Ask the BJC Expert

Ask the BJC Expert

The Role of the House OB

Scott Williams, MD

Published on Wednesday, August 16, 2017

Dr. Scott Williams is a House OB at Progress West Hospital in O'Fallon, MO.  

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Joining me on the phone line today is Dr. Scott Williams. He is a house obstetrician at Progress West Hospital in O’Fallon, Missouri. We are going to talk about what exactly that is and how it could be important to some of you folks out there. Doctor, good morning.

Good morning Mike,

Thanks for joining us. What exactly is a house obstetrician (OB)?

We are obstetric hospital doctors. At Progress West, BJC which is the program I work in, it is a group of very seasoned board certified OB/GYN doctors averaging about twenty years of experience. We provide care for the hospital obstetric patients in labor and delivery. We work in collaboration with the nurse and the patient’s private obstetricians to care for those patients.

So your exact role at the hospital would be overseeing this particular area of OB?

Right, I would largely compare it to an emergency room (ER) doctor’s role except that the emergency type care we provide is pregnant women in labor and delivery rather than the actual ER. We could be in the triage area of labor and delivery evaluating a patient in labor. We could be admitting or evaluating patients for a host of high risk labor associated diagnoses; things like toxemia, preeclampsia, premature labor, infections like urinary tract infections in pregnancy, medical conditions like influenza in pregnancy and so on. We assist the private obstetricians with their caesarian sections (C-sections) and other surgeries such as tubal pregnancies. On occasions we provide those services as an emergency or deliveries if emergency care or emergency C-section is necessary prior to the arrival of the patient’s private OB. We occasionally provide emergency care; we are available for this, for post delivery conditions such as fevers or hemorrhages. The thing is Mike that I was in group medical practice for 20 years and I know that the private obstetricians are pulled in a million directions from the operating room to the labor and delivery. Their patients are emailing them, their patients are phoning them and sometimes they’re texting them. As the OB hospitalist, or house doctor, our focus is 100 percent labor and delivery. We are there to provide support for that team and to improve the safety of the patients in labor and delivery.

You know it is amazing when I think about all the advances that have been made in the areas of labor and delivery, pregnancy and things. You know even 10 or 20 years ago things were so different, but still it requires a patient to do specific things. What are some of the things that make for a healthy pregnancy?

Oh, you are quite right Mike, and most of the things the patient manages for herself such as her diet, appropriate vitamins, absence of tobacco and alcohol, appropriate sleep and exercise, and monitoring fetal movement herself in the third trimester. She may not have complete control over some underlying medical issues such as high blood pressure, diabetes, lupus or depression but she can certainly improve the management with caring for herself and it is best, obviously, for her and her baby to work with the doctors and nurses to manage her medical problems which often lessens or can even eliminate the impact of those medical conditions on herself or her baby.

So let’s take it from pregnancy to delivery. There again that’s a whole other area where a healthy delivery can be so important. What can the patient do to make it easier?

In my opinion, go to a safe environment where emergency response is in place. Most of our area hospitals have the OB hospitalist or OB physician in place, anesthesiologist and pediatrics that are there 24/7, 365 days a year, holidays, or Christmas morning at six whenever it is necessary. We are there all the time. I think it is also important in terms of improving the labor experience for the patient to respect her choices. Some patients want an epidural, some patients don’t, some patients want their labor induced or augmented, some patients don’t and it is important for all of us involved in the support team to respect that patient’s choices and respect her autonomy. The interventions have to be agreed upon by the patient whenever they are recommended or needed.

I would imagine, and this is just me guessing, any undue stress at that particular juncture is not a good thing for the mother who is in delivery.

Stress is absolutely not good, for the mother or the baby.  Studies do show that emotion, depression, and anxiety and the stress hormones produced by those have an effect on both mother and baby.

So now let’s bring the other half into this thing. The husband, the guys you always see pictures of standing aside; but I can personally say that I went into the delivery room when my girls were delivered and they do play a key role. Sometimes it’s the husband or there is a helper. What role do they play during delivery?

The family member that is there Mike, they have to understand that for the woman, like you understood with your two children, the woman is under an incredible physical and emotional challenge. It is important to respect her autonomy. It is important to support her choices. It is important to understand that her responses might not be her typical responses to you in a less stressful situation. None of us can truly be in her shoes but that husband can be empathetic, can understand and he can respect her choices and really be just an understanding, empathetic supporter. That is what every woman needs in labor.

Of course, if the ballgame is on, don’t try to rush it along. The child will come at due time and it is not on your clock so you should keep that in mind as well.

Yes sir!

If folks want to contact your or learn more about the house OB at Progress West Hospital, how would they do that?

The labor and delivery program at Progress West Hospital can be reached at 636 344-2200.

That will point them in the right direction?

Yes sir.

Thank you Dr. Williams I appreciate your time.

It is a pleasure.

Dr. Scott Williams was with us today. He is the house OB at Progress West Hospital in O’Fallon, Missouri as we “Ask the Expert” from our friends at Barnes-Jewish St. Peters Hospital and Progress West Hospital.

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