Birth experience: when a substitute OBGYN delivers your baby

Gisela - posted on 07/12/2013 ( 3 moms have responded )




Birth experience: substitute OBGYN delivers your baby

A new hospital trend has a substitute OBGYN who works at the hospital deliver your baby INSTEAD of your personal OBGYN. If your baby was delivered by a substitute OBGYN you had not previously met during your prenatal care, please share your thoughts and experience. Overall was it a positive or negative experience? Do you have any regrets about your personal OBGYN not delivering the baby? Was your birth plan understood and followed by the new OB? Would you do it differently/same with your next delivery? Overall was the care provided by the substitute OBGYN good, better, or worse than you expected? Were you aware a substitute OBGYN could deliver your baby or were you expecting your personal OBGYN to deliver your baby?

Thanks for sharing!!


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Michelle - posted on 07/13/2013




Well we have great government medical care where I live so I didn't get to choose my OBGYN. I had all 3 of my children publicly (not paying for a private doctor) and only had a doctor called in for my first delivery. That's only because there were complications.
My other 2 births were both attended by midwives and they were the best. I had never met them during any of my visits but the last one I had was wonderful. She almost sat and read a magazine while I got on with what I needed to do.

Mary - posted on 07/13/2013




The term you are looking for here is "hospitalist". It refers to a practice that started in the late 1990's. This care provider is an employee of the hospital, and does not have a private practice where they see patients. They only manage in-patient care when a patient is hospitalized. Although it is more common in generalized medicine, the concept is starting to grow in obstetrics. These practitioners are often referred to as "laborists".

As Jodi pointed out, for a fair number of women, they already end up being delivered by an OB or midwife that they don't know. Labor and delivery are not something that can always be planned, there is always the possibility that you and your baby will be "ready" at a time when your care provider is unavailable. This can happen for a variety of reasons: your OB is away, they can't make it to the hospital in time, they are already tied up with another patient, or they had already arranged for another practitioner to be on call at that time. No one person can be available 24/7, 365 days a year for all of their patients.

In the practice you are talking about, the patient (should) go into it knowing that they will be seeing one provider (OB or midwife) for all of their outpatient office visits, but that their inpatient care will be provided by another. Typically, the inpatient portion will be managed by more than one person, since these hospitalist/laborists are made up of a group of practitioners that work shifts that provide for one of them to be in-house 24/7.

It has it's pros and cons. WIth a laborist, the care is being provided by someone who is not overtired; they have not been up all night (or day) dealing with other patients in the office, in labor, or in surgery. They are already in the hospital when you arrive, so there is no waiting for them to arrive to deal with whatever issue or emergency. They are (or should be) highly skilled at labor management and all types of delivery procedures since this is all they do, all day, everyday.

For providers it makes a lot of sense. The private OB/GYN or midwife can fully concentrate on seeing and managing patients in the office. They are not being distracted by numerous calls from the hospital regarding laboring patients, nor are they having to leave in the middle of office hours (ever had your scheduled appt canceled because your OB was in the hospital delivering someone else, or had your provider seemed so exhausted you suspected they weren't really listening to you because they had been up all night in L&D with another patient?) There is also a HUGE benefit when it comes to those insane malpractice premiums. For the hospitalist, it is paid for by the hospital itself. For the private practitioner, their premiums are more than halved, since they are no longer doing deliveries (this is the #1 reason that most OB/GYN's give up doing OB altogether). It also impacts patients in a positive way; office visits tend to be longer, more thorough, and allow more time for questions and discussions, since the OB is not as pressured to see a huge volume of patients to cover those insane malpractice premiums.

On the downside, a woman comes in to deliver a baby, and is cared for by a total stranger. That stranger should have their entire prenatal record (and any birth plans) on hand, but they don't really know the woman, nor does the woman know them. If you come in, and for whatever reason, just don't like that in-house OB or midwife, there really isn't another option - for the next 12 hours or so, they are it. Ideally, the hospital would have weeded out any sub-par practitioners; the input of their colleagues and the nursing/support staff will hold much more weight than it does with the standard private practice model of care, but it doesn't guarantee that your personalities or childbirth philosophies will mesh.

Jodi - posted on 07/12/2013




LOL, my OB didn't make it to the birth of my daughter she came so quickly. The midwives delivered her. I'll be honest, I could care less at that point. Out was out, and that's really all I cared about. My OB made it about 5 minutes later and took care of all the post natal care.

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