When your doctor won't deliver at (insert preferred location here)

bumpuser10258960 · October 2014

At my first appointment, my doctor said, "I deliver at XYZ hospital". I hadn't previously thought about that hospital/location as being the place where I wanted to ideally deliver for several reasons. I plan on bringing this up with my doctor at my next appointment, but I wanted to know if anyone else is going through this and how did the conversation go with your Dr? What are my options if I choose to deliver elsewhere? I would hate to have to start going to another doctor/group because I really love her, but I didn't realize (foolishly) that the doctor wouldn't just go to whatever hospital I chose (within reason).

I'd love to know if anyone else is going through something similar.

jacqueleen1 · October 2014

It is my understanding that most OBs are associated with specific hospitals because they need hospital "privileges" to work there and/or are accustomed to birth methods for that facility

colleen4019 · October 2014

Yea. Mine can only deliver at one specific hospital & it's not my favorite. But I really really like my CNM so I'm willing to try out this hospital.

bumpuser10258960 · October 2014

After the conversation with my doctor, I realized that was probably the issue but thought that the doctor could/would be associated with more than one hospital. I'd really hate to have to find a new doctor at this stage, especially since I have such a long-standing relationship with this doctor. I guess that is something I should have thought about before.

JCWhitey · October 2014

You can show up at any hospital in the US and can't be refused treatment (which includes labor and delivery). So you can go to the hospital you want, you'd just get the doctor on duty and unless you register there as well they won't know anything about you when you arrive so you may find yourself filling out forms in between contractions.

I would voice your concerns with your doctor at your next appointment and explain why you want to deliver at that specific hospital. She may opt to refer you to a different doctor or explain to you your best options for delivery. Also check with your insurance, because they may consider the other hospital to not be your chosen hospital and you can get charged more. Where I live there are two major hospitals and you have to assign one as your "home" hospital and if you end up at the other the co-pay is almost doubled.

bumpuser10258960 · October 2014

Thanks @JCWhitey. I definitely plan on talking to my doctor about it at my next appointment.

pregarella · October 2014

Definitely something that needed to be thought out when you picked your OB, they only have privileges at their certain hospitals. At this point, you probably have no choice but to just accept the hospital where she delivers at, or change OBs, unfortunately.

Stargirlb · October 2014

wouldn't hurt to check out a few doctors who deliver at your preferred hospital just to see if you would like them. Then you can decide if your preferred doc is more important than the preferred hospital, or maybe get lucky and find a nice new doc who delivers at your preferred place.

bumpuser10258960 · October 2014

pregarella said:

Definitely something that needed to be thought out when you picked your OB, they only have privileges at their certain hospitals. At this point, you probably have no choice but to just accept the hospital where she delivers at, or change OBs, unfortunately.

My OB is/has been my Gyno since I moved here 7+ years ago. Back then, future kids were so not on my radar, but once I was thinking about it again, we should have definitely looked into that. I'm kicking myself for it now, but what's done is done. Now to do some homework and decide.

thejucheidea · October 2014

My doctor has rights at two hospitals and prefers the hospital where I want to give birth. I asked prior to starting with her if she delivered at my preferred hospital because I have fundamental disagreements with the other major hospital chain in the area, which is part of Catholic Health Services. I honestly care more about the hospital than the doctor, and while I love my doctor, I will not be sad if I have a different doctor deliver because I know I'll have my husband and doula with me and that's all that matters.

rm2013 · October 2014

What are your reasons for not wanting to deliver at that hospital? Are they minor, like its not as new/nice or as close to your home? Or major, like they don't have a NICU?

If they are minor IMHO the doctor is WAYYYY more important than the hospital. If all goes well you will only be there for 2 or 3 days anyway.

bumpuser10258960 · October 2014

rm2013 said:

What are your reasons for not wanting to deliver at that hospital? Are they minor, like its not as new/nice or as close to your home? Or major, like they don't have a NICU?
If they are minor IMHO the doctor is WAYYYY more important than the hospital. If all goes well you will only be there for 2 or 3 days anyway.

It's minor, for the most part. The hospital is older and I have to pass 2 newer/nicer hospitals to get to this one (from home). It's also located in a densely populated area of the city, so this hospital is notorious for having long wait times, etc (which I know won't matter if I register with them for delivery). It's mostly trivial, but I was really hoping to deliver at this new state-of-the-art hospital that is very close to my home.

JCWhitey · October 2014

I actually disagree and I think the hospital and nursing staff is more important than the OB. And I only say that because in *most* practices you may not even get your OB at the delivery, but rather the on-call, and that often OBs are only there for a small part of your labor/delivery.

I chose my hospital because 9/10 your doctor will come in when you go into labor because each doctor only has a couple of women due each month. But I just so happened to go into labor while she was on vacation and the on call doctor didn't even get there until I was already pushing. At that point I really could care less who was between my legs poking at my cervix, I was happy to be pushing and nearing the end. But I did really appreciate my giant birthing suite with the jacuzzi tub and 300 square feet of room to pace around in. And my amazing nurse, I can't imagine that experience without her!

rm2013 · October 2014

@jcwhitey @mandjs lol we are opposites. For me, my OB of 15+ years was a solo practitioner so I was guaranteed her or the one other doctor who did her on call. A lot of scary stuff happened during my delivery and I ended up needing an unplanned c-section. I really didn't care about the hospital just having MY doctor that I trusted. I couldn't imagine going through that with a doctor i'd only had for a few months. And afterwards every single nurse that checked my incision site was shocked and asked who was my doctor because they said it didn't even look like I had a section (I have to take their word for it bc obvs I couldn't see).

Regarding the pediatrician, we picked the one we liked and it was NBD they didn't go to the hospital. all the staff docs do is check the baby's vitals and give a couple shots, and again just for a few days. I wouldn't based my child's care from birth to 18 on who can visit her in the hospital for just the first week of her life.

JennyP0222 · October 2014

This happened to me actually. My OB practice switched their hospital between my last delivery and this upcoming one. I LOVED the hospital I delivered at with my first, it is 5 minutes from my house and is a state of the art and baby centered maternity center. Now the hospital they have switched to is a 30+ minute drive, older, smaller, etc. I made the choice to stick with my OB and suck up the hospital switch though. While it is TRUE that your OB might not even be the one to deliver you, and if they do they are not around that much during labor anyway.....the prenatal care I get from my OB is so good and I am so comfortable with her. 9 months of care vs the hospital where you deliver. I think the 9 months is more important.

crunchymamaof2 · October 2014

This was a huge issue for us this pregnancy. I absolutely adore the midwives I saw my previous pregnancies but they only deliver at a certain hospital. I get really stressed out when I visit L&D Department of that hospital since my son was in the nicu for 3 weeks and I immediately think of that. The other hospital (they're literally 5 minutes apart, if that) is where we want to deliver, but that meant I had to find a new provider. Fortunately I like my ob this time around.

With my current group, you can choose either hospital, but if you want one of your providers you have to choose the one they associate with, they have a partnership with the bigger hospital, and will provide your prenatal care and will coordinate with the hospital so they have all your records. But you'll get whoever is on call. who delivers me doesn't really matter, though it's nice to have someone I am relatively familiar with.

loraxmama · October 2014

I'm going to jump on the side of those saying go with the hospital you want. I picked a research hospital with a high chance of private rooms. I knew going in the on call Dr. would deliver. Honestly I was with the nurses way more than the Dr.

While it is important to like who does your prenatal care I feel the hospital is just as important. It'll be the first place you learn to be a mom. Doing that in your ideal environment is important in my opinion. Plus what if something happens and you stay at the hospital a little longer than the normal day or two? You'd probably rather be somewhere you're most comfortable. Just my thoughts.

good luck whatever you decide

thursday · October 2014

My doctor is part of a practice so who ever is on call is who delivers the baby. When DD was born they all delivered at my preferred hospital and only one also delivered at a hospital I didn't really want to go to. I figured the odds were in my favor to deliver to the hospital I wanted to go to and everything worked out. Now I go and they all deliver at both hospitals, I am not thrilled but changing doctors is not an option for me.

BitsyBelle84 · October 2014

@thursday Why is it a problem that they all deliver at both hospitals? Wouldn't you just go to the hospital you wanted to deliver at?‌

transplantedhawkeye · October 2014

I think it depends on what your plans and philosophies on labor and delivery are, and what you think matters most to you about environment.

If you are planning a natural child birth with few medications and interventions or are hoping for a vbac- med free or not, provider is very important, as are the policies of the facility they deliver at.

In both cases you will need much more support from your provider and having a relationship with your provider and a chance for many discussions would be beneficial.

If you are taking a more laisez-faire approach to labor and delivery, perhaps the environment for recovery may be more important to you, where you will be spending more of your time.

thursday · October 2014

@BitsyBelle84‌ well I haven't confirmed, I will at my next visit but my understanding is where ever the doctor on call is when you go in labor is the hospital you go to. You don't get to choose. It is possible that they have one on call at each hospital which would be awesome.

BitsyBelle84 · October 2014

@thursday I would think they would be required to have one for each. If you show up to the hospital in active labor it is my understanding that they have to treat you at that facility, but I could be wrong. I hope you get to deliver at the hospital you want.

transplantedhawkeye · October 2014

And if you show up to a hospital without an OB unit you will be transferred, usually by ambulance if delivery is imminent, and particularly if you need a c/section.

BitsyBelle84 · October 2014

MandJS said:

BitsyBelle84 said:

@thursday I would think they would be required to have one for each. If you show up to the hospital in active labor it is my understanding that they have to treat you at that facility, but I could be wrong. I hope you get to deliver at the hospital you want.

That doesn't mean someone from HER OB practice will be there. Just that whoever is on call at that hospital that night will handle it.

transplantedhawkeye said:
And if you show up to a hospital without an OB unit you will be transferred, usually by ambulance if delivery is imminent, and particularly if you need a c/section.

Oh, that makes sense. I've never had an OB practice that was associated with more than one hospital that did not have an on call at all the hospitals. And it had never occurred to me a hospital might not have an OB unit. Thanks for the info ladies.

AEmily · October 2014

I would always deliver at a hospital that your OB has been credentialed with for delivery and surgery rights. It's an incredible amount of paperwork and expense for most places to get credentialed with each hospital system and for each Doctor, PA or midwife, which is why most only credential with 2-3 hospitals.

The OB clinic and Hospitals that they credential with are linked up with their computer systems or continuously updating your patient chart so the hospital has your most up to date records.

Having worked in OB/GYN for serveral years the actual delivery/surgery is the majority of the DR's paycheck too. They are paid office charges for the regular check ups and then the majority is at the delivery. When you think about their pay for 9 months of care it's actually not as big of a payout that you'd think for a Dr. (definetly not saying it's bad though!)

Plus that's the best part for them. They love to deliver their own babies and bring them into the world being that they helped with their care until that point!

Just my thought

loraxmama · October 2014

transplantedhawkeye said:
I think it depends on what your plans and philosophies on labor and delivery are, and what you think matters most to you about environment.

If you are planning a natural child birth with few medications and interventions or are hoping for a vbac- med free or not, provider is very important, as are the policies of the facility they deliver at.
In both cases you will need much more support from your provider and having a relationship with your provider and a chance for many discussions would be beneficial.

If you are taking a more laisez-faire approach to labor and delivery, perhaps the environment for recovery may be more important to you, where you will be spending more of your time.

FWIW I went in knowing I was going to go med free and that I wouldn't know the doctor delivering. My husband as my support was more important than the doctor. I had a wonderful experience and felt like the doctor was secondary. I had specific desires that I just communicated to the nursing staff. Not knowing my doctor didn't hurt or hinder my natural childbirth plan in any way.

Edited to add- my approach was in no way 'laisez-faire' and I will be delivering in the same hospital again this time.

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