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Tuesday
Jan042011

When Choosing an OB...

…do you choose a male or female? Why? 

This was a recent Navelgazing Midwife Facebook question. The answers were, as expected, all over the place. I’ll comment at the end. 

RR: When I chose an OB (I have a midwife this time), I chose a woman. I don't understand having a doctor that specializes in female body parts but lacks them himself. 

JB: I prefer a midwife. And female. No more MEDwives either.

(The MEDwives discussion comes in a later post.) 

MGD: A woman. No matter how many books a male OB will read, he will never know what a menstrual cramp or a contraction will feel like! 

PNB: I use to believe that having a woman would be best because she could sympathize with what I was going through and possibly relate to some of the issues of pregnancy, but after my first pregnancy and birth I know that isn't always true, even when the Dr. you are seeing is pregnant, which she was. So, after that, I didn't have a preference. 

HFT: I choose a midwife as well, but actually have been under the care of a male OB for the past year or so. Of the available OBs in this area, his practice allies with my philosophy more closely - so I guess my answer is whoever I can find that most closely provides what I'm looking for. I do prefer a female though. I'm not terribly keen on the idea of some strange man poking around my lady bits, medical degree or not. 

JW: Neither has preference. I have met enough women physicians that see pregnancy as a pathology and enough men that respect female autonomy. I have had a female OB, a male OB and a midwife attend my births. The male OB was far more respectful of my birth plan than the female OB. The midwife was the best - but I was much more cautious and thorough when I interviewed her. 

TS-K: A woman. And they have to have had children themselves. 

JD: I would always choose a midwife first. If I needed a surgeon, I would choose whoever I felt most comfortable with, gender wouldn't matter. For some reason I do prefer female Dr. for my kids though. 

CES: I don't think gender matters. What matters is having a health care provider that listens to you and respects your decisions, even if you do not agree. I love my OB. He is kind and very compassionate (to me, I don’t know about his experiences with others, but have not heard negative about him. I have never worked with him as a doula. However, I have a few choice words about his colleagues.) 

SGM: Instinctively, I would say woman. I prefer midwives, but since becoming a doula I would say that the male OBs seem a lot gentler than the women OBs. Males doing OB-GYN work still makes me think... why? Do they love women, or hate them? Money or perversion? I don't know. I over analyze things for sure. 

KBH: Jennifer took the words out of my mouth! Of all the OBs I've seen, I've probably gotten more patronizing, ignorant, and condescending remarks from the female physicians though, personally.

It really comes down to the person, male or female, the practice, and their philosophies to me. 

JA: I always thought a woman until I was pregnant with my first and saw a male OB who respected my birth wishes and who I felt most comfortable with... and cared for my husband as part of the birth team as well. 

AS-K: MIDWIFE. Period. I have seen female OB who loves to cut women so for an OB it doesn't matter which one but they'll never have the same respect for women as midwives do. 

LMS: After being betrayed by a trusted male OB, I am fairly certain I will be seeing female docs from here forward. Sadly, recent events have risked me out of future midwifery care. 

JRBB: Woman. There's just some things that men will never understand. The last male OB I went to drove me screaming for my current midwife. I have been treated by her partner/backup OB, a woman who is by far one of the sweetest people I have ever met. If I needed a surgeon, she's it, no questions. 

SS: Haven't had the opportunity to choose, honestly. I go where my insurance brings me and try to avoid the heavier intervention nitwits where possible. But I always end up in a mixed practice with no control over anything. (Mixed by gender, mixed by approach to birth, mixed by everything really.)

What's below the waist or if someone has facial hair doesn't matter to me. What I would care about is a person's attitude. But I haven't had the opportunity to choose that either. Nor do I think I will with any other births that I have in the future.

I think that I also would want to choose someone who would not have assumptions about my experience based on their own experiences or lack of experiences. Honestly, I would want someone with the same approach as Alex (my partner) during my last birth: I know what I need. He had no preconceptions, or at least did not have any preconceptions that caused him to respond on my behalf other than in ways that I had asked him to.

A woman's experience with cramps or contractions? Honestly, I would prefer someone who simply understood that if I say "it hurts more when you do xyz during a contraction" without applying their own experiences to it. As long as my expressed feelings and wishes are listened to, I don't care.

I could easily and happily give birth alone in Times Square surrounded by strangers. I don't care who is there. I care about the reasons I am being touched against my will, and how the touching takes place.

I do not want to be touched BY ANYONE during labor. Touch is a violation. If I touch you, or ask for touch, yes. But any other contact, words uttered, etc. is a violation.

I would, if I could, choose someone who understood that about me, that believed me when I said that, and that would truly balance that with the safety of my baby taking priority, of course.

I was told on a hospital tour that being "open" to the experience would make it more likely that I would be happy with the birth. I found the opposite to be true. Allowing myself anger and skepticism and not blindly trusting those that did things that raised questions... that is what made my experience a positive one, although had anyone been at both births they would likely have said my first birth (which I found violating) was the "positive" one because I was passive and asked few questions.

(I got angry when my reasonable requests were ignored like the tightening of a contraction monitor during a contraction, and when questions were ignored. I was sort of "meh" about the touching without asking for permission because I expected it and can make excuses for it.) 

EVU: Does not matter to me as long as they have a great reputation. 

SP: The OB who encouraged my VBAC was a man. The family practitioner who encouraged my home births and came afterwards and examined me and the baby-and didn't charge for it, was a man. I don't think openness of mind and spirit is sex selective.

MG: I would not get to choose an OB, if I saw one it would be in a transport from a midwife-attended homebirth, and I would get whomever was on call. Outside of birth... I don't call Dr's I see for Gyn care, OB's, I call them GYN's, because although I understand why the two specialties are conflated into one, I think there's an important distinction between maternity care and gynecology. If I needed to seek care with a GYN, I would have 2 main criteria - who gave me information about my health and my choices and then let me choose, and who was capable of comfortable paps, and while I'd probably rank a woman who provided such care above a man who did, I'd put those two criteria far above the anatomy of my care provider.

I like that you distinguished between OB and GYN. I should have said that in the original question; thanks for bringing it into the discussion.

NY: I generally don't use OBs at all, but during my homebirth transfer with my 4th, I called all of the hospitals to see who was on-call and I chose to go to the hospital that had a VBAC friendly woman- not because I was VBAC-ing but because I felt that if she supported VBAC then she would be more open to letting me do my thang. And she did- she never told me what to do, when to push or anything. She actually didn't even touch me until my son's shoulder's got stuck and his heart tones were dropping.

The prospect of a male Dr. was terrifying for me and I felt that a male would not be empathetic enough for me to feel comfortable birthing with him. Had I been transporting to get a c-section it wouldn't have really mattered. I figure they all do it enough I'm sure they get great practice.

NKW: I also would rather have a midwife....however, (if an OB,) man. Women OBs seem to have a "oh honey....you'll be fine....we've all done this" attitude and it frustrates me. But, that's just my personal experience. 

LH: I prefer female OBs, which also happen to be the majority of OBs in my area. With my first pregnancy I saw a male OB and he said some terribly hurtful things to me so that put me off male OBs pretty quickly.

My current OB and the backup that I've seen are both really nice and seem to be really supportive of more natural birthing.

Then again I'm in a country in which the midwifery model of care is the norm and the only reason I'm seeing an OB is because I'm high risk. Go figure. 

NM: No preference of gender. Want a care provider who listens and considers me a part of the health care team.

Not always easy to find. 

KP: Midwife!! Both my midwives have had male back-ups (one OB, one FP), and I've not gone to an OB/GYN other than those single visits during each pregnancy. I'm not anti "male OB" but would prefer a female, I think, if I had to choose between two equally supportive OBs of the opposite sex. Now, if I had to choose between a wonderful male OB and a horrible female OB, I'd definitely choose the latter! 

CSM: Because of a history of abuse, I do best with a female or a male who isn't Caucasian. 

ND: I would have thought that it would be that women would be more sympathetic to other women... so I thought, in the past, it would be a female. But, from experience, I have found more good male OBs than female. Although, that said, I have found horrendous male OBs and phenomenal female OBs... so, more than anything, one that is good and mother/baby-friendly. I couldn’t care less about gender. But, as others have said, this is why I choose a MW. 

KP (again): In the vein of "a woman understands in a way that a man cannot possibly know" (about childbirth, contractions, or menstrual cramps), I was reminded of something a female friend once told me after she had joined the Army or Navy -- male drill sergeants were in general "better" than females, because they would soften up if the female private claimed PMS or cramps, whereas the females would basically say, "Suck it up, wimp; I had to march whether I had cramps or not, and you will too!" So, I can see that male OBs might have the same response -- because they don't have the female equipment, they may just listen to the woman's complaints, whereas a female (depending on whether she's brusque or not) may assume her own mild cramps are everybody else's bad cramps, and brush off real pain as inconsequential. 

JM: I have always preferred a woman, I think women know the needs of another woman, but I have been proved wrong lately. 

KM: I went with a woman when I was pregnant with my son because I thought she'd know about what I was going through. That she would understand my fears and my beliefs. Nope. Turned out that she didn't care and was "c-section" happy. Now that I'm with my midwives, I'm happier, they understand me, they talk to us like family and I love that they know what we are going through. 

NgM: I used to hire only female docs, mainly because of a history of abuse, but it didn’t take long before I realized that, far too often, female docs have had the femininity beaten out of them in medical school. It is common knowledge that the minorities in a given culture must perform above and beyond, far above, the majority. It’s that way with females in med school (although the numbers are pretty evenly split now, med school is still distinctly patriarchal).

Over the years, I’ve had and seen some ghastly female docs and some phenomenal male docs. But, make no mistake, there are just as many of the opposite out there.

Two female OBs stand out more than all the other crappy/mean/evil doctors. One was Sarah’s doc when she had her son. She was in a damn hurry and Sarah didn’t even push for five minutes… telling her to hurry because she had another delivery to do so she was going to cut an episiotomy. Sarah sat up and yelled at her not to and the doctor said, “I hope you tear,” while taking the baby’s head and pressing upwards on it, causing her to tear into her urethra and right to her clitoris. I know it’s mean to think so, but we gloated when we heard she’d had three days of an induction before a cesarean herself when she had her baby.

The other bitch (and I mean that in the nastiest of ways) was a doctor who Pit’d to Distress a client of mine. Made me sick to my stomach.

I’ve also known a couple of male CNMs, one of whom I liked a lot. I’ve never met a male midwife that wasn’t a CNM, though… and the prospect feels weird. I’m sure that’s what doctors said about females entering the medical field a hundred years ago.

I wanted to say one more thing about the “Why would a male doctor become an OB/GYN… he must have issues.” I’ve actually heard (read) that as a lesbian, that I must be some lecherous homosexual to want to be a midwife. Well, at least for me, that isn’t true at all. While I totally agree there are a plethora of misogynistic (and even abusive) doctors, I also hope there’s a place for believing that not all male OB/GYNs are perverts wanting to get into women’s genitals as a career.

Thank you, all of you, for sharing your thoughts. Really, really great dialogue!

  Dr. Dale Lapp, San Diego, CA. (VBAC-friendly doctor)