Why do people let their OB's "play god"?? - Page 3

[mamatolevi]

Originally Posted by texmati

This is so true...
It's sad. I wonder if they could get away with it with men?

I've noticed a marked difference between in CP attitudes when it's just me in there vs. when it's me and my DH. They are much more respectful when DH is present - male or female. sickening.

[WaitingForKiddos]

Originally Posted by Storm Bride

Honestly...I don't think they try it as much with men, but I think they could get away with it. .

This reminded me of the ob who branded a woman's uterus with the initals of his medical school. Happened a few years ago.

[Full Heart]

Storm Bride I have to agree with everything you have said. I always value your posts, they are always thoughtful.

I understand the frustration people feel when watching someone blindly follow any drs advice without first taking all the risks and benefits into consideration. They truly feel that drs are looking out for their best interests though, they are the ones who are educated extensively in this field. Why should someone have to do the research that their drs already have done? Of course they fail to realize that its their body and no one knows it like they do. They fail to realize their dr doesn't know everything there is to know. That the information their dr has is not contained in a secret library that you only get the key to once you graduate med school. The information is there for them too.

However there are so many reasons why women do get induced and go with the epi and do what their drs say. I've discussed here how I was forced to have induced labors at home. My choices were be dropped by my mw (which funny they don't have the same laws drs do. They don't have to continue care for 30 days), go unassisted or go to the hospital. If I wanted my homebirth with my mw guess what I had to do. If a woman wants her hospital birth with her dr guess what she has to do? This pg has taught me so much about respect for other peoples decisions. And you know no one has to justify their decisions to anyone else. Its theirs and theirs alone. And if you start bashing people for their decisions don't be surprised if they start doing it to yours. I have to tell you if my mw said you have to go be induced right now because you are 41 weeks I would say ok. Without hesitation. And I've planned hbs for all my kids. Life happens. Fears creep up. We don't know what womans lives are like, before pg or during. We don't know what they have been through, what they have seen, what underlying fears they have.

As Storm Bride said

I do think the women who listen to them get a worse rap than they deserve, though. Our society protects the image of these people as trustworthy experts, who are looking out for our best interests...and a lot of people really believe it.

Blaming the mothers is not going to help. Women need support. And this is def not a new thing. When my mother had me she did whatever she was told. She went along with everything because it was what you did. My mil had twlight sleep, you certainly had no choices then. If anything its gotten better. Things are less dangerous now for the most part. But we have hit a plateau.

I agree women need to be the ones to force change, but they have to be empowered to do that. Its good to ask why they go along with drs but we should ask it in a way that we aren't judging.

[ell]

Originally Posted by Storm Bride

hmm...I don't. I think it's unfortunate that we've put OBs in the position of being "experts" and that we suffer from a widespread perception that they care about our best interests. They're dangerous, imo - their arrogance and ignorance can kill, and can also cause tons of damage, both physical and psychological, to the people who trust them to know what they're talking about...and to be honest about the risks, and about their own motives. They like to be on a pedestal, but they don't want to take the heat that comes with it. I don't think they get an unduly bad rap at all.

They do care about our best interests. It's just that their teaching and belief system leads them to believe that their way is the best and only way. OBs see everything - from the easiest birth to the most horrid. They are naturally conservative in terms of treatment and yes, they will go to intervention far more quickly than a midwife will. Does this make them evil? No. It makes them conservative. Sure, there are bad seeds that schedule c-sections to make tee times but I truly believe those are the minority and the majority of doctors would rather see a woman with a stress-free vaginal birth. The fact is, doctors save lives every day. Yes, there are more interventions than there should be, and that needs to be changed. But even with that, more lives are saved than are lost.

But there are those who choose to believe that allopathic medicine is evil and there's no way to convince them otherwise.

[texmati]

Originally Posted by ell

Do people in general question anything with their doctors? "You have cancer. You need chemo." Do most people question that or go do a ton of research and challenge their doctor? No. So it's no surprise that most people don't challenge their doctors in childbirth either.

Having said that, I think docs - and women who listen to their docs - do get a worse rap than is deserved.

not to get into a debate, but I just had this conversation with a good friend of the family-- a cardiologist/surgeon. She was upset that I was *gasp* interviewing doctors.

OB-ing is different than a lot of other practices. Heart surgeons save lives every day. So do oncologists. OB's don't. Their job is to assist the mother into bringing a baby into this world. A *lot* of that has to do with educating the parents, listening to the mother ect. So the mother should question the OB, and the OB should educate the mother.

ETA, I do agree that there are good and bad docs (and midwifes, for that matter), and it's possible to find good ones.

[flowers]

THIS IS IT!!!!!!!!!

I think about this all the time! I think this is exactly the place where change can occur. I think it's futile to try to expect the doctors to change and educate the women. It's time for the women to educate the doctors! That is such a powerful switch!

I'm very independent and strong minded, but even I go into a weird mode around doctors. (Which is why I never went to one while pregnant). I even did it around my mw. Started acting all quiet and soft-spoken and sometimes left without saying what I wanted to say. I'm very aware of it and with my ds2 I made a pact that I would be my own provider and anyone else was my support team. This felt so much better!

So how do we do this? I don't have any concrete answers but I think we are heading into this direction anyways. People are questioning and self-educating and we can just support anyone we know. When I am talking to a pregnant mama who says, "oh I have to do this test, but I'm not sure." I always gently remind her that she does not have to do anything! It's totally up to her and it's so important for her to self-educate so she knows what she wants and doesn't want. Most women don't even know they can decline certain tests or procedures. So first step is just getting that out there.

Originally Posted by dmariev

Oh I'm right there with you!! My OB said "we don't do vbacs" to which I replied "oh, that's nice, cause I don't do repeat c-sections" He doesn't like me too much heeheehee

I love this! !

Originally Posted by WaitingForKiddos

This reminded me of the ob who branded a woman's uterus with the initals of his medical school. Happened a few years ago.

This is extreme and completely DISGUSTING!

There is that story of an edition of Williams Obstetrics (the bible of obstetrics) that had this included in the index:

chauvenism, male: entire edition

I forget the exact wording but it seems there was an editor who was just a bit fed up!

That's what we need...fed up women ready to make a change.

[AnnR33]

I really try to not judge others but it's so hard to hear of others that don't question anything that is being done to them. I was on another board and some moms were talking about having blood work and internal exams at 36 or 38 wks. I asked what the blood work was for since I never heard of having blood work done that late...the mom had no idea. She just does it. Arg! This makes me sad!

I tried to gently insert some comments about why internal exams are not necessary but I think most think of them see it as a gauge of progress and want to know if they are 1 cm, etc even if it means nothing in the big picture. It frightens me that an OB/dr/etc would do an unnecessary internal exam for some inaccurate "progress" check and possibly introduce bacteria or who knows what else.

I try to educate when possible but I know it's an uphill battle. I figure if I can encourage a few moms to question their dr and think harder about what is done to them then I'm happy that these few are more in control of their situation.

[jammomma]

I think there are a lot of women (and men) who simply don't want to do their own thinking.

Many people just want others to make the decisions for them.

There are many people that were never taught critical thinking skills, and many people don't like to read or learn new things or accpet responsibilty for the choices they make in life.

I think when making healthcare and birthing decisions it comes down to simple differences in the ways that people choose to live their lives.

There are always going to be people that slavishly follow whatever an authority figure tells them without question, whether that authority figure is a doctor, their government, or their religion.

[MamaMonica]

Moved to Birth and Beyond, since this is more of a birth topic than pregnancy.

[fawnanddoe]

This thread has become a for doctors or against doctors discussion. I do have a few things that I want to add.

First off, pregnancy and birth is not a disease. Yes, there are some women who have complications during pregnancy and need interventions during pregnancy and birth, and doctors are great for that, BUT the majority of women have uncomplicated pregnancies and do not need these medical interventions.
A few years ago the cesarean rate was 1 in 5 women. It is now 1 in 3 women. Does that statistic scream "these OB's have our best interest at heart!" no, not at all. The fact that the cesarean rate has gotten so drastic is scary!
OB's are specialists. They are not specialists in normal, unmedicated vaginal births. If you watch The Business of Being Born you will see all of those OB's say that in their years of training they did not see a "normal birth". So you are trusting these people that were not trained in normal vaginal birth but they were extensively trained in complications, medicine, and interventions.
I do believe that not all OB's are the same, and there are some great ones out there, but for every good one there's a huge handful of not so good ones.

I had to go to L&D once during this pregnancy for a kidney stone. Let me tell you, I was NOT informed, and I was really trying to be informed. I was asking them constantly "why do you need to do this?" and what exactly were they going to do. I asked them exactly what they were going to test my blood for. Then I was told that I needed to be hooked up to an IV. I asked them why because I was perfectly capable of keeping myself hydrated. Eventually because it was so late I got the IV because I really needed to sleep and not drink water, what a nightmare that was, it took THREE nurses to put the IV in me, this is where they deliver babies! I would be pissed if I was in labor and three different nurses are sticking a needle in me and not getting it right. Eventually they got it. I woke up several times and my arm was hurting a lot, finally when I was awake for good I called the nurse to take the IV out. I was ignored the first time and told to go back to sleep and it would be fine. I buzzed her again and said no, take this IV out. She promptly said "I need to call someone and ask because you need that". What? No I don't! Finally she came and took it out.
So, I'm getting off my point here, but I was very knowledgeable and I questioned them a lot. I left feeling like I did not have a ton of interventions, although I felt as though there were some that were forced on me.
I finally got my hospital bill and WOW WAS I SURPRISED!
So I got an internal exam to make sure I was not dilated, simple, right? Turns out that wasn't the only thing I got! Apparently they gave me the fetal fibronectin test. I talked to my midwife before I went into L&D (I was out of town at the time) and she told me about this test and that it was expensive and unnecessary and that they wouldn't do it unless I was having contractions and/or dilated. This test was almost $700. I asked them what they were going to do and they didn't tell me that.
Also, turns out they tested me for syphilis and gonorrhea. Almost $500 worth of STD tests that I have already had. If they had read my file that my birth center faxes them they would know this, and when I asked them what they were testing me for they did not tell me STD's. I would have told them no, it's not needed.

Anyway, I tried. I was very persistent, I was probably their least favorite patient, and I got home, got the bill and felt completely violated. I am contesting those charges, there is no way I am paying for something that was not needed and I would have declined.

Also, someone mentioned that patients don't question when a doctor tells them they have cancer. For one thing, if you have a disease and you are going in for testing to find out what that disease is, that's one thing. You need interventions, you are sick and have a disease. When you are pregnant it is not a disease.

I do feel some women get a worse rap than they should, but then again there are a whole bunch of women out there who will blatantly tell you they don't care and the doctor can do whatever he wants because he's doing it for a reason, or because it's best. Or whatever.

[rainashine]

Storm Bride and Full Heart, I really appreciated your posts.

Being one of the mamas who had a 41 week arbitrary induction that ended in a c-section, I find the mama blaming rhetoric on these types of threads very frustrating. I truly did not know. And the thing that is frustrating is that I don't know how I could have known that I even needed to do research. It's all great to say mamas need to take contol, make their own decisions, and that they are just stupid for not questioning anything. But seriously, I think for the majority of women out there, it's not a matter of just wanting to go along with things because it's easier. It's a matter of not having ANY information that indicates otherwise.

I really thought I was informed. I knew about doulas but thought dh would be enough. I wanted a natural birth and the hospital was great at mascarading as supportive of that. I'd never heard of delivering in anyway but on my back. It never occured to me that you could check hospital statistics or that would even be helpful.

While I was pregnant, I read breastfeeding books, Week-by-Week, and What to Expect. No one, and I mean NO ONE, recommended anything else to me. No one, even those who knew I found out later, told me my choice of hospitals (chosen by proximity of course) had a reputation for inductions and slicing and dicing.

Now I'm looking into becoming a doula and CBE probably some in reaction to what I went through. But know that me in those roles will never impact those like me before I had my child because they just don't know.

I think my point is that our whole culture surrounding birth is such that women are so ignorant of normal birth that they don't know that they're not informed. Please stop blaming the mamas! Any maybe a few well placed gentle comments to a mama-to-be can really make a difference.

[NinaBruja]

i really wish there was a way to do something about bad doctors and nurses who give misinformation.
i was lurking on mdc and researching birth while pregnant with my first and i remember being in an argument about induction. they had been trying to induce me since one day before my edd. i was 41 weeks and they were having a fit. the nurse was literally yelling at me that i was overdue and my baby would die if i didnt get induced. i said 'im not overdue until after 42 weeks' and she asked me if i ever had a baby before i said no and she said 'well then how would you know if this is normal or not. youre not a doctor!'
she yelled at me and made me feel tiny and stupid. incredibly stupid. like i was only 20 what could i know.

it still makes me so angry! i even had my membranes forcibly swept without my permission which broke my water and put me on the clock and then throughout labor i had doctors calling me in my hospital room all of them finding new ways to play the dead baby card.

no one deserves what happened to me. i wish there was some way i could get their licenses revoked.

[SashaBear]

Originally Posted by Storm Bride

I sincerely wish that c-sections didn't bother me at all. I wish I had the "give me the epi in the parking lot" mindset. I envy it, from the bottom of my heart. I want to be like my SIL, who had an induction, "failed to progress" and had a c-section...and was relieved. I'm not like her...but I wish I were. I really do.

This is so me! I wish I didn't have a problem with my c-section. I wish it didn't make my heart ache. Honestly I recovered faster with my c-section than my vaginal with epis. Sometimes I dread the idea of having another child because of the fight I will have with family if I go for a HB or doctors if I go hospital VBAC.

[MegBoz]

Originally Posted by Norasmomma

As my DH says Dr are just like mechanics only they work on bodies, so there are good ones and there are bad ones. I tend to agree with him on this.

I disagree. I think the % of bad American OBs is much higher than the % of bad American mechanics. I say this because of our culture:

• birth is seen as a medical event (DOC IN CHARGE - not woman - & her emotional state of mine is irrelevant)
• OBs don't practice evidence-based care & don't seem to think they need to
• The obstetric "Omerta" (OBs can do no wrong, view protecting the interests of OBs as far more important than the actual health & safety of women & babies, and won't speak out against one another, even if they recognize malpractice) (See "Born in the USA" by Dr. Marsden Wagner)

I think American obstetrics is in a sorry state. MUCH WORSE than american car mechanics.

[MegBoz]

Originally Posted by dogmom327

Plus our society puts an incredible amount of pressure on pregnant women to just do as the doctor says and insinuates that doing anything else is irresponsible and is risking the life of the baby.

:
ITA with that whole post, but especially that.

Additionally - it's a simple equation that goes as follows

1. Birth is risky
2. birth is a (risky) medical event
3. we must rely on doctors to handle risky medical matters
4. we must rely upon, and fully trust doctors to handle birth

I love the joke from that famous "PING" Monty Python sketch, the OB says to the Mom, "You're not qualifed, dear!"

Originally Posted by fawnanddoe

They couldn't tell me that normal gestation was NOT 42 weeks, and if I had a healthy pregnancy they can't make up medical reason on why they have to induce then.

Actually, the risk of stillbirth does rise slightly at 41W. Granted, we all know there is risk in induction too - but there IS some, slight risk in going beyond 41W.

[amandaleigh37]

I haven't read all of the other responses but I'll throw in my $.02...

This was me at my first birth. I never questioned anything. In all of my experience, everything I'd heard from family, the way I was raised, etc. - doctors knew everything. To question or go against what a doctor wanted was pretty much putting your baby in danger. Doctors = safe. I never would have considered that the doctor would want to induce me for convenience. I assumed it was because it was best for my baby, which was ALL I cared about.

Now, of course, I know better. And this shift in thinking started when I began reading and listening to other women who KNEW BETTER. I don't think I was "stupid" before, I was just doing my best based on my experience. And sadly, raised in a family where no one would ever DARE question a doctor, that's what I thought was "right". I had never heard women talk about taking control over their birth, or the risks of "unnecessary" interventions - my doctor never once mentioned a risk of ANYTHING he wanted to do, so it's no wonder that many women don't believe there are any.

I also know it's hard to remember what it's like to think that way, once you've "seen the light", so to speak. I wish I could go back 2 years and shake some sense into the old me before I had my son. But thankfully, I found this place and started reading and learning to question things and I'm better off now because of it.

[MegBoz]

Originally Posted by rainashine

I find the mama blaming rhetoric on these types of threads very frustrating....While I was pregnant, I read breastfeeding books, Week-by-Week, and What to Expect. No one, and I mean NO ONE, recommended anything else to me.

Yup, lots of Mamas can feel totally informed. I read "The Mayo Clinic Guide to a Health Pregnancy" & it actually said, "The CS rate is around 25%. There is nothing you can do to reduce your risk of a CS."

BS!!! What a TOTAL LIE! But how is the average Mama to have know that the biggests risk factors for having a CS are the HCP & facility you choose???? How is the average Mama to know that so many CS were iatrogenic - Doctor caused & could have been avoided if the doc didn't unnecessarily intervene in the normal process?

It's a shame.

But what DOES annoy me are the people I meet casually who I try to clue in... who I TELL that I discovered, thanks to reading "Thinking Woman's Guide" "Pushed" "Born in the USA" & the movie BoBB, that there is a CHASM b/t evidence and pracitce. THat the CS rate is MORE THAN DOUBLE what the World Health Org says it safely should be.

When I tell them this & they still don't investigate further, still keep planning to deliver at hospitals with CS rates around 40some %) THEN I get annoyed..... (Co-workers of mine)

[DahliaRW]

Originally Posted by ell

Do people in general question anything with their doctors? "You have cancer. You need chemo." Do most people question that or go do a ton of research and challenge their doctor? No. So it's no surprise that most people don't challenge their doctors in childbirth either.

Having said that, I think docs - and women who listen to their docs - do get a worse rap than is deserved.

Actually, I did question when I had cancer, and I was only 18. I asked for articles and stats to back up the course of treatment they were recommedning (which they gave me). I also went to a local universities medical library and accessed medical journals online (my mom was a student there and logged me in). Now, probalby most people wouldn't do that. But in all honesty, my otolarongologist and oncologist were WAY better and discussing pros/cons and making sure I was giving informed consent (even before I questioned them) then any OB I have ever met. I really do think that there is a problem with a lot of OBs not practicing evidence based care. Oncologists and such HAVE to be up to date with new practices and procedures, they have committees at hospitals that discuss cases and courses of treatment. OBs don't have that, and it doesn't seem that many care to have that type of collaboration either.

Now the whole blame the mom/blame the OB thing. I think it goes both ways. I definitely blame myself for being so ignorant about my ds1's birth even if I wasn't sure where/how to reasearch. But I also blame my OB for not giving me adequate information or helping me there. And I learned from friends and others after that and ended up with a wonderful hb with ds2. So now I give friends resources to learn when they are pregnant. And I only blame those women for being ignorant who refuse to use their brains and look into things for themselves when the resources are offered.

On a slightly different train of thought, if it's about the money (as mentioned earlier), then how do stats compare between the US and countries with UHC? I believe here in the US, the c/s rates are lower at military hospitals than civilian ones, and I'd believe that the money could make the difference there.

[fawnanddoe]

Originally Posted by MegBoz

But what DOES annoy me are the people I meet casually who I try to clue in... who I TELL that I discovered, thanks to reading "Thinking Woman's Guide" "Pushed" "Born in the USA" & the movie BoBB, that there is a CHASM b/t evidence and pracitce. THat the CS rate is MORE THAN DOUBLE what the World Health Org says it safely should be.

When I tell them this & they still don't investigate further, still keep planning to deliver at hospitals with CS rates around 40some %) THEN I get annoyed..... (Co-workers of mine)

This is exactly how I feel too. I don't think that women are stupid. I do believe that some women think they are informed when they really aren't. It definitely has a lot to do with our culture and what is "socially acceptable" or "right". I would probably never go to an OB myself, but that's what is correct for me and not everyone feels the same way. I respect that some women want to do things differently because my way is not the only way. BUT there is a lot of pure ignorance out there! I have done more research having to do with birth than I probably did throughout all of high school! Because of that I can pull up tons of articles, statistics, I can even go through pros and cons of tons of different things and support those pros and cons with percentages. I can recommend books or DVD's to watch to get a different perspective and the majority of the time when I suggest these things or have a discussion about these subjects people are not willing to even check out my side of the story! I have had very heated discussions with people about everything from birth to circ to vax to breastfeeding to cloth diapering and the list goes on! I have been told that just because I am going natural doesn't mean I am a hero and they offer epidurals for a reason.

And I think this is my biggest issue, the ignorance factor. It's not the women who truly believe they are informed and doing the right thing, it's the women who will not even listen to the other side of the story, the women who are not willing to investigate anything further.

[Storm Bride]

Originally Posted by ell

They do care about our best interests.

Do you have any evidence of that at all, or is it just your personal belief? I know there are individual OBs who care about the best interests of their "patients", but that doesn't mean that the obstetrical industry does, or that all the care providers do. My personal experience with OBs says you're wrong. Someone on a bb expressing an insubstaniated claim that my best interests are even on their radar isn't going to change what I've seen with my own eyes.

It's just that their teaching and belief system leads them to believe that their way is the best and only way. OBs see everything - from the easiest birth to the most horrid. They are naturally conservative in terms of treatment and yes, they will go to intervention far more quickly than a midwife will. Does this make them evil? No. It makes them conservative.

I had an OB tell me that if I didn't have surgery when he wanted me to, he'd drop me from care - at over 41 weeks pregnant. (That particular OB is one I've seen work before, and he's not a misogynistic jerk, nor is he particularly c-section happy...but he's convinced that he is right.) I had another OB do a c-section after I said "no". Maybe they do care about the best interests of the people in their care...but if they can't be bothered to find out what those interests are or to listen when they're told, in so many words, then what they're thinking is irrelevant. The OB who threatened me with abandonment was pleased as can be that his "push" (his word) was successful. He was convinced that I was okay with the c-section, because I had a healthy baby. I'd had two c-sections before that, and had clearly and repeatedly explained that a c-section was not a good outcome for me - period. He wasn't listening, because he didn't care what was best for me. He cared about his guidelines. Treating fully grown women as if they're brainless infants without the sense to come out of the rain (if they need to) isn't looking out for anyone's best interests - it's stroking one's own ego. OBs bringing up one's "option" for a tubal at every prenatal appointment, when it's already been clearly declined multiple times, are not looking out for the best interests of their patients. OBs who frame the procedures they don't want you to undertake in the scariest possible terms, while completely neglecting to even mention the risks of the procedures they do want you to undertake, are not looking out for your best interests.

Sure, there are bad seeds that schedule c-sections to make tee times but I truly believe those are the minority and the majority of doctors would rather see a woman with a stress-free vaginal birth.

Who decides what constitutes "stress-free"? Doctors aren't listening to what women want to have happen in L&D. How can they possibly be looking out for the best interests of their patients when they can't even be bothered to find out what those interests are?

The fact is, doctors save lives every day. Yes, there are more interventions than there should be, and that needs to be changed. But even with that, more lives are saved than are lost.

Again - do you have proof? How much better is infant and maternal mortality in countries with high interventions? I've been digging in the stats for a few years now, and I haven't found an improvement from all this.

Plus, you're doing one of the things the OBs do. You're weighing this solely in terms of lives. It doesn't matter to them how many women they unnecessarily traumatize, or how many infants are subjected to negative impacts on their health (both major and minor), as long as they believe they're saving lives. If they think there's any chance at all that someone will die, then they feel perfectly justified in making that woman's life hell, causing her lifelong physical damage, and hurting the health of her baby. That is also not looking out for someone's best interests. Pregnant women are treated like children who aren't allowed to have any say in their own care.

But there are those who choose to believe that allopathic medicine is evil and there's no way to convince them otherwise.

Evil? No. Both arrogant and ignorant? Yes.