice since he 
  differentiates how much protein you need in the first trimester from how 
  much you need in the last trimester and has very reasonable and 
  scientifically backed information on things like travel during pregnancy 
  (including what immunizations are safe to get if you want to go to Africa), 
  sports, exercise, medications, testing, etc. 
  
  You might also go about picking a doctor by picking a hospital and then 
  getting a doctor who delivers there.  I loved my small community hospital 
  where there were only 12 beds in the maternity ward.  It was important to me 
  that I be in a small unit with liberal policies toward visitation and such. 
  
  Once you pick a hospital, they will probably hook you up with a birth 
  instructor and that way you can learn all the hospital policies and stuff in 
  class.  Our class toured the maternity ward, met all the nurses we might be 
  with, etc.  
  
  >        (3)  This being the end of the first month of the pregnancy, when 
  >would be a good time (in terms of which month of pregnancy it is) to begin 
  >interviewing pediatricians?
  
  We interviewed in the 8th month.  We wanted to interview early enough in 
  case the baby was early, but late enough so the pediatrician would remember 
  us when the baby was born. 
  
  ------------------------------------------------------------------------
  From: sue@ariel.ucs.unimelb.edu.au (Sue McPherson)
  
  First of all, Sarah Alice McPherson was born at 2:09pm on Thursday 22nd of 
  August - she weighed 3.295kg (7lb 4oz), was 50cm long and her Apgars were 9 
  and 9. 
  
  Generally speaking I was reasonably happy with my obstetrician, but if I 
  give a quick run-through of my birth experience you may see where I could 
  have done better if I'd been a bit more selective. 
  
  I went to see my GP at six weeks to have the pregnancy confirmed (I was 
  actually 8 weeks - I didn't know then that they count from the last period, 
  rather than the actual date of conception). He asked if there was a 
  particular Obstetrician I wanted to be referred to and as I didn't I went to 
  the Ob. he suggested. 
  
  I fully intended to be assertive (but not aggressive) at my first 
  appointment to make sure I had someone who would listen to me and not be 
  unduly interventionist. The first appt went quite well, he was very friendly 
  and explained everything cleary (I'm O- and my husband is A+, so I got a 
  full run-down on Rh problems, antibody tests, anti-D injections and the 
  importance of contacting him at any hour if I should start bleeding). He 
  also took a phone call while I was with him, it was a woman who had 
  miscarried two days earlier, and I was impressed by his sympathetic manner. 
  
  Subsequent check-ups went reasonably well - although I often felt a bit 
  rushed, but that was largely due to the fact that I had virtually no 
  problems throughout the pregnancy. 
  
  I was due on the 17th and only finished work on the 16th so I was quite glad 
  to be a few days late to have a chance to rest a bit, however by the 21st I 
  was starting to get sick of sitting at home and waiting. I saw the Ob. that 
  day and mentioned this, he assured me that there were no signs of any 
  problems and that it was quite normal - when pushed he said we would discuss 
  induction when I saw him the following week. I told him that my sister was 
  visiting from interstate and wanted to see me and baby before she left in a 
  few days time and she had been suggesting various means of hurrying Sarah 
  along. The Ob. replied quite seriously that sex could do it. 
  
  I was willing to try anything, so that night we did ... and sure enough I 
  felt the first contractions at about about 2am. I was reasonably comfortable 
  so I got up, had a shower and tried to get some rest, although I was unable 
  to get back to sleep. At about 5am things were getting more serious and I 
  rang the hospital to tell them that I would be coming in sometime in the 
  morning (they suggested I stay at home as long as I felt comfortable, but I 
  should come in by 7.30am - so as to avoid any risk of getting stuck in the 
  traffic). I kept reading and walking around during contractions until 6am - 
  when Dave woke up. He had breakfast and we played computer games until 7 
  when we left for the hospital. My waters broke about 5 minutes after we 
  arrived - it only felt as if I'd lost control of my bladder and I was slowly 
  leaking! 
  
  I went into a delivery suite, with contractions coming every 4 minutes. By 
  about 11am things were starting to get quite painful and I was getting an 
  urge to push - but it hurt A LOT if I did. The midwife said I wasn't into 
  second stage yet so I shouldn't push - I wanted to know how far along I was, 
  but she couldn't tell me after insisting that I NEEDED to know just how 
  dilated I was another midwife came in and told me that only the Dr. could do 
  an internal examination. When I asked where he was I was told that he had 
  been contacted and that he had a consulting session at another hospital (on 
  the other side of the city!) and that if my labour continued smoothly he 
  would arrive sometime after 2pm. After another hour of getting nowhere I 
  told the midwife more forcefully that I NEEDED TO KNOW how I was 
  progressing, she was able to feel that the head was 'down', she explained 
  that I was probably fully dilated, except for a small lip of cervix at the 
  front (which was what hurt when I pushed). At about 1am I felt the 
  contraction which cleared the lip and was a lot more comfortable - and very 
  keen to be pushing. At 1:50 I told the midwife that the baby was just about 
  there - but she insisted that there was no sign of the head yet. The head 
  appeared at the next contraction and Sarah was born 2 contractions later -
  the midwife only had one glove on! With the actual delivery being so quick I 
  had a small tear which the Ob. stitched up when he arrived 15 minutes later. 
  
  So, conclusions and recommendations in the light of my experience....
  
  1. If you're overdue, sex might help but.. do it first thing in the morning, 
     not late evening as it would really have helped me if I'd had a good 
     night's sleep beforehand. 
  
  2. Find out what the Obstetrician feels about being present during labour 
     and delivery. While I didn't expect the Ob. to be there for the whole lot 
     unless I had real problems, I did think he would drop in from time to 
     time. I think the critical factor was that he worked at two hospitals 
     (about a half hour drive apart). 
  
  3. Apart from missing the actual birth I wasn't too unhappy with my Ob., but 
     I didn't think I had a great rapport with him and although this is 
     sexist, I think I would try a woman Ob. next time (if there is a next 
     time). 
  
  4. Although reading lots can be a good preparation, I think the things which 
     were most helpful were the programs run by the hopsital - a couple of 
     parent education nights where they showed videos of births (both straight 
     forward, long, forceps and ceaser deliveries) and then had midwives to 
     answer any questions. As well as information on the hospital, breast 
     feeding, transporting babies, etc. It's one thing to read about birth but 
     it seems much more relevant when you see it. Also a lot of men have never 
     seen a birth so it helps the 'support person' to get an idea of what to 
     expect. 
  
  ---------------------------------------------------------------------------
  From: margaret@b17a.ingr.com (Margaret Wiginton)
  
  I am NOT an expert..but I did read recently (sorry, can't remember where) 
  that it is wise to find out how many Caesarians the OB/Gyn you're 
  considering performs versus the total number of births he/she oversees. The 
  gist of the article was that far too many Caesarians are performed these 
  days and that its more desirable to find a doctor who is willing to give 
  nature more of a chance. 
  
  ---------------------------------------------------------------------------
  From: rob@ll.mit.edu (Rob Steele)

  (Margaret Wiginton) writes:

  >I am NOT an expert..but I did read recently (sorry, can't remember where) 
  >that it is wise to find out how many Caesarians the OB/Gyn you're 
  >considering performs versus the total number of births he/she oversees. 

  A doctor friend warned me about this.  The percentage of cesareans an OB  
  performs is an excellent indicator of his philosophy and competence but docs  
  have very big egos and resent being questioned as if they were merchants.  
  (I  heard a nurse say once that doctors have "M.Deity" degrees.)  You might 
  want to  ask anyway and reject candidates who show a lack of humility but 
  you probably  ought not start off on the wrong foot with the one you end up 
  with. 

  BTW, my wife and I really like _Husband Coached Childbirth_ by Bradley (ever  
  heard of the Bradly method?). 

  -------------------------------------------------------
  From: beth@hpfcso.FC.HP.COM (Beth Crespo)

  First you need to know what you want and don't want and then find a 
  caregiver that is most likely to provide the kind of care you want. I 
  suggest you consider a Family Physician (a certified specialty, not simply a 
  General Particitioner) and possibly a midwife. I found I am most comfortable 
  with a Family Care Physician because then *one* doctor was caring for my 
  health and the baby's health. 

  Since the risk of having a C-section is directly related to your doctor's
  C-section rate, ask what percentage of deliveries are via C-section.
  If the doctor's rate if very low, you can feel more confident that a 
  C-section is *really* necessary if this doctor recommends one (as mine did).

  If you want to avoid an episiostomy ask how often the doctor does them, and 
  what the doctor does to help avoid one - my doctor applies oil packs and 
  provides support to the perinium (sp?). 

  Also ask about the recommended care during labor - if you want a natural 
  delivery pick a doctor who recommends light meals and juices during early 
  labor. Also ask if his opinion of various methods of mananaging labor 
  (Lamaze, Bradley, Yoga, drugged). 

  If you have any specific health concerns discuss the doctor's familiarity 
  with care of that condition during pregnancy and labor. For example, I have 
  mild asthma and wanted a doctor familiar with the Bradley approach since the 
  patterned Lamaze breathing brings on a coughing fit. 


  I first interviewed the office staff over the phone and eliminated some 
  doctor's based on what I learned - i.e. no evening hours makes it difficult 
  for a working woman and shows IMHO lack of support for working mothers. The 
  doctor I was most interested in (and ended up choosing) did not charge for 
  the interview visit if you ended up using him for pre-natal care. The nice 
  part of an interview visit is you meet the doctor on equal terms, in his 
  office with all your clothes on! 

  I read many books from our public library about pregnancy and infancy. I 
  found that if they were more than 10 years old the pregnancy books were 
  totally outdated. We also took a class called Pregnancy in Your 30s which 
  was only mildly worthwhile - the best advice was to finish any major 
  projects before the baby comes - we painted our entire house interior before 
  getting pregnant. I attended a pre-natal exercise class which I enjoyed and 
  which kept me motivated to stay active. If you have a day care shortage in 
  your area it is not too soon to reserve infant day care. You should also 
  look into non-hospital based prepared childbirth classes, the Bradley 
  training begins during the 3rd (?) month and fills up fast. 


  >   . . .      when would be a good time (in terms of which month of 
  > pregnancy it is) to begin interviewing pediatricians? 

  Not necessary if you pick a family care doctor. Otherwise before the last 
  month of pregnancy. 

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Newsgroups: misc.kids