Choosing a doctor as a Catholic mom with multiple c-sections

 Steven Joseph's arrival, Dec 2007

I'm currently 9 weeks pregnant, so I was excited that the Team Whitaker blog was hosting a little series called "Choosing the Right Birth Plan" last week.  I'm definitely in the throws of decisions about doctors and hospitals, and typically spend hours during pregnancy thinking about my upcoming births, and working through emotions and experiences I went through during my previous 4 c-section deliveries. 

What I fail to realize each time I read a different birth story is that I tend to have strong emotions that come up whenever I read these stories.  I can appreciate each of them as unique and personal stories, but I also have a hard time with getting "advice" from other moms whose experience is in no way similar to my own.  Sometimes I put myself out there, commenting or asking advice on certain aspects of prenatal care, and other times I'm just given information freely from others who are certainly just trying to give some positive insights.  Still other times, I'm reading stories out of curiosity, only to find that in all these cases birth stories and advice has become a very personal issue for me to deal with.

I've written out Thomas' birth story, but each time I've tried to write out the others it has become a painful writing process that I couldn't complete.  Suffice it to say that I've had 4 c-sections, and with the first 3 of them I labored all the way to 10cm and then for various reasons ended up needing to deliver by cesarean.  This is still very hard for me to swallow, particularly when it comes to the different decisions that led to those complications.  I remember hearing that a similar experience of a friend who had a nearly-complete labor ending in a c-section, and I felt absolutely devastated for her (this was before I had given birth).  After going through it myself 3 times over, it's still sometimes hard for me to believe it is a part of our story.

Let me also explain that I know many people today don't see an issue with cesarean deliveries.  To the general public, they're seen as just one more valid means of birthing a baby.  Which they are.  But to most of the population, there isn't much concern about it affecting the future of a family because they only plan to have 2, or maybe 3, children.  As a Roman Catholic married couple who has vowed and hoped to welcome many children lovingly from God and accept Church teaching regarding birth control and sterilization (as I talked about here), this issue becomes a very important concern and consideration for our family.

And so, I obviously have some serious considerations when it comes to choosing a care provider for myself and my children.  Not only have I had some difficult deliveries, but I've also experienced two early miscarriages and have a son with a heart defect that required open heart surgery.  I want to be sure that we have very experienced and pro-active doctors who are some of the best in their fields.  Surely if someone is going to be stopping my son's heart and repairing it, or opening my abdomen to deliver my baby while I'm awake, I want to be sure I can trust that person with our lives.

Ellie's arrival, April 2005

And so, here are some of my own major considerations when it comes to choosing a doctor, in particular an OBGYN for maternity care and cesarean delivery.

1. Trust.  As I just mentioned above, I have to trust that doctor with my life.  I want to know that he will do everything in his power to be there when I am in labor and/or delivering my baby.  I need to trust that he will do everything he can to help maintain the pregnancy in the beginning when I have sometimes had hormone imbalances requiring supplementation.  I need to trust that he will do all in his power to help prevent me from going into pre-term labor, but that he will also recognize when it is the most prudent time for me to deliver the baby.  I also need to trust the doctor I choose to be one of the best in his field, and trust the maternity and post-partum care at the hospital where that doctor delivers.  

Finding the doctor through a person I trust has been important for me.  My first OBGYN was chosen through some advice from fellow Catholic school teachers, and looking up names on a list of pro-life OBGYNs.  My other trusted doctor came from the recommendation of a friend and mother of 6 whose husband is a physician.  She always had the most positive things to say about him, and I knew I could trust that she would probably choose the same type of doctor I was looking for.  He also happens to be on the Pro-Life OBGYN website.  One More Soul is another website that offers a list of NFP-only doctors and practitioners.  Unfortunately, many areas don't have NFP doctors, but at least many have pro-life ones!

As I spent some time recently trying to find a local doctor to use, I quickly realized that I was going to have a hard time finding someone through the recommendations of friends in my homeschooling circles, because so many of them were looking for a different type of doctor.  Most moms with a normal birth history want a doctor who is more laid-back and open to things like natural births with little intervention.  On the other hand, I'm looking for a respected surgeon, an older and experienced doctor who I can trust as a fatherly figure (Yes, I prefer male obstetricians).  I want someone who I can trust would be able to handle a high-risk delivery if complications occur.  Unfortunately, I just don't feel that level of trust for newer doctors.  I want to know that they have decades of experience dealing with complications and have a track-record of positive outcomes!

The day after Mary Clare's birth, January 2003.  I was hugely swollen with fluids, but my hubby looks pretty awesome!

2.  Respect.  This is an issue that can be a definite source of contention between open-to-life Catholics and their doctors, regardless of delivery history.  Many medical professionals today discount the successful use of Natural Family Planning among patients.  The typical way that gynecological care works is that if there is a problem with your cycle, they put you on birth control pills.  If you want to avoid pregnancy, they prescribe birth control pills or an IUD.  After a woman has 2 or 3 c-sections, they tie her tubes.  It's just how most Americans today plan their families, and some doctors just cannot get past it.

So as a Catholic couple who uses Natural Family Planning or other natural means of baby-spacing like Ecological Breastfeeding, we have found it important to find a care provider who respects that aspect of our married life.  In most cases, pro-life Christian doctors usually fit the bill.  I don't want to continually be asked about birth control or sterilization, especially during early pregnancy!  I want my doctor to respect my hopes to have a large family and I want to know that he is fully confident in his ability to deliver my babies.  I also want to feel comfortable in his office if I have to bring my children, and feel respected by the staff when it comes to phone communication.  And of course I also have to be confident that I can respect my doctor's opinions and decisions relating to my care, especially his advice on how he thinks my body would handle future pregnancies.

3. Peace.  In the end, there will never be a "perfect" doctor, but we have to choose the one who we think best meets our needs, and ask God to send us that peace.  When I met my first OBGYN, Dr. M, when I was pregnant with Mary Clare, I instantly felt a feeling of peace and comfort when under his care.  He prayed with us, encouraged us, and spoke as a fatherly figure who would care for me.  I didn't have that deep feeling of peace with the doctors I chose for my 2nd and 3rd deliveries, and then Dr. M had to retire.  But when I found and met Dr. R before I was expecting Thomas, I had that same feeling of peace.  Even though I wasn't pregnant at the time, he gave me all the confidence I needed to be assured that he would take care of my baby and me.  In all the decisions relating to my prenatal care, I've felt that same peace and comfort in the recommendations he has made.  In fact, he often tells me what he would do if I were his daughter.

When we discovered we were expecting last month, I was instantly filled with anxieties about how I would choose a new doctor in our new city.  I'd already tried two practices in town, and had a true lack of peace when it came to thoughts about delivering in a different city and a new hospital.  After a lot of prayer and discernment, and even trying another local doctor (who was already recommending a tubal ligation and whining about how I was going to "kill" him making him do a 5th c-section), I happily went back to Dr. R, even though he is over 4 hours away.  When he walked into the exam room, his presence gave me an immediate feeling of peace.  As we discussed the issues of my pregnancies and the issues relating to being a long-distance patient, I still felt that peace deep within me and made the decision then and there that I would move forward under his care.  Thankfully, I also had the support of my husband to choose whatever doctor I would be most comfortable with.  I also have the support of our extended family and long-time friends in the area, because if all goes well, we will need to spend more time there for appointments and several weeks there awaiting baby's arrival around February.

Steven Joseph meeting his brother Thomas, Sept 2010

I know there are a lot of issues that go into choosing a doctor and birth plan.  Most women I know have deep-seated opinions about childbirth, as do I.  For many, it is not so much of a medical experience, but a peaceful welcoming of new life.  But for others like me, pregnancy and delivery are a true medical experience.  From the day I get a positive pregnancy test, the work begins with getting bloodwork, ultrasounds, medications, and doctor appointments.  The actual delivery is always a scary experience as I face that cold operating room once again and hope and pray that there will be no complications.  It truly is a small price to pay when it compared with the immense blessing of an eternal soul, and a new member of our family.  Thanks be to God that we have many choices for doctors and various options for delivering babies safely.  May He continue to give me the strength to make it through all the trials of pregnancy and delivery, and may I continually find peace and trust in His most Holy Will.