Family Physicians

The Family physician and Natural Birth

Congratulations on your pregnancy! What next? We all know that prenatal care is important, so you need to go to the doctor, right?  When pregnant, most women choose to go to the doctor who has been offering their gynecological care, or well –woman care.  However, you might wish to look into using a Family Physician as your doctor for the birth of your baby.

“Cradle to grave”

Family physicians can offer care for the whole family! They can care for you during your pregnancy, labor, birth, and then care for both you and the baby afterward.  It’s one stop shopping! According to Dr. Amy Potter “Family Medicine has a philosophical alignment with midwifery care and a medical training that aligns with obstetricians”.  They are a great option for those who medically need, or who are more comfortable with seeing a doctor, as opposed to a Midwife.  This allows women who are at higher risk to have more normal care, and a less medicalized approach.

Studies show that women who utilize a family physician have less chance of needing a cesarean section.  Most family physicians cannot do surgery, and thus have a vested interested in preventing the need for surgery.  But these days some are training in surgery and can safely conduct a cesarean surgery if truly medically needed.  Even so generally their cesarean rates are much lower, and VBAC rates are higher than that of obstetricians.

In the 20th century women were traditionally cared for by their family doctor during pregnancy labor and birth.  It was only during the latter half of the century that  Obstetrics became a separate practice and specialty.  However, some family physicians continue to attend births, as well as care for the whole family.  This continuity of care provides knowledge of the family as a unit, and a better understanding of what care would be appropriate.  Since Family physicians approach pregnancies as a normal and healthy part of the life cycle of a woman, they generally take more time with each patient, and see the woman as part of a family unit that influences her health. Studies show that this continuity of care results in better outcomes, and happier patients.

Supporting natural Birth means following Evidence based maternity care practices. Evidence based maternity care is care that results in better outcomes.  Most times less intervention is healthier for both Mom and baby, and family physicians tend to have lower intervention rates than obstetricians.  A great way to find out if a careprovider is practicing evidence based maternity care is to schedule a get acquainted appointment, and utilize the  guidelines of the Coalition for Improving Maternity Services (CIMS) “10 Questions to ask”.

Family physicians receive extensive training in breastfeeding, which better allows them to support a nursing mother and her family.  Mothers receive more accurate information, and have higher rates of breastfeeding success.  According to Dr. Scott Hartman “Family physicians are trained to focus on self-empowerment and engagement in care for their patients. They are trained to emphasize mind-body-spirit connections and consider integrative approaches to care.”

Approximately 25 percent of family physicians provide maternity care and attend births. They may work together with an obstetrician or refer to an obstetrician if a complication arises. But in the long run they offer a more “family-centered” model of care.  See below for a list of a family physicians in the Rochester area who supports natural birth.

References:

Choosing a Caregiver – Options: Family Physicians and Obstetricians for Maternity Care. Childbirth Connection 3/15/11; http://www.childbirthconnection.org/article.asp?ck=10555)

Hodnett ED. Continuity of caregivers for care during pregnancy and childbirth. Cochrane Database Syst Rev 2000;(2):CD000062.

Coco AS1, Gates TJ, Gallagher ME, Horst MA.Association of attending physician specialty with the cesarean delivery rate in the same patient population”. Fam Med. 2000 Oct;32(9):639-44.

Coalition for Improving Maternity Services (CIMS) http://www.motherfriendly.org/

 Rochester Area Family Physicians:

Scott Hartman, MD; North Ponds Family Medicine & Maternity Care, 55 Barrett Drive,  Rochester,  NY,  14580,  585-758-0750, scott_hartman@urmc.rochester.edu     Our practice provides medical care for women, children and men of all ages, including maternity care. Women seeking to deliver at Highland Hospital and experience a more natural, unmedicated or minimally medicated birth may be interested in seeing a family physician such as myself for maternity care. I subscribe to the principles of the Mother Friendly Childbirth Initiative. I hope to help women and families make informed choices in order to have the kind of birth experience they desire.

Assaf Yosha, MD, North Ponds Family Medicine & Maternity Care, 55 Barrett Drive,  Rochester,  NY,  14580,  585-758-0750, assaf_yosha@urmc.rochester.edu
Dr. Yosha has years of experience providing patient centered obstetrical care in the Rochester community.  He has fellowship training in higher risk pregnancies, but keeps to his non-interventional Family Medicine roots, treating childbirth as a natural process. Our office provides high quality and personalized prenatal care.  Our goal is to be present when each one of our patients delivers her baby at Highland Hospital.  We care for women seeking to have a VBAC.  Our commitment extends beyond the birth of your baby with guidance through your postpartum period, including breastfeeding support and newborn care.