Ep 150: 9 Tips For Choosing the Right OB Doctor

Ep 150: 9 Tips For Choosing the Right OB Doctor

Nicole: In this episode, you are going to learn nine tips to help you make sure you have the right doctor for you. Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OB G YN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now let's get to it.

Nicole: Hello. Hello. Welcome to another episode of the podcast. This is episode number 150. Thank you. Thank you for spending some of your time with me today. So in today's episode of the podcast, I am sharing nine super important tips to help you make sure that you have the right doctor for you to care for you during your pregnancy and your birth. And the emphasis here is really on you because it's going to be individualized to your unique needs. There is not a one size fits all approach when it comes to the doctor that you have for your prenatal care. One doctor who may be really great for one person and perfect may not be the right doctor for another. So all of these tips are geared towards helping you find a doctor who is going to best meet your needs. All right, now, before we get into those nine tips, let me do a quick listener shout out. This is from Claudia CS and the title of the review says I'm an NCR convert exclamation point. I have been listening to Dr. Rankin's podcast since I found out about my first pregnancy at six weeks. And since then I have become a full fledged avid convert to her episodes. Yes, yes, yes. I love it. As a fellow physician, I respect so much the time and energy that she takes to bring evidence to her episodes and to offer every viewpoint to a topic in an unbiased yet caring way in a time when no one is shy about offering their strong opinions about how you should approach your pregnancy. She gives you information to go into your own pregnancy, labor and parenthood armed with plenty of knowledge, the breadth of topics she covers and people she interviews are awesome. I used to eye roll at birth prep courses, but I'm so in love with Dr.

Nicole: Rankin's podcast, that I've enrolled in her birth prep course, and I'm excited to go through it with my husband. Yes, yes. Yes. Well, thank you. Thank you for that very, very kind review. I so, so appreciate it. It is interesting. The longer that I have been doing this work, the more healthcare professionals, including physicians reach out to me and say that they appreciate my approach and appreciate that I'm thinking in a way and presenting things in a way different than what they are taught and in a way that more aligns with what they want and believe is important for their, their care during their pregnancy and birth. Unfortunately, I also get a not, um, small number of stories of people who had bad experiences with their birth, um, as physicians and feel sort of conflicted about it, or, or have, um, are having a hard time dealing with it.

Nicole: So I say all that to say that I'm so glad to have you, and thank you for those kind words. And I'm also super excited that you are inside the Birth Preparation Course. And I would love to have everyone listening as a member of the Birth Preparation Course. The Birth Preparation Course is my signature online childbirth education class. It is the premier class to get you calm, confident, and empowered for a beautiful pregnancy and birth. You can check out all the details of the Birth Preparation Course at drnicolerankins.com/enroll and just real quick inside the Birth Preparation Course, I use my unique five step beautiful prep, beautiful birth prep process to get you ready for birth. And step one of the process is to set the tone for your birth before you learn anything about labor and birth, you really need to get your mindset, right.

Nicole: Your mindset is so important for your birth. You need to get your support lined up. Step two of the process is you learn all of the details of labor and birth. You'll understand what's happening in your body during labor and birth. You'll understand what happens in hospital birth. What is evidence based and what is not, uh, you'll understand how to, uh, push how to avoid vaginal tears, all to good, great stuff in step two of the process. Step three is where you prepare for the possibilities. Birth is an unpredictable process, and the way that you ride that unpredictability is to know the possible things that may come and know what questions to ask. If they do come step four is prepare for the postpartum period, cuz you need to start getting ready for postpartum while you are still pregnant. Uh, it doesn't have to be overwhelming, but there's definitely some great information there to help you get ready for those first six weeks.

Nicole: What to expect with healing in your body. Some tips for breastfeeding, what to expect with your baby, warning signs to look out for after birth. A lot of people don't realize that a full 60% of maternal mortality actually happens after birth. So you get those warning signs there and then step five of the process is to learn how to make a birth plan or birth wishes that work to actually help you have the birth that you want. So I am so passionate about the work that I do inside the Birth Preparation Course, all of my work period, and it goes along great with the podcast to have you super extra ready, prepared, and again, calm, calm, calm, confident, and empowered for your birth. You can check out all the details of the Birth Preparation Course again at drnicolerankins.com/enroll. Woo. All right. That was a mouthful.

Nicole: A good mouthful. Y'all come join me in the course. All right. So let's get into those tips for making sure you have the right doctor. Okay. So tip number one is that you do not have to stay with the same doctor who you've always been with. Okay. The same doctor who did your yearly exams may not be the best for your pregnancy. You may really love this person. You may have connected with this person. You may have been with this person for years, but the way that they approach those annual exams can be completely different than the way that they approach pregnancy. I'm not saying that that's likely, I'm just saying that you need to be aware of the possibility. I have seen this happen where people were like, oh, I love this person during my annual exams, but during pregnancy, they had a whole different take and philosophy towards pregnancy that wasn't really in line with what they were looking for.

Nicole: So that same person, again, may not work. Okay. So just be open to understand that that could potentially occur and it's not personal. You know, sometimes things are just a little bit different depending on the setting. Okay. So related to that is tip number two. You do not. I repeat, you do not have stay with a doctor once you have started with them for prenatal care. Sometimes it may take a few visits before you figure out that someone is not right for you. You know, you may not notice that on the first visit or even the second visit, it may not come up until you have a discussion about something in particular, or you've just realized over the course of the, the care that things weren't quite right for you. So it doesn't matter how long you've been with that person. It doesn't matter if you were with that person before your pregnancy.

Nicole: If they are not meeting your needs, you don't have to stay. As a matter of fact, you, you should not stay and you can change doctors up until the very end of pregnancy. Okay. And the extreme case, I had a couple of birth story episodes where people fired their doctor at the very like 41 weeks and someone else who fired her doctor during labor. I do not suggest you do that because that is very stressful. Um, and it definitely gets harder. The further along you get to change doctors. So you want to do it as soon as possible. If you realize that something is not a good fit and something that I have also realized recently that I didn't realize before, or that I saw, I learned this from a conversation inside of the Facebook group for the Birth Preparation Course. That's another thing you get with the Birth Preparation Course is an amazing community.

Nicole: And of course you have women in the group who are going through it with you as well. So inside the community, someone brought up that her doctor's office required that she pay her whole insurance deductible upfront, and then they like refund you any, um, extra after that or anything that's left over after the delivery. And I was like, what? I never heard of this before. So I took the question to a Facebook group that I'm in. And actually it's not uncommon that a doctor's office may charge you like, what's your insurance deductible in the beginning. And then they'll refund you. And the reason that they started started doing that is because a lot of times they weren't getting paid the insurance deductible after the baby was born. So this was kind of a way to ensure, you know, that they get paid for their services.

Nicole: So I totally get that. And a lot I'm, I'm, I'm getting to a point and a lot of practices do this and you have to make that payment of the deductible by 28 weeks. So I say all that to say that if you know that the doctor is not right, then you definitely want to make that change early. So you're not stuck having have paid all of this for the care. And then you have to go to another doctor and maybe pay again all of those kinds of things. So if the doctor's not working for you do not stay. Okay. All right. Tip number three is to ask for recommendation from friends, from online communities. Uh, but I want you to be intentional about the way that you ask, okay. It's not just, oh, who do you recommend for OB? Okay. I want you to be specific and intentional about the things you ask.

Nicole: Okay. So you want to ask from women, or you want to ask women who are similar to you if you can. Right. So for example, say you want an unmedicated birth. It's great. If you can talk to someone who also wanted an unmedicated birth, they may not necessarily have had an unmedicated birth, but you want to know how supported they felt in those desires of having an unmedicated birth. Another example say, you know, that you're someone who asks a lot of questions that you have lots of questions about things, and you wanna say, Hey, how is your doctor when you ask questions? Um, did you have, when you ask questions, did they respond in a way that you felt was useful for you? Okay. So if you know, you're somebody you're gonna have a lot of questions and ask, okay, how was your doctor when you asked questions?

Nicole: You want to find someone ideally, maybe who recently had a baby, like within the last couple of years, cuz they can give you some more, um, recent or current experience about working with that physician. And on a similar note, maybe somebody who recently had their first baby, because I think that, or I know that when you're having your first baby your needs during your prenatal care may be different. The second and third, you know, after the first time, the second and third times tended to be like more routine, you know what to expect. It's a little bit different. So definitely try to chat with someone who recently had their first baby. Okay. And then some other specific questions that are great to ask, how is the doctor's bedside manner to, did they listen? Did you feel respected? Um, how did they make you feel? And that's gonna vary, like some people want someone who you feel like a connection with.

Nicole: Some people are like, oh, they were all about business, but I knew that they would take care of me if, if they needed. So it's again, it's just about finding and understanding what you're getting into and finding something that works for you. Another question that, um, you should definitely ask that. I think a lot of people don't ask is how did the office run? For example, how long are wait times, if you cannot stand waiting and you need to get in and out of your appointments, then you want to ask that question. Um, there are some doctors, myself included when I was in the office. I was constantly behind. I didn't mean to be, but the way it was scheduled, I just, you know, I was always behind. So if you can't or don't want to wait then, you know, ask what were the wait times, ask about the quality of the staff.

Nicole: Sometimes the staff can make or break an office for sure, like, are people rude? Do you get your questions answered? That kind of thing. And everything is probably not going to be perfect. There's no perfect situation, but at least, you know what you're getting into, for example, it may be like, Hey, you know what? Yeah, I would have to wait 30 or 45 minutes for my appointment. But when my appointment came, I wasn't rushed and I could get all my questions answered and I felt good about the care I received. Okay. That was me. I'm gonna say when I was in practice, at least I hope that that's what I was trying to do anyway. So it may not be perfect, but you want to ask those more specific questions. So you have a better sense of what you're getting into and find someone who, aligns with what you need.

Nicole: All right. Number four is a general question to try and get a sense of how your doctor practices like their practice style. Okay. And this question's gonna sound a little bit off and you may get a responses that vary. And I'm gonna talk through that. And just, just a second, but the question that I want you to ask is, you know, do you have a particular way that you approach pregnancy and birth and you may get a response like, um, no, not, I mean, not really and nothing that I can think of and that that's okay. You may not get a, a ton of responses from that, but there are two responses that I think can give you a really great amount of useful information. So for example, if I was asked that question, although I'm not sure I would've known how to answer in the beginning of my career.

Nicole: This is something that I certainly developed over the time. And course of years of practice, I would say, you know what, pregnancy and birth are normal. They're natural. Most of the times things go fine. Um, sometimes problems do pop up even serious problems and I'm ready to deal with any problems that, that come up. But I start from a place knowing and believing that pregnancy are normal and natural and that's how, how we approach it. But I'm prepared if things pop up just in case. So in that sort of response, you can hear that I'm saying like it's normal, it's natural. Um, something else I might also say, as you know, I, I wanna center the needs of the person giving birth in, in the conversation and in the discussion and in the care, uh, if you hear some things like, um, oh my God, pregnancy is dangerous.

Nicole: Having a baby is very dangerous. Okay. If you hear things that are like fear based talk about how they approach pregnancy and birth. I, I, I'm not saying that that's a bad doctor per se, but that's not necessarily the energy that I would want around someone caring from me during my pregnancy and birth. I, I want someone who understands that it's a normal and natural process, but can deal with problem is when they come. Like that's, that's, that's what I would want. Uh, it may not bother you if, or maybe you also feel like pregnancy is a scary thing. I don't think it is, but I'm just saying all that to say, like, if you have someone who says, oh my God, it's scary. Oh my God, it's dangerous. Oh my God, it's, it's, it's difficult. Then you, you may wanna consider whether or not that person is right.

Nicole: And aligns with what you want for your pregnancy. Okay. And again, like I said, you may not get, you may just get a sort of, eh, I can't say that I have a particular way that I approach things and that's okay. But if you get those other responses, it can be helpful. All right. Number five, tip number five. If you have anything that you know that you want, talk about it early, but be mindful of how you discuss it. You want to have that discussion and ask the right type of questions in the right way. Okay. So what I mean by that is that when you ask questions about things, you wanna try your to start the question off with a what or how, and not a question that can be answered yes or no, because those, what and how questions are going to force the doctor to give you a more detailed response.

Nicole: Okay. You can't just get like a yes, no answer. So a good example of that is, for example, you want a VBAC, okay. So VBAC is vaginal birth after cesarean or maybe TOLAC trial of labor after cesarean, but you want a VBAC a vaginal birth after cesarean, you don't wanna ask, do you support VBAC cuz then they could just be like, oh yeah, sure. Yeah. I support VBAC or you don't wanna say, is it okay if I try for a VBAC oh yeah, sure, sure. Yeah. That's fine. If you wanna try for a VBAC that's fine, because you may miss some really important information. What you wanna start that conversation off with is, is how do you approach women who wanna VBAC, so when you say, how do you approach, then they're going to have to give some thoughts or give some answers on how they approach things.

Nicole: Things they may talk about are like, oh, sure, VBAC is fine, but I don't do it. If you have more than one cesarean or I don't support, um, labor induction with VBAC or I believe you have to be delivered by a certain amount of time, or they may say, oh, um, I'm fine with VBAC and I support it if you want to be induced, or it should be just be more of a conversation. And the question in the, um, topic of feedback, you really should have more questions as you ask and more specific things. So you know that the person is supportive. I'm not gonna get into those questions here, but this is just an example of how you can't just say yes or no questions. It really needs to be how and what questions when you can, because those are the ones that are going to give you more detailed responses.

Nicole: It's going to force your doctor to give you information. And it also doesn't, I don't, I don't want it to be like an adversarial sort of thing, like demanding or, um, you know, like I I'm having to VBAC. So, so what do you think about that? Or things like that, just you wanna just open it up as a conversation in a discussion so you can gather information and then use that to make the best decision again, for the care for you. All right. Tip number six. And this is, are there any non-negotiables and I got this after I recorded a birth story episode recently, and that birth story's gonna come out in a month or so might be longer than that, where she said her doctor had a non-negotiable of induction by 41 weeks. That was one of the things that she said in the beginning of care.

Nicole: Like, this is something that I is, I believe strongly about that, that we should induce folks by 41 weeks because of the risk of stillbirth. And your doctor, again, may not have any things that they consider non-negotiables, but I think it's not a bad idea to ask. So some things that maybe, or I've heard doctors say that are non-negotiables for them, induction is one by, by 41 weeks, but things like no induction with VBAC or you have to have an IV, or you must stay on the monitor during your labor. So just ask, is there anything that is like a, non-negotiable about care during pregnancy and birth? And again, this is just to see if it is in line with what you want and whether or not that supports the best care for you. And it's also an opportunity to ask, like, why, like, why is it that way, is there any wiggle room, those kinds of things. So ask, are there any non-negotiables

Nicole: Okay. Tip number seven. Understand how the practice works. All right. Not all doctors will explain this when you make it an appointment or when you get seen in the office. So you may have to ask, ideally, when you make an appointment, they should explain all of this to you in the first visit, but it doesn't always happen. So some things to understand about how the practice works. Number one, will I see you or will I see other doctors, it can be very different depending on the practice, some practices. And I should say like very few practices. These days are kind of solo doctors by themselves, where they're the only one that is not common. Most of the time your doctor is going to be part of a group practice with sometimes just a handful of doctors, maybe like three or four doctors. Sometimes it may be like 10 doctors or 15 doctors.

Nicole: It could be a lot. So you want to know, will you see the same doctor or will you see a variety of doctors during your prenatal care? And there's no right or wrong answer to this. Some practices like you to meet as many of the doctors as you can. So that during the course of labor, you will have met anybody who could potentially be there for the birth. Cuz most of the time when practices have groups, it's rotates who the doctor is on call. It's probably not gonna be necess necessarily your own doctor unless they happen to be on call. So they want you to rotate and meet everybody. Some choose the approach of you see the same person during your pregnancy and you form that bond and that relationship. So they can care for you during your pregnancy. With the understanding that for the birth you may have whoever happens to be there on call.

Nicole: You may have a hospital doctor like me. And again, there's no right or wrong answer. You just wanna know what you're getting into. And then another question or another issue or thing that you want to understand about how the practice works is what do I do when I have questions outside of my appointments, I cannot tell you how often I see folks pop up in the hospital who are confused about this, who don't understand that they can call their doctor's office after hours and get questions answered, or they may call their doctor's office after hours and not get a doctor. They may get connected to a nurse who kind of triages and decides what to do based on the responses. So you want to ask what happens when you have questions outside of your appointments? Can you send emails for instance, can you send messages through the electronic portal?

Nicole: When will you expect responses to those? Hopefully you don't have questions or things that pop up outside of appointments, but you want to know what to do just in case the worst is when you find yourself in a situation and it's like, oh snap, I got this question. I don't know what to do. I don't know who to call. I don't know how to reach anybody, any of that kind of thing, or, you know, you, you know that you can send the question through, through the portal, but you may not realize that it's not gonna get answered for 24 to 48 hours, okay. And another question that I want you to ask is what happens if I need an urgent appointment? How typically can I get an appointment? If I have an urgent issue, it is not uncommon necessarily that it can be a challenge, especially for a busy practice for you to get an urgent appointment.

Nicole: It may be that they're just gonna tell you, you just gotta go to the hospital to get seen. And I not saying that that's that's bad, but going to the hospital is gonna be a lot more and potentially more expensive. So ideally you would love to have a situation where they say you, Hey, if you have an urgent appointment, we can typically get you in that same day or the next day. So you just wanna have an idea in the back of your mind, how soon you can be seen, if there's an urgent appointment, hope if you need an urgent appointment, hopefully you never need an urgent appointment, but you just wanna be prepared just in case.

Nicole: All right, tip number eight. And this is one that a lot of people don't necessarily realize you are not just choosing a doctor. You are choosing a hospital too, okay. Doctors usually deliver at one or maybe two hospitals. So you are not just choosing that doctor. You are also choosing the hospital where they practice as well. So if you have any particular desires about where you want to give birth, then you definitely want to ask where they deliver. They should tell you this information, but they don't always tell you that. And I have seen unfortunately, instances where people didn't realize that the hospital where their doctor delivered was not covered by their insurance. So they themselves scrambling at the end of pregnancy in order to find a different doctor or in the worst case, they show up, um, in the hospital and, and need to have something done.

Nicole: And then in the registration process, they're like, oh, your insurance, isn't accepted here for this particular hospital. So you're not just choosing a doctor, you're choosing a hospital. So make sure that one, you are comfortable with the hospital and that your insurance, it works at the hospital too. And I have a podcast episode on how to be sure you have the right hospital. And we will link that in the show notes. I can't think of the number off the top of my head. Um, but again, we'll link that in the notes, um, of the episode. All right. And then the final tip on being sure you have the right doctor for you is to do a gut check. Okay. Pay attention to how the doctor is making you feel. Did she rush you when you were asking questions? Does she seem annoyed when you talk to her?

Nicole: Is she dismissive of anything that you say, did you just have a bad feeling in your gut? Your spidey senses are tingling then, eh, I don't know about this. Something doesn't feel right. If any of those are the case, then pay attention to it because maybe you need to find another doctor. We are given the ability to have those, those body, that body compass, those things that happen in our body that give us signals about what is happening in the world around us and how it is affecting and whether or not there's something there that we need to be concerned about. Like, don't ignore that intuition and those feelings we're given that gift of those things for a reason. All right. I said it earlier, but I have seen women stick with a doctor who they didn't feel comfortable with and then they really end up regretting it.

Nicole: So it's so important that you find a doctor for you. So do that gut check, pay attention to those, those little whispers, those voices, those feelings. And if something is telling you to look further, then do so you may find that, oh, you know what, that wasn't I was, was overly concerned for no reason. Or you may find that. Yeah. I, I need to find something different. I just don't want you to ignore that. Okay? Because remember you deserve to have a doctor who is there to support you during your pregnancy and birth. And I know that there's a lot of bad press and things out there, and unfortunately, bad doctors out there, but not everyone is like that. There are actually some great ones out there who are kind, who are caring, who are supportive, who will make you feel great during your pregnancy.

Nicole: You just may need to do a little bit in order to make sure you connect with someone. Okay? So that's it just to recap the nine tips to sure you have the right doctor for you. Tip number one, you ain't got to stay with the same doctor who you've always been with before your pregnancy. They may not be the right one for you. Tip two. You don't have to stay with a doctor once you have started with them. Please change if that person is not right for you. Number three, ask for recommendations from friends, from women who are similar to you and be intentional about the questions that you ask. Number four, ask your doctor, do they have a particular way that they approach pregnancy and birth? Knowing that sometimes they may not give specifics, but some of those extreme examples like, oh, it's fear based may raise some red flags for you.

Nicole: Oh, you may. Or you may get reassurance that they really support the things that you wanna do. Tip number five, if you have questions about things, anything that, you know, you want in particular, be mindful of how you ask those questions. Be sure that you ask how and what questions and not questions that can be answered simply yes or no. Number six, ask if your doctor has any non-negotiables. Number seven, understand how the practice works. Who are you gonna see? How do you get appointments? All of those good, great things. Number eight, understand that you are not just choosing a doctor, you are choosing a hospital too. And number nine, do a gut check about out how you feel. Now I have even more questions for you to ask inside my birth plan class, Make A Birth Plan The Right Way, making a birth plan is not just about a template or form or Googling it and just sort of, you know, filling out this piece of paper and bringing it to the hospital.

Nicole: It really is a process of making sure that the doctor and hospital actually support what is in your birth plan. And that's what I teach inside that class. You can check out that class and sign up for it. It's on demand. It's a great class under an hour at drnicolerankins.com/register. All right, so there you have a, it do me a favor, share this podcast with a friend if you like it, and also subscribe to the podcast wherever you're listening to me right now, and leave a review in Apple Podcast. I do shout outs from those reviews. And I just love to hear what you say about the show. And don't forget to check out the birth preparation course. It will get you calm, confident, and empowered to have a beautiful Dr. Nicole rinkin.com/enroll. So that's it for this episode do come on back next week and remember that you deserve a beautiful pregnancy and birth.