By Karen Finucan Clarkson

No matter what phase of life she is in—from onset of menstruation through menopause—a woman is likely to have intimate discussions with her obstetrician or gynecologist.

Finding a qualified doctor with whom you are comfortable may not only impact your health but, in the case of expectant mothers, the health of a child.

"There's no one ideal reference point," said Dr. Ann Burke, medical director, Obstetrics and Gynecology at Holy Cross Hospital in Silver Spring. "In many respects, it becomes a cross-check kind of system." Qualifications, insurance and hospital affiliation are just a few of the factors that influence a woman's selection.

At the top of the list is board certification. "In this day and age, every physician should be board certified or board eligible," said Burke.

The American Board of Obstetrics and Gynecology (www.abog.org) certifies physicians in obstetrics-gynecology (OB-GYN) and several subspecialties, such as maternal-fetal medicine, for high-risk pregnancies, and gynecologic oncology, for cancer of the reproductive system.

"Things have changed from the old days when you could pick anyone and say, 'I want to see him,'" said Dr. Mark S. Seigel, an OB-GYN in Rockville who serves as a trustee of MedChi, the Maryland State Medical Society, and is vice president of the Maryland Section of the American College of Obstetricians and Gynecologists. "For many women, insurance is a major concern."

Both Burke and Seigel suggest checking with insurance companies from the start. "You can love your doctor, but if she doesn't take your insurance, it's not an ideal situation," Burke said.

Many patients rely on family and friends for recommendations. "You can read about me on the Web or see my name on the Washingtonian list, but that won't tell you much about me as a person. If you talk to your girlfriend and she says, 'Here, try my doctor; he's great,' that means something," Seigel said. Expectant moms might want to consider an OB-GYN's hospital affiliation. "If a woman has identified a hospital she wants to use, every hospital in the area has a physician referral service," said Burke. Given that most pregnant women visit their obstetrician 13 times over nine months, the location of the doctor's office is important, said Seigel. "Convenience matters."

For women in the workforce, a physician near the office is often more convenient. But, said Burke, "If a woman develops a pregnancy complication and can no longer work, she might prefer to be closer to home."

The size of the practice also is worth exploring. Many group practices rotate on-call duty so there's a chance your OB-GYN won't be the doctor delivering your baby. It also could mean you will see someone else for a prenatal appointment if your doctor is called to the hospital.

Solo practices can be more intimate. It's important to ascertain, however, who will be on-call if you go into labor when your doctor is out of town or in surgery. And, if she is delivering someone else's baby during office hours, your appointment may be rescheduled.

Expectant mothers might also want to explore a physician's approach to labor and delivery. What are the doctor's positions on induction, pain control, Cesarian sections and episiotomies? And what percentage of the doctor's deliveries are vaginal or by C-section?

For some women the gender of their OB-GYN is important, said Seigel. "In my practice, there's me and Dr. Sujithra Jayaraj, because some people want a woman."

As you search for an OB-GYN, remember that this relationship could be lifelong. Given that, it's important to spend the time and find someone with whom you are comfortable and who will deliver optimal care.