What’s A ‘Laborist’ And Why Is She At Your Birth?

Go home and go to bed, OBs! Stay in the margins, skilled midwives! There’s a new birth attendant in town and she’s coming to a hospital near you.

Or, perhaps, she’s already there.

In an effort to fill the void of obstetrician-gynaecologists who have stopped delivering babies, US hospitals are increasingly staffing “labourists” or “OB specialists” to attend the births up in Labor and Delivery.

These laborists are, indeed, doctors themselves. They just don’t have their own OB practices, don’t pay astronomical malpractice insurance and typically work only part time — maybe a weekend shift or a few nights a week.

Some hospitals think having labourists fill in during birth will make giving birth in the hospital safer since they can be with the labouring mother from the time she arrives at the hospital. Labourists also won’t suffer sleep deprivation, since their shifts are defined. The fact that labourists will attend the births also means OBs won’t have to cancel the morning’s appointments to rush to the hospital. So it’s win-win … for doctors and hospitals!

But let’s focus on the mum for a sec. Is it fair that after doing all her research and getting to know her OB over nine-ish months that she should show up on the big day and be greeted by a perfect stranger? After discussing her birth plan, hopes and dreams, should she have to go over it all again, presumably between contractions? What about philosophical clashes between the pre-natal OB and the labourist? Is this the final step in the McDonald’s-isation of L&D?

The woman featured in this Boston Globe article on labourists was pleasantly surprised by her labourist and all the attention she got while in labour. She says she had never spent so much time with a doctor. And this was BEFORE she even began pushing out the baby. What’s interesting to me is that this woman wasn’t even told a labourist might be there attending her birth. That would bother me greatly.

I’m all about midwives and homebirth, but I’ve had a hospital birth and I do kind of like the idea of (1) someone attending the birth who’s pulling a shift and not anxious to get home and (2) a doc who is well-rested and not burned out on birth.

Is a labourist for you? Is this any different than getting care from a large practice of OBs who share responsibility anyway? Or does this make you want to hug your midwife a little closer?