Finding a Doctor and Choosing Between a Hospital and a Birthing Center

With this being our first pregnancy, Matt and I didn’t know what the “process” was like for selecting a doctor and specifically, we didn’t realize that if you didn’t have a doctor, there would be a countdown to find one as soon as possible. For the most part, my husband and I practice a holistic and organic lifestyle – so why would our birth plan be any different?

That was our priority; finding someone that was well-versed in living a natural, holistic, and organic lifestyle and would extend that belief towards pregnancy and birth.

As mentioned previously, the only doctor we saw up to this point was the fertility specialist. While they confirmed the pregnancy and helped with blood tests, the next steps were to find an OBGYN to deliver the baby and a medical practice for all the pre-natal appointments.

My husband and I can’t just pick a name out of a hat with just about every decision we make. We’re very thorough, and since this was for our first-born, we didn’t want to choose just any OB doctor. We wanted to pick someone that we connected with and that understood and respected our personal beliefs towards medical care. The easiest place to start was asking my general doctor for a list and our family and friends that we felt like had a similar lifestyle. We tried searching the internet, but as you can imagine there was a lot of information for us to filter through.

Which Doctor Was Right for Us?

A lot of my friends were surprised to hear that I didn’t already have an OB that I liked, but I never had the specific need to have an OB before getting pregnant – I always got what I needed done by my general doctor. Additionally, the more information my husband and I read, the more we were open to having a midwife deliver our baby.

Questions, Questions, Questions

Below are our initial questions that we used to help pick the right delivery partner for us; however, it’s such a personal decision that every couple will have to make for themselves. I am by no means saying this is how you should pick your doctor but it worked for us.

• Do we have to have ultrasounds?
• What is your opinion about ultrasounds?
• What is the energy output of the ultrasound machine you use? Can you set it to the lowest?
• What is your definition of a natural delivery?
• What is your cesarean rate? Natural delivery rate?
• At what point and in what circumstances do you recommend different medical interventions?
• Do you delay cord clamping?
• Where can you deliver a baby?

Honestly, we weren’t sure what all to ask, but we did know that answers to the above questions were important to us. Additionally, meeting with the potential doctors and touring the practice gave us a better idea of what kind of birth we ultimately wanted.

We took our time reviewing all potential doctors. Something to keep in mind during your search is that doctors aren’t willing to meet with you or answer your questions “for free.” In our experience, every single one charged a “consultation” appointment that wasn’t covered by our insurance. Fees ranged anywhere from $50 – $75 for a 15-minute meeting. Let’s just say, Matt and I weren’t willing to pay that consultation fee to meet every doctor, so we did what we could by asking whoever was working the front desk. Fortunately, they were open to doing that, and just about every practice called us back with answers.

Hospital or Birthing Center?

When we found out that we were pregnant, the thought of having our baby at a birthing center didn’t even cross our minds. We just assumed that we would deliver at a hospital because everyone we knew that had kids did just that. Additionally, the idea of having access to a NICU center and other forms of medical interventions in case of an emergency also eased our minds. However, after reading multiple books, (click here for my list of recommended books – coming soon!) and touring both types of facilities, we determined that delivering at a birthing center was the right choice for us and would ultimately give us the delivery we wanted.

We didn’t realize how time sensitive choosing a doctor was or should be. I was around 15, almost 16 weeks pregnant and was surprised to find out that they would have to get “special” approval from the main doctor to set up an initial appointment. That is because they would like to meet with their patients at 8 weeks. (Apparently, I had missed 2 “crucial prenatal appointments”.) Fortunately, it worked out for us, and I was approved to be seen by their team of midwives.

Touring OBGYN North / Natural Beginning Birthing Center in Austin, TX

We toured OBGYN North / Natural Beginning first and had the opportunity to talk a nurse and ask our initial questions. They had just about everything we were looking for, plus there were a lot of couples there that had similar, if not the same, mindset as we did. Overall, the birthing center was very nice. There was a waiting room, albeit, the nurse did point out the delivery rooms ARE NOT soundproof, a small communal kitchen area, and 3 delivery rooms. Each room was equipped with a queen bed, a jet tub, and a bathroom with a large shower. It looked like a very nice hotel room. The nurse, Sydney, did an excellent job explaining what giving birth there was like:

• A duo team made up of a midwife and a nurse will deliver your baby
• During your prenatal appointments, you meet with all the midwives so no matter who is on call when you go into labor, you’ve met them all
• They support a natural delivery with barely any medical interventions (some are available dependent on your situation)
• What if you want an epidural? They can transfer you to the hospital conveniently located directly across the street and continue their care there (they have admitting rights at that hospital)
• No continuous monitoring – aka you’re able to move freely while in labor
• They encourage you to eat and drink while in labor (she said labor is like running a marathon, try running a marathon without food and water) – she even used the example “If you’re up for it, you can order a pizza while in labor” – My husband is convinced this is why I chose this place, it is not…the main reason
• You can deliver your baby in any way and anywhere you would like
• They support water births
• They do not separate the mom and baby
• Offer mom and baby an herbal bath post delivery
• Discharged within 4-6 hours after delivery
• A nurse will visit you at home within 24 hours to check on mom and baby

Touring St. David’s Hospital – North

Directly across the street from the birthing center is the St. David’s Hospital – which has both a Women’s Health Center and a NICU. The tour was also led by a nurse that gave us the breakdown of what to expect and gave us more specifics as we navigated to the different areas of the delivery and labor rooms.

We toured the delivery rooms but if you have a C-Section you would have your baby in an operating room – which we didn’t see due to sanitary reasons. The room itself seemed like a standard delivery room for a hospital – e.g., has a bathroom, delivery bed, small sitting area for visitors and partners. The nurse also explained the different medical equipment in the room, and the different positions mom can labor in (e.g., reclined, squat bar, etc.) She also gave us the opportunity to ask specific questions about the labor room – here were ours and their answers:

• Can you choose not to have the baby taken away from mom?
  • If having a vaginal delivery, they do encourage immediate skin to skin, but the baby will be eventually taken away to be cleaned and checked and will be in the nursery. Your partner or caretaker has the opportunity to accompany the baby while mom rests.
• Can you eat/drink while in labor?
  • No, in case you have to have an emergency C-Section, they don’t allow you to eat or drink.
• Are you able to freely move around assuming you don’t get an epidural?
  • Yes, while it is required you have to have an IV for fluids, they can make it where you are mobile. Additionally, if not necessary, they won’t continuously monitor mom and baby. (One less thing to hook mom up to)
• What are your options for where and what position you can deliver your baby?
  • Has to be in the hospital bed; can recline and have squat bar for support
• Do you offer perineum support?
  • Depends on the provider, most OBs do not – ask your doctor.
• C-Section Rate vs Natural deliveries?
  • Didn’t have the answer
• Avg. length of stay after delivery?
  • C-Section: At least 3 days
  • Vaginal Delivery: 2 days
• Can you refuse Vitamin K, erythromycin, and Hep B shot?
  • Yes, have to sign some paperwork.

After touring the delivery room, she took us through the rest of the labor and delivery wing – nurses’ station, family waiting rooms, nursery (where you see all the babies), and then a recovery room (after you had your baby.) Keep in mind that if you choose to deliver your baby at a hospital, you’ll have to sign some additional paperwork based on your specific hospital’s policies and standards. We were told that paperwork couldn’t be signed in advance. In other words, it would need to be filled out at the time you arrive – in labor, between contractions.

At the end of the tour, my husband and I felt strongly that the birthing center was the right choice for us. While this hospital was nice and definitely seemed relatively progressive, it still treated giving birth in more of a “we have to prevent problems” kind of thing as opposed to it being more of a naturally occurring event that has been taking place since the dawn of (wo)man. What was reassuring about the birth center was that because it’s across the street from the hospital, we could be transferred easily if we needed to; additionally, the providers at OBGYN North have admitting rights at that hospital.

Have questions about deciding where to deliver your baby or finding a doctor? Feel free to comment below! There’s no one right decision, do what’s best for you and your family.

Resources:

Birthing Room Photo: Photo Courtesy of Natural Beginning Birthing Center.

OBGYN North’s Website – http://www.obgynnorth.com/

St. David’s North Austin Hospital Website – https://stdavids.com/location/st-davids-north-austin-medical-center