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Choosing a Pregnancy Practitioner

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Family Physicians: Beyond the Pregnancy

They say the best way to find out about a doctor who delivers babies is to talk to the delivery-room nurses, so when Laurette Platt, 38, a labor, delivery, and emergency nurse in Fillmore, Utah, got pregnant, you could say she was the horse's mouth. In fact, that's how she chose Brent Jackson, MD, her own family physician, to deliver her fourth child, even though she had used an obstetrician for her other children before moving to the small town. She chose Jackson despite warnings from her last doctor to stick with an obstetrician because she had hemorrhaged during her last delivery. The closest obstetrician was 90 miles away.

"I'd sort of been brainwashed in nursing school and from my previous pregnancy experience that I had to use an ob-gyn. But I had worked with Jackson. I knew his skill. He's as skilled as any ob-gyn I've ever worked with. And I saw how he good he was with his patients. He was willing to try anything I wanted as long as it was safe for mother and baby. I requested not to have an episiotomy (which is a cut made below the vagina to widen the opening during delivery), and he didn't give me one."

Jackson's background in family-practice medicine, which provides training in a broad spectrum of medical care and emphasizes a patient's emotional well-being, not just physical conditions, turned out to be a plus for Platt. When her husband, Mark, was shipped out to Haiti on a military mission during the pregnancy, Platt developed an irregular heartbeat and started getting anxiety attacks. Jackson speculated the condition probably was related to the stress of worrying about her husband. "I was having a hard time, and he really worked with me," says Platt. "He was very kind and patient, and he treated me with a lot of respect."

Only about 30% of all family physicians deliver babies, and the ability to find a family practitioner to manage your pregnancy will depend on a variety of factors, including the existence of a family-practice medical training program in your area and competition from local obstetricians. In rural towns, family physicians are often the only doctors for miles and routinely perform obstetrical care.

Like midwives, family physicians try to keep the process as natural as possible. "I approach a pregnancy as a family event, a positive thing, a happy time in people's lives," says Bruce Bagley, MD, a family physician in Latham, N.Y. "We acknowledge that there's going to be some pain, we give some nonmedication ways of dealing with it, involve the husband or father and family so the woman isn't winging it, and keep medicines to a minimum." Family physicians usually won't take high-risk cases, and they consult with or refer to obstetricians and other specialists when necessary. Some perform cesarean sections, but most refer patients to specialists if necessary.

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