Pregnancy: First Things First; Get Thee to a Doctor

Choosing a doctor is probably one of the most critical factors of your pregnancy, but for many women, it's not an area that they want to address. It just feels too hard trying to figure out where to find a doctor and which one matches you. If you already have an OB/GYN, you're the lucky one. If not, just how do you choose the doctor who is right for you?

More: Interviewing Your Doctor

Finding a Doctor

There are many ways to find a doctor, but probably the best way is through word-of-mouth. Talk to your friends who have had babies and get recommendations from them. Did they like their doctor, was he or she easy or difficult to talk to, what are his/her credentials?

Just remember that the same doctor who suits your friend may not be a match for you.

Next question: Do you want an OB/GYN (obstetrics/gynecology) or a family practitioner? Both are physicians, but their areas of interest are vastly different.

Family practitioners are primary care physicians, which means they take care of a wide range of medical problems or conditions. Their patients run the gamut of all ages; from babies through geriatrics.

Family practitioners have a breadth of knowledge on most disciplines of medicine, and many of them will manage and deliver generally uncomplicated pregnancies. However, a family practitioner is also trained to know when to consult a specialist, such as an OB. If a pregnancy or labor gets to a point where there are complications, generally a family practitioner will consult an OB for advice, and the OB might assume the care of the patient.

The OB/GYN specializes in women's health and obstetric issues, both low- and high-risk cases. Typically, the OB/GYN will have a significant amount of experience in managing pregnancies and delivering babies, for obvious reasons–that's all the OB focuses on–pregnancy and women's health concerns.

Hospitals will give you lists of their doctors, but even better, go to the hospital of your choice and talk to nurses. Nurses always know who the best doctors are. You can check with a hospital to see if they will provide a doctor's credentials and ask if there is any litigation pending against that doctor, but hospitals are not necessarily required to divulge that information.

You can check with your state board of medical examiners to find out if the doctor you've selected has had many complaints filed against him/her. Doctors get on that list when a hospital is compelled to report them. If a hospital deems that a physician has committed an unwarranted act or poses a danger to patients, the hospital can and will suspend a physician's privileges until an investigation is completed. Hospitals don't want to be sued, therefore usually they won't hesitate to suspend a physician if they feel it is justified. However, suspension is a very serious offense, which could adversely affect a physician's career so hospitals will only proceed with this course of action if they deem it necessary.

Midwives

Some women may prefer someone other than a physician to care for them. Certified Nurse Midwives (CNMs) are an acceptable alternative to physicians. Rest assured that the majority of nurse midwives consult with OB/GYNs for any particular patient concerns they may have, but they act autonomously for most uncomplicated pregnancies.

Although some midwives will perform a "home delivery," the majority of them prefer to deliver babies in a hospital setting where there are obvious advantages. In addition, midwives may offer a different "flavor" of care; for example, alternative ways to address pain or manage labor. Plus, the high likelihood of having a female midwife (although there are a few men) appeals to many women.

There are two types of midwives: those who are certified nurse-midwives and those who are not nurses but are still certified. The key word is certified. Make sure your midwife is certified if that's the way you choose to go.

Here are two definitions of both certification types, taken from The American College of Nurse-Midwives.

• Certified Nurse Midwives are registered nurses who have graduated from a nurse-midwifery education program accredited by the American College of Nurse-Midwives (ACNM) Division of Accreditation (DOA) and have passed a national certification examination to receive the professional designation of certified nurse-midwife. Nurse-midwives have been practicing in the U.S. since the 1920s.
• Certified Midwives are individuals who have or receive a background in a health-related field other than nursing and graduate from a midwifery education program accredited by the ACNM DOA. Graduates of an ACNM accredited midwifery education program take the same national certification examination as CNMs but receive the professional designation of certified midwife.

More: Choosing the Right Hospital for Your Delivery

A Counseling Session with a Doctor

Here is a little known fact about doctors: They really wish that you would get in to see them and counsel with them before you get pregnant, rather than after. That way they can react to a medical problem you might have before the pregnancy, rather than afterward, when it might be too late. It's particularly important with women who might have medical considerations factoring into their pregnancy.

At this point, the doctor could tell you what your options for pregnancy are and whether or not you're a high-risk patient. Factors that might be important to discuss with your doctor ahead of time are:

• Current health and past medical history
• Age of mother
• Heart and/or lung problems
• Drinking or smoking
• Past pregnancy-related history

Wondering what your first appointment will be like? Check out Your First Prenatal Visit.