How to Choose a Paediatrician

By Dr Nicoletta Hay – Paediatrician Morningside Clinic

One’s first pregnancy is an extremely exciting time – but also a time when so many decisions need to be made. One of these is about the doctors that will be taking care of you and your baby.

What some people are unaware of, is that your obstetrician, who follows your pregnancy until birth, is not the person who will be looking after your baby – his or her responsibility to your baby ends when your baby is born.

A paediatrician, a doctor who has specialised in paediatric care, will have this honour – and his or her job begins at birth. Because a normal vaginal birth is considered a low-risk time if uneventful, paediatricians are not present at the birth unless the obstetrician or midwife are concerned – and the paed is usually called to check the baby soon afterwards in order to perform the first neonatal check.

However, because caesareans sections are usually performed because of a problem with either mother or child, a paed is always present at a caesarean birth. What most mothers are not aware of though, is that they are able to elect the paediatrician of their choice to attend the birth. If they have no preferences, the obstetrician will then call one to the birth. There are, however, various things to consider when choosing a paed.

All my colleagues and I have been asked to attend caesareans births in hospitals where we are not primarily based. Whilst this seems easy enough, what one must remember, is that all is well if the baby is healthy – if there are problems however, a doctor must always be in close proximity and it isn’t always in the best interest of the baby to have a doctor who is not on the premises should there be an emergency, and thus the first important thing to consider in choosing a paed, is proximity to where the baby will be born.

Other factors influencing your choice of paed will depend on whether any problems were picked up with your baby during the pregnancy. If there is something that will need immediate intervention after birth, (for example a tracheo-oesophageal fistula, exompholos, pulmonary problems, cardiac abnormalities etc) your choice of paediatrician must take into account what additional services are available at the hospital where he/she is based. These include the quality of the ICU, presence of neonatologists or paediatric surgeons etc and the proximity of the hospital to your home, as you may need to be visiting the hospital for extended periods.

And lastly, your choice of paediatrician will depend on personal factors – would you prefer a male, female, older, younger etc – and this is also important as you will probably have a long relationship with this person. Remember too that you are not bound to the paediatrician that was at your child’s birth for life – if you do not feel comfortable, change!

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