By Lisa C. Clough, MS Ed., CHES
Sarah M. Gutman, MD, MSPH
Gutman is assistant professor of Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania, as well as an OB-GYN and complex family planning specialist. Her clinical interests include miscarriage management and group prenatal care. She is passionate about reproductive justice and health equity.
What are the most important factors in aligning a woman with the right OB-GYN?
A good place to start is to think about what goals and healthcare needs you have. Are you hoping to find someone just to be available for annual visits, or do you have more in-depth concerns you’d like to address, such as irregular menstrual bleeding, pelvic pain or prior complicated pregnancies? Some providers have topics that they focus on or feel particularly equipped to address.
Other factors to consider are if you’d feel comfortable with a male physician, if you are comfortable seeing trainees such as residents and fellows and how the office is structured. Is there someone on call to answer after-hours questions? Could the same person who sees you for annual gynecologic visits be your prenatal care provider if needed? There are many different models of care, so it may take some time to find the right provider that fits your needs.
What are the most important questions women should ask when researching/trying to identify an OB-GYN that is right for them for pregnancy?
One of the most important questions to ask yourself is “Do I feel comfortable with this provider, and can I talk to them about the things that are on my mind?” It’s also important to think about some of the logistics around how practices offer care — for example, which hospital does that provider deliver at, and is that somewhere I can easily reach when needed? Many practices have a call pool that covers the labor and delivery. Understanding who would be at your delivery and how that’s determined can help set expectations early in pregnancy.
When it comes to pregnancy and birthing philosophies, what are key questions a woman should ask their potential doctor to be sure [there is] alignment with their personal preferences and medical needs?
Many pregnant people have strong feelings about how much intervention they would ideally want during labor and delivery. Reviewing that with your care team to see if priorities align is an important step. For example, patients who desire access to a tub during delivery should check if that is an option, or what is the labor unit’s policy around continuous versus intermittent fetal heart rate monitoring? For patients wanting to labor without an epidural, ask what support is available for laboring women — are doulas welcome, and are there other options for pain management? Alternatively, for patients who do want epidurals, is there anesthesia available 24/7?
You may also want to find out from your doctor if pediatricians are available at the time of delivery, is there a neonatal intensive care unit (NICU) affiliated with the hospital where you would deliver and does the hospital have gestational age cutoffs that could mean a preterm baby is transferred somewhere else?
Your doctor should also be able to tell you how the labor and delivery unit is structured, where you would deliver and who will care for you in addition to them. Having this information in advance can help make what is often an intense and emotional day feel more comfortable.
How long before pregnancy should a woman begin care with the OB-GYN she would want to care for her during her pregnancy?
Ideally, we love to see patients prior to pregnancy to get you established with the practice if you’re considering pregnancy in the next year. Many offices offer a pre-conception consult, where you get to know the providers, discuss healthy habits prior to pregnancy and can review options for genetic screening. Of course, many people become pregnant without planning it in advance, in which case it’s good to establish care as soon as possible.
As part of their interview process, what are the questions a woman should ask their OB-GYN about postpartum care?
The postpartum period is an essential part of obstetric care and should be planned for ahead of time. Ask if postpartum visits are typically in-person or if they can be virtual. It can be good to know when these visits occur — does the office do a two-week visit or only six to eight weeks postpartum? Additionally, it is important to understand what support is available to patients who need extra resources, such as mental health care or lactation support, and which contraceptive options the practice offers and how those can be arranged for.
