Stork tries a new strategy

On the morning of her Caesarean section, Tyriesha Tucker met the woman who would deliver her baby - obstetrician Hyun-Joo Lee - for the first time.

That was fine with Tucker, a tiny woman who was 41 weeks pregnant with her second child. She didn't care whether she had a long relationship with the doctor who would cut into her womb that day. What mattered, she said, was that her doctor knew what she was doing.

By early afternoon, Lee, whose job was to care for all the women in labor on Albert Einstein Medical Center's busy maternity floor that day and night, was furiously scrubbing her hands and arms for Tucker's surgery. Within 15 minutes, she was smiling at Tucker's daughter, Sabriah, who yelled and kicked while inhaling her first breaths of cold operating-room air.

"Hi, cutie," Lee said brightly. "Happy birthday."

Not that long ago, most women expected a doctor who saw them through their pregnancy to deliver their baby, no matter when their labor pains began. Sacrificing nights, weekends and family plans was just part of being an obstetrician.

Now, societal changes, from young doctors who demand more family time to heightened concern about safety and efficiency, are leading doctors and hospitals to rethink the division of labor in obstetrics.

Though their numbers are still tiny, hospital-based doctors like Lee - whom Einstein calls "laborists" - are more likely to deliver babies while other obstetricians work uninterrupted in the office or O.R., even enjoy their time off without fear of the pager. Proponents say such specialization improves care and makes it easier to recruit young doctors, who find the field's long hours and high costs of malpractice insurance unappealing.

"This has a predictability to it that is attractive to young people who are going into obstetrics," said Arnold Cohen, Einstein's chairman of obstetrics. "This is a chance to get the top people back into ob-gyn."

The field is evolving. Obstetrics leaders disagree about what exactly a laborist is. Purists say they need to work full time on the labor unit.