Is everything that goes wrong the fault of doctors? - Page 3

[its_our_family]

I'm commenting as I go along but....

Originally posted by Greaseball

Doctors also give women advice that can cause life-threatening problems. Women who follow the doctor's advice of minimal weight gain, low-calorie and sodium restricted diets are more likely to develop eclampsia than those who are under the care of midwives and receive instruction in real nutrition and are "allowed" to gain as much weight as they need.

I recieved this advice 2 months ago from a midiwfe. Her direct quote was "You need to start limiting your caloric intake and the amount of protein you are taking in to insure that you have a small baby in order to make delivery easy"

So obs aren't the only ones shoveling hooey.....

[its_our_family]

Ok, so I have no quotes from books or actual research or an expert opinion. I have had one c/b and am planning another for next week.

My first c/b was due to ftp. Was it my obs fault. Not entirely. I was induced at my own decision. I made my choice for induction without doing research. I knew I was tired of being pg and I wanted that kid out! And that is what I based my decision on. I didn't take my obs word on everything butfor the majority of thigns I let him do his own thing. I believe with patience and more knowledge things would have been different. Which is my point.

Yes, obs do things that don't make sense. At times they speak without really knowing (ie estimating fetal weight and predicting the day you will go into labor) in order to appear either more knowledgeable than they are or just to be annoying (not sure which )

I do not believe that every women is "Cut out" for homebirth or for UC. I would have loved either one but i can't redo the past. Anyway, I think you have to look at just more than the ob and the overall medical profession. You have to look at us as a society. People aren't into the thing that is natural. They don't care how nature intended it to be. They want a baby at the easiest most conventient way possible. When women cease to be comfortbale the fun and cuteness of being pg is over.

When it comes down to it women are as much to blame as the ob themselves. Why? because most ppl do not research what they have gotten into. They have decided to take the word of the "professional" No one cares if you did it without drugs. If it hurts they don't want to do it.

Until the ideals ppl have change then nothing will change. Nothing will get better. No one will learn.

You can blame the ob for everything if you want. But at some point "we" gave them the power. I don't think it is right or fair and we weren't the ones who did it but we are paying the price for those who did. I just hope that things will be different for our childrens children.

[Alstrameria]

ok, but it's my vagina!

And Greaseball, you can bet nobody is shoving their arm up there without me saying so. If my perspective is skewed because I'm in Ontario, CAN, then I will bow out now.

blueviolet, who is the woman who agrees to these things? Someone uninformed and scared. Dh and I made concious decisions about these things well before labour and discussed them with our provider.

Shouldn't I bear the responsibility for being informed? It's my birth. Sure I consult with professionals for various reasons, including my doctor, but ultimately the decision to (or not to) vaccinate, become vegetarian, give birth, etc, is mine. And, my choice is respected.

Jen

[Greaseball]

"You need to start limiting your caloric intake and the amount of protein you are taking in to insure that you have a small baby in order to make delivery easy"

What a bunch of crap. It's not only the size of the baby that makes delivery easier. Someone on this board said her 8-lb homebirth was easier than her 3-lb vaginal hospital birth.

Cigarette smoking and pill popping used to be recommended for controlling fetal size.

[Quirky]

Originally posted by eilonwy
You found these extreme examples (and yes, they are extreme) because these are what you were looking for. Last week on Oprah, I saw a show about a doctor who has been doing surgeries on women in rural parts of Africa (Ethiopia, I think) who had a common complication of prolonged labors: they developed holes between their bladders or colons and their birth canal, thus rendering them unable to contain urine or feces. Most of their babies were born dead after labors of between 2 and 14 days. I disagree with the idea that we have no sense of what's normal in childbirth.

Wow, I can't believe no one has responded to this. Don't tell me they didn't mention on Oprah that Ethiopia has one of the highest rates in Africa of female genital mutilation. Many in Ethiopia practice the most extreme form of female genital mutilation, the pharaonic form or infibulation. This is where a girl's external genitals (clitoris and labia) are cut off and the sides of the wound are sewn together, leaving only a tiny hole for the excretion of urine and menstrual fluid. Men often use a special knife to cut their brides open on their wedding night (or cut them over the course of several weeks) to be able to have sex. With all that scar tissue and no elasticity of the tissues, of course childbirth is extremely dangerous, and birth attendants often have to cut extensively to allow the baby's head out. Even the milder forms of FGM create a lot of scar tissue and inelasticity that contributes to birthing difficulties. Add chronic malnutrition to that, childbearing early and often, and the practice of infibulating a woman up again after childbirth, and you have a recipe for disaster.

Ethiopian women's experiences under these circumstances can in no way be considered a data set for normal childbirth.

[newmainer]

Wow. fascinating thread...

Eilonwy, you mentioned a couple times about doctors in "this day and age" In my experience interviewing peds for my daughter, the "newer" docs who are out of med school in the past 10 years or less are so married to their med school education still, that they refused to think beyond anything mainstream and that recommended by Such and Such Board. We went with an older doc whose been around the block enough to make some intelligent, experienced based decisions. I had a homebirth with some ooooooold school midwives, so can't comment on whether this would hold for obs, but I'm sure examples abound.

And you might read Diary of a Midwife. Excellent book. Her first hand accounts of being a nurse in delivery in hospitals while getting her CNM prior to being a homebirth midwife are beyond scary. I was floored at the actions she witnessed from doctors ( manually ripping open a womans' cervix because it was taking "too long"- a female doctor, too!) This wasn't the 50s, or 60s, but mid 80s. I doubt all that much has changed. check it out; great book.

oh, and has anyone else ever wondered, amazed, that the majority of ob/gyns are men? This isn't to male bash, but they will NEVER, EVER experience pregnancy or birth... isn't it weird that they are presiding over it and making decisions about care based on something they can't even remotely imagine? Witnessing it is not the same as doing it. I know this is OT, but man this just boggles me. (Not to say that a female doc is always better, but at least if she has given birth herself there's some recognition there...) And the majority of midwives are women. hmmmmmm.....

[cottonwood]

its our family wrote: "My first c/b was due to ftp. Was it my obs fault. Not entirely. I was induced at my own decision. I made my choice for induction without doing research. I knew I was tired of being pg and I wanted that kid out! [...] You can blame the ob for everything if you want. But at some point "we" gave them the power."

Very true! At the same time, doctors take an oath to "do no harm." If any person is in the hospital for anything and asks for a procedure that they do not understand the risks of, it is the doctor's responsibility to educate that person and even refuse to perform a medically unnecessary and risky procedure.

[Greaseball]

I was floored at the actions she witnessed from doctors ( manually ripping open a womans' cervix because it was taking "too long"- a female doctor, too!) This wasn't the 50s, or 60s, but mid 80s. I doubt all that much has changed.

No, it hasn't. Not long ago there was a story from a mother on this board whose cervix was ripped open. She was never told what was happening, either.

Most female OBs do not have children, and those who do often have them by cesarean. I also read that nurses have higher c/s rates than the rest of us. Doctors' wives have even more.:

[cottonwood]

Alstrameria, I think you misunderstood what I was trying to say. I wasn't very clear, so I went back and edited it.

Quirky, THANK YOU. I meant to comment on that and forgot. Really awful stuff. Eilonwy, was your point that birth practices here are normal compared to that?

Newmainer, another good book for taking an inside look at hospital birthing practices is "Hard Labor" by Susan Diamond, who is an L&D nurse.

[KKmama]

I'm not sure if I believe that most OBs are men. It certainly isn't the case anywhere I've lived. And slightly more women go to med school these days than men...

Not sure if I believe that women OBs don't have kids, either. All the OBs at my clinic are women, all have kids or are pg. (Not a statistical sampling, I know...)

I don't know how they or RNs have had their kids, but I'm a little sceptical of that, too...

Not trying to be a weenie, but any references?

[OnTheFence]

Originally posted by KKmama
I'm not sure if I believe that most OBs are men. It certainly isn't the case anywhere I've lived. And slightly more women go to med school these days than men...

Not sure if I believe that women OBs don't have kids, either. All the OBs at my clinic are women, all have kids or are pg. (Not a statistical sampling, I know...)

I don't know how they or RNs have had their kids, but I'm a little sceptical of that, too...

Not trying to be a weenie, but any references?

Where I live about 1/3 of OBs are women. All but one I know have birthed children. I love my OB and sad I have to find a new one. She went along with everything during my pregnancy that I wanted, loaned me medical books, and tlalked to me a great deal about her own pregnancies (she was also pregnant at the time), breastfeeding, PPD, etc. What man could have done that? LOL The only think my OB and I disagreed about was breastfeeding. She advocated breastfeeding but pretty much thinks that after the first couple of months the baby really doesnt get much benefit from it. She knew I breastfed past a year. She breastfed her first child 4-5 months, her second child she breastfed longer.
My sister was a L&D nurse for 10 years. She would never have a homebirth, had two medicated births but she could have gone natural with her last one. She didnt get the epi until she was 9cm, the only reason she said she got it was because she was having a tubal after. @@ She did have a midwife doula for her last birth and she believes there are too many interventions in childbirth today. She isn't aginst homebirth, but she says she has seen to many things go wrong to really advocate for it.

Kim

[Greaseball]

Not trying to be a weenie, but any references?

I just make it up as I go along. Heh heh, not really. Here is my reading list:

Open Season, by Nancy Wainer Cohen
Birth as an American Rite of Passage, by Robbie Davis-Floyd
Mal(e) Practice, by Robert Mendelsohn
Mothering articles
Our Bodies, Our Selves

Lots of others that I don't use nearly as much...

[pamamidwife]

I cannot possibly add any more to this thread (and I'm thinking that it's probably useless, since so much evidence-based info has been given and the OP is firm in her beliefs, which is fine), but I do have to think about the WHO's ratings of infant/maternal morbidity/mortality rate worldwide - and how there are 23-25 countries that have BETTER rates than the U.S.

Also, the arrogance of so many Obstetricians includes the belief that many of the problems with birth today are the fault of the woman and the imperfection of the female body. One only has to visit the www.obgyn.net forums to read the belief systems.

An acquaintance of mine is an OB (can you believe it!??) and he said that not only are they being pushed to do more cesareans, but they receive lower malpractice premium costs if they have higher rates. He also reminds me that the majority of OBs are in it for the surgical aspect. In addition, many practices are starting to induce women at 39 weeks routinely. This is very against evidence and safety for both mother and baby. However, a managed labor is what the goal is - after all, our bodies are completely faulty and could kill us or our babies at any minute - even if we're apparently "healthy". "Birth is dangerous and risky".

While it's world-rocking to hear another side to commonly held beliefs (that birth is inherently dangerous and OBs have improved outcomes), some people are not ready for that sort of life change. I know I denied it forever. I actually *thanked* my OB the day after birth for cutting my vagina deep into my rectum.

The belief is deep. Evidence based, though, it is NOT.

The bottom line is there is a minority of women who need surgical intervention and hospital-level assistance in birth. I am grateful for the surgical expertise of OBs when I transport care. However, it has become less about evidence-based care (even getting full informed CHOICE from a provider - OB or CNM in the hospital - is a joke), and more about saving your ass from a lawsuit.

If I worked in the hospital, and saw the results of so many mindless interventions, not to mention the high-risk births on daily level, I probably would be scared of birth, too.

[Greaseball]

He also reminds me that the majority of OBs are in it for the surgical aspect.

That reminds me of another book on my reading list, A Woman In Residence by Michelle Harrison. She is a OB resident. She tells of one male resident who does not like obstetrics at all, but he tolerates it because he likes to do surgery.

American Rite of Passage gets into that too - when asked why they chose obgyn, doctors say "Because I like to operate" instead of "Because I have deep respect and awe for women and babies."

[its_our_family]

Originally posted by pamamidwife
He also reminds me that the majority of OBs are in it for the surgical aspect.

I have also heard that most mws are in it so they don't have to go to medical school. (Not saying I believe it at all...but it said but I do believe that there are mws out there that are as dangerous as some obs)

[pamamidwife]

Originally posted by its_our_family
I have also heard that most mws are in it so they don't have to go to medical school. (Not saying I believe it at all...but it said but I do believe that there are mws out there that are as dangerous as some obs)

Yeah, I responded to the ignorant comment above made by your chiropractor in another thread that you posted it on before.

Whatever.

I would NEVER make it through medical school. Not because I'm not smart enough or not because I don't want to invest the time, it's just that I don't always agree with western medicine's heroic savior attitiude. (I don't vaccinate my child, I don't believe in the liberal use of antibiotics, among other "radical" things that would never keep me paying money to attend a school that tried to teach me the exact opposite). CNMs, in essence, DO attend medical school. Through nursing and their clinicals, these all take place within the medical model.

That said, I'm sorry you got stuck with some egotistical CNMs. You live in a state that is hostile to homebirth midwives and I'm sure the CNMs are not willing to align themselves with anything but the medical model.

Still, hearing it from one outrageous, egotistical chiropractor (who sounds pretty full of himself from the way you have talked about him) does not make it so. Please remember that. I find the repeating of that - especially because you SAY you don't believe it - so offensive.

This thread is interesting, because nobody is saying that you cannot have a normal, beautiful birth with an OB. Nobody is saying that all homebirth midwives are peaceful and accurate with their information. We cannot - and should not - make blanket statements. However, "most" is a term that we need to look at - and see where the information is coming from.

I get most concerned about the consumers. With all the VBAC backlash (totally NOT evidence based, but all about CYA in lawsuits, nevermind not looking at what inductions like cytotec or prostaglandin gels do to ruptures!), the push for more cesareans, the push for inductions, etc., I'm wondering that women are getting exactly what they are demanding.

Your care provider in pregnancy is your partner, hired help. They are NOT Gods, nor are they the ones that should be making all the choices in your care. However, so many women do not want to take responsibility for their choices. It's a reason why our malpractice rates are SO HIGH - women turn over the power, the doctors gladly accept that power and then BOOM! Women are upset over the outcome. Granted, women are not given choices ("we're going to break your water now to speed things up"; "the epidural has very few risks to you and NONE of the medicine gets to the baby") about their care.

Whose "fault" is it? It's all of ours. That's why it's so heartening to see women educating themselves and learning about their choices - whether they choose a repeat cesarean, an epidural, or a homebirth. It's great to see women pointing out erroneous attitudes about birth and our bodies.

I'm not sure where this current train of thinking will lead, but I have no doubt that it will continue to get worse before getting better. I'm willing to stick it out and trust that all of us will have an easier time - including those OBs (and get back to practicing evidence-based medicine, rather than fear-based medicine) and women about to birth.

[Greaseball]

Your care provider in pregnancy is your partner, hired help.

Yes, why do we pay people to tell us what we can and cannot do? Why do we pay people who almost always do things to hurt us? There seems to be a real hierarchy in patient care, and the patient is always at the bottom, even though she is the one who pays for everything.

Some doctors claim they do all their stuff "because the patient requested it." That makes no sense. If doctors did everything patients requested, there wouldn't be so many people dying after being turned away from doctors. What about all those people with AIDS who request treatment and then don't get any? Most likely, what happens is doctors do everything they can to convince a patient that something like an episiotomy is a good idea and then of course she will ask for one, which they do. I think that is another way people blame women. "She asked for it." Well, what were the circumstances around it? Was she educated on alternatives? Had she been told all her life never to question or disobey a doctor (or men in general), as many women are? I think women need support if they are to overcome these attitudes.

Doctors also suggest things to women while they are at their most vulnerable. After I had been pushing for hours and the pain was a lot worse than I thought it would be, the OB came in and asked if I wanted a cesarean. Of course I did, then! I thought it would be great if I could just be put to sleep and wake up and the baby would be there. I think that's an inappropriate thing to suggest to a first-time mother who is havng a hard time, especially when the baby is not in any danger. No one asked if I would like to change positions, have something to drink, or take off the monitor. (I actually found the EFM to be painful.)

T
A friend of mine was a medical student planning to be a pediatrician. Then he had a nervous breakdown (as a lot of med students do) and decided it wasn't for him. He is now a nuclear engineer. One would think if his main interest was children, he would have then tried to become a child psychologist, teacher, or something else that helped children. Instead he went for something totally different. I don't think he wanted to go into pediatrics out of concern for children. Reminds me of people who become OBs when they have no respect for women.

[Greaseball]

Heh heh, it's me again! I just had to post about one of those "extreme situations."

A 42-year-old woman had 2 cesareans for CPD/FTP, and wanted a home birth with her 3rd pregnancy. She was under 5'2, carrying twins, and the first twin was breech. She had to look out-of-state for a midwife who was willing to help her, and the midwife had to fly in. The woman was in active labor for three full days and nights, and each baby was about 7.5 lbs. And, of course, everything was fine. The ultrasound had also gotten the gender wrong. (This is all from Open Season.)

I actually don't think the situation is that extreme.

[its_our_family]

Originally posted by pamamidwife
Yeah, I responded to the ignorant comment above made by your chiropractor in another thread that you posted it on before.

That said, I'm sorry you got stuck with some egotistical CNMs. You live in a state that is hostile to homebirth midwives and I'm sure the CNMs are not willing to align themselves with anything but the medical model.

Still, hearing it from one outrageous, egotistical chiropractor (who sounds pretty full of himself from the way you have talked about him) does not make it so. Please remember that. I find the repeating of that - especially because you SAY you don't believe it - so offensive.

Ok, I know my state isn't very homebirth friendly...obviously But my chiro had 2 of them. and it was also the way he told me I should be going. I don't think it is an ignorant statement. I believe there are SOME who have done just what he said. I do not think it is the majoirty by far. In fact I think that majority are doing it becuse of the right reasons. So, I guess I can't say I don't believe it is true in every case but some cases, yes.

Is my chiropractor egotistical....yes,in some ways, but aren't most ppl in some ways?

It is very true around here that cnms are very medically minded. I got the brunt of it being vbac.

And I have not just heard the comment from ONE egotistical chiropractor. I've also heard it from a midwife or 2 and an ob or 2. I was just trying to show that the mud slinging goes both ways.

[charmander]

I just wanted to say - what midwife would WANT to go to medical school? Doctors study pathology and how to treat diseases and abnormalities. They are trained to intervene.

Unless there are complications, birth is a normal, natural process and NOT a medical event. But you wouldn't know it if you gave birth in a hospital.

cmd
DS age 5
DD 13 weeks (home birth)