What Happens When Your Doctor Can’t Deliver Your Baby?

Even the best-laid birth plans are bound to encounter a hiccup or two. One of those snags could be that the OB you’ve seen throughout your pregnancy might not be the physician who delivers your baby.

Fortunately, there are ways you can prepare and cope if you encounter this bump in your birthing plan.

Why wouldn’t your doctor be there for your labor and delivery?

It may surprise or even shock first-time parents to learn that the obstetrician or midwife they’ve seen month after month (or more) might not be joining them in the delivery room.

But depending on the physician and practice chosen for prenatal care, it’s not uncommon. It’s actually a good thing for everyone involved.

"Obstetricians work in call groups and share hospital tasks, particularly nights and weekend call coverage," said Kyler Elwell Silver, M.D., assistant professor of obstetrics and gynecology at the University of Texas Southwestern Medical Center in Dallas, Texas.

"It would be impossible and unsafe for a single physician to cover all care 24 hours a day, seven days a week," Silver said.

Doctors are people, too.

"In addition to deliveries, physicians have clinic responsibilities, surgical responsibilities and home lives that can all limit their ability to be present at delivery," Silver added. "Physicians also travel, get sick, have babies, watch their children’s awards ceremonies and go to funerals."

The type of practice a pregnant person chooses can help predict who will be present at the delivery, said Amy Wetter, M.D., an OB-GYN at Pediatrix Medical Group’s Northside Women’s Specialists in Atlanta.

"Some practices have a solo doctor, while others have multiple doctors with mid-level providers like certified nurse midwives and nurse practitioners," Wetter said. "Some doctors deliver all of their patients unless they are out of town, [and] others only deliver on specific days while a hospitalist, their partner or a midwife delivers the majority. Some groups cover with other groups on certain days or weekends, so asking if your doctor or group covers with any other group is important."

What happens if a different doctor delivers your baby?

The "must-haves" of every pregnant parent’s prenatal care are different. For high-risk pregnancies, or those with conditions such as preeclampsia or high blood pressure, more monitoring is required up until their due date.

Their primary care physician may include a rotation with a different physician at the birth center. This rotation enables on-call doctors to familiarize themselves with your situation.

Regardless of your desired birth scenario, knowing what the possible plan B will be ahead of time is important. Ask how likely (or not) it will be that your doctor will be present at your labor and who will be there instead if they can’t be. If it isn’t already part of the arrangement, meet this other provider beforehand.

"This is a conversation a patient and her OB should have at their first obstetric visit," Silver said. "It is important for both the physician and patient to be clear about delivery expectations. Unfortunately, babies and labor do not follow a nice, predictable schedule."

If it’s possible, try to see different providers at the practice during office visits so you can get familiar with them, Wetter said.

"Since most women have 14 or more prenatal visits throughout their pregnancy, if you are going to a group practice, I would encourage you to meet all the providers at least once," Wetter said. "You may choose to see one provider more than the rest, but meeting everyone once is a way to ensure you are not surprised by another provider taking care of you."

How can a different doctor affect my delivery?

You probably feel comfortable with your doctor and already have the birth plan laid out. Bring a copy of your birth plan to the hospital with you on delivery day so everyone who’s involved in your labor and delivery, whether that’s the doctor or midwife, can be clued into your preferences.

Speak up and ask questions if a new provider hasn’t explained the next steps or procedures clearly enough or seems to be ignoring your wishes, or if you feel uncomfortable, Wetter said. If you’ll have a birthing partner in the delivery room with you. This could be a key role for them to play.

Still, patients need to understand that the birth experience is inherently unpredictable. Parents may need to temper their expectations a bit to avoid unnecessary stress and disappointment.

What matters most is choosing a certified nurse midwife or medically trained doctor you trust to care for you and your baby.

"While we are so sad to miss deliveries, it is our ultimate goal to have a healthy mom and a healthy baby," Silver said, "and sometimes that means another doctor is delivering your healthy baby."

The bottom line

Pregnant women have 39 weeks to get comfortable with their OB-GYNS or midwives. When the delivery date arrives, and their usual doctor is unavailable, it can feel overwhelming. Flexibility is important. Enlist the help of your partner to advocate for you, so you can better focus and prepare for the bigger task at hand.

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