Tuesday, July 30, 2013

Initial Impressions of My New Care Provider

I had been seeing a nurse-midwife at Kaiser for my prenatal care until last month, when we moved from southern California to the Bay Area. I had to find a new provider and hospital to go with my new location and insurance. Switching care providers mid-pregnancy, especially when you've been happy with your care and been with the same provider for two previous pregnancies, is difficult. I didn't know anyone in my new location whom I could ask for a recommendation. To some extent, I felt like I was basically (figuratively) letting the phone book fall open and calling whoever was on the page it landed on.

While I think I might have preferred to stick with the nurse-midwife route, I did take the step of asking on a parenting group I frequent if anyone was from the area and could help me choose someone and someplace. One of the hospitals here was highly recommended, and a perusal of the hospital's website made it look quite inviting. I looked at the hospital's list of OB providers and chose a group of nine OB's located just across the street from the hospital. Their office staff was friendly and helpful and sounded on the ball and competent. They explained that they assign each provider a certain number of patients who are due within the same month, and you stick with that provider throughout your prenatal care, and there's a very good chance she will be the one to deliver your baby. I liked the sound of that, as my previous experience with group practices was that you needed to meet everyone in the practice because they rotated call duty. She gave me the option of three of the doctors and I said I really didn't know any of them or have a way to choose, so she suggested one and made me an appointment.

I had that appointment a few weeks ago. The office was easy to find, right next to the hospital. A few things I was immediately on alert for. First of all, how busy was the office? It looked busy but not crowded. I saw no formula advertisements or paraphernalia (but no breastfeeding posters, either). They didn't seem to be running behind (I had a 10:15 appointment and was seen on time), and no one seemed to wait long in the waiting room before being called back. The billing office was very helpful in confirming my insurance and payment responsibilities.

The medical assistant who took me back was competent in taking my weight and blood pressure. The office used a regular doctor's scale and a hand-pumped and manually read blood pressure cuff. Kaiser always had fancy new digital equipment, and there was something charming and hands-on about doing it the "old fashioned" way. The MA wasn't sure if I'd need a gynecological exam, since I was farther along in my pregnancy and transferring care, but she had me undress from the waist down just in case. The stirrups on the table were covered with oven mitts, which I found very funny. I appreciated that they were covered - it showed respect for the patient's comfort - and I appreciated that they were not branded. (I've seen formula-company branded stirrups in other OB offices!)

The doctor herself came in promptly and was a sweet and personable woman. She checked the baby's heart beat and did a quick external ultrasound to take a measurement of his head, for her own records, since I had not yet obtained my records from Kaiser. She measured my fundal height and said I was measuring right on track. There was no mention of my weight gain (about 17 pounds so far), so I figured there was no concern there. She said she definitely wanted to hear about my history, but that we could do that in her office where we'd be comfortable (and I'd be dressed!), rather than sitting in the exam room. I really appreciated that!

I met her in her office, where she listened to my three previous birth stories and my concerns. She said I was obviously a good candidate for VBAC (this being my fourth baby and potentially third VBAC), and that her office and the hospital, and the nurses at the hospital, were very supportive of natural birth. She said she was on call mostly during the weekdays because she has two kids at home (in fact, she had just returned from maternity leave after having her second), and that there was probably a 75% chance that I'd get her as my delivery doctor. If she wasn't available, then one of the other doctors from the practice would be on call, and she of course trusted them fully to take good care of her patients.

Overall, I feel good about this doctor. I'll see what happens in the weeks to come (my next appointment is in about two weeks). She seems like she'll listen to me and respects that, hey, this is my fourth; I may know a little something about this process. She seemed to be willing to listen to my assertion that Pitocin and I don't get along, and that I really don't need it anyway! She was pleased and a bit surprised to hear that though I had blood pressure issues with my first two, I did not with my third.

Of course, I'll have a much fuller report once I actually deliver this baby! (Three months to go...)

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