How to choose the best Obstetrician for you

• Your GP may offer recommendations
• If you have certain medical conditions that may impact a pregnancy, your specialist may recommend you to an Obstetrician who is experienced in caring for people with these medical issues. Examples can be cardiac disease, auto-immune disorders and hereditary genetic conditions. Your specialist will need to liaise with your Obstetrician throughout your pregnancy, so many specialists will have already had experience with a certain obstetrician and feel confident in his/her experience and expertise. If your pregnancy is classified as high risk, working with an Obstetrician with experience in these areas is essential for you to receive optimal care.
• You may have family or friends who have had their own experience and can confidently recommend an Obstetrician due to their own positive experience. One of the primary influences on a woman’s choice of an obstetrician is word of mouth. It is important to remember that what you consider important aspects of your care may not align with your own personal priorities.
• The hospital where you prefer to delivery will have a data base of which Obstetricians are accredited to deliver at their hospital. Most Obstetricians have a web page where you can find out further details about their practice as well as about their level of experience and expertise.

You should feel free to contact an Obstetrician’s office and ask them questions that are important to you and will help you in your decision making. The staff should be able to answer most questions that you have.

• Is the Obstetrician available when you are due to deliver? It is important to understand that doctors need holidays and breaks just like everyone else. If they have leave booked when you are due most Obstetricians will have it planned well in advance. Some practices also have a group share arrangement and only work and remain on call certain days/nights of the week. Most will have a weekend roster.
• At which hospitals does the Obstetrician deliver?
• How often would you have antenatal appointments? It is important to understand that each pregnancy is different and certainly some patients require more regular antenatal appointments than others due to certain conditions.
• What are the fees? What is covered by Medicare and your private health insurance?
• Does your practice have midwives working in the rooms?
• Is your Obstetrician contactable after hours?

It is vital that you feel relaxed and comfortable with your Obstetrician and that you should not worry about asking too many questions. You should be able to speak to your Obstetrician frankly about any concerns that you may have. You should also be open and honest about your expectations regarding the type of delivery that you hope for. If you have concerns about pain relief, induction, elective caesarean section or VBAC you should be confident to speak to your Obstetrician and to take on board his or her advice. This is the key to a successful and low stress pregnancy and delivery. You should also feel welcomed and cared for by the Obstetrician’s staff. They also play a key role in your care, especially if your Obstetrician has midwives working in his/her practice. A big part of the antenatal care is to build your trust – respect and trust are essential.

In order to be an Obstetrician in Australia you must be accredited by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). To become an accredited Fellow of RANZCOG takes at least 13 years from the point a person begins to study medicine. This involves completing basic medical training at a tertiary university and teaching hospital (6 years). They must then work in a public hospital for a number of years before applying to enter the RANZCOG specialty training program. During the six years of training the doctor must pass a number of exams and be signed off as competent in every obstetric and gynaecological procedure. There is also ongoing training and professional development processes that must be met in order to maintain accreditation and registration.

The Public System

Here in Melbourne we have many good public hospitals. They are generally zone based so you need to reside in the area that the hospital is located. During the pregnancy you will be seen by a variety of health care providers including doctors in training, medical students, midwives or student midwives/nurses. These staff are overseen by a more senior Obstetrician. Who delivers your baby will depend upon who is rostered for labour ward when you come into labour, are being induced or having an elective caesarean section. If all progresses normally you should expect to stay in hospital for approximately two nights post-delivery and three nights if you have a caesarean section. There are no out-of-pocket fees if you deliver through the public system provided you have a Medicare card and you are an Australian citizen.

The Private System

In order to be delivered in a private hospital you will need to book in with a private Obstetrician. The benefits of choosing a private Obstetrician is that you have a choice of which hospital you would like to attend (most obstetricians deliver at more than one private hospital), you can choose the Obstetrician who will be present at the birth, see you for all of your antenatal appointments at a time that suits you, and you are able to develop a rapport with him or her and their supporting staff. Whilst not necessary, you would need to have private health insurance that covers you as a private patient in a private hospital. You would need to check the conditions of your private fund to find out the waiting period before you are eligible to be covered. Most funds have a 12 month waiting period from the time you join up with them. Your private insurance will cover your stay in hospital for your delivery and postnatal care as well as any antenatal admissions to hospital during your pregnancy. This should also cover any admissions to special care nursery for your baby if problems develop post-delivery. Having a private Obstetrician means associated out-of-pocket expenses that are not fully covered by Medicare and your private health insurance. Your Obstetrician’s office should advise you of these fees on booking in or at your initial antenatal consultation. Most Obstetricians will have their own ultrasound machine and will have done additional training in obstetric ultrasound. This means that your baby will be scanned at each antenatal visit. A private obstetrician is on call for you 24 hours per day and can be contacted via a paging service after hours and on weekends.

The above considerations should assist with you choosing the right Obstetrician and pregnancy care for you. Pregnancy is one of the most exciting and rewarding events in your life and you should feel fully supported and comfortable with the obstetrician who is assisting you along the way.