As I write this post, I am six months pregnant with my second child (another girl!). Though I am so excited to meet her and FINALLY squeeze her little cheeks, I find myself acutely aware of the profound impact that the education, experience, and temperament of the person entrusted with the birth of your child can have on the outcome – the difference between a healthy baby and one facing the challenges of a birth injury. The unique curse of my profession, specializing in medical malpractice, is that, as I await the arrival of my own child, I cannot be blissfully unaware of these potential tragic outcomes.
At about 12 weeks, I was asked by my family doctor if I had made a decision about which OB in town I wanted him to refer me to. Honestly, I had no clue. My first child was delivered by my family doctor (more on that in a minute), but since her birth and this pregnancy, he had made the decision to stop delivering babies. I also learned that the few OBs I knew had good reputations in our town recently retired.
Now, at 26 weeks pregnant, I have made the decision about my OB. I thought it would be helpful for others in my situation to know how I – as a medical malpractice lawyer – came to this decision.
1. Decide first whether you want an OB, Midwife, or Family Doctor
The first big decision to make is who you want to be in charge of your prenatal care and the delivery itself. In Ontario, expecting parents can choose between obstetricians (OBs), midwives, or family doctors for their care. Each option has its own unique approach and considerations. OBs are specialists in high-risk pregnancies, whereas midwives offer a more holistic and personalized approach to low-risk pregnancies. Family doctors can provide comprehensive care, but they might not be as specialized as OBs in managing certain complications.
There are some birth injury lawyers (I am looking at you, @RyanBreedon) who would give the advice to always go with an OB. And I get it. OBs have the most specialized education and experience in labour and delivery of the three options. With that said, in my view, it is not always as cut and dry as “always choose an OB.” In Barrie, our hospital’s practice is to rotate through an on-call schedule of OBs for labour and delivery. If there are 6 OBs with privileges at our hospital, each day a different OB will be on call. Even if you are under the care of one of those 6 OBs, you are not guaranteed to have him or her deliver your baby. You essentially have a 1 in 6 chance of your OB being the on-call OB on the day you go into labour.
This is why we chose my family doctor for the birth of our first child. We knew that the chance of him being the one to deliver our baby was high (and in fact, he did deliver my daughter). We also trusted our family doctor whole heartedly. Our relationship with him is very good and we know a lot about his education and experience through other physicians we know. For my daughter’s birth, it made sense to have him deliver her.
For this second baby, finding out my family doctor no longer delivered was a real bummer. I had to go back to the drawing board and make a decision between OB, midwife, and family doctor. We ended up choosing an OB, because in the absence of a close relationship with a family doctor, we wanted to choose someone who specialized in labour and delivery.
2. Consider Hospital Affiliations
You will want to consider where you want to give birth before choosing who your doctor is. Doctors are not able to walk into any hospital to provide care to a patient. They have to apply for privileges at any given hospital, and usually only maintain privileges at 1 or 2 hospitals. If you know you want to give birth at a particular hospital, you will want to choose a health care provider will privileges at that hospital.
When deciding which hospital to give birth at, make sure the hospital aligns with your birthing plan, offers the amenities and support you desire, and is conveniently located for you. Assess their facilities, reputation, and maternity services to ensure a comfortable and safe birthing environment.
3. Ask for Referrals
Just like when you need a good lawyer, seeking referrals can be invaluable when choosing a healthcare professional. Talk to friends, family, and colleagues who have gone through the childbirth experience. Their insights can provide you with firsthand knowledge of different practitioners and their approaches. Personal recommendations often offer peace of mind, knowing that others have had positive experiences.
In addition to getting recommendations from family and friends, I recommend asking your family doctor (particularly, if he/she practices in the same town as the hospital where you are planning to give birth) for recommendations of who he or she would recommend AND who he or she would stay away from. If you have a close and trusting relationship with your family doctor, this can be a great way to help narrow down who to choose to birth your child.
On a final note, labour and delivery nurses are so incredibly knowledgeable, not only about labour and delivery itself, but about the reputation and skill of any particular doctor. If you know an L&D nurse at the hospital you intend to give birth at, I recommend putting a lot of weight in his or her opinion.
4. Do a deep dive on Google
In this digital age, Google is your friend when it comes to researching healthcare providers. Take some time to research your shortlisted OBs, midwives, or family doctors. Look for reviews, testimonials, and any news articles related to their practice.
In particular, search doctors on the College of Physicians and Surgeon (“CPSO”)’s website (I am linking directly to their public doctor search portal here). All doctors have a profile on the CPSO website, which includes the following information:
- What year that physician was registered with the CPSO;
- Where that physician obtained his or her medical degree (and any postgraduate training he or she has completed);
- What hospitals that physician holds privileges at;
- Whether he or she is a specialist in any particular area;
- Whether that physician has been disciplined by the CPSO or has had his or her registration suspended.
In addition to searching on the CPSO website, go to CanLII, which is a public database of judicial decisions in Canada. In the document text search bar, search the doctor you are considering choosing to deliver your child, to ensure he or she has no reported legal decisions against them. You should know, though, that this will not show if the doctor has any pending legal action against him or her, nor will the CPSO necessarily revoke or suspend a doctor’s licence who is involved in ongoing legal action.
5. Be realistic about availability
Availability is a crucial factor, especially in the world of healthcare. Some OBs, midwives, and family doctors may have limited openings due to their schedules and patient load. It’s essential to be realistic about their availability and whether it aligns with your due date. Waiting too long to secure a healthcare provider could lead to limited options, so start early and book your prenatal appointments as soon as possible.
Choosing the right healthcare provider for your pregnancy and delivery is a deeply personal decision. As a lawyer and pregnant mama, I’ve come to appreciate the complexity of this choice. By following these five steps, you can navigate the process with confidence and ensure that you and your baby receive the best care throughout this exciting journey.
Remember that it’s essential to trust your instincts, ask questions, and establish a strong rapport with your chosen healthcare professional. As you embark on this adventure, know that you have the power to make an informed decision that’s best for you and your growing family.