New pregnancy, New OB, What do I ask?

[Noahsmom]

Hi, I am pregnant and will have my first OB appointment tomorrow. This is a new OB and I am not sure how to approach my meeting with her. I haven’t decided whether to go the C-Section route although I probably will. I can’t imagine that the recovery would be worse than my first traumatic birth.

But if I do go vaginal, how do I know these doctors are properly trained? The practice comes really highly recommended from moms, nurses, and docs. But still, is there any way to know if they have had judgments against them for injuring babies?

I’m thinking I will discuss my concerns about a vaginal birth and talk about the possibilities for doing a planned C-Section.

How did you approach your first meeting with a new OB?

One thing I am wondering too… When these posts come up on the board about vaginal vs. C-section, sometimes I see a study cited that moms with BPI babies have an 82% chance of another BPI baby with vaginal delivery. Does anyone have the citation or a link to the article? If it’s true, then how does that square with another often repeat statement that BPI injuries are nearly 100% preventable?

Thanks so much for the information and help.
Maggie

[dmom]

Hi, Maggie:

It is traumatic going through the next pregnancy after a BPI, isn't it? I totally understand what you're going through.

My 2nd child, Danny, was 12 pounds and has the BPI. As a result, I made sure to have a planned C-section with my third, and she was fine. Every doctor I consulted said to have a C-section the third time around and not risk another injury. That had a lot to do with the fact that my first two were macrosomic, but the TCH doctors also told me about the higher risk of a BPI with a subsequent baby (sorry - I don't have that article on hand! Maybe someone else does, or you could look on TCH's website for it).

I would make really sure that your new OB is a high-risk specialist, especially if macrosomia is an issue for you. When I found my new OB, I sat down with him in his office for a consultation and explained everything that happened with Danny's birth and that pregnancy so he would be fully aware of all my issues and fears. I outlined my great concerns about making sure my third child would be safe, and he recommended a C-section at 38 weeks.

I made sure my first visit with him was a separate consultation - and not a doctor's appointment with me in an exam room - so I could deal just with the BPI issue.

As far as knowing a doctor's past, you can check with your state's board of medical examiners to see if she had any judgments against her. But it is quite hard to find out much information unless the doctor lost a case before. You could always ask her, I guess! "Hey, doc, who was the last baby you injured and when?" But that might not be the best move strategically, would it?

I think that the best advice I could give you is to be totally upfront about everything before you entrust any doctor with this child. Check her out, ask her everything you want to know, be prepared and be honest. And if you have any red flags at all, LEAVE and find another doctor.

Good luck to you!
Janet

[Ginne]

Personally, I'd ask if they had ever had a difficult delivery that resulted in a BPI. If they haven't, question them on what they would do if presented with...and give senarios.

The Doctor would have to realize it is not a criticism of his/her skill, just a justifiable fear that needs answers. Besides, part of the questions they should be asking you is about your previous pregnancy and delivery.

Good Luck,

Ginne

[Tanya in NY]

Good for you in going to this appointment informed!

I would ask what the doctor's experience is with shoulder dystocia? How many have they experienced? What manuevers did they use to get through it? What was the outcome? Have they ever delivered a child with BPI? What about monitoring because if you have to be monitored frequently while in labor, that puts you in a more restrictive situation for alternative birthing positions. How about alternative birthing positions? Would this OB allow you to squat, deliver on your hands/knees, or side lying? That's a start.

Good luck.

Tanya in NY

[m&mmom]

I would make sure they follow the Carpenter-Coustan conversion to diagnose gestational diabetes and I would not give birth lying on my back.

Cindy

[Noahsmom]

Hi,
Thanks for the advice. I wasn’t sure what some of the terms were, so I googled them. I gather that Carpenter-Coustan conversion is a more accurate test for gestational diabetes? I will ask about that; I was never diagnosed with gestational diabetes with my first. He was a little bit big, (8lb, 1oz), but I don’t think that’s too far from average.

Thanks again.
Maggie