Getting your OB/MW vs. the on-call

AmyRI · October 2012

I see on here a lot that if you go to a practice with, say 4 OBs or midwives, that you only have a 25% chance that your care provider will be the one to deliver baby.

The way my practice works is that you get the on-call OB if you need to be seen at night, i.e. between ~9pm and 6am, or if your provider is out of town and unavailable. However, during the day, they all show up for their own patients and make every effort to show up on weekends even if they aren't "on call." With DS, I had gone into labor in the middle of the night and called the answering service and got a call back from the on-call OB, who went to the hospital but just went to sleep there. He never actually saw me. My OB woke up in the morning, called in to see if any of her patients were in labor (there were 2 of us) and went straight to the hospital, getting there an hour before she would normally be at her office. She canceled her appointments for the morning and delivered both me and her other patient, even though she was not due to be "on call" that day. Honestly, it seems like a great compromise to me and I'm comfortable with the fact that if labor goes really quickly and happens all at night, I won't see her, but if it's a time she's awake, she'll do everything in her power to be there.

Is my practice atypical, and most places you really do only have a small chance of seeing your real provider?

runrinserepeat · October 2012

I don't actually know. To be honest, I cared so little about who the doctor would be, that I never asked. I figured I would labor with DH in the room until it was time to push, and the doctor would come in, deliver the baby, and be gone. And that's pretty much how it happened. I had the on call doctor, but I arrived at the hospital at midnight and delivered at 4 in the morning. My OB stopped by a few hours later to say hi.

nosoup4u · October 2012

I think it depends on what size the practice is. I went to large MW practices for both my pg 20 MW, so the chance of having the ones I knew the best was low.

LaurelBee · October 2012

That actually sounds great! My OB practice had 6 and there was no way of knowing who would deliver. The OB that was in hospital the day I delivered Ds was called into an CS, so they called the on call OB. She was my least favorite of the group and I really regret having her deliver Bc of my episiotomy. Not to mention I had to wait to push for 25 mins before she arrived, which was awful.

Now I'm planning a HB and will have one of two MWs attend. Plus an assistant who could either be a CNP, Doula, or student MW.

KrisM86 · October 2012

My practice has 5 midwives and I will get whoever is on call when I go into labor. However, I don't really have one main MW throughout the pregnancy. I see them all at different appointments so I get a chance to know them all. I feel perfectly comfortable with each of them. I will say that my MWs spend the entire appointment with me...I don't see a nurse at all...and we have plenty of time to talk and get to know each other.

Necack · October 2012

My practice has 8 OBs and 2 MWs. Since they rotate who is on delivery duty patients must see all of them for prenatal care. Each visit I see someone new to get to know all of them. This way it won't matter who is delivering when I go into labor.

Nechie122 · October 2012

Your practice does sound atypical to me. Most patients don't like it when their appointments are canceled so usually OBs keep their office hours, surgery days and call schedules separate. I know I'd be pretty upset if I rearranged my whole work schedule for an appointment only to be told, oh, well, we'll have to reschedule you. And imagine how tough that is on the office staff! I imagine in busier practices OBs have patients going into labor everyday so they need to set limits.

ETA: I have heard of practices where OBs say they try to deliver every baby but I imagine they have a lower volume of obstetric patients compared to gynecology patients.

wittyschaffy · October 2012

Mine sounds a little like yours. They rarely all out cancel your appointment in the office but they will be there to deliver their own patient if they're doing that part of labor/delivery during the day. If they can't get back to the office for your appointment, the NP sees you or one of the other docs cover. If you're ready to deliver and it is on the weekend or over night, you'll get whoever is on call that day.

NydaP · October 2012

My OB was one of two doctors at her practice. I went into labor at night and arrived at the hospital at 1:30am. They called my OB and she came to the hospital. She stayed all night and delivered my son at 6am. I don't know if she just happened to be on call or chose to show up but I appreciated her being there the entire time. By the time I had my second son, the practice had added a midwife. I ended up seeing her the entire pregnancy, not intentionally, just because that's how it ended up. I asked about who would be on-call to deliver and she explained that the two doctors would be on call if I went into labor during normal business hours. Otherwise, she (the midwife) would be on call for evenings and every other weekend. There was also a midwife at the hospital who would be on call for the weekends nobody from my practice was on call.

I was concerned about delivering with a complete stranger, however I was fortunate enough that I went into labor early on a Monday morning. My midwife was called to the hospital but my OB happened to be there as well. So my OB was able to deliver my second baby as well.

I think it will depend greatly on the size of your practice. With two docs, I had a pretty decent chance of delivering with my regular doc. But at a practice with 10 docs, your chances would be reduced.

AmyRI · October 2012

Thanks for all the responses! It's very interesting to hear all the differences between practices.

Nechie122:
Your practice does sound atypical to me. Most patients don't like it when their appointments are canceled so usually OBs keep their office hours, surgery days and call schedules separate. I know I'd be pretty upset if I rearranged my whole work schedule for an appointment only to be told, oh, well, we'll have to reschedule you. And imagine how tough that is on the office staff! I imagine in busier practices OBs have patients going into labor everyday so they need to set limits. ETA: I have heard of practices where OBs say they try to deliver every baby but I imagine they have a lower volume of obstetric patients compared to gynecology patients.

I think this is part of the success of this particular practice. While there are 4 OBs (used to be 6, but 2 have retired recently), and there are a lot of OB patients, there are tons of GYN only patients. They only deliver at a smaller local hospital, not at the baby factory women's hospital 15 minutes away, so I think a lot of OB patients opt for other practices that deliver at the specialty hospital.

Through 1 2/3 pregancies and several years of GYN appointments, I've only had her cancel 1 appointment for a delivery. I completely understood, but I know the office staff does have to explain to many people that it's the downside of having an OB/GYN, and not just a GYN.

LollyBug18 · October 2012

There are only 2 OB's in my doctor's practice and I'm pretty sure the only time my OB would not deliver my baby is when she's out of town (like next week, please stay in, baby!!). I'm spoiled and can't imagine going to a larger practice or having anyone other than my doctor deliver my baby. Smile

robyn2201 · October 2012

I get whoever is on call that day. I believe there are 4 or 5 OB's on rotation and I do not meet them before hand. All my prenatal appointments are with my OB. It was this way with DD, different OB/hospital. My new OB said that she was on call twice last week.

Unfortunately that's how all the local hospitals near us do it. I also don't have the option of going with a practice that has MW's. It's either an OB or home birth. Due to this, we made sure to ask lots of questions on our tour to find out how natural friendly the hospital staff was. Looked at the c-section rates and hired a doula. I also stayed home quite awhile after my water broke with DD.

annabelle.27 · October 2012

I went to a midwife practice of three when I was pregnant with DS2. They stayed with their patients- you saw one midwife throughout your pregnancy and called your midwife in case of emergency, with any questions, or when in labour. She would then choose one of the other midwives to be her assistant if you were having a homebirth. They accepted only 4 births per month so that they would be able to provide that continuity for patients.

With DS1 I saw a physician group of five. They all had days and weekends when they were on-call, pre-assigned, and they remained at the hospital during their entire 24 - 72 hour shift. They would handle any births that came in during that time for their practice, did post-natal check ups, and any obstetrical emergency walk-ins that came into the hospital. I had no single care provider- who you saw for your prenatal appointments was entirely left to who was working the office on the day you scheduled your appointment. It was actually a weird group. They all had non-obstetrical practices outside the joint obstetrical practice, so they each served one office day a week and six in-hospital days per month, or something like that, with the rest of their time being at their other practices.

lkm2006 · October 2012

My OB practice sounds a lot like yours (except I doubt they would show up on weekends/holidays).

I know my sister went into labor on the morning I actually had one of my visits scheduled (we see the same OB). She delivered her baby and kept all of her appointments, maybe just getting backed up a little.

Seeing how the OB really only shows up for the very end and check in's, it shouldn't required them to get too far behind. She was actually on time by the time my appointment rolled around and my sister's baby was less than an hour old!

Jenilyn and Matthew · October 2012

Ours makes every effort to be there, even though there are 6 OBs in the practice. They do have an "on call" doctor each night and weekend, but we have our OBs number to let him know when I go into labor. Even though I'll labor at home as long as possible with this one, I'll still call my OB to give him a heads up, hoping he can be the one to deliver me! I know if I show up ready to push (that would be nice) without calling first, then I'll get whoever's there.

BLPL101 · October 2012

sweettalkin417:
I get whoever is on call that day. I believe there are 4 or 5 OB's on rotation and I do not meet them before hand. All my prenatal appointments are with my OB. It was this way with DD, different OB/hospital. My new OB said that she was on call twice last week.

Mine is the same. Unless I deliver during the week and it has to be during the day, I will end up with whoever is on rotation.

Nomer · October 2012

Your practice sounds nice considering it's a little bigger. Mine, we just have 2 OBs in the practice and no midwives. It is a really small hospital and with my first my OB wasn't on call but he told me he would try to be there for my birth and he was

The other OB in the practice is not NEARLY as nice as mine and so I really appreciated having my OB for the birth. I had the other for my strep-B test and he was not gentle at all and not easy to talk to. This time I am only a couple weeks from due date and my OB told me he is on for the next month basically so I am sure I will get him for my second birth too. I think they alternate being on call and also do frequent vacations when one is off and the other is just on all the time.

kagwiz · October 2012

I am a little nervous about this - as I have the same situation...

There are about 15 OBGYNs that deliver out of the University Hospital that I will be at - only 4 or 5 of them are based out of the office I go to. I have seen a few different doctor's so far...but there will be a good possibility that someone I have never even met will deliver. I THINK by that point I won't care...but it has been causing me a little anxiety lol!

From what I have been told - this is pretty normal!

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