What to Consider When Selecting an Ob/Gyn

Your relationship with your obstetrician/gynecologist is one of the most intimate professional relationships you may have.  Although it can take time for this relationship to develop, you should feel comfortable with this person and should be able to trust your obstetrician/gynecologist with your most private concerns.

Important questions to consider when selecting an obstetrician/gynecologist include:

1.Does she/he have experience caring for and delivering high risk pregnancies?

None of us want to experience a complicated, high risk pregnancy. However, an attending of mine in my training used to remind us at the beginning of every call night, “The sickest patient will be the one you least expect.” Even if you consider yourself to be healthy, pregnancy and labor can unexpectedly become risky to mother and baby. You want to make sure that your obstetrician has the training and experience to handle any surprises from severe pre-eclampsia to acute hemorrhage. If you live in a major metropolitan area, you also want to know if your obstetrician delivers at a level 3 center with in-house anesthesia and an experienced NICU. Hopefully you don’t need those services, but if you or your baby were in grave danger, you would want to feel confident that your obstetrician can manage your care and that she/he has the resources needed to do so.

2.How will she/he manage a pregnancy that goes beyond the due date? At what point will she/he insist on induction?

These questions tell you a lot about your obstetrician’s medical beliefs and style of practice. Some providers believe that babies should be delivered as soon as possible while others may take a wait and see approach. A seasoned obstetrician may tell you that the answer is not easily defined because she/he will need to consider multiple factors specific to your situation in deciding when and how to recommend an induction.

3.What are her/his views about the use of doulas?

Again, this question tells you a lot about your obstetrician, whether she/he is open to a holistic approach and whether she/he is going to help create a supportive environment. Doulas are labor companions who can help ease anxiety during labor and offer emotional support. A great doula may be someone you hire or it may be a family member or friend. In any case, knowing your obstetrician’s opinion will give you insight into their practice style and if it matches with yours.

4.Will she/he deliver my baby?

No one physician can be on-call 24 hours a day/ 365 days a year. Most obstetricians share call with other doctors in their practice or community. You should know who the other doctors in the call group are and how the call rotation works. Some groups are extremely large so you may not have an opportunity to get to know all of the doctors who may attend your delivery. Other groups are smaller and may have a system in place for you to meet the other doctors who may deliver your baby. Also, in many communities ob/gyn’s perform circumcisions upon request. If this is relevant to you, don’t forget to inquire about it and whether or not she/he uses anesthesia.

5. What is the practice’s policy for handling emergencies?

For example, will your doctor be able to see you on a regular office day or will you have to wait for an opening or see a mid-level provider? Who can you reach by phone during office hours or after hours for an emergency? How long does it typically take for the doctor or a nurse to return your call? Many large groups utilize a nurse telephone triage system, while in a small group you may be able to reach your doctor or nurse directly.

Thankfully routine pregnancy is only 40 weeks, give or take a little bit, so you should also consider your gynecological needs when selecting an ob/gyn. Consider some of the following:

1. How far in advance do I need to schedule a routine annual if I want to see my doctor?

This gives you insight into how accessible the doctor really is. As a mother and working woman myself, I want a physician I can actually see even if nothing is wrong and I am not pregnant. Everyone’s schedule is different so consider how important this is to you. I have had friends tell me they haven’t seen their doctor in years because they cannot get an appointment scheduled for months.

2. Does she/he prescribe birth control?

There are many patients and physicians who do not believe in the personal use of contraception, and this is to be respected. As a woman’s health care provider, however, I believe that an ob/gyn should be comfortable and knowledgeable discussing the factual pros and cons of all methods of contraception. Some birth control regimens may not be suited for women with certain medical conditions. On the other hand, some providers will not place IUD’s in women who have not had children. Be sure that the ob/gyn you choose is able to meet your individual needs.

3. Are you comfortable with the ob/gyn?

I think this is crucial. If you need to discuss STD testing, vaginal dryness and hot flashes or …something smelling badly down there, you need to feel able to do so. Moreover, if you are going to have surgery you need to feel confident that your surgeon is going to take good care of you. You should also consider your own value system and lifestyle. She/he may not live exactly as you do, but your healthcare relationship will be more comfortable if there is understanding and respect.

For additional information about a prospective physician, you can verify licensure with your state’s medical board. You can also verify that your physician is board certified through the American College of Obstetricians and Gynecologists. Both will offer information on a public website.

You can also contact Capital Ob/Gyn Associates of Texas directly at 512-83-OBJEN or visit our website www.capobgyn.com.


OB JEN in NSIDE Magazine!

We are thrilled to announce that Dr. Jen Mushtaler was featured in NSIDE Magazine’s July/August issue.  Read the article to find out how OB JEN got started in her medical career and what the future holds for Capital Ob/Gyn Associates of Texas!

Dr. Jennifer Mushtaler grew up fascinated by science. Her father was a NASA engineer who worked on projects like the Mars Land Rover, Hubble telescope and Mission Control.

In school, classes would always stop to watch the space shuttles launch into space.

With a mathematics teacher for a mother and surrounded by engineers, astronauts and PhDs, Mushtaler thought she would become an engineer.

In fact, she did, earning a degree in electrical engineering at UT. However, she soon became drawn to medicine and continued on to medical school at UT Southwestern Parkland Memorial Hospital.

“It brings together science, innovation and healing people,” Mushtaler says of her chosen field. “The surgical specialty of ob/gyn was truly my calling. For me, there is very little that rivals the miracle of birth.”

The incredibly important journey of pregnancy and childbirth, along with general women’s reproductive health, is clearly something Mushtaler deeply loves and respects.

After 10 years of private practice experience, in October 2010, she founded Capital Ob/Gyn Associates of Texas, which operates on a collaborative philosophy of partnering with women in their health care needs, rather than the more traditional medical atmosphere of doctor and patient. The office setting is warm, intimate, compassionate and private.

“Each woman presents with her own unique health concerns and philosophies, so care plans are developed to address that uniqueness while adhering to the highest professional standards,” Mushtaler says. “My patients are so pleased with the atmosphere and the high level of care we offer. I sincerely hope there continues to be a future for this style of practice in the new age of medicine before us.”

Mushtaler is excited about today’s advances in minimally invasive surgery, which allows her to routinely perform major gynecological surgeries in an outpatient setting. Complete cancer resections and lymph node samplings are being done robotically.

“Patients avoid lengthy hospital stays and recoveries,” she says, “and the cosmesis is beautiful.”

She chuckles when answering a question about a “typical day.”

“There is nothing typical about ob/gyn, managing my own practice, balancing marriage, two wonderful young daughters and time for athletic endeavors,” she says. “I often find myself thinking, ‘Well, that was an exciting day. I wonder what will happen tomorrow!’”

Indeed, Mushtaler is incredibly active, counseling by example for her patients, as well as her daughters. She encourages women’s fitness and athletics, and is highly involved with causes such as LIVESTRONG, breast and cervical cancer awareness, triathlon training and much more.

Affectionately known as “OB Jen,” she constantly updates her blog at www.whosyourobjen.com with news and resources on these topics.

“I swim, I bike, I run because I believe there is a strong relationship between the physical and nutritional lifestyles we choose and our complete health,” she says.

In fact, her expertise with women’s fitness issues has led to her invitation to speak in forums such as the GOTRIbal podcast, which focuses on female endurance athletes.

“You don’t have to completely stop training when you get pregnant,” Mushtaler told GOTRIbal CEO Tanya Malasch. “You shouldn’t be going hard, but get out there for the love of it, and continue your base.”

Mushtaler recommends training at about 80 percent of your maximum heart rate while pregnant to stay safely in your aerobic zone; and for pregnant women who decide to begin a fitness routine, she recommends beginning very moderately and building up.

“I try to get them started by walking,” she says. “My recommendation is 30 minutes a day, five days a week. I do not recommend training in the anaerobic zone, as that has been shown to compromise blood flow to the baby.

“My patients come in all shapes, sizes, lifestyles, and no matter where they are in their health needs, I want them to feel empowered and encouraged.”

“Dr. Mushtaler is amazing,” says Tessa Spencer, who has been a patient for three years. At 35 years old, Spencer discovered she was pregnant, which came as a big surprise.

“Dr. Mushtaler and I worked out a plan of treatment for me and the baby, and she monitored me weekly,” Spencer says. “I had a very high-risk pregnancy, and she spent a lot of time talking to me and helping me make the right choices for my baby.”

Spencer had a Caesarean delivery at 34 weeks, but she and her baby were able to go home in two days.

“I always feel a sense of being at home with a good friend when I am with Dr. Mushtaler,” Spencer says. “She treated me and my baby with respect and love. I really felt she cared about us as individuals, not just patients.”

Such experiences and outcomes are very rewarding to Mushtaler.

“I find it particularly rewarding that my patients know that my interests are synonymous with theirs and trust that if medical intervention is needed, I will use it judiciously,” she says. “I love the long-term relationships I have developed with my patients and the opportunities to heal by simply listening, by medicine and by surgery when it is needed. The relief to a patient following a successful surgery and delivering healthy babies to happy, healthy mommies are equally gratifying.”

For more information, contact Dr. Jennifer Mushtaler and Capital Ob/Gyn Associates of Texas at 512-83-OBJEN or visit www.capobgyn.com.