Why I Chose a FP to Deliver My Baby
By Laura Johnson Morasch, MPH

I have been a patient of Dr. Audrey D’Andrea’s since 1997, shortly after receiving employee benefits from CAFP. Wanting to be a good booster, I cross referenced family physicians in our HMO book against the Academy’s member records to find an FP who was a member and who recently had finished training. I chose Audrey Heffel, MD (she subsequently took the married name D’Andrea), who practiced in Berkeley after training at UC San Francisco / San Francisco General Hospital.

This choice was fortuitous in big and small ways. Within weeks of my first visit, their office moved to a location closer to my home. Somewhere along the way, probably in discussing my work at the Academy, which consists of protecting family physicians’ scope of practice, I learned that Dr. D’Andrea delivered babies at Alta Bates Medical Center - the leading maternity center in the East Bay.

With delight and great anticipation, my husband Erin and I learned last summer that I was pregnant and we were expecting our first child. Still being a patient of Dr. D’Andrea’s, I transitioned easily from women’s health to prenatal patient. Assuming my pregnancy proceeded normally, I knew my baby would be delivered by Dr. D’Andrea. How cool, I thought, that my work helping to protect family physicians’ rights to deliver babies might be reflected by having a baby delivered by my own family physician.

I loved being pregnant, and receiving prenatal care from a primary care physician made a lot of sense to me. I didn’t think of pregnancy as a chronic medical condition, and I don’t think Dr. D’Andrea did either. I was surprised by how straightforward prenatal care actually was: weight check, measure my belly, and listen to the heart beat. The occasional test had to be performed in keeping with the current standard of care, but for the most part I just had to lead a healthy lifestyle and count the days going by while my body took care of the rest.

I went through my pregnancy feeling a little detached from what was actually happening inside my belly. One of the exceptions was the monthly chance to hear my baby’s heart beat on the Doppler stethoscope. I still remember what Dr. D’Andrea said the first time she found the heart beat of my then-3 month-old fetus: “beautiful.” Hearing this made me realize just what a miracle new life was, and how much it meant to her, too.

Like many pregnant women, I spent the last few weeks of my pregnancy thinking about what birth would be like, how I would handle the pain, and what I wanted from the experience. It has gotten all too easy to shrug off the pain of childbirth with analgesics and epidurals, but my intuition told me that pain was an important part of the passage into motherhood. What would an obstetrician have told me about pain medication? I’m guessing the prevailing attitude toward pain medication in the obstetrical community was summed up by my labor and delivery nurse, who said, “you don’t get any awards for handling pain.” Contrast this with Dr. D’Andrea’s encouragement and support for attempting childbirth without pain medication, a critical step in my efforts to adopt a “can do” mindset about a pain medication-free birth.

Dr. D’Andrea has an awesome customer service feature: to the extent possible, she delivers all her own obstetrics patients. But as chance dictated, the weekend before my due date and the weekend of my due date, Dr. D’Andrea would have been unavailable. I was saddened to think that I might miss the chance to have my baby delivered by anyone but her. Luckily for me, though I didn’t think so at the time, my son was nine days late. Maybe he was waiting until Dr. D’Andrea could deliver him. Who knows?

Giving birth was one of the highlights of my life. I was induced with Pitocin around 4:00 pm on Saturday, March 9, and a lot had happened before Dr. D’Andrea came to the hospital at around 8:00 pm. She came to check on me in my birthing room and then went to change. Though my eyesight was cloudy, I saw Dr. D’Andrea differently when she came back wearing her scrubs and protective goggles. The smiling, caring primary care physician had changed into something more, well, serious. I was impressed by the transformation and reassured by her presence. After much pushing and yelling, and with a little help from a vacuum extractor, Dr. D’Andrea delivered my son, Samuel Braden Morasch, at 9:58 that night.

As neat an experience as it was to have had my birth attended by a family physician, it was cooler still to have a family physician around once we were a real family. Dr. D’Andrea came to the hospital the next day to check on me and Sam - what service! Even more critical was our newborn visit to Dr. D’Andrea’s office with Sam and Erin. I was on a post-partum roller coaster, and benefited hugely from Dr. D’Andrea’s take on breastfeeding and newborn care. Roughly paraphrased, she said “I look at these things from the perspective of family. You have to do the right thing for the baby, but you have to keep the family healthy and happy, too.” Ta-dum! A light went off in my head, and now I really understand what it means to have a family physician care for me. Her advice continues in this practical “the baby is part of a family” way that has been a tremendous help in my new role as mother.

Because I know the trend is toward family physicians not including obstetrics in their practices, I cherish the experience of Sam being delivered by my family physician. I feel tremendously privileged to be a patient of Dr. D’Andrea’s, and am thankful that Alta Bates has made a place for family physicians in their maternity services. FPs provide a critical consumer choice for women who want to minimize the chances of medical intervention during childbirth and for wonderful gift of continuity of care from mother to newborn. Thank you, Dr. D’Andrea, for continuing to deliver babies and for the excellent care you gave my family and me.