Week 15: OB Interview questions

In a few weeks I will be meeting with an obstetrician at the nearest hospital to me. It’s a city hospital with a NICU and is known for being highly interventionist, and one person who has experience at the hospital (though not in L&D) told me that the staff has a generally patronizing attitude of “We know best, now do everything we say.” There are two other hospitals with NICUs in the area, although one of them is more than an hour away, so I don’t have too much choice if I end up needing a hospital.

This hospital became my first choice when I discovered that one particular OB has a collaborative attitude toward home birth and midwives. He has publicly said that pregnant people will be safer in situations where the OB and midwife have a collaborative, rather than hostile, relationship, and I could not agree more. I’d love to have a guarantee that he would be my doctor if I should have to transfer in labor, but I know that’s not how hospitals work – he teaches in addition to his clinical practice and there are at least 15 other doctors in the faculty practice. So I’m trying to figure out how to get the most out of this meeting, and how I may use it to determine whether this could be a safe place for me.

I’ll probably only have 30 minutes, if not less – I will ask beforehand to make sure I know how long I have. I need to structure my questions as carefully as I would an interview with a busy person with whom I have virtually no follow-up potential, so as not to miss the most important questions. I do think that I will learn a lot from things other than the actual answers to the questions – the surroundings, the atmosphere, the doctor’s attitude, tone of voice, etc.

My intro:

I’m planning a home birth with a licensed midwife, and I am doing research on backup hospital options to figure out what my first choice would be. I’d like to explore how we can create a collaborative relationship, in case I need to transfer. (2 minutes)

Questions:

How are home birth transfers generally handled here? (5 minutes)

How does hospital staff practice informed consent and refusal? (5 minutes)

I have some very specific needs related to past trauma, meaning that staff would need to treat me differently from most other laboring women. What is the best way to communicate my needs? What is the chance they will be respected? (5-10 minutes)

Conclusion:

I want to work with you and foster goodwill. I am willing to have several visits with you and/or other doctors here, and I am willing to discuss tests or other prenatal care preferences you may have that would make you feel comfortable working with me. If you are willing to continue this relationship, let’s make a plan. (2 minutes)

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About investigatingbirth

My investigations of birth began in 2009 when I was trained as a doula. I helped women consider the evidence on common interventions, and helped them prepare for the physical and emotional challenge of giving birth. After some time it became clear to me that there was another type of challenge that I was unable to adequately prepare them for, the challenge of the maternity system. But it was only after my own traumatic birth in 2013 that I realized how little I had understood. I began to ask questions that few around me - doulas, nurses, midwives, doctors - were comfortable hearing. Questions like: Under what circumstances, and for what reasons, do doctors not practice informed consent? How do hospitals deal with other patient populations vulnerable to abuse? How does loss of professional autonomy, for obstetricians, and professional authority, for midwives, impact the quality of care they are capable of providing - regardless of their training? This blog will collect noteworthy information that attempts to answer these and other questions. Most of what you see here will be aggregated from other sources and analyzed. You will also see original interviews, and the occasional opinion piece or personal story, as I try to piece together a clear picture of the system in which American women give birth.
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