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Selecting a hospital/practice questions


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  #1  
February 8th, 2012, 01:03 PM
Dee
Join Date: Feb 2012
Posts: 1,416
I am in the process of selecting a hospital for delivery and associated midwife practice for prenatal care. I'm reading that we should interview health care providers and tour the facility to make sure it's the right fit, but there aren't any good strategies on how to do that in a way that is respectful of everyone's time and resources.

Background: I've read about our hospital options online, and there are different attractive features about our two top choices (nurturing labor environment v. world class facility if anything goes wrong). I'm having difficulty getting a feel for the midwife practices, there is less information online. I don't have any personal recommendations to go on for either, though I did find positive (and negative) "reviews" about both on a local discussion board.

My Question: How did you go about selecting your facility? Or your practice? Did you make appointments with more than one, interview them and then decide?
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  #2  
February 8th, 2012, 01:11 PM
pauriemmo's Avatar Veteran
Join Date: Jan 2012
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My DH is in the Army. We don't really get choices. We just go where they tell us.
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  #3  
February 8th, 2012, 01:26 PM
momma_d's Avatar Platinum Supermommy
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Location: Texas
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I had my Dr all picked out and then turns out they aren't taking ANY new OB patients, even if you are an existing regular patient! Soooo that plan fell through. I got a recommendation from their office for a new OB but ended up going with a different practice that a couple of my friends recommended. I looked up reviews online and everything had great ratings. I have my first appt next Thurs so we will see how it goes! And in terms of the hospital, I just looked up the hospitals they are associated with and didn't see any issues so I'm kinda just going with the flow!

If you are interested in actually seeing the hospital, I'm pretty sure most hospitals offer tours you could go on. IMO I would go with the "nurturing labor environment". That just sounds much more pleasing In terms of Midwives, I have never used a midwife but I'm pretty sure they are used to getting "interviewed" by people
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  #4  
February 8th, 2012, 01:34 PM
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If you want to tour a hospital then you should be able to get a tour without a problem. You should also be aware that your midwife may only deliver at a certain hospital. We have two really good hospitals here, but my Ob office will only deliver at one of them. Also if you are wanting to interview your midwife first to get more information then you could just call the office to set up a time for that. I picked my Ob because my dh is military, and I only had two choices. I chose the office that delivered at the hospital with the NICU, so no matter what happens I will be seen by my Doctors.
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  #5  
February 8th, 2012, 01:49 PM
3Sapphires's Avatar Platinum Supermommy
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I did some research on line, and after calling a closer practice, and not liking what they told me about their VBAC policy, I went with the midwife practice I had originally had in mind.

The closest office they have to me is an hour away, and the hospital w/o traffic is an hour and 20 minutes away, but I really think this was the best choice for me in getting the VBAC I want.
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  #6  
February 8th, 2012, 01:58 PM
Dee
Join Date: Feb 2012
Posts: 1,416
Your responses are all very helpful, thank you. (And it's good to be reminded that we're lucky to have several great choices!)

MrsTiffy - I think I was clear when setting up the first appointment with one that we were currently exploring our options, but there's a pre-appointment interview with a nurse, and I'll work it into conversation again. Thanks for the tip.

momma_d - "Nurturing" is where I'm leaning, whereas The Dad figures if we have a major teaching hospital within reach, why not get the best medical care available? I think we'll talk more about what "best" means when it comes to childbearing and delivery.
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  #7  
February 8th, 2012, 04:23 PM
JulieMc's Avatar Loving my babies. :)
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I'd go with nurturing.

In my experience... "world class facilities" means higher level NICU, more interventions, higher c/s rate, etc. Great if you need it, but overkill if you don't.

As for how I picked mine...I switched around a lot with each pregnancy. I finally found an amazing midwife with my 2nd and I don't anticipate having to do any switching ever again. For me it was trial and error. I'd see if I liked them, and if I did stick with them until they did or said something that scared me off. I have no qualms about taking my business elsewhere if their care doesn't live up to my expectations.
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  #8  
February 8th, 2012, 04:49 PM
JennaBee's Avatar Mega Super Mommy
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For us the hospital you go to only has a select amount of providers that work there. If it's totally new to you I would start with the facility and then see what providers are associated with it. You can always ask for an intake interview to talk with a provider. Some key things to look at are the number of providers in the practice, the transfer rate (if you want to deliver outside of a traditional delivery room) and their policies regarding L&D. For us, I chose the better OB over the better hospital. I am quite high risk and feel that I would have the best care for this baby by being followed by a terrific OB and MFM during the pregnancy vs. the fancier hospital.
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  #9  
February 8th, 2012, 09:02 PM
bettyearl's Avatar Beth, mom to 4 boys
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As long as you are early on in your pregnancy (Read: definitely before the 3rd trimester) you should be able to just see different doctors for you appointments until you find one you feel really good about.

Doing as much research before hand will serve you well with your satisfaction after your baby's birth. I *thought* I was happy with my doctor with my first son, but after he was born and I learned how much I would have changed. I was SO much happier with my 2nd birth. And my 3rd went pretty well too, even though I didn't have my "ideal" doctor he was willing enough to let me do things a little differently than he would have routinely.
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  #10  
February 9th, 2012, 07:29 AM
Dee
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Quote:
Originally Posted by JulieMc View Post
In my experience... "world class facilities" means higher level NICU, more interventions, higher c/s rate, etc. Great if you need it, but overkill if you don't.
This is a very good point. If the pregnancy is progressing normally, why risk unnecessary c/s, etc.? (Though, the three women I know who started delivery in the "nurturing environment" hospital ended up with a c/s that they did not want...)

JennaBee - That's helpful to think about. Thanks.

bettyearl - Fortunately, I'm still very early, so we do have time to decide. I think an early tour of facilities and an initial meeting will go a long way in helping us find the right place.
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  #11  
February 9th, 2012, 08:30 AM
Kaema's Avatar Kris
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With my first pregnancy I literally just picked a name off a list of Drs and went there. I was miserable about the hospital I would be delivering at because it's the only one in town. I was kind of shuffled around between the doctors in the practice and then ended up only seeing the other doctor for all my appointments. I liked the doctor's themselves, but was not happy about how some things were handled. For example, I got a big MRSA abscess on my butt and because I only had pregnancy medicaid, the only people I could really have look at it were my doc's. It got so bad I couldn't sit and if my butt even brushed something I was howling in pain. When they looked at it they were like "It could be MRSA but... no. No that's a brown recluse bite." ((ON MY BUTT)) They just decided it was a spiderbite and put me on antibiotics without even culturing it. I had my boyfriend caring for the wound multiple times a day ((which turned into a fingertip sized hole)) and two weeks later HE got an abscess when he had seen, cared fr, and came back positive for MRSA. My practice still insisted I never had it and two weeks after taht I got another abscess which of course did culture positive for MRSA. After that whole fiasco I was done with this practice, and so over the fact that the local hospital was a knife-happy baby factory. Granted they had a brand new level 2 NICU, but I didn't care about that. Around 30 weeks, I ended up switching to the dr that my Bradley instructor used to work for as Erin had mentioned nothing but good things about this Dr. Making the switch was the best thing I did for myself during pregnancy. It was like a weight off my shoulders. This Dr is almost 45 mins away and the hospital is a little over an hour, but I don't regret the switch at all. With this pregnancy I still had the doctor's number in my phone and got an appointment right away! They remembered me and it's a great feeling being there again.
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  #12  
February 9th, 2012, 01:30 PM
Dee
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They didn't test you for MRSA?! That seems crazy to me. No wonder you switched. Sounds like the other guy is worth the drive.
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  #13  
February 9th, 2012, 08:30 PM
palmetto_moon's Avatar Mega Super Mommy
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I knew I would love my midwife the very first appt I had with her. She walked in and sat down in the chair like she intended to stay put a while rather than the typical "do you have any questions?" while the providers hand is already on the door ready to go.
The way that my midwife sat down and talked for a good while, un-rushed and un-hurried before she even did the exam got me hooked! As I've mentioned on another thread, the hospital she works at isn't the best IMO as far as being mother/baby friendly but I tolerate the two days in the hospital to get prenatal care and be delivered by a wonderful midwife.
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  #14  
February 10th, 2012, 10:23 AM
amazing_love's Avatar Platinum Supermommy
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I picked an OB that i liked a lot first. She only delivered at 2 hospitals and a birthing center. I considered the birthing center but decided since it was my first baby and i had no idea how it would go, whether i'd want meds, etc. to go with a hospital. One of them is known to be better than the other so i just went with it. I did a tour and its a nice hospital, no complaints other than interventions are common but i think that goes with most hospitals. Nice that you have the "nurturing" option. I'm going with a birthing center this time because i decided i didn't really feel like staying in bed through my entire L&D this time. The birthing center my OB used to deliver at closed down because someone else now owns it and apparently didn't feel comfortable with it so they decided to put a room inside the hospital to replace it. IMO its a load of crap because its still a hospital and they don't offer water births which is what i want. It is all about what you are looking for and wanting with your birth. My OB told me i should do the birthing center when i showed her my birth plan and i should've listened. I'm now going to a center with midwives since going to my OB is no longer an option. FYI I did ALOT of research last time but in my case the hospital protocols took over. Best of luck and hopefully you find something that meets your wants and needs
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  #15  
February 22nd, 2012, 05:42 PM
Dee
Join Date: Feb 2012
Posts: 1,416
I just wanted to thank you all again for your input. Last week we took a tour of the "nurturing" hospital that's closer and smaller (not an option at the other one unless you're already planning to deliver there), and today we had our first appointment with one of the midwives at the smaller local place. It.Was.Great. Having the other medical options available is truly a benefit of where we live, but unless I turn out to be very high risk or we have serious concerns about our child's health, I don't think we need the shiny fancy hospital for now.

Anyway, thanks again. Your thoughts were really helpful in weighing our options!
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