How to choose an obstetrician

THE relationship between an obstetrician and his/h er patient should be one built on trust. Currently there are more than 150 registered obstetricians and gynaecologists in Jamaica, the majority of whom are well trained and have good obstetric outcomes. With so many options, how does a pregnant woman choose the right obstetrician for her? What characteristics does she look for before making such an important decision? Today I will give you some tips to guide you in this regard.

1. Stick with your gynaecologist

Most gynaecologists also practise obstetrics. If you are comfortable with your regular gynaecologist and he/she also has an obstetric practice, the most logical decision would be to remain under the care of this doctor throughout the pregnancy.

2. Get recommendations

Discuss with friends or relatives who may have delivered recently with particular doctors. Discuss their experience with that doctor – their bedside manner, philosophy on delivery, knowledge base, confidence, personal interaction, experience, and any other characteristic that may be important to you. Does the obstetrician in question have any public forums such as a website or social media? What are the comments or feedback by patients on his/her page?

It is also important to do background checks. Is this obstetrician registered with the Medical Council of Jamaica? Have they been disbarred? Have they ever had any obstetric lawsuits? If so, for what reason?

Obstetrics has the highest litigation for any medical speciality. International studies report that most obstetricians will have at least one lawsuit in their career. If your obstetrician has had more than two lawsuits, there may be a problem with his/her obstetric management and he/she may not be the doctor for you.

3. Research hospitals

Identify which hospital you want to deliver at. Does your obstetrician in question have delivery privileges at this hospital? Is your pregnancy high risk? If so, is there a neonatal intensive care unit available at the hospital or in close proximity? Is the paediatrician working with your doctor experienced and accessible?

Make sure that your insurance is valid and that the hospital will accept your card. Remember, in Jamaica all insurance claims for private obstetric care are made after delivery, so you need to find out about the costs for antenatal visits, ultrasounds and delivery fees (including C-sections), as these have to be paid with cash.

Talk to the midwives. Midwives at hospitals will have worked with most private obstetricians and are familiar with their management and delivery style. Ask the midwives for recommendations.

4. Schedule consultations

In early pregnancy, you may have narrowed down your search to two or three doctors. Schedule appointments with each, see which one you feel most comfortable with. If you are feeling rushed, it can be indicative of how the entire pregnancy will be, and re-evaluation will be necessary. Have a list of questions ready. Are they accessible via phone or e-mail out of office hours? Who will be doing the delivery? In the event that they cannot do the delivery, who will be their replacement?

It is well known that some obstetricians prefer to deliver via C-section versus vaginal delivery, for many reasons. However, it must be noted that in some cases a C-section may be absolutely warranted for the best outcome for mother and baby. The World Health Organisation suggests a C-section rate of 15 per cent and lower to be normal. Find out from the doctor in question what their rate is. Remember that some doctors only practise high-risk obstetrics, and their C-section rate would be higher than a regular obstetrician. So this should be taken into consideration.

5. Follow your gut

Choose the doctor you feel most in sync with after the consultation. Gut feelings are usually right. Remember this is a lifelong choice, so ensure that you are fully comfortable with your decision.

Dr Daryl Daley is a cosmetic gynaecologist and consultant OBGYN at Gynae Associates, 23 Tangerine Place, Kingston 10, and shops 46-50, Portmore Town Centre. He can be reached at 929-5038/9, 939-2859, 799-0588 or drdaryldaley@gmail.com .