Choosing the Right Obstetrician

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Choosing an obstetrician can be one of the first decisions you make as a mummy-to-be. Here are some tips to ensure you’re choosing the one that’s right for you.

WORDS RACHEL LIM

 

Shopping for an OB/GYN to care for you and your bun in the oven? Use our set of criteria to help make your search focused and fruitful.

 

1. Your Health History

 

Do you have any chronic health conditions such as high blood pressure, epilepsy, heart disease, diabetes, and/or previous complications during pregnancy and labour that may require special care? If so, enquire with the OB/GYN you are considering what experiences they have had in caring for patients like you. You may need to be cared for by a maternal foetal medicine specialist or perinatologist, both of whom specialise in high-risk pregnancies.

Kate Ong, 30, mother of an 11-month-old boy, shares her experience of changing two OB/GYNs before eventually finding the right one to attend to her Protein S deficiency condition. Protein S deficiency is a rare inherited thrombophilia often associated with foetal losses in pregnancy. It is seen in approximately 1 in 500 to 1 in 3,000 people. Homozygous Protein S deficiency in neonates manifests as a catastrophic and fatal thrombotic complication termed Purpura Fulminans (PF).

“The first OB/GYN I saw did not know much about my low Protein S condition. The second OB/GYN recommended me to see a blood specialist but he eventually had differing opinions with the blood specialist on my condition. It was not helpful to hear confusing medical advice,” says Ong. 

 

2. Recommendations from General Practitioners and Friends

 

You could start shortlisting by asking your regular general practitioner if he/she recommends the services of a specific OB/GYN and more importantly, why. You could also check with a few trusted friends who have given birth recently for their recommendations. Given that you are BFFs, perhaps her OB/GYN will be right for you too.

 

3. Online Reviews from Other Patients

 

It is also helpful to use online pregnancy and motherhood forums for reviews of OB/GYNs to gather impartial information such as OB/GYN’s bedside manners, skills like stitching for both perineum and Caesarean wounds, after-hours availability, etc. With a shortlist, visit each OB/GYN’s website to read up more on their credentials, philosophy and testimonials.

 

4. Choice of Hospital

 

You should be comfortable with the hospital where you give birth as well as with your OB/GYN.

 

 

Most OB/GYN in private practice locally have admitting privileges to just one or two hospitals. Therefore, when you choose an OB/GYN, you are also choosing the place where you will give birth.

 

 

If this is your subsequent pregnancy, you might need to take your previous length of labour and your home distance from the hospital into consideration. My second labour was just short of one hour from onset of pain to baby’s delivery. Had I lived any further away from the hospital, my OB/GYN thought I might have to deliver in the taxi!

 

5. Obgyn’s Personality and Bedside Manners

 

Pregnancy and childbirth are exciting but nerve-wracking at the same time. The best OB/GYN for you should be someone you feel comfortable with and can communicate with easily. Consider these questions to help you assess if there is a fit between you and your OB/GYN:

 

  • How comfortable do you feel with the OB/GYN?
  • Do you find it easy to ask the OB/GYN questions without feeling judged?
  • Does the OB/GYN explain things clearly, completely and confidently?
  • Does the OB/GYN appear interested in you and your baby’s well-being?
  • Does the OB/GYN seem like someone who respects your wishes?
  • Do you feel that your concerns are validated and addressed?

 

Constantia Lim, 38, mother of a five-year-old girl and a two-year-old boy, shares her experiences of changing her first OB/GYN during the early stages of her first pregnancy when her OB/GYN then revealed to her that her OSCAR test reading was high. OSCAR stands for One-Stop Clinic for Assessment of Risk. The OSCAR test involves the Nuchal Translucency (NT) test plus a sample of the mother’s blood which is analysed for levels of free beta-hCG and PAPP-A (Pregnancy-associated plasma protein A). The combined data will give a risk estimate of Down syndrome with an accuracy of 90 per cent.

 “I think my OB/GYN then was very insensitive. Her nurse called to tell us that the OSCAR test reading wasn’t good and would want us to go down to the clinic as a couple. During the session, my OB/GYN just broke the news to us as a matter of fact and told us to either choose to do Chorionic Villus Sampling (CVS) or Amniocentesis to determine. Being a first-time mum, my OB/GYN did not offer any consolation such as the (fact that) false positives of the test is actually high. I had to frantically search the whole internet for answers,” says Lim.

 

6. OB/GYN’s Practice Outlook

 

Are you an au natural kind of girl? You need to find out your OB/GYN’s attitudes and viewpoints on issues such as induction of labour; use of pain reliefs such as epidural; assisted delivery such as the use of forceps and/or vacuums; and episiotomies.

Is this your subsequent pregnancy and are you considering a vaginal birth after a caesarean (VBAC)? VBACs are controversial and it may not be easy to find a practitioner who is willing to do one. If you are keen to give it a try, you will need an OB/GYN who supports the idea. A decision for or against VBAC should be a joint decision between you and your OB/GYN after having taken into consideration the pros and cons of VBAC in your situation. The hospital where your OB/GYN delivers at should also be supportive of VBACs.

 

7. OB/GYN’s Location and Charges

 

Take into consideration how hard it is to get to the OB/GYN’s clinic from your home or work since you are going to be stopping in a lot over the next nine months. Factor in the fact that you might be travelling with young toddlers or pre-schoolers in tow if it is your subsequent pregnancy.

 

 

 

The arrival of your little bundle of joy will undoubtedly add stress to your finances. Compare various OB/GYN’s packages to find one that fits your budget. A budget is especially important if your pregnancy is high-risk or if you are carrying multiples as you and/or your newborn(s) might require hospitalisation care after delivery.

 

 

In Singapore, hospitalisation fees differ significantly between government and private hospitals. Also, you might want to verify your insurance coverage and increase it if necessary.

 

8. OB/GYN’s Demographic Profile – Age, Gender, Religion, Country and Culture

 

Lastly, narrowing down your search might be as simple as working out if you and your husband have any preference about the OB/GYN’s demographic profile. Consider these questions to help you figure out your preferences:

  • Would you feel awkward or uncomfortable with a male OB/GYN?
  • Do you have more confidence in a young or a more mature OB/GYN?
  • Would you be more comfortable sharing your concerns with an OB/GYN who is of the same religion/culture/country of origin as you?
Thanks for sharing!