# Family Practice Physician delivering your baby?



## GuavaGirl (May 6, 2008)

Is anyone having a family practice doctor deliver your baby? ....or have you in the past?

I actually just learned, a few months ago, that they can do that.

A friend of mine, who is in her 3rd year of residency, told me that she would recommend a family practice doctor, because they will let you do things more natural. I really respect her opinion because she's a doctor who has had 2 natural births herself, and is a firm believer in the fact that birth is not a pathology.

Anyway, I'd love to hear about anyone's experience they've had with having this type of doctor provide prenatal care and delivering your baby?

(not pregnant yet, just looking at the limited options in my town)


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## Leav97 (Oct 23, 2004)

I had an OB the first time and choose FP for this baby. So far FP has been a much better experience for prenatal. I can't speak to delivery yet.

The OBs were in a on call rotation so you never knew who was going to be there for delivery. My FP Dr will be there baring any huge problems.

The OBs appts were 5-10 min. My FP Dr takes 20 and I'm sure would take longer if I had any questions.

The OBs were very much into policy. So far my FP Dr has been more willing to discuss alternatives.


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## earthmama369 (Jul 29, 2005)

We used a family practice group resident for both of my pregnancies and I'm very happy with that choice. They were supportive of my vegetarian pregnancies, me refusing certain tests, breastfeeding through my second pregnancy, and having natural childbirth. The second time, they even set up having a waterbirth at the non-waterbirth-equipped hospital for me. We don't vax or circ and they've been fine with that, too. They were very respectful of our birth plans and, I think, as knowledgeable and skilled as an OB or midwife...philosophically, they straddle the line between the two.


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## Hollin (Jun 26, 2005)

The baby I just had was delivered by a GP and I got pre-natal care from him too. He was great and pretty much let me do what I wanted. He did seem more hands off than the OB I saw with my first. My OB stripped my membranes without asking at 37 weeks. The GP didn't even want to do routine vaginal exams until 40 weeks.


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## kltroy (Sep 30, 2006)

I had my VBAC 8 months ago with a Family Practice doc. It was a really great experience! Like midwives, they are not surgeons (so less likely to rush to cutting), and generally take a more holistic approach to things... perhaps it's because they're caring for both mom AND baby? Anyway, my birth story is in my sig - I was very pleased and had a completely natural birth.


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## alegna (Jan 14, 2003)

In many areas FP won't even consider it due to the malpractice insurance.

-Angela


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## neverdoingitagain (Mar 30, 2005)

I'm in Canada, so my experience might not be too relevant.
Both of my pregnancies were with a family doctor. My first delivery was with an OB due to an unexpected complication. Second was with a family doctor, with the complication under control (if that makes sense







)
My second birth with the family doctor was much more relaxed and he respected my decisions. I still giggle a little when the nurse told him that I said I was ready to push (probably expecting him to confirm that I was indeed ready), and he told her that if a woman says she's ready to push, she's ready.








I'm surprised that more people on here aren't using a family doctor and are going to OBs. Aren't OB's more expensive?


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## Peony (Nov 27, 2003)

FP here are the only docs that will do VBACs.







I've known several women that have birthed with one after previously birthing with an OB and they all have been very pleased with their care.


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## Veritaserum (Apr 24, 2004)

For family practice docs that are still doing maternity, many of them are more relaxed about technology and birth. I teach childbirth education and two out of the three doctors I feel comfortable recommending are family practice. You still need to ask questions, though. I used a family practice doc with my first baby and I ended up with an elective "totally safe" pitocin induction with AROM at 3cm, npo, and an epidural. So, some of them are still going to be medically-minded. Same goes for midwives, too, though. You need to ask questions.


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## cappuccinosmom (Dec 28, 2003)

My parents were FP's and delivered a few babies in their time. If I knew an FP like my folks who was willing to do deliveries and was natural-birth friendly, I'd go for it.

My mom even had a patient nearly deliver a footling breech in her car, having come to mom's office in labor instead of gone to the hospital. Oops! Natural birth though, and healthy baby.







:


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## doctorjen (May 29, 2003)

Quote:


Originally Posted by *alegna* 
In many areas FP won't even consider it due to the malpractice insurance.

-Angela

Actually, we don't suffer quite the same malpractice issue as the OBs due - but many family docs still choose not to provide maternity care due to lifestyle issues, or feeling inadequately trained, or (and this is a big one) inability to get privileges and support due to the OB monopoly in the US.

In general, family docs that do maternity tend to be more evidenced based than OBs. Our training focuses a lot more on evidence and our speciality's position statements and protocols tend to be more in line with the actual evidence and less about medical-legal risk. (Such as our VBAC statement, comparared with ACOG's)

I'm a family doc who does attend births - about 60-70 a year, with in general very low intervention rates and a high rate of client satisfaction (judging by the number that come back to me for baby #2 and 3 and the number of family/friend referrals I get.) I have a personal belief that all routine maternity care in the US ought to be provided by non-surgical providers - family docs and midwives, and we should let the OBs do what they do, which is operate.

One caution about using a family doc or a midwife in a hospital setting is that it is important to know what their back up situation looks like and how much they have to follow the policies and protocols of their hospital and their surgical back up. I practice in a great situation with a very supportive OB who stays out of my way unless I need him, and then just arrives to do what I want him for. Still, when my hospital banned VBACs, I was stuck like everybody else (prior to that I had an over 90% success rate.) Some family docs have very restrictive hospital policies that require them to consult OB for just about everything (one hospital I know of family docs have to consult before they can even do AROM) and that often leads to a situation where the OB is actually in the hallway calling the shots and it's someone you've never met. (This is the same for some hospital CNMs as well.)


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## lookingforaname (Jun 17, 2007)

I'm using a family practice doctor who says she's been accused of acting like a midwife. . .

Love her!

I am sorta worried about her backup support, since she's just one person, but she assures me that all the docs in her group are natural friendly . . . . I don't know though. That's the main thing that worries me. I DO miss the midwives we used for our first two (have since moved to a locale without midwives around. . . )


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## dogmom327 (Apr 19, 2007)

I birth at home with a CPM/DEM so a low-risk hospital birth isn't something I can picture well, but if for some reason that wasn't an option, this would be the order of my preference:

CNM (around here they are the only MW's with hospital privileges)
Family Practice Doc (lower intervention and better continuity of care through the birth)
OB as a very last resort


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## Romana (Mar 3, 2006)

It depends on the individual doctor, but generally speaking, family practice physicians are much more natural-birth friendly/supportive than OBs. Partly because OBs approach birth with the mindset that if it doesn't work out, they can always just do a c-section. A family practice physician would have to call in another doctor to do the surgery, so the whole approach is a bit different. Many doctors who wanted to deliver babies but hated OB went into family practice medicine so their could do it differently.

There aren't many who do this, however, because the malpractice insurance is so expensive.

Both CNMs and some family practice doctors can deliver babies in the hospital (or out of hospital). I would interview some of each and see who you feel would be the best fit.

Avoid seeing an OB if possible. Also, it helps to get opinions from local doulas - they see a lot of different doctors/midwives in action and can give you the inside scoop.


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## mommyfied (Jun 25, 2007)

I considered a family practice doc this time after feeling like I'd exhausted my OB options in this area. She actually was okay with me breastfeeding while pregnant and I really liked her. My last OB had told me my miscarriage was due to BF.









Anyway, my particular FP doc did not do deliveries herself. Rather, she did all the prenatal care and when it came to the birth it would be handled by the family practice residents. They are overseen by an OB, but according to one of the NPs at the family practice, he was NCB friendly even back in the 80s (he was her OB). I still think this would probably be my best in-hospital bet for this area, but I ended up going with a midwife and homebirth instead.


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## elanorh (Feb 1, 2006)

DH and I have a friend who is a Family Practitioner (out of school for maybe 3-4 years now?). He and I had a great time telling birth stories when we visited last.

His thought is that every woman is different, and we do amazing work while delivering babies. Give mom time, support, etc. and let nature take its course. He said some doctors become nervous about timelines or etc., but he definitely has a natural approach to it.

He's FP because he's from the rural midwest and wanted to provide that service (there's a serious medical drain from many rural areas). I gathered that in their community, it's pretty much FP for birth - those who want OBs need to travel further (and some do). It's a mw friendly state, so he works with mw's too I think. He's much less freaked out than our OB friend is, about another mutual friend who had a homebirth with a CPM.









I agree with others who say the real key is finding out their mindset. My OB is very midwife minded, NCB, extended bf supportive .... If he could do homebirths, with liability insurance, I'd have him do one in a heartbeat.


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## goatmom (Jan 9, 2009)

I had an FP for prenatal care with four babies. With the fourth, I had the same FP do the care and deliver the baby. In the military, it is quite common. With my first three, there was an OB residency at the hospital, so they did all the deliveries. With the fourth baby, there was an FP residency so they delivered the babies too. And that was a VBAC delivery. I loved them. I esp liked that they would know my whole family and also be the pediatrician. If things are relatively uncomplicated - it is a great way to do it. All the FPs I have used knew when to call for help. With my 5th, I had a complication, so I was sent to the high risk OB by my FP. She still stopped by while I was in labor to see how I was doing. Unfortunately, with this baby, I don't have a choice. Good luck with your decision.


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## SallyN (Feb 5, 2008)

I just switched from a CNM who reports to an OB to a CNM who reports to an FP.

I'm sure much of the difference b/w the two midwives and two doctors has much to do with personality, but I'm finding myself MUCH happier with the CNM/FP pair.


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## seraphim0517 (Jan 7, 2009)

I used a FP for #1, ok for a hospital way way better than an OB. #2 used a mw at home, and we are getting ready to UC with #3.


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## MyBoysBlue (Apr 27, 2007)

I had an FP for my first. He was pretty relaxed. He did try to give me an episotomy. But he listened When I told him no. So over all not bad. He was ok. I wanted to go with him for my second too, but he had semi retired and didn't deliveries anymore. I am thankful for that as I was forced to see a few other docs one of whom was so horrible that I was finally able to commit to a UC for my second.


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## LokiPuck (Jan 11, 2003)

I had an FP for prenatal and delivery. She was awesome. Very supportive of my birth choices, didn't nag me about my weight gain (about 50 lbs), didn't hassle me when I declined prenatal testing for birth defects. She was low key during my labor, taking a let's wait and see approach, even though I had developed pre-e during the last few weeks and ended up having to be induced.

She is actually a friend of the family. I will definitely be using her again when/if I have another pregnancy.


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## Storm Bride (Mar 2, 2005)

My primary care in my first three pregnancies was with a family physician. My GP would have attended for the birth of ds1, but they called an "emergency" c-section when I got to the hospital. He apparently assisted with the surgery, but I was already unconscious by the time he entered OR.

He quit handling obstetrics cases, so I switched to his wife for those (he is still my main medical care provider, however) with my second and third pregnancy. I had the vast majority of my prenatal appointments with her, but also consulted with an OB, because of my "high risk" status after having a c-section. Both of those ended in c-sections.

I've only consulted with an OB - never had one for primary care. I may go that route this time, but I'm still seeing both doctors concurrently and deciding which route to take. I do find the atmosphere in my GP's office much more friendly, but I have some negative associations due to my last few experiences. The new (wouldn't go back to the last one if he were the only practicing OB on the planet) OB's _office_ sucks...but she's awesome.


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## turtlewomyn (Jun 5, 2005)

Our FP is also an OB and does deliveries. I might use him, if I decide not to go the homebirth route (I had two pregnancy losses last year including an ectopic with emergency surgery, so I am putting off deciding a birth location until I actually have a healthy pregnancy again, if I wanted to homebirth I would have some additional obstacles in this area because it is an HBAC).

He is one of the few doctors in town that does VBAC and the only one I know of that will attend a twin birth. He is pretty open to listening to mom and answering questions. I don't know if this has anything with him being an FP or not.

He did stop for a while (I think due to the malpractice insurance) but is back at it.


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## Norasmomma (Feb 26, 2008)

I had an FP for my DD, she was not the Dr that attended her birth because she was out of town, but her replacement was a pediatrician who also delivers babies. I ended up having an emergency c/s due to my uterus pretty much giving out and DD's crashing, but they let me labor for a very long time without interventions before it became apparent that _some_ intervention was necessary. I pushed for almost 3 hours until my uterus became so fatigued and DD was stuck beyond belief(after 30+hour labor).

I very much enjoyed my experience with the Dr who did attend the birth and her colleague who ultimately did my c/s, they all treated me wonderfully and I am going to go to the same Dr who did attend DD's birth. My FP still takes care of our medical needs, but I really like the bedside manner of the other Dr, she is a little, spunky lady and would love for her to do my rc/s(can't vbac due to a large fragile T incision and high risk of uterine rupture). I'm okay with it, all the Dr's were really good.

Most of the docs around her are FP with birthing credentials(I live in a small area). There are a couple OBGYN's but they are all awful male dr's and I wouldn't go to any of them, they are rude and have terrible bedside manner.


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