Originally Posted by WildKingdom
Originally Posted by MegBoz
An excellent Q. From an advertising perspective, if I were to design an advertisement (& I am in marketing full time), you need to follow the guidelines: "Interrupt, Engage, Educate, & Offer."
To interrupt (grab attention) I'd start with, "You CAN NOT TRUST your OB." Maybe with an image of a wolf in a doc's lab coat (i.e. "wolf in sheep's clothing.") Something deliberately controversial to grab attention & generate interest. This also elicits fear, which is a good advertising concept to get attention & get interest so people read the ad.
I'm a doctor. Words can not describe how offensive I find this.
Well, let's talk about it.
Of course, there ARE lots of OBs who ARE "trustworthy." As I wrote, as a marketing professional, I would consider deliberately using a controversial & fear-creating statement to get attention.
But I do believe the statement is true. I do believe American women --on the whole-- cannot, and should not, "blindly" trust their OBs. By "Blindly" I mean - just completely hand over your decision making power exclusively to the OB - don't bother to question or do your own research. From what I know, I advocate even a greater level of skepticism of American OB's recommendations than the recommendations of an American heart surgeon or ENT. I'll give my reasons below.
So here's why I say "You cannot trust your American OB":
- American obstetrics is widely regarded as not being based on evidence
i.e. Cochrane database - I think they even granted "the wooden spoon award" to the practice of obstetrics for said reason. Also, as Dr. Wagner writes about in "Born in the USA' - the practice of "vigilante obstetrics" - considering something safe until proven dangerous, 'experimenting' on women without informing them the practices are experimental & not evidence-based.
(While I wrote a long post, this FIRST bullet point is, by far, the most important argument for my OB distrust, IMO.)
- Stats back this up (lack of evidence-based care)
again, the CS rate is double what WHO says max should be, and simple common sense tells you 33% is excessive, the episiotomy rate is also still over double evidence-based. Research shows docs seem to do it out of 'habit' more than need - i.e. the rate is highest among older docs, lowest among residents.
- American OBs are often putting their own convenience ahead of mama & baby's best interest
Consider the fact that 'emergency' CS rates rise at dinner time and night time, as well as prevalence of inductions & often casual attitude with which OBs address induction, consider doula-bans
- American OBs are often putting their own liability fears ahead of mama & baby's best interests
Consider the prevalence of cEFM, not allowing filming of the birth (the latter was policy even in my NCB-friendly hospital.), VBAC-bans
- American OBs also seem very out-of-touch with natural birth.
As Dr. Marsdan Wagner writes, "Fish can't see the water they swim in." They see medicalized, interfered-with, NON-physiological birth so often, that they think such intervention is always necessary! They don't see how the initial medical interventions caused the other 'problems.'
This lack of understanding of the natural process makes me further "not trust" the average American OB. Specific examples include not encouraging (& active discouraging) movement in labor (Um, yeah, then diagnosing "Failure to progress!") not even discussing optimal fetal positioning with patients, LET ALONE giving advice on how to attempt to PREVENT & FIX OP position (something that can cause failure to progress.) Not even being familiar with alternate pushing positions from lithotomy or semi-sitting, and therefore not really being familiar with the VALUE of these positions in helping 2nd stage progress, encouraging hydrotherapy as a first line of defense against normal labor pains (instead of drugs.)
- In other words, their "go to tools" to help a situation that is not doing 'well' or even to help maximize the odds of a best situation are predominantly drugs & surgery.
I don't have a lot of stats to back this up, but again, it seems American OBs are out of touch with natural, lower-tech methods to optimize natural birth.
Of course, obstetrics is also unique in that the vast majority of patients don't "NEED" any treatments! Whereas other American Docs are generally treating people who REQUIRE assistance (with the exception of a general practioner, I don't think many healthy people go to ENTs, oncologists, or heart surgeons merely for "check-ups.") This complicates matters, in my opinion, and leads to my greater distrust of American OBs vs. other American docs.
I feel bad saying, "you can't trust your American OB." I hate being THAT jaded - I hate feeling like a wack-job doctor-hater conspiracy theorist. I have NOT been ultra-natural focused in other areas of my life. To elucidate this point, I started my pregnancy assuming I'd get an epidural because 'why go through all that pain if you don't have to?!'
But the more I read, the more I learn, the more convinced I become that "you can not trust your OB" is indeed the sad reality in America today.