Definition of Gynaecologist and Obstretrician
First and foremost, you need to differentiate between a Gynecologist and an Obstetrician. Obstetricians treat women before, during and after pregnancy. They routinely carry out ultra-sound scans on pregnant ladies, deliver babies and carry out surgical procedures, such as caesarean sections, when it becomes necessary due to the development of the pregnancy. They would also advise women on diet, exercise and lifestyle, perform diagnostic scans, order tests, and analyse laboratory test results. In simple terms, Obstetricians provide medical help and look after the pregnant women throughout their pregnancies and then deliver the babies for pregnant women. In Singapore, we need a Singapore Medical Council (“SMC”) registered and licensed Obstetrician to deliver babies in hospitals in Singapore.
Typically, gynaecologists diagnose and treat disorders and diseases of the female reproductive, genital, rectal and urinary organs. They routinely examine patients, perform scans using diagnostic imaging, and analyse laboratory test results. Gynaecologists also prescribe medication, and can advise on exercise and lifestyle changes. Sometimes, they also carry out surgery to correct abnormalities or remove diseased organs when needed. Hysterectomies are routinely carried out by gynaecologists.
Some gynaecologists choose to specialize in a particular field of gynaecological medicine, such as critical care medicine, fertility treatment or gynaecologic oncology, i.e. caring for patients with cancer. Gynaecologists are often train in obstetrics, which qualifies them to treat women during pregnancy and childbirth.
A Gynaecologist who is also trained in Obstetrics is commonly known as OB-GYN. It is quite uncommon in Singapore to find a Gynaecologist who is not trained in Obstetrics.
What should you look for in a suitable OB-GYN?
First and foremost, if your Gynaecologist knows your medical history and is also trained in obstetrics, it would be good to follow up with your current OB-GYN rather than changing to a new one. This is because you have already built familiarity and you are able to communicate properly with your current OB-GYN. You might also want to check out with SMC on the qualifications of your current doctor before you pursue further consultations with your current OB-GYN.
Choosing an OB-GYN is very a personal matter. Some women prefer their OB-GYN to be female because they acknowledge that their female OB-GYN would understand their situation better. Obstretrics and Gynaecology (O&G) is essentially a female related medical field, hence there would be such perceptions. Furthermore, most female ailments are private and it would be easier to talk to a lady doctor if we have any female medical ailments which needed to be treated by a gynaecologist. In actual fact, I had the very same notion when I went in search of an OB-GYN, only to find the most suitable OB-GYN in a very responsible, nice and calm male OB-GYN, who listened and understood my needs wholly
You might also want to take into consideration your medical history when choosing an OB-GYN. If you have chronic illnesses, such as high blood pressure, epilepsy, heart disease, or diabetes or other previous complications which might require special care, you should opt to be cared for by a perinatologist (a doctor who specializes in high-risk births). You must be absolutely honest with your OB-GYN about your critical illnesses. It would do you more harm than good to keep it from your attending physician. If you opt not to tell, you might not be able to get the required healthcare attention when your health or pregnancy runs into critical conditions. Hence, there must be a level of trust between the patient and OB-GYN.
Most OB-GYNs in Singapore have packages which are cheaper to take up if you know positively that you would be going through the whole course of your pregnancy with this OB-GYN. Usually the packages are offered from 16 weeks of pregnancy onwards.
If you need to find an OB-GYN and you are absolutely clueless, it would be appropriate to ask your family physician to recommend someone, or talk to friends or relatives who have recently had a baby or who work in healthcare. Childbirth educators or certified nurse-midwives are also good avenues for referrals. You can also search for renowned or recommended OB-GYN by browsing parenthood forums. Experienced mothers would be posting and discussing about the OB-GYN and it might be helpful to join in the forum and ask their opinions about the OB-GYN who they strongly recommend.
Another thing to note is the amount of money you are able to fork out for the whole pregnancy, labour and birth. In private hospitals in Singapore, it would costs S$5000 to S$9000 for normal vaginal births and S$8000 to S$15000 for caesarean births, depending on the type of room, costs of delivery and surgery which might be required during course of delivery. If you are considering the pricing, it would definitely be cheaper to seek healthcare attention from a SMC-registered and licensed OB-GYN at the Government Hospitals.
During your first visit to the OB-GYN, it would also useful to find out the doctor’s attitude about issues which are important to you, such as the routine use of interventions like IVs, continuous electronic fetal monitoring and episiotomy. You would not be able to predict how your pregnancy and childbirth would develop or turn out and what the individual situation would require, thus by asking and engaging your OB-GYN in the relevant questions which are important to you would help you recognize the general approach to care and practice patterns from your doctor’s responses to your questions.
You might also want to determine the doctor’s feelings about having a doula or other support people besides your partner present during labour and birth. You would be able to get a feel if your OB-GYN is supportive of natural birth and encourages breastfeeding. For myself, I wanted c-section from the time I knew I was pregnant. However, my OB-GYN advocates natural birth. He was able to sway me away from opting for c-section and to prepare myself for a natural birth which of course, did not take happen because my baby was too big and hence I had an urgent c-section at 38 weeks. You never know what to expect during child birth even though you might have engage a doula and prepared yourself for natural birth, only to end up in c-section.
Essentially, you are the only person who can determine which factors are more important to you. Pregnancy and childbirth are exciting, but they can also be stressful. So the best healthcare partner is one you feel comfortable with and is to communicate with easily. It helps to ask yourself questions like these:
- How comfortable do you feel with the doctor?
- Do you find it easy to ask questions of the doctor?
- Does the doctor explain things clearly and completely?
- Does the doctor seem interested in you personally?
- Does the doctor seem like someone who will respect your wishes?
Besides the above questions, you must also ask your OB-GYN who is his back-up doctor is when he is overseas on conferences or holidays. If the back-up doctor is someone that you like and trust, then it would be great but if the back-up doctor is not ideal for you, then you might want to discuss your options with your OB-GYN. Don’t change your OB-GYN unnecessarily. Work out your schedule with him or her and make sure that he or she could be around for your timely birth. If it’s impossible to find a balance in the schedules, then you might want to change but make a learned change because you might not be able to find another OB-GYN like your current one.
In addition, you might also want to consider the hospital which your OB-GYN is operating in so that you are comfortable with where you are giving birth as well as with your health provider. Most obstetricians practice only in the hospital, and many have admitting privileges to just one health institution. So essentially when you choose your OB-GYN, you are also choosing the place where you will be giving birth at.
If you have answered and researched all of the above, I am sure you are ready to choose an OB-GYN. It would be good to make a decision before the 16 weeks of pregnancy so that you can ride on the package which is a huge cost saving than paying your OB-GYN monthly consultations fee and also fees for your monthly ultrasound scans and routine tests.
(Reference has been made from www.babycentre.com and www.ehow.com)