Ob-Gyn -- Solo Practice vs Group Practice?

I'm actually extremely happier with midwives--they stay with you through the entire labor. By phone and in person.
I had a great experience.
my ladies (they are in a practice with 4 obs so you have that safety net as well--OBs that understand bedside care)
Debi Lesnick & Gaye Koconis
North Shore Associates
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I went to a solo practice doctor my entire first pregnancy. I went into labor on the weekend and he wasn't on call so another doctor delivered my baby. I think you should stick with the doctor(s) that you are most comfortable with now because there are no guarantees when it comes to delivery unless it is planned.

I agree that you should be comfortable with the dr that delivers. However, and maybe I had a different experience then most, the dr. that delivered my son was in the room like 15 minutes of the delivery. Pretty much only the time it was to deliver. Maybe others have had the dr in longer but even if I would have got one of the dr that wasn't my preference (my normal dr was actually late) I still felt that the others were good drs. Good luck.

I had 3 children.The first 2 with a " solo" doctor,the last one with a women group practice.
At the end to be honest, it's most important to have a great nurse.My last nurse was there for me and my younger children,they were in the room with me to watch the last one being born.It lasted 15 hours, she even worked some overtime to be there with me,I loved her.The doctor was just there for an hour max.
I liked the group practice better, at the end.
Congrats and good luck.

for what it's worth...I worked with practices (different ones) for each of my pregnancies. When my first was born I got the doc whose style I liked least, but she turned out to be fabulous and the experience was positive.
The same thing happened when my twins were born - the 4 in the group all had different levels of comfort with vaginal delivery for twins and i got the one whose approach least matched mine. In the end though, I feel like I had the birth experiences that I was supposed to have. I was glad that I had docs that would not just "yes" me - they listened and took my wishes into consideration but were still confident in their approach and we came to decisions together...it ended up being a nice collaboration.

The birth often does not go as planned. It's good to have a plan, but it's better to plan for that plan to change. A good primer for motherhood :)
Good luck with your decision.
O.

I delivered 3 kids with 3 different doctors. To be honest, the doctors did not make that much difference. What was most important was the NURSES. Your labor nurse is with you for the entire time, and it's who you deal with for everything.

The doctor just swept in when it was time to deliver, but it was my nurse who helped me get what I needed for my many hours of labor. (Shout out to the wonderful delivery nurses at Good Shepherd).

I used a midwife practice with three nurse-midwives and I loved them all... three was a good number so that I got to know all of them (and they me), and there was no fear of them all being sick or out of town when I delivered. I've accompanied a few friends during labor and delivery with an ob/gyn, and in my experience the ob/gyn has very little to do with the delivery - literally only comes in to catch the baby. It's the nurses who check your progress during labor and coach you on pushing. You're right that the individual doctor makes the call on episiotomy, but pain meds are all your choice, and it's the nurses who may pressure you one way or another on that.

Didn't even have time to read all of the responses, but I'll give you my take on it. With my 1st and now my 2nd, I go to a group of 3 women ob/gyns. Although I do have my preferences, I think you must remember that you should empower yourself to let them each know your wishes. Don't be intimidated by their status. It's incredibly important to make sure you communicate the same concerns with each doc, even though they are suppose to write everything in your chart so that they are communicating with each other. Things can get lost in translation.

If one of the docs disagrees with you and the others don't, I would let those that agree with you know that you don't feel comfortable with that other doc or that you have a fear that they will not comply with your needs/wants. Keep the communication lines waaaay open with them. It's your body and your baby. I was a super easy patient, but I can't tell you how many times I had to stop the docs as they were literally walking out the door and basically force them to listen to my questions and concerns. It was worth it, and they respected me for it. Good luck in which ever choice you make.

I've had babies both ways. My first two were more from a solo practice. (an OB-GYN and a midwife) and the third was a group practice. As you said there are positives to both. With a group practice you are more likely to get in to see a doctor at a preferred time because there are more doctors available. With the group doctors I also had more technology available if I needed (ie: sonogram machines in office and blood drawn in office). But with the group practice I didn't feel like the doctors knew me as well. Personally I liked the solo practice better. I would've continued to go there if we hadn't moved 2 1/2 hours away. I think it is important to be comfortable with all your doctors though, because you don't know who will deliver. Just because they are a midwife does NOT mean they are better or worse though. With my first my OB delivered and my second her midwife. I personally had a better expirience with the OB. Although the midwife checked on me more through the day (I was induced with my first two and in labor for many hours with both) when it came time for delivery my OB talked to me and explained things to me and helped me, etc.. etc.. The midwife was more content to just talk to the nurses in the room and I felt more like "HI!!! I"M IN ACTIVE LABOR HERE!!!" With my third I was delivered by a midwife and it was a very positive expirience she was very comforting and helpful. I got lucky to get someone I liked of the group practice. So, it is important to be with someone you are comfortable with. And I think it is more improtant to ne comfortble with a majority of the people if it is a group practice. If your prior OB is too far away maybe you can check with other people (if you know anyone in the area) and see if they had an OB or group practice they really liked or were really happy with.
Another thing to consider is if you furthur away doctor deliveres at a hospital that is furthur away or not. Many doctor deliver at the same hosipital, so that may not be an issue.If you are induced it won't be too big an issue, except usually if you are induced they ask you to get to the hospital early in the morning (6:00 am for both my older kids), which can mean leaving REALLY early to get there on time. But if you are having contractions the furthur away you are and longer you are in the car the more uncomfortable it is. I went into labor on my own with my third and it was about a half hour drive to the hospital, which isn't bad, but feels longer than that with contractions every 5 minutes. So I know this was alo of babbling, but I hope somewhat helpful. Good Luck! and Healthful Pregnancy!

I went to an OB/Gyn practice with 2 doctors and two nurse midwives. Although both doctors were completely competent, I definitely felt more comfortable with one than with the other. HOWEVER- when it came down to it, I saw the nurse-midwives more than either doctor during my pregnancy. Nurse-midwives are the BEST!!!

when it was time to deliver, I was in labor a VERY long time (not to worry- it is not the same for everyone!) the point is, I was there for so long that I cycled through both doctors and both nurse-midwives coming in to visit and check on me and the hospital nursing staff had changed shifts and come back again! So I saw pretty much EVERYONE at some point, but went into labor with one of the nurse-midwives present. So you really don't know who you'll end up with in a group practice.

But, honestly, I don't know for me if it would have made that much difference. The nursing staff were so attentive, and so comforting and terrific while I was in labor, but not yet 'bearing down' that they really made the most impression on me.

Once it was time to actually get to work and start pushing, you could have marched a band through the room and I would not have noticed. I was so intent on the physical act of pushing and the labor itself, that the rest of it just really didn't matter very much to me at the time.

So I don't know if that helps. All I can say, is if you go with the group practice, at least you have a good chance of being familiar with everyone, even if they aren't your favorite. You could always also have a doula or make sure your husband has your birth plan if you are really concerned about it. But honestly- when it comes down to it, you will push and be focused on that and end up with the baby! If you are like me, a lot of the 'getting there' part of the day will be a giant blur!! Good luck!

Congrats on your first baby!

It's great that you are being so thoughtful about choosing a practitioner. I loved what you said about how, when you are in labor, you are "stuck" with your provider -- so true!

I was just reading this great piece from Childbirth Connections:
http://www.childbirthconnection.org/article.asp?ClickedLi...

I thought of it when I read your post. Keep in mind that it is focused more on midwifery care -- which might not be of interest to you. But I liked the part about what to consider when choosing a provider. Hope this helps!

J.
Birthways Labor Support and Postpartum Doulas

I just wanted to throw in my vote for a midwife. I had a very competent one for my first pregnancy. She had her own office, but alternated shifts at the hospital with two other midwives. They were also affiliated with two doctors that were on call in case any complications arose or any surgery needed to be done. The practice of midwifery treats the entire pregnancy through different eyes than those of a doctor, and I feel it best cares for both the mother and child. Midwifes are also more open to letting you have more say so over your labor and delivery. I ALSO would highly, highly, highly recommend Bradley classes for birth education. They are a little more expensive than what the hospital typically offers, but are sooo worth it. They teach you how to have a healthy pregnancy, and do a really good job of preparing you for childbirth so that you have the best experience possible and the baby has the best experience, too!

I have a group practice and it worked out well when my daughter was born (we were also induced, so I knew ahead of time who the doc of the day was). When it comes to using pain meds etc, it's YOUR opinions that count, so no matter which direction you go, make sure what you want is documented. If you choose a group practice, you can ask for an "on call" schedule for the practice that way you know before going to the hospital who will be there.

Hi :)

Have you considered a Certified Nurse Midwife? They are required to be backed by an OBGYN (surgeon) but are very attuned to the birthing process as it occurs naturally. It may be refreshing to investigate that as an option as well.
They also deliver in hospitals, unlike what most people conjure up when they think "midwife" (unfortunately.)

I have birthed both of my daughters with CNMs and have had wonderful experiences both times (with different ones) and would be happy to talk more about this if you would like.

Congratulations!
M.

SY-

I went to a group practice and did like all the doctor's in the practice, however, NONE of the doctor's in my practice were on call the night my son was born so I ended up having a completely different doctor deliver my son. He was WONDERFUL, but the person that was in the room with me the whole time (besides my husband) was the Labor and Delivery nurse and she was absolutely AWESOME! The doctor was in the room for about 5 minutes before my son was born. So to me the nurse was the best part of the delivery process.

Just wanted to share with you - it's a hard decision to make because the labor part of pregnancy is so important and so scary! My doctor's were also part of a nationally ranked hospital for Labor and Delivery (we lived just outside of Boston, MA at the time) so that helped with knowing that my son and I were in great hands, no matter what.

I've done it both ways & prefer solo practice. I had a very good OB office for my first baby & hadn't met all of the docs yet, ended up with the last one I hadn't met on the day of my delivery. Nice to have a stranger in there lol. With my second I found an excellent solo practice & ended up needing a C-section. It was good to know I was in great hands, wouldn't have been as secure with a stranger doing that, though he did grab another doc to assist, but they were obviously used to working together they chatted all about football during the procedure! lol. I told them I thought doctors only talk about golf & we all laughed. Seriously, both have their benefits, I suppose my doc hardly ever gets a vacation or arranges a sub well in advance & introduces them to his patients, but it really was nice to know & trust my doc & have him actually do the delivery.

Good luck & congrats!!
D.
ps, I HIGHLY recommend WomanCare in Palatine, I used to see them for the regular checkups, they're excellent.

A friend of mine who was due yesterday (still no baby yet) has seen a nurse-midwife for all 3 of her pregnancies. The problem this time for her, was that her midwife lost her partner in the practice and is without another partner until next week. So, her midwife didn't have a "backup" in case she had to deliver 2 babies at once. And every time she had to deliver during office hours, all of her patients were rescheduled. Her midwife had 19 babies to deliver in September all by herself. That may be an issue for you with a single provider practice. Also, your old doctor may not be on staff at your local hospital, which would mean that you would have to drive all the way out to whatever hospital she is on staff at, in the throws of labor. Or what if you have an emergency and you go to your local hospital? Your doctor wouldn't be able to treat you at that hospital. My doctor belongs to a group of 6 great doctors. There is one there that I really didn't like, but I only saw her once and she was not on call when I delivered. Both of my kids were also scheduled inductions, and I had my doctor both times. My doctor really made sure that she was available for me, too. With my first child, my doctor was seeing patients in the office, and when my nurse called and told her that it was time for me to push, the doctor ran right over and delivered my son, while the nurse-practioner saw her patients in the office. It only took a half hour, so after I delivered and she sewed me up, she went right back to seeing patients in the office. Then she came by after hours to check on me. The second time, she was at the hospital doing scheduled c-sections, and she timed my deliver to be in between the 2 surgeries. (She is that good!) So the odds are, you will get your doctor for the actual delivery, as long as it's not in the middle of the night. I suggest you stay where you are at, as long as you have seen a couple of doctors that you like. And you should see all of them. You might like the other 2 also, and then you would have 4 out of 6 that you like. I hope this helps. Good luck and congratulations!

You should definitely feel comfortable with your doctors, but one thing to keep in mind is that during your pregnancy, you'll go to the doctor roughly 15 times. The plan is every 4 weeks until you are 28 weeks, then every two weeks until 36 weeks, then every week until your due date. If you go late, you'll go twice a week. At the end it feels like you live at the doctor's office. Is it realistic that you can make that drive every week when you are 36 weeks pregnant?

My doctor is a group practice, but they don't have the "delivery of the day" person so you are guaranteed to have your doctor deliver you anytime except three weekends a month and when they are on vacation. If you are in the city and want their info, drop me a note.

Good luck.

I used a solo practice for both of my babies.. two different ones. The first one, I didn't like because of my labor experience, but the whole 10 months of pregnancy was fine.

The second one, I had a great experience all the way. My doctor is awesome, and the couple of times he was out of town, the doctor covering for him was also wonderful. They are both out of Good Shepherd in Barrington. I had a planned C-section for the second baby, but he decided to try to come 3 weeks early, and my doc was right there at the hospital at 5 am on a Sunday to get him out for me! He was wonderful.

So I like solo practice, but that's all I've known.

I haven't read your other responses so I hope I'm not repeating stuff! I'd talk about your concerns to a doctor in the practice with whom you feel comfortable. I had a similar situation with my OBGYN. They had 2 highly qualified and educated and experienced midwives. I was comfortable with them doing my routine exams and trusted their advise and answers to our questions, but I wanted a doctor at the birth. They worked with me, were non judgemental (I was afraid they would be offended), and a doctor delivered my baby. If they are a good practice, then they will understand where you are coming from and make you feel comfortable about your decision.

Have you thought about seeing a nurse-midwife? I saw mine, and I got either 30-min or 60-min of her undivided attention for each appointment, which you do not get with a doctor. Nice thing is that a midwife completely respects the decisions you make about your body. When interviewing a midwife or doctor, there are a few questions you should ask depending how you want your birth because you and your husband are going to be the true advocates about your delivery and how you would like it to go (though we know the baby has other things in mind. :)

The episiotomy rate should be less than 2% anything higher is a red flag
The c-section rate should be less than 15%.
What is the doctor's philosophies towards labor and delivery? Are they willing to work with you no matter how long it takes or are they quick to induce and if labor doesn't progress fast enough for them, will you have a c-section. The typical first time mom will labor an average of 24-30hrs...many docs do not wait that long...though some do, so you have to ask.
Does the doctor keep up with the latest research and trends. The ACOG now says laboring women are allowed to have light liquids such as juice, broth, jello, etc...though these guidelines just came out in August...can't tell you how many do not know their own organization changed this.

Since my insurance changed, I am now seeing a solo Doctor of Osteopathy aka DO but she is still an OB/GYN, (she just hired a doc to help her with clinicals once a week while she is in surgery, but that is it) she has a 4% c-section rate and a very successful VBAC rate, she works with you and is with you throughout your entire labor and delivery. I am very excited about her knowledge base and is comparably to a midwifes. She is up on the new recommendations for pregnant women to be taking at least 5000iu of vitamin d3, she recommends good, quality prenatals (many of the prescriptions are not that good...honestly) and she completely honors what your body does.

As you can see, you have to get a feel for what you really want and how you want your outcome.

Feel free to send me a message if you want more info.

J. W. MPH
Maternal and Child Health Educator
Chicago Examiner Family Health Expert
http://www.examiner.com/x-7158-Chicago-Family-Health-Exam...

I had both my children delivered with a "Solo" practice and was really happy - I personally like seeing the same person at every visit so the Dr. was familiar with my entire pregnancy -I was also concerned about "luck of the draw". The major difference is that I had been the practice for 15 years and was also uncomfortable with changing. I moved to Carol Stream and drove to Arl. Hts and delievered at Northwest Community instead of CDH. There is another Dr. in the office who can address problems if he is unavailable, but he is aware directs treatment. With my last baby in July, there was a very real possibility that his back up practice would deliver our daughter because he was on vacation (he stratigically schedules them based on how many pregnancies he is managing- and know when he tends to be busier)- he actually checked in with the office (from Europe) while on vacation since there were some concerns at the end. Ultimately, he delivered her the mornign after he got back and everythign went smoothly There are pitfalls - your appointments can be rescheduled often if the dr. is delivering, or you may have to wait (my Dr. was ALWAYS running late) if something comes up. He told me honestly how he handles deliveries etc when I was pregnant with my 1st and gave me the option to go to another practice after my 1st visit if I was uncomfortable. Good Luck - the most important thing is you are comfortable with the care you receive.

If you choose a group practice you NEED to be ok with ANY of the members of the group being "on" the day you go into labor. Yes, it is luck of the draw. Now, theoretically, group members should share a common philosophy, but this is not always the case.

If you are healthy and low risk, I highly suggest seeing midwives instead of OB/Gyns. Midwives are trained to support normal healthy pregnancies - they differ philosophically from a doctor in that they consider pregnancy and birth to be a natural physiologic process that generally works well with little intervention. OB/GYNs are trained surgeons who receive specialized training to deal with complications and high risk pregnancies. They view pregnancy and birth as a medical condition that needs to be treated and monitored closely and cautiously.

You might also be interested in knowing the 2008 c-section rates for several hospitals in the Chicago Area. Individual practices may vary, of course, but this should give you a sense of the overall level of intervention you can expect if you birth at a particular hospital. I will also note that the outcomes for these locations (as measured by # deliveries versus # live births, and # NICU days per baby) are NOT different from one another. The source data for this can be found here: http://www.idph.state.il.us/about/hfpb/pdf/2008 Hospital Profile.pdf

43% Rush University Medical Center 2061 births 894 c-sections
40% Advocate Good Shepard in Barrington IL 1724 births 698 c-sections.
35% Advocate Med Center in Oak Lawn 4233 births 1520 c-sections.
34% St. Joes's Chicago 1895 births 647 c-sections
30% Advocate Condell, Libertyville 545 births 165 c-sections
29% UofC Med Center(Maryland St. South-Side) 2013 births 585 c-sections and Illinois Masonic Chicago 2931 births 866 c-sections.
28% Northwestern Hospital, Chicago 11,958 births 3418 c-sections.
26% Elmhurst Hospital, 1426 births 374 c-sections and Evanston Hospital 3,590 births 966 c-sections, and Hisndale Hospital 2252 births 588 c-sections.
25% Swedish Convenant, Chicago 2464 births 618 c-sections.
20% West Suburban Hospital, Oak Park, IL 2175 births 453 c-sections.
14% Uof IL Med Center(Taylor St.) 2893 births 433 c-sections

Hi

Firstly, congratulations on your pregnancy! It is indeed a wonderful time in a woman's life and pregnancy, labor and becoming a mum are all huge, life changing experiences. Good on you for wanting to think through your birthing options at this stage. Women who take control, inform themselves of their options, ask questions and do the preparation have consistently been shown to have more positive birthing experiences and better outcomes both for themselves and for the baby.

You are so right to question who will be there at your labor because that will profoundly affect the type of labor and the experience you have. I am from the UK but came over here three years ago after which i shortly became pregnant for the first time. Being in a strange country I had to start from scratch in terms of finding providers and working out your system. I am also a Clinical Psychologist who has specialized in physical health so i know the importance of getting these choices right. Did you know that the USA is one of the only countries in the western world who uses ob/gyns to deliver babies? Did you also know that ob/gyns are predominately trained to be surgeons and are not trained in the 'art; of delivering babies. In fact very few ob/gyns ever get to observe a natural labor, (i.e. one that is not induced, not hurried according to a hospital scheduled and not restricted by keeping a woman lying on a bed unable to move and unable to eat or drink)? In virtually every other developed country we use midwifes who are trained in the art of supporting a woman's body to do what it knows how to do. I would like to challenge you on birthing being a life-threatening situation. It rarely, rarely is. Interestingly, the USA who uses ob/gyns (you would think the safest option) to deliver 99% of babies has one of the the highest infant and mother mortality rate in the western world ( i think only second to Cuba?).

I had my daughter with an independent midwife practice (A Womans Place) at a birthing centre in a hospital. I can honestly say it was the most incredible day of my life. I had a small team - my amazing husband, my wonderful midwife and an incredible doula (Tanya McHale - did you know that the research shows that having another supportive woman with you who is experienced in labor can shorten your labor and make it a more positive experience for you). I was encouraged to eat, drink, move around, get in and out of a hot bath and do it all in my own time. How any woman can birth without these basic things is beyond me - labor is a physical marathon and to not be able to eat and drink would have been tantamount to torture...and physically impossible...no wonder ob/gyns have to resort to drugs, cutting, suctioning or c-sections. I gave birth without any intervention, needed no stitches and two weeks after the labor, it was as if i had never given birth. This is not uncommon amongst my group of friends back in the UK but seems to be unusual for women i have met here.

If you are interested in learning more about this (and I appreciate it goes against USA cultural norms, beliefs and service provision - it's a big ask to get anyone to think outside of the box they are used to) I found the following very useful in beginning to understand the choices available to pregnant women:

Ricki Lake's documentary The Business of Being Born - watch the trailer at the website (you can rent it from netflix)
http://www.thebusinessofbeingborn.com/

Ricki Lake's book 'Your Best Birth"
http://www.mybestbirth.com/

Ina-May Gaskin's book Guide to childbirth - if a pregnant woman was to do only one thing to prepare for her labor it should be to read this book. The first half of the book is just beautiful, gentle, positive birthing stories that help you to remove the cultural bias we have been indoctrinated with that birth is all about panic, rushing to hospital, beeping monitors and PAIN!!! It also covers the mind/body aspects of labor - that just like every other mammal, we need privacy, peace and quiet and time in order for our bodies to labor efficiently, for the hormone pathways to work optimally. Strangers, bright lights, being required to fill out a million forms (?!), fear etc all switch off your birthing hormones (hence the almost ubiquitous need for pitocin in the USA).

http://www.amazon.com/s/ref=nb_ss?url=search-alias%3Daps&...

The documentary Pregnant in America, also available on Netflix.
http://www.pregnantinamerica.com/newsite/trailer/youtube/

It is quite a journey to go on - to get your head round all of this - but for me, one so worth it. I don't think you can put a price on having the birth day of your baby being the most incredible experience. It is so wonderful for my husband and i to be able to look back at the day our daughter was born as the most magical day of our lives. It also meant that she had a gentle beginning to her life and neither of us had to cope with getting over any hangovers from medication or recovering from head wounds due to ventouse/forcep delivery, or even having six weeks without being able to hold her easily due to recovering from a c-section - you just hit the ground running so to speak!
And yes, to finally answer your question, one provider you know well is preferable. There is no place for a stranger or even a practitioner you do not like and trust at a normal birth - that alone can switch off birthing hormones and switch on our animalistic 'flight or fight' hormones.....

I wish you all the very best with whatever choices you make. There are more conservative and sensitive ob/gyns out there if you decide to continue on that path - just make sure you ask the right questions and know your rights - Ricki Lake's book is fabulous for this.

I understand completely. I love my practice and as a natural childbirth educator, many of my clients have gone to them. They are located out of Lisle called the Dupage Health Specialists ###-###-####. I have had very good experiences and it is a woman's practice. Please feel free to contact me should you have any questions I would be happy to help!

Well, although my OB is part of an outstanding group practice, with my first child I NEVER saw any of the other docs and my OB was there for my emergency c-section. For my 2nd, I saw 2 or 3 of the docs in the practice.. liked them all... but again my OB was my doc the whole time, made all important decisions with me... and we ended up having to schedule another c-section anyway. My OB office is part of a teaching hospital, so I knew going in that the chances of my OB being at the hospital or her office if I went into labor were high anyway. A lot goes on during those 9 months. You're going to end up having weekly appointments and possibly even more than that at the end. Lots can happen. I certainly would not want to be an hour away from my doc and hospital. You may end up having to go to the nearest hospital in the event of an emergency or if your labor progresses really, really quickly, which does happen. I'd really think about that distance. Maybe your OB from the past could refer you to someone closer to where you live that shares a similar philosophy...

I have been with a group practice for both of my girls. They make you see each doctor at least once so you at least know who they are. After that, you can schedule with the doctors that you prefer. There were 2 out of the 4 or 5 that I preferred. After I met with all of them, I scheduled all my appointments with one of the 2 that I liked. My first was induced, so the doctor at my last appointment scheduled it for when he was on call. My second came early and I did end up with one of the ones I preferred. I would go with the closer hospital because you never know how long you will have to get there once labor starts. If you like most of the doctors, but not 1 or 2, you should have a pretty good chance of getting a doctor that you like. They also ask you at one of your appointments as your due date nears if you will be wanting pain medication so it is on your chart. I don't know of any doctor that wouldn't give pain medication unless you are too far along in labor or some medical reason, otherwise you shouldn't have a problem. I also think most will do an episiotomy if it is necessary so I wouldn't worry about either one. Good luck and hope this helps! I agree with Cari M, the nurses do all the work, the doctor doesn't come in until the baby is ready to come out. The nurses are the ones who will make you feel comfortable and everything else. You'll probably see your doctor for about 15-20 minutes or so and that's it.

My first baby was with a group practice, my second baby was with a solot Oby-Gyn. I much prefer the solo Oby-Gyn. There was 1 or 2 doctors I liked at the group practice, but the group practice lacked a personal touch. The birth was fine, but didn't get the doctor I preferred.

It was when I called back after being pregnant again, and knowing something was wrong, that the nurses treated me like a number. Wait until you're at x number of weeks before coming in, and by the way, fax us your medical card. I said the pregnancy wasn't right, and they said I had to wait.

I immediately called a solo doc, got in to see her, and she confirmed my suspicions. She knows me, knows my family, and has a personal touch. She worked through some infertility, and when we finally became pregnant again, the delivery was so much better knowing she was there.

My vote is for solo oby-gyn.

My experiences with a group practice for pediatricians was nearly the same - it was more about the business and not about the patients. We ended up switching to a much smaller practice.

Best of luck!

If you are not comfortable with 2 out of six of them, and haven't even met two of them, get out! You're right when you say the person who delivers is critical. If you know already of a solo dr that you like, go see him/her. Your gut feeling usually is right, so go where you feel good about the care they are providing. If you don't know of a good solo dr in your area, post that. These women are great for giving advice on who they like & why.

Good luck

I go to a solo practitioner who is AWESOME. That doesn't mean that I would never consider a group, but I love my doc so much no way am I changing.

For what it is worth, when you go into labor you're going to spend WAY more time with the L&D nurses and your doctor will not be with you during the (potentially) several hours it takes you to labor. He/she may check in from time to time but until you're ready to push or it is "go time" they won't even be there. To me, it's more critical to make friends with the nurses, residents, etc. who will be spending WAY more time with you.

As far as your delivery wishes - you write out a birth plan to help guide the process. Talk to the NURSES first and be clear...again, they're the ones who will spend all the time with you before pushing begins. You DO get input regarding pain management, episiotomy, but write it all out in an easy to read form and bring it to the hospital with you.

I think it is all a personal preference as to whether you choose a group or solo doc, but quite honestly in the end the doctor that delivers your baby really won't be there until "showtime" and by that point you'll be so ready to get the baby out that you won't have time to worry about the little details - just "push 'em out"!

Practical example: I was in labor for 20 hours (starting around 4:00 pm). The doctor was in contact with the hospital but I did not even see him until the next morning, as there was no need. However, once I began to push...for 3 hours...he was there most of the time. Ironically, after 3 hours he said "Let's give you a break" and stepped out literally for 5 minutes. I delivered my baby without him even being there, but had like 3 nurses and a resident and all went fine. Of course as soon as the baby came out he was running back down the hall to help with the 'catch and clean'. All went well and all my delivery requests were fulfilled.

I had a group practice for my first 2 children, and there was a doctor in the group I didn't really like, so after doing the one appointment (as they like you to see everyone at least once) I scheduled all other appointments with the 2 I liked the best. Both deliveries I wound up having the one doctor I disliked the most doing the deliveries, as he was the one on call. I also had to go into Labor and Delivery for complications with my second, and he was the one on call that night as well.
For my 3rd pregnancy, I had moved in the middle of it, and switched to an OB practice where each OB delivered their own patients unless gone on vacation. So when compications arose, and I came in early, MY doctor was the one who responded! It was great to go into labor with the doctor I had built a relationship with.
The biggest concern I have for you is that you mentioned the solo doc is an hour away--you will have ALOT of appointments. The last trimester, you go every 2 weeks, and then once a week the last month--that is a lot of driving for those quickie appointments. That hour long drive can get pretty long.
Hope this gives you some food for thought.
Good luck!