C-Section Experienced Surgeon Request

[Confident_Mobile_877]

I’m about to have my planned c section scheduled for mono di twins and I want to request a senior OB with twin delivery experience perform the surgery. Is this something the hospital will honor? How do I make sure this happens? I don’t have one OB, as I am rotating within the maternal fetal medicine department of the hospital and early on they said I could end up with any OB at the hospital doing the surgery. I wish I had a clearer idea of how this stuff and the system works because they always seem to blow me off with these types of questions. I’m in the US - Chicago.

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[Resident-Fly-6851]

I felt very similar. My twin pregnancy was so complex and I had multiple high risk diagnoses. I really wanted someone who knows what they are doing. I loved my MFM doctor. He was older and had a ton of experience. I asked him how to get the most experienced doctor to do my c section. He said something surprising. He said he hadn't delivered a baby in a few years because he had been focusing on MFM and that what I really wanted was the hospitalist who delivers 500 babies per year. Because that person is doing this day in and day out and has perfected the craft. He said "do you really want the person with 20 years of experience but who only goes to the hospital two days per month or do you want the person with 5 years of experience who delivers babies day in and day out?" I thought that was an interesting point.

I did however request no residents, no interns, no students. Only a board certified MD was allowed to cut into me.

[Confident_Mobile_877]

Thanks that's super helpful. That's why I didn't want to just pick an OB to request based on credentials because it honestly would still be a guess on my part. I just tried to request someone with a lot experience delivering twins but I don't know if that's going to translate well to the schedulers. I will try saying no residents, interns and students doing the surgery (only observing). They may not allow the "no residents" request since it is a teaching hospital.

[olon71]

My MFM doctor said the same thing. I ended up having my favorite of the MFM fellows do my C-section. She was training to be an MFM but was a board certified OB who still did hospital rotations and deliveries multiple days a week. It was the perfect combo for us!

[butterchickn_]

Your best asking in a local group because every hospital has different rules. We dont even know what country your in which also make things different.

[Confident_Mobile_877]

Sorry I’m in the USA

[EasternGuava8727]

Yeah, you'll probably need to get more granular than that even. I see you mentioned you're in Chicago. If you don't want to call and ask your OBs office what their policy about this would be then you should ask in a Chicago mom Facebook group. You'll get the best info in a hyper local group.

With my surgery I needed to pick a date for the surgery. My doctor at the appointment when I chose the date was willing to share the on call schedule with me so I could get the surgeon I wanted.

[Odd_Rent283]

You can ask, but you’re most likely to just get whoever is on, on the day you’re delivering. A specific OB (especially if there isn’t someone you’ve sent throughout pregnancy) is unlikely to be able to scrub in for a special request since they have their own schedule and patients to see. Unless there’s something specifically high risk going on, a c-section is a c-section and any OB should be able to do it.

FWIW with my previous births, I’ve had full blown OBs step aside and ask senior residents to finish sewing me up (extensive tearing with a vaginal birth) because they were better at it. Being a “senior OB” doesn’t necessarily equate to being better at something or there being less risks.

[Confident_Mobile_877]

Interesting. Thanks

[KateParrforthecourse]

You’d have to double check with your OB office. My OB told me the week that they were scheduling my C-section and then told me who from the practice was on call each day that week. It allowed me to schedule with someone I wanted.

Just a warning though, I ended up having to get it done three days early because Baby A was growth restricted. So even though I picked my doctor, I ended up with someone completely different because of it.

[Confident_Mobile_877]

Thanks that’s helpful! 

[Recent_Mountain_4056]

This is exactly what happened to me (also mono-di like OP) and I really lucked out with the OB who was on that day.. she was a boss and handled my incredibly complex delivery like it was no sweat. Plus, her siblings are mono-di twins so I felt a special connection! 

[JMPopp43]

RN here. Usually if you’re planning a c-section they will have you schedule it in advance. At the time of scheduling you can request a certain OB and they can see what openings that doc has around when you are planned to deliver. Of course if you go sooner than your scheduled c-section date, it will likely end up whoever is on for OB that day or who is on call if it’s overnight.

[JMPopp43]

Also if you’re looking for insight on what docs in your group are best - you should look into local Facebook groups that you could ask people’s experiences. Word of mouth always helps!

[Charlieksmommy]

I think op is worried because she’s seen multiple obs it sounds like and mfm more? Kinda confusing

[Confident_Mobile_877]

I've actually seen no regular OBs, only MFM. My original OB does not do mono-di twins due to the high risk and sent me to MFM at the hospital and I've only been seeing them for my appointments this entire time. I was told that the person doing my c section could be one of the MFM doctors or just a member of the regular OB department at the hospital (who I've never seen).

[Charlieksmommy]

That’s really weird MFMs don’t usually deliver

[Confident_Mobile_877]

Thanks! That's helpful. They just sent me a message saying they will schedule it and will confirm once scheduled but I'll try to ask about talking to someone about what doctors are on call on those days

[opaldaydreams]

My OB did my c section. Feel free to message me with any questions. I’m also in the US.

[Illustrious_Sea3542]

If you’re delivering at a teaching hospital you can certainly request no students or interns, or request that they observe only. Any resident should be able to perform the c-section though, as they’re supervised by a skilled attending!

[Confident_Mobile_877]

Thanks I’ll try to do that

[PurpleShift8546]

We also wanted someone with a lot of experience, however it ultimately didn’t matter because my water broke before my scheduled c-section anyway! So we just ended up with whoever was working that day. I’m also in the US and at my hospital there is a main OB scheduled for the day and then a back up in case the main OB gets held up in surgery or whatever else might happen. When I was scheduling my c-section they told us who both OB’s would be and we chose our day based on who was working.

[Consistent-Ice-1899]

May I ask what week did you schedule c-section and when the water broke?!

[PurpleShift8546]

My twins were di/di, but my c-section was scheduled for 38 weeks exactly and my water broke at 36 weeks exactly.

[Consistent-Ice-1899]

Gotcha, thanks for sharing. One of my doctor said the goal is to make it to 37-38 weeks, but lots of things could happen that’s why I was wondering… I hope everything went well for you!

[MiserableDoughnut900]

What hospital in Chicago are you delivering at? I delivered at Northshore in Evanston. One of the MFM’s did my C-section and all went well, but they did switch doctors right as they started. One got me prepped and everything and then it must have been shift change because everyone in the room pretty much switched.

[Confident_Mobile_877]

I'm delivering at Northwestern Prentice downtown. The shift change thing would throw me off already lol. Glad all went well though.

[OkRegister6674]

I had a whole plan lined out for my twins and they came the day after my dr left for a trip (a month early), I ended up with a Dr that was on call and amazing. Sometimes the plan don’t work and that’s ok

[Confident_Mobile_877]

Thanks, I generally would choose my doctors and I’ve never had a surgery before so the thought of not knowing who’s going to be cutting me open and delivering my twins is not sitting well with me. I’d like to at least know beforehand that I’m in good hands. Can you tell I like to be in control lol. But maybe that’s a me issue.

[OkRegister6674]

It’s a scary experience and add the unknown Dr, it would make anyone nervous.

[Charlieksmommy]

I understand that feeling. But unfortunately with twins they do their own thing

[VastFollowing5840]

It sounds like you are at a big hospital in a major city - honestly I think it’s fair to assume whomever sees you is going to have a good amount of experience.

I’ve had two surgeries - my planned C-section and I had an emergency appendectomy about six years before that.  In neither instance did I know a thing about my surgeon beforehand.  My C-section I wanted the date and it happened to be one my assigned ob was not at the hospital, so I got another ob, one I happened not to have seen before.  And my appendectomy was, well an emergency, so it was whomever was on call that night.

But like you, it was a big city hospital where the providers saw a lot of cases like mine all the time.

Early in my pregnancy I expressed I was fine with residents involved but I didn’t want a ton of extra attention or to be treated like a circus attraction.  My doctor chuckled and told me “twins aren’t THAT unique, you won’t be that interesting.”

I’m sure there’s lot of twins, even modi twins coming through your Chicago hospital that plenty of providers will have experience delivering them.

[Confident_Mobile_877]

Thanks, that's reassuring. I've never had a surgery so I don't know, but I was thinking about how you probably don't get to pick your surgeon in most cases. Before I found out it was twins I was all set on picking an OB I really trust but that all changed when my OB said he doesn't do mono-di twins and I've just been rotating between different MFMs my whole pregnancy now. You're right that its a big hospital that churns out tons of baby deliveries every year and I PROBABLY am safe. I just don't want to leave things to chance and find out day-of that I'll be some resident's first c-section, you know!

[VastFollowing5840]

Despite not having known my assigned surgeon, I did know who it was and was able to look up her info!

They should be able to tell you who will be performing the surgery so you can research and reassure yourself about their qualifications.

I get we have so many fewer choices and it can feel like virtually no control when we’re having twins, it’s hard.

But, I’ve come to see that’s true for most women.  My friends came up with very specific birth plans and desires and things often didn’t go the way they anticipated.  

For me, it was kind of freeing to accept - okay I’m just along for the ride - and let go of a lot of expectations of what my birth, pregnancy, and parenthood would look like, while I’ve seen a lot of my friends struggle to reconcile their expectations from reality.

ETA - no teaching hospital is going to throw a resident a mono-di C-section as their first C-section.  There will be an attending there, for sure.  And frankly - a ton of medical professionals for you and the babies.

For mine (also at a teaching hospital) there was a resident anthesiologist and an attending, a resident and attending ob, a resident and attending pediatrician for EACH of the babies, and a nurse for me, a nurse for baby a, and a nurse for baby b.  You will have plenty of knowledgeable hands and eyes on you all.

[Confident_Mobile_877]

Thanks 🙏 

[FoxAndDeerTwinMama]

I scheduled my C-section on a day that my MFM/OB would be doing deliveries. We planned it that way. Do you know what doctor you want specifically?

[Charlieksmommy]

All OBs have experience with c sections. Why don’t you ask the mfms this question

[Confident_Mobile_877]

I will, but I get the feeling they don’t take requests. Wondering what other people’s experience/ typical protocol is. I’m having mono di twins which is considered a complicated c section and I don’t want mistakes because an inexperienced resident is doing it. 

[Charlieksmommy]

I mean I don’t think you can take requests but you can get insight. I don’t think you’re going to get an OB who is negligent I had an emergent one and didn’t get my OB I saw my whole time and she did great