If all else fails, check Yellow Book online or the phone book, under “Physicians.” Look for the headings “Obstetrics and Gynecology,” “Maternal-Fetal Medicine,” or “Family Practice.”
If your health insurance company hands you a list of practitioners, try to check them out with friends, acquaintances, or another physician to find the one in the bunch that seems right for you. If that’s not possible, visit and meet with several of the candidates personally. In most cases, you should be able to find someone who is compatible. If not, finances permitting, you may want to see if you can switch plans.
Making Your Selection
Once you’ve secured a prospective practitioner’s name, call to make an appointment for a consult. Go prepared with questions that will enable you to sense if your philosophies are in sync and if your personalities mesh comfortably. Don’t expect that you’ll agree on everything—that doesn’t happen even in the most productive of partnerships. Be observant, too, and try to read between the lines at the interview (is the doctor or midwife a good listener? A patient explainer? Does he or she seem to take your emotional concerns as seriously as your physical ones?). Now’s the time to find out this candidate’s positions on issues that you feel strongly about: unmedicated childbirth versus pain relief as needed in childbirth, breastfeeding, induction of labor, use of fetal monitoring or routine IVs, cesarean deliveries, or anything else that’s important to you. Knowledge is power—and knowing how your practitioner practices will help ensure there won’t be unpleasant surprises later.
Almost as important as what the interview reveals about your potential practitioner is what you reveal about yourself. Speak up and let your true patient persona shine through. You’ll be able to judge from the practitioner’s response whether he or she will be comfortable with—and responsive to—you, the patient.
You will also want to know something about the hospital or birthing center the practitioner is affiliated with. Does it provide features that are important to you—for example, plenty of LDR or LDRP rooms, breastfeeding support, a tub to labor in, the latest fetal monitoring equipment, a neonatal intensive care unit? Is there flexibility about procedures that concern you (say, routine IVs)? Are siblings allowed in the birthing rooms? Is extended family allowed during a surgical delivery?
Before you make a final decision, think about whether your potential
practitioner inspires trust. Pregnancy is one of the most important journeys you’ll ever make; you’ll want a copilot in whom you have complete faith.
Pregnant and Uncovered
If you’re expecting and uninsured, you’re probably more concerned with figuring out how you’re going to be able to afford prenatal care than you are with who’s going to provide it. For tips that can help you get the care you and your baby need, see
page 56
.
Making the Most of the Patient-Practitioner Partnership
Choosing the right practitioner is only the first step. The next step is nurturing a good working partnership. Here’s how:
Tell the whole truth, and nothing but the truth. Give your practitioner an accurate and complete general, gynecological, and obstetrical medical history. Fess up about an eating disorder you’ve battled or eating habits that are otherwise unhealthy. Speak up about any drugs—prescription or over-the- counter (including herbal), legal or illegal, medicinal or recreational, including alcohol and tobacco—that you are currently taking or have taken recently, as well as about any past or present illnesses or surgeries. Remember, what you tell your doctor is confidential; no one else will know.
When a question or concern that doesn’t require an immediate call comes up between visits, write it down and take it to your next appointment. (It may help to keep your PDA handy or to keep pads in convenient places—the refrigerator door, your purse, your desk at work, your bedside table—so that you’ll always be within jotting distance of one.) That way you can be sure that you won’t forget to ask all your questions and report all your symptoms (you will if you don’t write them down; as you’ll soon discover, pregnant women are notoriously forgetful). Along with your list of questions, bring a pen and pad (or your PDA or the
What to Expect Pregnancy Journal and Organizer
) to each office visit so you can record your practitioner’s recommendations. If your practitioner doesn’t offer up all the information you’ll need (side effects of treatments, when to stop taking a medication if one’s prescribed, when to check back about a problem situation), ask for it before you leave so there’s no confusion once you get home. If possible, quickly review your notes with the practitioner to be sure you’ve written down just what the doctor (or midwife) ordered.
When in doubt, call. A symptom has you freaked? A medication or treatment seems to have triggered an adverse reaction? Don’t just sit there worrying. Pick up the phone and call your practitioner (or e-mail, if your practitioner prefers to answer nonemergency questions online). Though you won’t want to call or e-mail at every pelvic twinge, never hesitate to check in about questions that can’t be answered in a book such as this one, and that you feel can’t wait until the next visit. Don’t be afraid that your concerns will sound silly—if it has you worried, it’s not silly. Besides, doctors and midwives expect expectant moms to ask lots of questions, especially if they’re first timers. When you do pick up the phone or compose that e-mail, be prepared to be very specific about your symptoms. If you’re experiencing pain, be precise about its location, duration, quality (is it sharp, dull, crampy?), and severity. If possible, explain what makes it worse or better—changing positions, for example. If you have a vaginal dis charge, describe its color (bright red, dark red, brownish, pinkish, yellowish), when it started, and how heavy it is. Also report accompanying symptoms, such as fever, nausea, vomiting, chills, or diarrhea. (See When to Call Your Practitioner,
page 138
.)
Keep up to date. Read those parenting magazines and visit those pregnancy websites, by all means. But also realize that you can’t believe everything you read, especially since the media often report medical advances before they are proven safe and effective through controlled studies—or report worrisome pregnancy warnings based on preliminary data that’s yet to be backed up. When you read (or hear) about something new in obstetrics, ask your practitioner—usually your best information resource—for his or her take on it.
When you hear or read something that doesn’t correspond to what your practitioner has told you, don’t keep it to yourself. Ask for an opinion on what you’ve heard—not in a challenging way, just so you can get your facts straight.
If you suspect that your practitioner may be mistaken about something (for example, okaying intercourse when you have a history of incompetent cervix), speak up. You can’t assume that he or she, even with your chart in hand, will always remember every aspect of your medical and personal history. As a partner in your own health care, and one who knows your body like the back of your hand (and then some), you share the responsibility of making sure mistakes aren’t made.