From the very beginning, building a family comes with many options and decisions. Whether it’s when to start trying to get pregnant, how to announce the news or which baby name will guarantee your child’s future success and happiness, a decision that often gets overlooked is choosing an obstetric care provider.
Whether you’re considering a family practice provider, OB/GYN physician or nurse-midwife for your pregnancy, establishing care with someone before you conceive is a great idea. They can help you with routine wellness care and ongoing contraception needs, as well as preconception planning—including any concerns you might have about conceiving, such as fibroids, PCOS or endometriosis.
How do I choose an OBGYN?
At WHA, we are fortunate to be able to offer a range of prenatal care options in the Portland, Oregon area to help people in their journey toward parenthood, including OBGYN physicians and certified nurse-midwives. Here are a few things to think about regardless of which direction you’re considering in your choice of provider.
1. Provider’s credentials and experience
When selecting an obstetric care provider, the first thing to check is credentials and experience. Look for board certification; that could be family practice, obstetrics and gynecology or nurse-midwifery—all indicate the provider has training in obstetrics and has met rigorous standards in their field.
While specialty board certification is not necessary to deliver babies, all of the doctors at Women’s Healthcare Associates are board-certified in OB/GYN or, for those physicians who have recently finished their residency, will become board-certified within three years of joining our practice.
Similarly, all of WHA’s nurse midwives are certified through the American Midwifery Certification Board.
Experience is important, too; a provider with many years of practice has likely handled a wide range of situations and can offer seasoned expertise. In the case of a family practice provider, ask about how much pregnancy care the individual typically does—and what happens if complications arise during pregnancy that exceed their scope of care. This is particularly important if their practice does not include specialists.
2. Your medical and pregnancy history
Your family, genetic and pregnancy history are important because different obstetric care providers can specialize in different types of pregnancies. For instance, a strong family history of diabetes increases your risk of having gestational diabetes, which may put you at higher risk during your pregnancy.
If you have had a cesarean section during a prior pregnancy and you’re considering vaginal births after cesarean (VBAC), it will be important to work with a provider who has experience supporting that type of birth and can help you assess your chances of success.
Being aware of your history and risk factors will help guide you in choosing an obstetric provider that is appropriate for your needs. Certified nurse-midwives are experts in low-risk pregnancy and birth—but are also trained to recognize and manage certain types of complications, either alone or in partnership with an OBGYN physicians. OBGYNs also love caring for low-risk pregnancies, but are trained to look for and manage complications, including surgical (c-section) delivery, when necessary.
3. Reputation and reviews
A provider’s reputation can give you valuable insights into their practice. Ask for recommendations from family, friends or your primary care physician. Additionally, online reviews and ratings on healthcare websites can provide a broader perspective. Pay attention to recurring themes in patient feedback, whether positive or negative.
Many medical practices now publish patient ratings from their own patient survey programs, and this can often provide more representative and detailed feedback than other online sources. Look for details on how the survey program is administered and how results are displayed to verify authenticity.
3. Bedside manner and communication style
The relationship you have with your obstetric care provider is important. Look for someone who listens to your concerns, answers your questions thoroughly and explains your options clearly. If you’re able to establish routine care with an individual before you conceive, you’ll be able to get a good sense of what it will be like to work with them during and after pregnancy.
All the providers at WHA use a shared decision-making approach in partnership with patients. This means your values, preferences and needs are weighed alongside the best available medical evidence and your provider’s expertise to arrive at decisions that are best for you and your unique situation and goals.
4. Practice philosophy
Understanding a provider’s practice philosophy is essential to ensure their approach aligns with your preferences. Discuss their views on birth plans, pain management and medical interventions. Some providers may support low intervention, natural births, while others might advocate for more medicalized approaches. Choose a provider whose philosophy resonates with your values and preferences.
5. Hospital affiliation
The hospital or birthing center where your provider practices can significantly impact your experience. Research the hospital’s reputation, especially regarding its maternity services. Consider factors such as the availability of advanced medical facilities, neonatal intensive care units (NICUs) and support for high-risk pregnancies. A well-equipped hospital can provide peace of mind in case of emergencies.
WHA’s providers attend births at five Portland, Oregon hospitals–including both Providence and Legacy facilities.
6. Availability and accessibility
Practical considerations like office hours, appointment availability and wait times are important when choosing an obstetric care provider, as is their office location near home or work. Check how easy it is to schedule appointments and whether the office is reachable after hours for urgent questions or concerns.
Another important consideration is who will care for you when you go into labor. Does your provider share call responsibilities with other clinicians and what are their credentials? Are they part of your provider’s practice or part of the larger community? Will you have the chance to meet those people before you arrive at the hospital?
7. Insurance and billing
Another important consideration is how your health insurance provider covers pregnancy care under your specific plan. This includes the routine services of your provider, as well as labs, ultrasound, any non-routine care and your hospital stay.
Choosing a provider and hospital within your plan’s network can often result in lower out of pocket expenses for you, so you’ll want to verify that the provider you’re considering is contracted with your plan and the hospital that person attends births at is, as well. It’s also important to understand how they’ll bill for your care, when you are expected to pay your estimated portion of the total and whether they offer payment plans. Financial surprises are the last thing you want in the final stages of pregnancy or—worse—when you’ve just brought home your newborn.
8. Support team
The team surrounding your obstetric care provider is also important! From the front desk to the lab to financial coordinators who specialize in billing questions, having a comprehensive team working on your behalf can enhance the overall experience and minimize unnecessary stress along the way.
You’ll be able to get to know some of these people if you establish care before you become pregnant. Also research additional specialists available to support a healthy pregnancy, such as behavioral and mental health, genetic counseling and screening, OBGYN specialty care (if choosing a family practice physician or nurse-midwife) and high-risk obstetrics if complications arise. In-house laboratory and ultrasound services can also make for more ease throughout the process.
9. Personal comfort and preferences
Your personal comfort with the provider cannot be overlooked. Feeling comfortable and respected by your provider is essential for a positive pregnancy and birth experience. Trust your instincts and choose someone who makes you feel at ease.
Remember, the right provider will support you throughout your pregnancy, addressing your concerns and respecting your choices. Take the time to research and select a provider who makes you feel confident and cared for, setting the stage for a positive and memorable birth experience.