There’s this this really amazing OBGYN based out of Atlanta, GA. He encourages informed decision making, and shared risk between parents and care providers. He uses evidence to navigate his and his patient’s choices, instead of fear. I want to clone him, because unfortunately, he is the exception and not the rule. So how can parents differentiate and find a quality care provider? How do you get the dirty details on your OBGYN?
Haters Gonna Hate
First off, let me clarify that I am PRO OBGYN. I hold in high regard competent, talented, compassionate, and flexible care providers. Doctors that support informed decision making, and embody integrity, intuition, and intelligence are an asset to any community. I’ve been at births with many amazing doctors over the years and man, they are so valuable.
However, I am ANTI sub-par care providers, and sadly, they’re definitely out there. It’s not safe to assume that all OBGYN’s would be a good fit for you and your growing family. I would be doing a disservice to you to say you can blindly pick any care provider and it would be ok.
OBGYN’s Have Dirt?
Yes, OBGYN’s have dirt. Some like to perform episiotomies and use the vacuum to speed things up in order to get to their other patient in another room or hospital. Others have extremely high cesarean and induction rates, leaving women feeling like their bodies failed them. And others coerce their patients with fear, or use other manipulative tactics.
Sorry to be the bearer of bad news, but yes, there are bad OBGYN’s out there.
Health Insurance, Hospital Privileges, and High Risk Pregnancies
Before we move forward, I think it’s important to recognize that some parents have less options because of health insurance constraints, needing to choose a doctor with privileges at a particular hospital, or because of a high risk pregnancy.
For example, a couple in a recent childbirth class expressed their concerns regarding red flags they’ve experienced with their OBGYN. Over time they felt that something wasn’t right. Her fears were solidified when she learned of other women’s similar experiences.
When asked about switching she told me that because of some policy with her insurance company, she was not allowed to switch care providers in the third trimester. Instead of switching and having her delivery potentially not covered by insurance, they instead prepared to give birth ready for battle. Unfortunately, insurance companies have a lot of influence over what care provider a woman chooses.
Some women may be employees of a hospital and in order for the delivery to be free or low cost, she would need to deliver there and choose a care provider that has hospital privileges where she works. Others would love to choose a homebirth, but because of insurance they would have to pay more out of pocket to make it happen. Cost is a huge driving force in birthing choices.
High Risk Pregnancies
Women with high risk pregnancies may have even less options depending on the specifics of the health of mom and baby. There may only be one or two options in some circumstances.
If you find yourself in one of these special circumstances, please don’t give up and stop advocating for yourself and your baby. Reach out for help. You and your baby deserve to have respectful, evidence based, and safe care.
How to Get the Dirty Details on Your OBGYN
So how do parents get the dirty details on their care providers? I have a few ideas.
Facebook Groups – A Great Resource or Pandora’s Box?
This may seem silly, but I think a good place to learn a lot of information in a short period of time are in local, mom centered Facebook groups. Here are some things you need to know before taking the plunge.
- Ask the group “Who did you choose as your OBGYN and why? Did that end up being a good choice? Why or why not?”
- When someone responds, if necessary, ask her to elaborate on what specifically she liked about her care provider. What she may value in a care provider may be vastly different than what you value in yours.
- Some women are fiercely defensive over their birth choices. Don’t get derailed by the emotional responses that may come up. Stick to the facts.
A Facebook group is a good starting point to learn more about the dirty details on your OBGYN. You will learn about who the popular doctors are and why, who favors inductions and cesareans, and who’s been around for years and years.
NOTE: Employees of local care providers may be in these Facebook groups. Juuuuust a heads up.
Ask a Doula “off the Record”
If you want to get the dirty details on your OBGYN, ask a local doula. Doulas attend births at all local hospitals, birth centers, and homes. Wherever babies are born, they’re there too, which means doulas know a lot!
Some doulas are hesitant to spill the beans (myself included) because they want to maintain good working relationships with those they will be working with in the days to come. Gossip can wreak havoc on reputations and businesses. However, some may share personal experiences 1) in person and 2) when asked “off the record”.
Again, ask each doula specifically what she likes or dislikes about a particular care provider. Just because she’s a doula doesn’t mean that what’s important to her in a care provider is what is important to you.
Dig Up Cesarean Rates
Another way to get the dirty details on your OBGYN is to inquire about cesarean rates at a specific practice or hospital. Cesarean rates give a quick snapshot of how care providers operate. High cesarean rates may indicate things like excessive inductions or an anti-vbac policy, which are not mother or baby friendly.
Here are some ways to access this information:
- As far as I know, there’s no way to easily access cesarean rates by individual care provider. Leave a comment and tell me what you know!
- Some practices may give out this information via a phone call. Some may not. When calling around, observe what practices say and don’t say.
- Ask your OBGYN in person at an appointment or interview. Again, notice how he or she responds.
- Hospitals keep these stats on their doctors. Risk management may be the place to go.
- Cesareanrates.org is a good starting place for information in your state.
- For Florida (which as of 2017 has the highest cesarean rates in all 50 states) I used information from AHCA to find out that over the last 20 years my community’s cesarean rate has increased from 20% to 35%. Do a quick google search to to access your state’s statistics.
NOTE: Healthy People’s target cesarean rate for 2020 is 23.9%. My community’s cesarean rates are moving in the wrong direction. Sad.
Listen to Your Gut
So far we’ve asked other moms and doulas what they think, but now it’s time for you to pay attention to what you think. This is where we grow our discernment muscles.
In another post I’ve outlined 15 signs that it’s time to fire your OB. Take a minute and read that article. If you experience 2-3 of those signs, never mind a solid majority, it’s probably time to fire your OB or midwife and find a better suited care provider.
No matter what type of birth is planned (hospital birth, water birth, cesarean birth, etc.) it’s crucial to have a solid birth team. Every woman, partner, and baby deserves high quality, competent, and compassionate care. We are worth it!
To wrap it all up, the following are some takeaways to help you find the best possible care provider for you and your family.
- Ask for OBGYN recommendations in mother centered Facebook Groups. Ask for specific examples about why they recommend someone. Don’t get sucked into the drama. Stick to the facts.
- Ask doulas for OBGYN recommendations. Meet in person and talk to them “off the record”.
- Observe an OBGYN during an appointment. Read the article 15 Signs it’s Time to Fire Your OB and take notes of what you observe at each appointment. If necessary, talk it out with a few safe people to figure out any next steps.
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