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    Choosing a Pregnancy Practitioner

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    Family Physicians: Beyond the Pregnancy continued...

    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.

    In the final analysis, whether it's an obstetrician, midwife, or family physician, all providers perform the same routine tests, screenings, and prenatal care necessary to monitor the health and safety of the mom-to-be and her baby, and they're mindful to seek the extra support their patient needs when she needs it. In 1996, about 93% of all births were performed by a doctor (including obstetricians, family physicians, and doctors of osteopathy), and about 6.5% were attended by midwives (certified nurse-midwives and lay midwives).

    "It's really the personality of the person you're choosing -- somebody you get along with, somebody that listens to you, somebody who's sensitive to your issues," says Bagley. "That's the stuff that makes people like their provider, not the plaques on the wall."

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