Jump to content

How to choose OB & hospital?


9 replies to this topic

#1 epl0822

Posted 14 January 2013 - 05:10 PM

My DH and I are having a minor disagreement on where to deliver our next  (hypothetical) baby. I went public last time and, due to various  reasons, I now want to go private. DH has been doing some research and  quickly discovered giving birth at a private hospital with private OB  has a much, much higher rate of intervention. He is worried for me about  having an unnecessary c-section. Neither of us have any medical  background so if an OB said "you should get a CS because there will be  XYZ risks to you/your baby...." then I can't imagine us feeling very  confident about disagreeing and going against medical advice.

We've  moved into a new area and the few friends who gave birth around here  have all gone public. I don't know who to ask to recommend a good OB who  strongly supports natural births. And if I ring up and ask, of course  they will say they support a natural birth.

So my questions...
(1) when you were contemplating private vs public, did the higher intervention statistics put you off going private?
(2) how do you choose a good OB? Are there any specific questions I need to ask?

#2 IsolaBella

Posted 14 January 2013 - 05:17 PM

I asked online for personal recommendations, experiences with particular OBs.

I also found a blog of someone who used my OB too.

I also did lots if reading about my PG and any potential complications. I knew my bubs was breech so from 30 wks started to research breech bubs. My bubs was one of the few who didn't turn. So when at 37wks my OB recommended cs for XYZ reasons, that concurred with what I had read.



#3 whale-woman

Posted 14 January 2013 - 05:26 PM

Part of the reason private obs have higher intervention rates is people who WANT more interventions know they can ask for them and get them. Other private obs are used by high risk people, or people with bad experiences in earlier deliveries not to mention older and wealthier women might be more likely to go privately, all factors which might increase the intervention rate. I wouldn't use public as I wanted a c/s which my private ob will provide. There is nothing inherently wrong with interventions, it's about what style of management you want. A private ob will give you different options than the public system and ultimately you can refuse intervention if you want.

ETA I was recommended my awesome ob by a friend I trust. Book in early if you go privately as the good ones book up fast. (as I suspect do the good birthing centres etc.)

The other thing to consider, since you say you have no medical background, is whether you should be so biased against interventions. Interventions can be lifesaving so it is possible (though a lot of EB will disagree with this) that a care provider chosen for a low intervention rate might be a bad choice. If you wanted to avoid íntervention at all costs fair enough, but I think good, competent care is much more important and a care provider that takes the time to understand your attitude to risk (as all delivery options have risks and benefits) and work with you to get the best outcome for you and your bub. A good private ob will take the time to do this.

Edited by whale-woman, 14 January 2013 - 06:00 PM.


#4 Futureself

Posted 14 January 2013 - 05:29 PM




QUOTE (epl0822 @ 14/01/2013, 05:10 PM) <{POST_SNAPBACK}>
(1) when you were contemplating private vs public, did the higher intervention statistics put you off going private?

No, because I understand the many factors that surround statistics and numbers written in isolation are essentially meaningless. For example: older woman are more likely to go private and older women have more complications therefore require more medical assistance to give birth safely. Another example is woman who need/want an 'elective' caesarean go private so they have the power to choose. Both these scenarios push a certain Private hospitals rates of intervention like epidural or caesarians way up but as you can see, don't necessarily apply to you.

QUOTE (epl0822 @ 14/01/2013, 05:10 PM) <{POST_SNAPBACK}>
(2) how do you choose a good OB? Are there any specific questions I need to ask?

How long do you 'allow' me to go overdue before talking intervention?
What is your experience with breech vaginal delivery?
What circumstances do you recommend induction?
How many caesareans did you perform, or average % last year? Is this due to you 'speciality' i.e If take on high risk mothers, are experienced with twins, etc

Ask on here for recommendations for OBs in a particular area. We can PM recs, just not post publicly.  original.gif

#5 Girlo

Posted 14 January 2013 - 05:35 PM

You might like to think about whether they are close to retirement if you want more than one more. I took a recommendation and was v v happy with my OB, but depending on when we start TTC for number 2, he may have retired!!

#6 epl0822

Posted 14 January 2013 - 08:35 PM

QUOTE (whale-woman @ 14/01/2013, 05:26 PM) <{POST_SNAPBACK}>
The other thing to consider, since you say you have no medical background, is whether you should be so biased against interventions. Interventions can be lifesaving so it is possible (though a lot of EB will disagree with this) that a care provider chosen for a low intervention rate might be a bad choice. If you wanted to avoid íntervention at all costs fair enough, but I think good, competent care is much more important and a care provider that takes the time to understand your attitude to risk (as all delivery options have risks and benefits) and work with you to get the best outcome for you and your bub. A good private ob will take the time to do this.

I'm not "biased" against interventions, I simply don't want to have one unnecessarily if an OB is overly cautious. I am not trying to avoid interventions at all costs, just want to minimise the chances of having them done unless necessary.

I am aware of the other statistical factors regarding the higher intervention rates in private hospitals.

#7 07gbam

Posted 15 January 2013 - 05:31 PM

Your question highlights one of the many problems and misconceptions ( no pun intended) surrounding modern obstetric care in the private sector.

We should not assume intervening in birth is a negative thing. Especially not because a nameless, faceless natural birth proponent has successfully planted the seeds of discontent and mistrust among inexperienced mothers-to-be. Nor at the very least because intervention is what has brought maternal and infant mortality to an all time low in the first world.
Intervention is not without risks but despite what some will try to convince you, is not done to make anyone's life easier other than that of you and your precious baby.They will come up with all sorts of seemingly convincing arguments, mostly emotive and based on ideology. Few have ever taken full responsibility for a labouring mother and those who have  will almost always have someone else to hand over to and go on to blame when things don't go as planned.
Obstetric intervention is a victim of it's own success, and like most things, becomes taken for granted and misrepresented in some sectors, turning it into a battle between women's perceived control over their bodies, and that of a male dominated profession hell bent on depriving you of what nature drove you to do. Ask your Ob what he/she did when their child was due, and if they will share their personal story with you , you will quickly see that no doctor takes unnecessary risks with their own child let alone that belonging to another family. There is no such thing as 'unnecessary caution' in medicine, and especially not in obstetric practice when anything unnecessary and in fact that IS necessary comes with a risk. Ask yourself whether the risks of letting nature taking it's course are more acceptable to you than the risks inherent in modern obstetrics with it's aim to anticipate risk and intervene when the risks outweigh letting nature do it's own thing. When the time comes to welcome your baby into the world you invited him/her into, you may feel driven to take whatever advice is given to you as mothers are inclined to do. There is no such thing as excessive caution when it comes to your precious baby. I felt I actually wanted my Ob to be 'overly cautious' about my baby.
The natural birth proponents are all about informing women that doctors 'unnecessarily intervene' without perhaps understanding that absolute risk is often impossible to assess , and that doctors act to avert disaster based on what they know is most likely to happen in a situation and not on what is certain not to happen. The birth process is unpredictable, there is no such thing as a low risk woman, and unless we come to understand that, birth in the first world will continue to be a battle ground between women who want 'control' over what is essentially a complicated and risky process, and those who wish to have someone 'look after' them during the birth.


#8 IsolaBella

Posted 15 January 2013 - 06:08 PM

As PP said modern obstetric intervention is why my first child and I are still alive (and also why I am still here with my third), it is why my SIL and her children are here, it is also why my sister and her baby are here (emergency premmie cs due to HELLP eclampsia).

We are very happy with that. My SIL wanted a water birth, that was not to be.



#9 SeaPrincess

Posted 15 January 2013 - 06:15 PM

(1) when you were contemplating private vs public, did the higher intervention statistics put you off going private? No. I went private primarily for continuity of care and secondarily for my choice of hospital.  I was lucky in that both of the private hospitals that I delivered in are well-supported by a team of midwives and both of my OBs were very much in favour of natural birth if possible.  The OB who delivered my first and 3rd babies normally works out of a low-risk hospital, but is also able to deliver at the main public hospital where high-risk pregnancies are referred, so I would have had that as well.  I never asked, but I suspect that was also the case with my other OB, since the 2 hospitals were neighbours.

(2) how do you choose a good OB? Are there any specific questions I need to ask? One of my OBs was recommended by a friend - she was a bit ahead of me and having twins.  He was happy to deliver twins naturally and is also pro-VBAC.  My first baby was induced for medical reasons, but he still arrived at 3.30am, so it certainly wasn't for convenience (although when I was induced for #3, he didn't make that mistake again!) My other OB was in another state, where at the time, the choice of private specialist was extremely limited.


#10 premmie_29weeks

Posted 16 January 2013 - 12:38 PM

07gbam that's the best post I've read on eb on this topic bravo!

I'm in Sydney's eastern suburbs and gave birth twice with an ob at prince of Wales private. Pm if that's anywhere near you and ill give you my obs details. He was wonderful, and I was lucky that neither birth presented any challenges. One was vb with epi and one all natural unexpectedly.



Reply to this topic



  


1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

WIN an exclusive performance from Sam Moran!

To celebrate the release of children?s musical series Play Along with Sam, out now on DVD, we?re giving one lucky parent the chance to have Sam perform at their child?s pre-school or day care!

Toddler freed after getting trapped in escalator

A shopping centre escalator needed to be pulled apart to free a toddler's trapped hand.

Why I'm kind of excited about my daughter's nits

Is it weird to say that I am secretly thrilled to find that my daughter Edie has nits?

Baby born at 10:11 on 12-13-14

Well, it's actually 13-12-14 to us over here. But still, Clare Elizabeth Keane's consecutive numerical birth time is pretty special.

On holding tightly and loving fiercely

We can't live in fear. This post is about Christmas and how at this time we should be celebrating life and grateful for what we have: our loved ones who we cherish fiercely.

Babies, relatives and coping with Christmas day

Everyone will love your baby but your baby may not be so happy to be passed around a lot of new people - nor may you want to feed with an audience.

Why I won't be posting pictures of my baby on Facebook

There are pros and cons to this policy.

The myths and truths of gender swaying

Here are a few popular methods hopeful parents-to-be use to try to get a baby of their preferred gender – and what an expert says about whether they really work.

10 easy DIY Christmas decoration ideas

It's officially time to get into the Christmas spirit. Why not branch out when you put up your tree this year and add a personal touch with a few DIY decorations? We've found the perfect easy-to-make ways to put more festive fever into your home.

The dangerous new trend of glucose challenge test refusal

A dangerous trend is seeing more mothers-to-be declining a relatively simple and painless test to check for gestational diabetes.

Office of Fair Trading reveals naughty toys ahead of Christmas

The Office of Fair Trading has pulled seven toys from shelves ahead of Christmas after they fail safety tests.

Video: Baby boy's trouble with twins

These twin girls will no doubt have fun fooling people in years to come, but nobody will be as confused as baby Landon.

Long-term reversible male contraceptive on its way

Men could soon have access to an injectable long-term contraceptive which works in a similar way to a vasectomy but promises to be easily reversed.

'I tried to kill my baby': one mum's story

After bathing and dressing her three-month-old son, Amanda had a rare moment alone with her baby.

Attack of the 'mummy brain'

I feel that almost every day, someone in my life - be they a friend, family member or complete stranger - feels the need to excuse my behaviour as I have other things on my mind.

Mum of baby who fell ill after drinking raw milk speaks out

A Melbourne mother has described how her son turned grey when he became seriously ill after drinking raw milk.

Australian divorce rate lowest since 1976

Modern newlyweds are now well into their 30s and marriage still offers something powerful a new book argues.

The aftermath of a traumatic birth experience

In Australia, 30 per cent of women find their birth experience traumatic, with 6 per cent going on to develop post traumatic stress disorder (PTSD).

Young mum burns 'from inside-out'

A young mum is in intensive care after she took a friend's antibiotic and wound up with an ailment that is burning her body 'from the inside-out'.

The disagreement that can break a relationship

If he doesn't change his mind, all I can hope is that I will. It would be a waste to spend the rest of my marriage mourning a baby that never was.

Download now: Essential Kids Activity Finder app

Got bored kids? Quickly find the best activities for kids wherever you are in Australia with the Essential Kids app.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

Co-sleeping or no-sleeping? Mum videos worst nap ever

One mother's futile attempt to sleep in caught on camera in a hilarious - and very cute - video.

Why children misbehave during the festive season

While we all like to imagine the holiday season as being a fun, loving and bonding experience; often our reality is quiet different.

I was fat-shamed by my doctor

The fear of being weighed is the most significant factor in women cancelling medical appointments - and now weight-shaming has happened to me.

End of an era: no more childcare

As we reach the end of 2014, we're closing the book on many things for another year, most notably childcare. Our last child has attended childcare for the very last time.

WIN an exclusive performance from Sam Moran!

To celebrate the release of children?s musical series Play Along with Sam, out now on DVD, we?re giving one lucky parent the chance to have Sam perform at their child?s pre-school or day care!

The 7-year itch is more like the 10-year itch: study

Contrary to popular belief, making it past the seven-year mark doesn't mean your marriage will be smooth sailing from there on.

Should children be forced to sit on Santa's lap?

We teach kids it’s okay to say no if they don’t feel safe, so why do some parents force their children to climb in to Santa's lap?

Stop telling us that parenting gets harder

I’m sure that parenting will get harder. But life isn’t exactly smooth sailing for many of us right now, either.

Baby born weighing almost 14 pounds

Yes, the bouncing baby girl was born by caesarean section. And mum says no more kids.

The dummy debate

I'm the first to admit that when I used to see tiny babies with dummies in their mouths, I thought "Hmm, lazy parenting." And now I apologise.

'I thought I was an only child'

Imagine meeting your double at a school sports event, or regularly being mistaken for someone you haven't met. Separated twins Margaret and Joy tell their story.

Carers admit to force-feeding children

As Sydney grieves the loss of Sydney siege victims Katrina Dawson and Tori Johnson, reports have suggested that both died as heroes.

 

How many weeks til Christmas?

On your To-Do list

Get the "Santa" shopping done without the kids in tow.

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.