Is it usual to meet with a nurse practitioner instead of a doctor for a first prenatal visit?

Question

I have scheduled my first prenatal visit since I am two-months pregnant. One of my friends referred me to one of her doctors. I have been told by my friend that the first visit is the most important, and the longest of the series of visits throughout the pregnancy.

My understanding is that I am supposed to see my doctor so he or she can answer my questions and concerns. The appointment I make is supposed to be with that specific OB/GYN doctor.

However, my doctor was not available at the time of my scheduled appointment. The nurse told me that she had an operation to participate in. Instead, the doctor's office suggested that I should see the nurse practitioner instead of my doctor.

The office also says that right now I can not choose any specific doctor for my visit. There is a team of doctors and nurses working together, so they actually don't know who I can meet each time I visit because my doctor maybe not available then. But there will be one available to take care me. Is these standard procedure in US? How can we be confident about the doctors since I have no single point of contact? Any one have any experience like this?

I come from another country. In my country, there is a one doctor who is with you for all the steps from beginning to delivery. Is that valid here?

I am not sure that I misunderstood anything. Can any one help me explain what it supposed to be a usual process? Can a nurse practitioner replace an OB/GYN doctor?

Addition Information: I am in PA. The hospital that I went to is about 300 beds.

Answer 1

Practice teams such as you described are not that uncommon. My wife and I (also in PA) went to a hospital specializing in childbirth that uses the same system. We met with a variety of doctors and nurse practitioners throughout our pregnancy.

Most of the early visits were with Nurse Practitioners and/or midwifes. Later on in the pregnancy, every trip included an ultrasound and a visit with the doctor, but this was because we were listed as a "high risk" pregnancy.

There were a couple of times we had questions that the nurse practitioner had to refer to the doctor, but she always told us when she wasn't able to answer the question, and had no reservations about referring the questions to the doctors.

It is important to mention that nurse practitioners aren't just nurses. They are experts in their fields, have masters or doctoral level degrees, and require significant additional certification above and beyond what standard Registered Nurses (RNs) have.

However, not all practices use this method, and there may be places you can go where you can have a single designated doctor. If that would make you feel more comfortable, you can ask for a referral to a different practice. It is very important that you feel confident in the care you will receive, and if having a single doctor will help, then by all means you should see what options you have.

Keep in mind though that pregnancies are unpredictable, and women tend to go into labor when they (and the baby) are ready, and not when they happen to have been able to schedule an appointment with a doctor. The chances of you being able to have a single doctor throughout your pregnancy and have that same doctor available for your actual childbirth are rather small. The chances of you going into labor when the doctor is off-duty, or with another patient, are fairly high, which is why some people see the practice team method as a strong alternative. Over the course of your pregnancy, you will get to know several doctors and Nurse Practitioners, so the chances of you having someone you actually know with you during your labor are somewhat higher.

As a side note, it was our experience that we saw a lot more of the nurse practitioner during our labor and delivery than the actual doctor. The doctor came in once to approve an unscheduled c-section, and then performed the actual surgery, and that was it. All of the rest (all 8 hours of active labor) was our nurse practitioner.

Our Pediatrician practice is somewhat similar. Whenever we schedule an appointment, we schedule with "our" pediatrician. However, whenever we have to come in for a non-routine visit (sickness, injury, etc.) we wind up seeing whichever doctor is available.

Answer 2

The hospital I did prenatal care with and gave birth at is part of PAMF in California, and they are a great hospital with a great reputation. However, my doctor was also part of a group of doctors, so I had never met the doctor who gave birth to my baby when it came time to deliver.

This was not a problem for me, and (at least in my case) the doctors in a group together all know and trust one another-- so if you trust your doctor, you can usually trust the doctors in his group.

But the most important thing is that you feel comfortable, so if you have a problem at all with the way your prenatal care is set up, you should definitely get a new doctor. Your old doctor may even be able to help set you up with someone better.

Answer 3

I guess it would depend on the practices of the clinic you are seeing. My doctor's clinic have hired a nurse to help them with the patient traffic as the clinic has gotten super busy. So the nurse may do things like ask and record questions, do weigh-ins, blood pressure etc., just to save time, but the doctor will do the examinations and answer specific questions that patients may have.

When you do see your doctor, it would be a good idea to be prepared with very specific questions to ask to see if your doctor is in fact a good fit for you.

Answer 4

In the UK, you never see a Doctor, as far as I am aware. You simply check you are pregnant, arrange for a scan and go from there. You have 2 scans, one at 12 weeks, one at 20 weeks, and if there are no issues, you simply get a due date, and phone the hospital when you are in labour, your waters break. My wife and I, with 3 kids, have not once seen a doctor whilst rpegnant, apart from when we conceived the first, which was in Australia.

We have never seen a quack once, other than that. I guess not really a valid answer, so it may get downvoted, but as this site is not US centric, I thought I'd add some othe rperspective; we have never been worried about not seeing a quack during the pregnancies. On the second pregnancy, my wife gave birth at 7.30am and we were home at 9am. I guess we all have different expectations from our health services.

Answer 5

In my country this is a midwife thing. Doctor (they are rarely real PhDs right?) is contacted in case of difficulties, such as maternal overweight. So my answer is "Yes, depending on cultural setting or staff economy issues". Reason: Midwives have great skill and experience by practice, but this has traditionally been overlooked in Western medicine. Doctors are more expensive, and this first visit is a routine matter (for them, not for you :) ). "No single point of contact" is indeed my experience as well. In a streamlined effective and slightly understaffed organization this is very often the case unless you accept odd appointment intervals. I sincerely hope your experience is better than mine! And good luck!