Why???!!!! So frustrating. - Page 6

[philomom]

Originally Posted by CI Mama 

The first conversation is the "this is so frustrating" conversation. That's the part of the conversation that's rehashing the sorry state of affairs with regards to birth in America & lamenting the fact that some HCPs and some women contribute to the problem in their own ways. It's the part of the conversation that's full of stats & research & facts, and the gist of that conversation seems to be justifying the frustration that things are so messed up.

The second conversation is the "why would women behave this way?" conversation. That's the part that's about trying to get inside the head of the woman who made the comment to the OP, trying to figure out why she would say that and/or why she would choose to trust her OB to the degree that she does. That's the part of the conversation that's not about facts, it's entirely about subjectivity. The gist of that conversation is taking up the part of the women quoted in the original post, trying to see things from that woman's point of view, seeking some insight into why a woman might have that perspective, or at the very least why she might say what she said.

To the first conversation... I realize that the state of American health care is not so great. Not just for having babies but for many other ailments. But this was not my experience for birth. I had amazing  births in a hospital with my CNM at my side. No Iv, no drugs, no cuts, no wires, no staying in bed, no extra personnel other than one hospital required nurse. I trusted my midwife and she trusted her back-up. I and my partner had taken Bradley... everything unrolled perfectly. I was empowered and in control. I and my partner still talk about those nights we birthed as good ones.. with smiles on our faces.

To the second conversation. I don't want to be confronting pregnant women. I think women are highly vulnerable at this time. I keep my comments or statements to one or two mild but thought provoking bits and then I back off unless they ask me more. Or, if asked... I might tell them about my glorious natural births. But yes, I do meet those women who ..

won't take a childbirth class because they want drugs during labor

who want to choose the baby's birthday not to coincide with other birthdays or major holidays

who won't even try to nurse because its gross

And notice... none of this is about the doctor or caregiver!

I do try to remain calm in person but inwardly.. most of this makes me seethe. I think that's where the OP's frustration comes in.

[CI Mama]

Originally Posted by philomom 

To the second conversation. I don't want to be confronting pregnant women.

Just to clarify....

I don't see the 2nd conversation as being about confronting pregnant women. I agree with you completely that that would be inappropriate.

I see the 2nd conversation as an exercise in empathy. Basically, trying to imagine where another woman is coming from by putting yourself in her shoes. I believe this can be done without asking intrusive questions, or without even knowing the woman in question! (we've done it here in this thread by just working with the one quote this is in the OP) It's more about being curious and trying to picture where someone else is coming from, while acknowledging that none of us has a perfect window into someone else's life.

[limette]

Originally Posted by CI Mama 

What I see happening in this thread are 2 different conversations, both of which harken back to what the OP posted.

The first conversation is the "this is so frustrating" conversation. That's the part of the conversation that's rehashing the sorry state of affairs with regards to birth in America & lamenting the fact that some HCPs and some women contribute to the problem in their own ways. It's the part of the conversation that's full of stats & research & facts, and the gist of that conversation seems to be justifying the frustration that things are so messed up.

The second conversation is the "why would women behave this way?" conversation. That's the part that's about trying to get inside the head of the woman who made the comment to the OP, trying to figure out why she would say that and/or why she would choose to trust her OB to the degree that she does. That's the part of the conversation that's not about facts, it's entirely about subjectivity. The gist of that conversation is taking up the part of the women quoted in the original post, trying to see things from that woman's point of view, seeking some insight into why a woman might have that perspective, or at the very least why she might say what she said.

Those are 2 separate conversations, and they are both valuable. If we want to see change in the world, we have to understand research and facts, the "aggregate" view. AND it is very valuable to try to get out of our own perspective and look at things from the point of view of someone else. Because let's face it, women are not all the same, nor should we be. We don't all want the same things and we don't all have the same realities to work with as we make our journeys. If we want to understand why things look the way they do from the bird's eye view, we also need to understand how they look from many different women's individual views. That gives us the opportunity to examine important issues that have already been brought up by PPs, for example, privilege and how it impacts us differently.

These 2 conversations can seem like 2 opposing sides, but they don't have to be. If we can be clear about which conversation we're contributing to, hopefully we can be more open to listening to each other.

I completely agree with the PP who said, "divided we fall." Regardless of what we believe, can we listen to one another?

I'm glad that I started this thread. The conversation is really interesting. I wanted to clarify that there was no prying involved. The woman posted her details on Facebook. She finally got in to have her induction and gave birth two days later. All went well as far as I can tell.

In regards to what CI Mama said; I think the first question is pretty obvious and one that gets discussed often on Mothering. The second is the more interesting one because as I've said previously I research things thoroughly before I make a decision especially important ones involving my body for example;

I started my period when I was 11. From the get go it was horrible. I was wearing several of those super huge depends diaper like things at a time and changing them every couple of hours. My period would last weeks and once it lasted two months. The pain was like labor pain for me. I spent a lot of time at home from school in bed dosed up with tylenol to take the edge off the pain. My family doctor had died and was taken over by a new guy fresh out of medical school. He was cocky and condescending. I complained about my periods numerous times that year and he fobbed me off saying all women get periods and that's just the way they are. I insisted that this wasn't right. Being a book nerd I eventually took my frustration to the library and started checking out books on women's health. I found out about endometriosis and it fit what was going on with me. I knew my mom had had a hysterectomy after my sister and when questioned she told me she had had endo too. I also read that the average time for a diagnosis was around 7 years because it took that long for a woman to realize it wasn't normal and then several years to get her doctor to take her seriously. Armed with this new info I went to the doctor's again. I asked him straight out if he thought that this was the problem. He said no you're fine. I pointed out that my mom had it. He said that didn't mean anything. He was getting a little bitchy at this point so I got bitchy right back. I was twelve and I fired my doctor and insisted he recommend me to a gyno. I got in pretty quickly and after a quick try on the pill I was scheduled for surgery to see what was up. My diagnosis? Endometriosis

Now I've had some good doctors over the years, but I've had many more bad ones. I also do my own research into my health and take what my doctors/midwives say as advice and go from there.

Am I coloured by my own experiences? Of course. But who ever said self-education was a bad thing?

[CI Mama]

Originally Posted by limette 

But who ever said self-education was a bad thing?

Your story shows the power of self-education in the most poignant way. Thank you for sharing.

I think a lot of women aren't "turned on" to the need to self-educate until they have an experience like yours...butting up against the limits of the system, encountering "bad actors" in that system, not getting the help they need, having to rely on their own resources to solve the problem. It's a shame it has to be that way.

[MegBoz]

Originally Posted by GoBecGo 

It is not intelligence which women lack.  It is something else.  It is the ability to question the very foundations of everything they know to be true and is held to be true by their society. 

Thanks, and I really liked this post of yours too.

Yeah, I see this point. & I guess it made me reflect on my upbringing. I was raised by a line of strong, independent, outspoken women. I was raised to think for myself, speak up for myself, learn things, and not blindly follow the pack. (I joke that I've always been "impervious to peer pressure" - even as a pre-teen I remember thinking it was stupid to go along with the crowd ONLY because that's what everyone else does.)

So it was easy for me to question authority & think for myself. So your post has made me reflect on how dreadfully difficult it could be for someone raised in the exact opposite way. (Even though I don't think chauvenism is that strong in America anymore, I know it still exists and I definitely agree that it's very common for everyone to be taught not to question doctors.)

Finally, I really see that point about how hard it can be to "question the very foundations of everything they know to be true." That took me back to the time I learned "THE TRUTH" about American maternity care. I started my PG with a practice of OBs who deliver at Johns Hopkins. Johns Hopkins is WORLD CLASS when it comes to medical care. I remember walking the halls of the hospital when I went down there for my 1st trimester screening (prior to my education & switch) & seeing posters with the cover of US News & World Report listing top hospitals. I remember thinking how lucky I was to live so close to one of the best hospitals in the nation. I remember feeling proud of my little town of Baltimore. (We're often in the shadow of DC & have few claims to fame (well, few positive ones!).)

Then I remember how shocked I was to read "Thinking Woman's Guide" & see how INSANE "nothing-by-mouth" & cEFM are, and then I confirmed that they were standards at Hopkins.

The chasm between evidence & practice shocked & angered me. It still does. Having been raised to question authority & the views of "the masses" I was still able to deal with this shock & find better care. But if I hadn't had such an upbringing, I can certainly understand how this reality would be too much for me to endure - too distressing to consider it might be true (& therefore too distressing to EXPLORE the possibility in the first place)- just plain too upsetting to face, let alone actively deal with. I can get that now that I think about it. I can get why people don't want to open their minds to the truth that they can't just blindly trust their OB. It is a very scary truth.

[CI Mama]

Originally Posted by MegBoz 
Having been raised to question authority & the views of "the masses" I was still able to deal with this shock & find better care. But if I hadn't had such an upbringing, I can certainly understand how this reality would be too much for me to endure - too distressing to consider it might be true (& therefore too distressing to EXPLORE the possibility in the first place)- just plain too upsetting to face, let alone actively deal with. I can get that now that I think about it. I can get why people don't want to open their minds to the truth that they can't just blindly trust their OB. It is a very scary truth.

I would take this one step further and say that you cannot put your blind trust in anything...not an OB, a midwife, or your body. Birth is not a 100% predictable or controllable process, and there is just a wild card factor that can pull the rug out from underneath anything that you place your trust in. The best we can do is play the odds, mitigate risk, and take a leap of faith.

But that truth is so terrifying that I think most of us don't have the courage or strength to face it. As I stated earlier...we all put our trust in something, whether it is the available information/resources right in front of us accepted completely as they are offered, or our own "alternative" path.

I would also like to gently offer up the idea that women who are raised with strong role models and are encouraged to think for themselves might still have an uneasy relationship with "THE TRUTH" (as you put it). THE TRUTH interacts with our own personal truths in ways that are unique for each individual.

[stik]

Then I remember how shocked I was to read "Thinking Woman's Guide" & see how INSANE "nothing-by-mouth" & cEFM are, and then I confirmed that they were standards at Hopkins.

I just wanted to affirm this.  I live 3000 miles away, and I hear that Hopkins is a horrible place to give birth.  I don't know of anywhere else that does NPO for laboring women.  The nurses where I had my first dd fed me a bagel while I was pushing.  I hear that's a little unusual.  The hospital where I had my second dd had a selection of clear liquids in minifridges at refreshment stations around the floor - soda, juice, water, ice, tea, coffee, and chicken broth.  I don't believe in clear fluids only either, but at least, given the policy, they had a good selection.  I could see a way to solve most problems I thought I might encounter in re. nutrition in labor with those fluids.  Likewise cEFM.  Many hospitals don't place a scalp monitor unless you have an epidural, and don't have women on monitors continuously.  

It's my understanding that Hopkins is geared for high risk births and pretty much nothing else, so they are pretty extreme in their policies even for patients who aren't high risk at all.

One frustration I have with discussing birth on MDC is that I see a tendency to assume that nothing has changed in re. obstetric management of hospital birth in the last 50 years.  There's a lot of fear about things that people are convinced doctors must be insisting on.  In some parts of the US, those fears are justified.  In those places, you might as well trust your OB blindly, because there are no other meaningful options.  You can argue until you're blue in the face and still wind up fighting a hospital with an outdated approach to NPO and bizarre policies about separating moms and babies "for observation."  But in a lot of places, those things are gone.  I think a focus on women's weakness, and allowing ourselves to be distracted by other people's birth choices and coping strategies makes women feel persecuted twice - once by inflexible medical management and once by other women.  And it ignores the success that women have had in changing the birth climate and the efforts that are going on to create even more change.    

[MegBoz]

Originally Posted by stik 

I just wanted to affirm this.  I live 3000 miles away, and I hear that Hopkins is a horrible place to give birth.  I don't know of anywhere else that does NPO for laboring women.

<snip>

Likewise cEFM.  Many hospitals don't place a scalp monitor unless you have an epidural, and don't have women on monitors continuously.  

It's my understanding that Hopkins is geared for high risk births and pretty much nothing else, so they are pretty extreme in their policies even for patients who aren't high risk at all.

One frustration I have with discussing birth on MDC is that I see a tendency to assume that nothing has changed in re. obstetric management of hospital birth in the last 50 years. 

LOL, well yeah, within NCB circles, Hopkins & GBMC are the places in greater Baltimore to avoid like the plague. But since I had zero exposure to any NCB-circles at the time, it was totally news to me.

Wrong on not doing NPO - see the link I posted earlier about the new show inside the L&D ward at Riverside Methodist Hospital in Columbus, OH, called "One Born Every Minute", "The moms aren’t allowed to eat during their labors." & actually even at the baby-friendly hospital I chose of of Upper Chesapeake in Bel Air, "official policy" was only clear liquids (although the CNMs I saw told me explicitly they don't agree with that- so it's not in practice.)

Also from that article, "Every woman is tied to her bed with continuous electronic fetal monitoring, and an IV,"

I'm not 100%, but nearly certain that it is standard at GBMC too. I wish I had my copy of "Born in the USA" on hand, since I believe it lists those stats, but I don't think cEFM is all that rare.

Interesting you should mention the fact that, "Hopkins is geared for high risk births." That is exactly what the nurse said to me when I asked about NPO & cEFM. When she confirmed they are standards, I said I wanted to transfer my care elsewhere. I've posted this before on MDC & I think it bears repeating here in this context. She replied - and these are her exact words - I'll never forget - 

"Yes, that would probably be best. If you're looking for more of a natural birth, it's probably best that you switch. We're a high risk facility. We're not used to healthy patients! I mean, we can care for them, but we're not used to them."

Now, I will give her credit for being so honest with me.. HOWEVER - this wasn't until AFTER I SAID I WANT TO TRANSFER that this info was provided. I was over 20W along at the time!!!!!!!!!!!!! & I had been going all along - called them up as soon as I got my + test. Why not tell me earlier?! I was the picture of health.

Not only that, but this is pathetic & a miserable excuse for poor, anti-evidence based care. Can you imagine if you went to your dentist, he pulled a tooth, then said, "Whoops! I didn't need to pull that tooth. It was fine! Oh, well, I'm not used to healthy teeth! I've been pulling rotten teeth all day the past several weeks."

No, that's no kind of excuse!!!!!!! It's the same thing. It's disgraceful & there's no way around that.

You are absolutely right that things aren't as bad as they were in the 1950s or even 1970 re: enemas, shaving, & denying women the birth support people she wants present with her. HOWEVER - I still think it's pretty bad. "Better than horrible" doesn't necessarily equal good.  So when I rant & rave about the dreadful state of American maternity care today, I really don't see a point in acknowledging the fact that it's better than it used to be. It's is still dreadful (in aggregate.)

Besides, the CS rate is only rising - steadily - and has been for a while. I think it was Henci Goer who wrote that once medical advancements such as anesthesia & antibiotics made CS relatively safe, "the genie was out of the bottle."

Finally, I don't think we are "allowing ourselves to be distracted by other people's birth choices" as you said. It's hard to control emotions - we can't help the fact that we feel frustrated & we're just discussing it. We also don't SAY to anyone's face that we find it frustrating! I don't think anyone who reads MDC really falls into the category of women who are "willfully ignorant" so such women aren't even seeing this conversation. so I don't see how our feelings & our discussion of them on this thread "persecutes" anyone.

[stik]

MegBoz, I'm deeply frustrated with your analogies.  They're hyperbolic, illogical, and dismissive of the experiences of many women who have benefited from obstetric care.  

There are problems in the US healthcare system (that are in no way limited to the state of OB care), but despite these problems, many women have had good, safe experiences within the system.  I don't think the system is dreadful in aggregate.  I think that's a myth put forward by an angry minority that isn't particularly well-versed in the history of OB and maternity care in the US (or that misreads it, as a poster did on the last page when she blamed doctors for problems that were caused by poverty and poor industrial working conditions), and that isn't aware of conditions worldwide.  If you think the state of maternity care is bad in the US, take a quick look at the birth climate in France or read the latest stats on perinatal infant/maternal mortality for low risk moms in the Netherlands.  Problems with the infant mortality rate in the US (the stat on which international comparisons make the US look especially lousy) are still being studied, but are more likely a result in disparities in access to care than a consequence of the care itself.

Does this let doctors off the hook for unnecessary inductions?  Heck no.  But more and more research is telling doctors to back off and they are doing it - new studies last year led to a virtual end to the scheduling of elective sections before 39 weeks gestation in hospitals across the US.  ACOG has issued a statement encouraging hospitals to reconsider VBAC bans and softening their guidelines for limitations on trials of labor. More and more hospitals are finding that rooming in not only lowers costs (no nursery to staff), but improves outcomes and maternal satisfaction with the hospital experience.  Hospitals in many areas are deeply invested in providing moms with good birth experiences because they recognize that mothers make most health care decisions for their families, and will not to return to a facility where they were treated poorly.  

MDC is the largest parenting board on the web.  It has thousands of posters and even more lurkers.  You may not be criticizing the woman in the OP to her face (although she's on the web enough to have a facebook page, it's within the realm of possibility that she's dropped by and seen the thread) but you are criticizing thousands of lurkers who made similar decisions and similar statements for their own personal reasons.  

In most forums on MDC moms are not allowed to criticize those who have made different decisions.  Homeschooling moms aren't allowed to criticize families that choose school, and vice versa.  Anti-vaccination threads can list millions of reasons to not vaccinate, but cannot criticize those who choose to do it.  There are some fairly significant limits on criticism of circumcision even on the anti-circumcision board.  Exclusive breast-feeders are not allowed to criticize moms who use formula, and can you even imagine the chaos that would ensue if the vegans and the TFers were allowed to go at each other on the forums?  I don't know exactly what the limits are in Birth and Beyond, and I'm happy to live with them whatever they are.  That said, expressing frustration with another woman's choices is criticizing her on a decision that is deeply personal, and as a feminist, it bothers me that people would feel compelled to do it.  

If you take the statement "I let my doctor choose for me" at face value, and if you feel frustrated about the process it implies, aim your ire at the doctor who slept through the class on patient rights, not the mom who is, like all of us, just muddling through.  

[Turquesa]

Originally Posted by GoBecGo 

It is not intelligence which women lack.  It is something else.  It is the ability to question the very foundations of everything they know to be true and is held to be true by their society.  And we are not on MDC away from the rest of those people because it's so easy to be so different.  Just my thoughts.  I'm not accusing any individual of being a woman hater, i just mean that society encourages this hatred of the individual when things are perceived to have gone wrong, and women suffer so much from it.

An excellent point.  It explains why so many of us feel FRUSTRATED by this state of affairs.

You lamented earlier: "Why do women hate women so?"

Two points come to mind.  First, I and other posters in this thread have taken care to emphasize that women, (including--and perhaps especially!--the one in the OP) are largely the victims of anti-evidence obstetrics.  They trust their providers, yes, but by engaging in anti-evidence interventions, their providers exploit this trust.  So what you're hearing isn't hatred or anger.  It's criticism.  And in my mind, it's a fair and well-founded criticism. 

Second, you stated:

Why be angry at a woman who didn't try to care for herself when she has lived her whole life in a society which tells her she isn't fit to do so and will be unfeminine if she tries?  One might as well resent the bird who imprinted on a dog at birth, for not flying - he doesn't know he's a bird!

But there's a difference between feeling angry at somebody and feeling frustrated by their behavior.  I love my sister.  I'm not angry at her for having chosen sleazy boyfriends, opportunistic friends, and massive debts.  But it's perfectly valid for me to feel frustrated  by her choices precisely because I love her and care for her.

On a similar scale, I have tremendous compassion for women under the "care" of providers who establish and then exploit a relationship of trust.  And like Limette (the OP), I want to shout from the moutaintop: "So FRUSTRATING!!"  It's frustrating on a personal level because I wonder what makes a woman completely surrender her rights and power to somebody who doesn't always have her interests at heart.  (And obstetrics, like all medicine, is fraught with numerous built-in conflicts of interest--e.g. profit, defensive practice, personal power, and even the desire for fewer and more predictable work hours).  It's frustrating on a grander, societal level because...well, read any of Meg Boz's rants on modern obstetrics to learn why     

[MegBoz]

Originally Posted by stik 

MegBoz, I'm deeply frustrated with your analogies.  They're hyperbolic, illogical, and dismissive of the experiences of many women who have benefited from obstetric care.    

For the record, the dentist analogy was a rephrasing of what the Hopkins nurse said. I did NOT intend that to apply to American maternity care on the whole. SHE was the one who said, "We're not used to healthy patients [and that's why we require NPO and cEFM for all births.]" I don't see the dentist removing healthy teeth as the least bit of a hyperbolic & illogical statement to rephrase exactly what she said. What Hopkins is doing with NPO and cEFM for all births is doing things that are known to be damaging to healthy people and using "we're a high risk facility" as an excuse for those protocols that damage the normal process for healthy women. That is EXACTLY the same as the dentist removing healthy teeth because "that is what we're used to here." He is damaging healthy people in the name of "habit."

I agree with you that the dentist analogy WOULD be 'dismissive" of the good maternity care many women have received if I'd used it to describe all American care, but I did NOT use it in that way.

QUOTE:

"There are problems in the US healthcare system (that are in no way limited to the state of OB care), but despite these problems, many women have had good, safe experiences within the system."

If you'd like to continue this debate with me personally, please use the quoting feature. Never have I ever said that every single solitary American woman has a bad experience. As a matter of fact, I've "typed until I'm blue in the face" saying it is "in aggregate" that the US system has problems. To call it "dreadful" on the whole doesn't mean there aren't many women who, nonetheless, have had fantastic experiences. Just as I've written REPEATEDLY that of course many CS that happen are necessary (I'm not an idiot - I don't honestly think everyone can or should have an unmedicated vaginal birth.)
Not only that, I had my own DS in a hospital and it was a great experience & I highly recommend the hospital!! So please stop these attempts at putting words in my mouth. If you have an issue with words I have stated, please quote. 

QUOTE:

"I don't think the system is dreadful in aggregate.  I think that's a myth put forward by an angry minority that isn't particularly well-versed in the history of OB and maternity care in the US (or that misreads it, as a poster did on the last page when she blamed doctors for problems that were caused by poverty and poor industrial working conditions), and that isn't aware of conditions worldwide."

As I said before, I don't see the relevance of history. I'm honestly baffled at your continuation of bringing history into it. The issue should be comparing modern American maternity care with modern evidence-based practices, not comparing modern American vs. historical American care. Just because it's better than it used to be doesn't necessarily make it good. I would say the same thing of sexism or racism. Both issues are infinitely better now than decades past, but does that mean there are no more problems?! Of course not! & just because we have it better than we used to have it, doesn't mean we ought to shut up & be happy.

Likewise, I know maternity care is much better in the US than many other nations, but I don't see how that possibly negates the presence of any problems. There are still problems with maternity care in the US - the fact that it's better here than elsewhere doesn't change that. Again, better than horrible doesn't equal good. 

As for calling it a "myth" that American maternity care is dreadful in aggregate - that is based on stats! Please- open up a copy of "Born in the USA" by Dr. Marsden Wagner & look at the chart with evidence-based rates vs. actual US rates (it's within the first several pages.) The numbers don't lie - there is a chasm between evidence & practice. There is no "myth" at play here - unless you think all all the evidence-based rates are unreliable & inaccurate, but an abundance of research studies from many different nations have contributed to those numbers.

QUOTE:

"Hospitals in many areas are deeply invested in providing moms with good birth experiences because they recognize that mothers make most health care decisions for their families, and will not to return to a facility where they were treated poorly."

I'm growing weary of this discussion & I probably ought to just zip it, because I'm fairly certain I keep repeating myself. It's one thing for me to repeat points in new threads, but when I keep repeating the same points on the same thread, it's probably time to step away. But anyway--- here goes.

I don't think the majority of HCPs have any negative intentions. Quite on the contrary, most of them probably want to do the best they can to ensure a healthy baby & mama first & foremost, and provide compassionate care as well. The problem is they are uninformed & out of touch with research! I think the title of Marsdan Wagner's article "Fish can't see the water they swim in" describes it best... they are so immersed in medicalized birth, they think the danger lies in being more hands off.

That Hopkins nurse I spoke with confirmed my suspicion that she'd be very nervous not being able to "see" my baby on the EFM continuously (as she put it.) I have no doubt that she believes cEFM is best & is necessary & she's just doing her job the best way she knows how. No malicious intent present. No desire to teach the crazy hippies a lesson. No mysogynist desire to punish women. Nope.

In other words... I agree with you that hospitals & HCPs WANT to provide Moms with good birth experiences.... but I also still say that American maternity care is dreadful.

Lack of malicious intent shouldn't excuse poor care. I'm sure we all know the cliche, "Good intentions pave the path to hell." Good intentions aren't "good enough." HCPs need to practice evidence-based care, and that means they must be familiar with evidence.

Being better than the past, being better than some other nations, and being based upon good intentions all don't excuse away anti-evidence based care.

Frankly, I find these 3 points all utterly irrelevant on the question of the quality of American maternity care.

[stik]

As fascinated as I am by the many systems that provide obstetric care in the US, I really am not in this thread to debate that.  I'm here to point out that there are a wide variety of contextual forces shaping that care, and that problems in the system are not caused by women who choose to (say that they) trust their obstetricians.  I'm arguing for compassion and empathy, rather than frustration and blame.  

It's OK for an individual woman to choose to trust her personal obstetrician.  Even in a flawed system, for many women, choosing to trust an OB is a rational choice.  

MegBoz, I'm here posting at this particular moment because your post addressed mine directly, but I really don't see this as a debate that I am having with you personally (if I was, this post would be much longer, and say much more about the importance of history, my opinion of Marsden Wagner, and the many ways statistics can lie).  But just so you know, I'm not a fan of the quoting feature and I use it as little as possible.  

[matte]

stik:

I agree that there is nothing necessarily wrong when a woman says she trusts her OB to make a decision for her. I researched my OB, I researched birth [I attended my younger siblings' births, I grew up spending summers at midwives' collectives in the forest, I was homeschooled... etc], I've had several discussions with my OB, and I believe that I can and should trust her. I would even trust her to make a decision "for" me, because I have made the conscious decision to work with her. I know that when I say I trust her to make a decision that I have placed that trust in her, and that it was my decision. I also know that I place that trust in her in part because I know that she has far more experience with birth than I do, because she is well-trained and experienced as an OB and also because she has four children of her own. 

I know that if I said what the OP quotes another woman as saying, this is what I would mean by 'trust.' Is it possible that this isn't what was originally meant? Sure. 

I don't know... I am a professional in what I do, and I ask that people I work with put their trust in me (knowing that the decision to work with me is their own). I respect the trust that my clients put in me. I try to have the same relationship with my doctors.

That said, I have had doctors I couldn't say this about (when I was forced to use a student clinic, for example). Sadly, in those situations my own education about the situation, and my objections, were not enough to change the shape of the care I received... there's so much context that goes into these things. If a woman says she trusts her doctor, can we respect the trust she has placed in that doctor? 

[Arete]

Would anyone mind if I went back to a much earlier post? (I just found this thread!)  Someone said way back that "I never went into labor" is a non-reason, or un-educated, or something.  I really want to know (not offended at all, I swear) if that would apply to me.  After membrane rupture I went about 60 hours, and tried everything my midwife could possibly think of (acupuncture, nipple stim, herbs, castor oil) but never had one single contraction.  (I was 39 weeks.)  At that point the non-stress test wasn't looking so good.  So she sent me to the hospital, and the rest is history.  Were we wrong?  What else could I have done??? 

[stik]

It sounds like you tried a lot of things.  Sometimes nature doesn't work perfectly.  I don't think you were wrong at all.  Sixty hours is a long time to wait, and with un-reassuring NSTs, it makes sense that you would not continue sitting around for nature to take its course at that point.  

I think the assertion that "I never went into labor" is a poorly-informed, non-reason for seeking medical intervention is highly problematic and fails to acknowledge that all bodies are unique.