Finding the Right Fit
Samantha and Natalie emailed and both started their questions with, "I know this might be silly or trivial but..." Ladies, please, there are no silly or trivial questions except for the ones you don't ask. Pregnancy, obstetrics, labor, birth, insurance plans, hospital policies and doctors' preferences are all so varied and complicated that I'm surprised at how few questions most women ask. Compound this with all the differing opinions from books, magazines, friends, sisters, parents, in-laws, friends of friends, the lady in the grocery store, your hairdresser and everybody who thinks it's their place to tell you "how it is" and this whole baby business is one confusing mess. Though Samantha and Natalie's questions are simple enough, each has a variety of components that make the answers more complicated.
Samantha's having trouble finding a good doctor and hospital in her area. She's four months along and has seen a practitioner she dislikes with "horrible staff" four times. She's worried that's not often enough (it is) and that she's a little late in the game for starting a new doctor search (she's not). The hospital she's set to deliver at looked dirty when she visited. How does Samantha pick a new provider and hospital she's comfortable with? Simple enough and yet, not really.
I don't know anything about Samantha's insurance or lack thereof, why she didn't like the clinic or what "horrible staff" means. A "dirty" hospital might just be an old facility. Regardless of these details, the best way to find a new doctor/midwife is to ask around. Ask friends who have positive delivery stories. Call the physician reference line at the hospital and insurance company and get names. Contact the county medical board to make sure these practitioners and facilities are reputable and schedule a meet and greet to discuss birth goals and evaluate your comfort level with the staff and doctor/midwife. At only four months pregnant, you still have time to make a change. Do it soon though as good doctors/midwives book up quickly.
As for the hospital, check to make sure it's JCAHO accredited—that's Joint Commission on Accreditation of Healthcare Organizations (pronounced "jay-co"). They're a private accreditation team that checks out hospitals for quality and safety standards. If they're accredited, they're up to snuff. If not, find another hospital. Since this is Samantha's first baby, she doesn't really need to find one just in her neighborhood. She'll have enough time once labor starts to get to a hospital a reasonable distance away as long as she has transportation lined up. Samantha lives in Brooklyn. New York's a big place with lots of options.
What if Samantha doesn't have insurance? Her options are more limited and she may end up at a county or teaching hospital that takes uninsured patients. That in no way means she'll be getting substandard care. In fact, lots of hospitals have midwife practices take care of their uninsured patients and do a wonderful, compassionate, highly skilled job. Medical interns and residents staff many teaching/county hospitals and provide excellent services. These young docs sometimes provide a level of enthusiasm in their care that might be lacking in practitioners who've been delivering babies forever. They're new but they're qualified and well supervised by experienced doctors.
I wonder why the clinic staff was horrible. Samantha seems like a real sweetie-pie in her email but maybe something in her interactions with the staff put them off. Were you courteous and flexible or demanding and rude? Was the staff hassled and harried because they were overtired, overbooked and at wit's end or was this just their baseline attitude every time you saw them? Did they have a style or policies that went against your culture, plans and goals? We nurses and doctors are just people trying to do our job and sometimes we don't behave as well as we could, especially if our patients are difficult or we don't understand what they need from us. Remember the golden rule: Treat others as you want to be treated. We'll try to do the same.
Next week I'll answer Natalie's question about ice chips and eating while in labor. It's not trivial. It's important. It just doesn't have a straightforward answer. Keep those questions coming, Ladies and Samantha, good luck finding the right fit.
Got a question for Jeanne? E-mail it to firstname.lastname@example.org and it may be answered in a future blog post.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.