What makes you want to take responsibility for your own pregnancy and birth? - Page 2

[mattjule]

I don't have time to read all the replies to this, but for me it was a variety of things. Going to a psychiatrist and answering leading questions and given a prescription on the first visit. Having my dad be misdiagnosed with cellulitis when he was really bitten by a spider and being in the hospital for over a month. A sister almost dying from a mixup with her medication at the pharmacy. My mother's gallbladder disease being misdiagnosed as panic attacks for 3 years until she had to have emergency surgery to save her life. But I think the psychiatrist thing left the most indelible mark on me. Learning that, after being told your whole life that your doctor knows better than you, he doesn't is very eye-opening. I mean, think about it. Are you sick? Gee, I don't know, I better go see my doctor. Am I overweight? Is this mole normal? What is with this strange rash? Why do I want to sleep so much? I don't know, I'll go see my doctor. They will tell me how I feel, then they will give me something to make me feel different. It isn't exactly a great leap in logic that so many women turn over their whole pregnancy to their doctor. And it is very scary to realize that doctors can be wrong. It wasn't until after my first baby that I really started paying attention to what my body told me. Luckily I was raised by a woman who bf'd and hb'd, who believed in Lamaze, so I read up on childbirth and I had a hb (I think I still would have birthed in the hospital if the nurses at the dr's office hadn't been so horribly rude to dh). But it didn't carry over to my whole life until after that experience. When I was ashamed that I had no idea when my last period was b/c I never paid attention and wasn't trying to get pregnant. When I couldn't take a pill if I felt bad b/c I was bfing. I started seeking the cause instead of trying to ignore the symptom. So I started researching.

But I think that until American society stops acting like your doctor is the end all in knowledge of YOUR body, women are going to keep trusting that their doctor knows better than them. And think about it, from the time we are 2 wks old, we are already going to the doctor, having the doctor tell our parents if we are sick or healthy, signing our self-knowledge over. We take our children to the doctor when they aren't even sick, just so the doctor can tell us they aren't sick. It weakens our confidence in our ability to know our children, it teaches us and our children that it isn't necessary to know our bodies b/c that is what our doctor is for.

This sounds militant and really, when my dc is sick or I am, I gladly go to the doctor. I just don't think our society needs to be so obsessed with western medicine.

[katja]

It's so nice to see a doctor asking these questions.

For me it is pretty simple--I *hate* being told what to do. I hate time limits, I don't perform so well under pressure. When I was about 18 someone loaned me Our Bodies, Ourselves and I thought that what they had to say about childbirth made a lot of sense. I've done lots of reading since then, and always knew I didn't want my births messed with, which is why dd was born at home. Plus I am a big reader and I like to know everything I can about everything.

[SamuraiEarthMama]

great questions, and wonderful responses.

i believe if more of our children were taught to question and research their decisions (and to be responsible for the outcomes), we'd have a happier world. but, especially in the US, we are taught from a very early age to hand over our autonomy to teachers, doctors, bosses, etc. if you read some of john taylor gatto's writings, you'll understand that we indoctrinate our citizenry at a very early age to abandon responsibility... in return, the nation gets a docile workforce and military. it's a widespread cultural phenomenon, not limited to childbirth. here at MDC, you are seeing the freaks and wierdos, those of us who choose to break away from that mainstream. we pay the price... often we feel isolated and unsupported, even though we KNOW we are doing the right things for ourselves and our families. but we are NOT doing the "right" things for society, and so we have to pay the price.

all this is rewarded by the lawsuit mentality... turn over your decision-making power, and get a perfect outcome, and if you don't, you'll get a big fat settlement instead. so really, there's no positive reinforcement for the free thinkers, other than what they gain from their knowledge and from hanging out with the other freaks.

sometimes, i don't think it's a question of why aren't there more folks who take responsiblity for themselves... it's more a question of why are there any folks who take responsibility at all?

katje

[oceanbaby]

I try to build that trust so that if I really feel something must be done, they can trust that I am doing what I'm paid to do, give good advice, and not just in a hurry to get somewhere.

That is exactly what made me choose the OB that I did. I switched to him towards the end of my pregnancy. It wasn't having a c-section that I was afraid of. It was being told I needed one and having to decide if I agreed while I was in the middle of labor. I wanted a doctor whose advice I could trust.

That's actually why I chose the ped that I did. She doesn't accept private insurance, so it's all out of pocket for us. She and I don't see eye to eye on parenting issues, so we don't discuss them. Her office is on the other side of the city. But she takes a natural, holistic approach to medicine, and I know that if she tells me that ds needs antibiotics (which she never has), I can trust her. And that's what I want to pay for. I don't want to pay for someone to just hand over a prescription.

[Mamid]

When you've had a nasty scare of a medical mixup in the middle of hard labour (the nurse about to hook in an antibiotic you are allergic to into your iv) you begin to not trust medical establishment.

Hell, I didn't trust them back when I was 16 and had my appendectomy, but that was my mother making the decisions then. The amount of antibiotics my family doctor _loved_ to pour into me - especially the liquids because I as still a "child" just pissed me off. Especially when the last liquid he scripted was done up in a flavour I react too - Banana!

And of course, the one thing that pissed me off the most was when I went for a prenatal visit I had scheduled 3 months earlier and had traveled 2000 klicks to see my family doctor's partner cause he was on vacation. Not only did I wait in 40C heat in the waiting room for over an hour then another half hour on the exam bed under a pitiful little paper blanket because she was backed up due to an "emergency" that really should have been taken care of in the emergency room, but she told me I had to come back in a month in order to do the exam she was supposed to do that day that I had scheduled because she was backed up! Then, when she heard my plans for birth, she called me irresponsible and worse! I had suffered a 19 week miscarriage about 3 years earlier and I was looking at plans A, B, C and D and had listed them to her!

That was the last time I ever saw that office. EVER. Saw the family doc once or twice in the mall and I still hadn't confronted him about his partner. I should have.

[Jennifer H]

Add me to the list of "that's just how I approach life." I'm methodical about everything. My dh had hernia surgery last week and I read everything I could get my hands on, insisted upon going to the doctor with him for his consult and then asking some very pointed questions about why he felt one technique (laprascopic) was right in dh's case. Dh was laughing that I could probably perform the surgery by the time I was done.

The other thing that happened to me is I worked in a hospital as a social worker and one of my areas was the NICU/L&D/Postpartum areas. A social worker only gets called into L&D when something is going very, very wrong. I got to see a few epidurals go very, very wrong. I also heard a few doctors on the phone to wives/girlfriends/friends saying they'd be home in an hour so as not to miss out on their tickets to the opera or Lakers game and then head off to do a "failure to progress" c-section. I know I had a skewed view, but it was enough to make me feel like I really wanted to go a more natural route and to be able to advocate for myself. Only way to advocate is to be educated about options.

I do sometimes wish I could just "play dumb" on some things. I have researched the heck out of GBS protocols and think the "screen all and treat all positives" is based on some LOUSY research (and as a public health measure is only done because many, many hospitals and doctors were not appropriately treating for symptoms). On something like that that is sooooo iffy I sort of wish I could just go with the flow and let them do what "the protocol", but I know that "the protocol" could put my baby at risk of other things so I won't escape the guilt either way!

[pinky]

Doctorjen, are you familiar with this program?

Centering Pregnancy Program

It's specifically geared at getting women more involved in their own care. It's a group-based prental care where you check your own weight, bp, etc. and then meet individually with a practitioner and then as a group. The website explains it better than me!

I just started this with the clinic (family practice) where I am getting my prenatal care, and it seems promising--though particularly suited to moms who are less educated and empowered (which, honestly, is not me--I think that's why my midwife wanted me in the group, LOL).

[saintmom]

I could write alot of flip answers like,doctors always make me sick(they do!)or I didn't need help getting this baby in why should I need help getting herout?But it's alot deeper than that.I'm blown away that a doc would ask why.Yeah!
I have a brother who has fragile x retardation.i always thought something had happened to mom so I've always been really wary of hospitalized birth.I read spiritual midwifery at 18 and that pretty much set the stage for how I would give birth.We didn't find out until he was an adult that his retardation is caused by a genetic mutation.
My first two were hb.the first was great,the second was a shoulder dystocia and big baby so more difficult.The next four were hospital with midwives.The 3rd i had a creep of a doc as the mw wasn't on call .I still resent being told to either have the baby or a c-sec.She was 10lbs.I still think that's why the subsequent hospital births were so fast-sheer terror!
Our last baby was a long 36 hour labor at home in the water.I wish I'd been brave enough to just do it on my own with all the others.It was tough it was long ,at times it was painful.I birthed her when I had no more strength like a runner hitting the wall,shaking uncontrollably before each contraction,and I not the doc not the mw reached down to take her in my arms and hold her,find she was a girl and look into each others eyes.
I'd been told at the beginning of that last pregnancy I was to old(46) I'd had too many mc's.I had to have an amnio etc,etc etc....So I walked away from allopathic care.My Mw were awesome.The're brave ladies who operate under the radar with an inate belief in womens ability to give birth.Not something that's learned in medical school.I was so very blessed to have found them.
The cnm came out to visit when dd was 3mo.She had taken care of me after my many mc's and done my first prenatal with dd.She was totally blown away by the birth pictures at how awake and alert dd was.She said you never see that in the hospital!

[Peppamint]

I took charge long after I should have, but there was a decided lack of support from my dh re: birthing anywhere but the hospital with anyone but an OB. After all, his mother gave birth six times knocked out on ether. Each time she had an episiotomy and greeted her child the next day when she finally woke. I assume they did forceps or some other form of torture. <shudder>

So needless to say, when I said homebirth during my first pregnancy he blanched and I backpedaled. I ended up being induced at 38 weeks because my BP was a whopping 130/80 (no protein in my urine BTW and my bp was less when I was at rest). Then dd's heartrate would drop (internal monitor ) when I tried to squat to push so I had to push in the lithomy position. So of course I ended up with an episiotomy that I think my female OB must have sewn up for my dh's benefit. Thankfully it isn't as bad since I gave birth again, perhaps the scar tissue stretched or something.

Anyway, when I got preggers with my ds I knew I didn't want the same experience but I was uninsured so I went and signed up for Hoosier Healthwise (medicaid for children and preg. women) and of course there is a limited choice of OBs and no midwives at all. So I signed up for care at an OB office that had something like 8 obs. At 19 weeks, I had decided to seriuosly pursue a homebirth no matter what, so we ended up paying the midwife's fee with our tax refund. I went in for my u/s and after the u/s was over I waited and waited for the doc and finally went to the receptionist. She told me that the doc was running over 2 hours late. I had family holding a huge table at Olive Garden so that we could celebrate. I left the OB office and never went back. They never called to see where I went either. I called my friend's midwife and she came to my house the next week.

I was empowered to take resposibility for my births after I handed everything over with my first birth only to be very disappointed. I decided that if it's that important to me, then I need to be informed and in charge.

It is me who bears the scars on my perineum and it is me who has to deal with the emotional baggage.

And yes, my second birth was fantastic. Still more intervention than I plan for next birth (internals only tell me that I can walk around for 3 weeks at 4cm, 90% and bulging waters) but it was the birth of my dreams. Even my dh is convinced and I hope and pray I never had to be admitted to the hospital again. For birth or anything else.

[cottonwood]

What motivated me to take responsibility for my own pregnancy and birth was largely the experience with my first. I hired a care provider I liked and who was well-respected in the community, and I didn't take it any further than that. I didn't ask any questions except the most basic ones in What To Expect When You're Expecting -- it didn't even occur to me that there were other questions to ask. It ended up being a terrible experience, which woke me up to the fact that no matter how educated and experienced and nice someone is, they will never know enough that I can fully trust them to know what is best for me.

Hearing other women's testimonies might have helped. Michel Odent, when he had his clinic in France, had a weekly get-together for all interested women (TTC, current clients, and past clients) to talk with each other. You could recruit women who took responsibility for their own care, maybe have them give little talks in certain topics. This could be a powerful thing.

I'm sure it would have helped to hear my care provider say, "listen, doctors and midwives don't always know what's best for the individual, sometimes they even practice with wrong or outdated information, sometimes they make mistakes or have lapses of judgement, and sometimes they practice according to malpractice fears rather than evidence-based information, and I am human and therefore not immune to any of that, so it is in your best interest to research these things yourself and make your own choices, and look, I'll help you find ways to do that. Here's where you can start:..."

[Mamid]

I'm sure it would have helped to hear my care provider say, "listen, doctors and midwives don't always know what's best for the individual, sometimes they even practice with wrong or outdated information, sometimes they make mistakes or have lapses of judgement, and sometimes they practice according to malpractice fears rather than evidence-based information, and I am human and therefore not immune to any of that, so it is in your best interest to research these things yourself and make your own choices, and look, I'll help you find ways to do that. Here's where you can start:..."

But if doctors and other medicos started to say that then they'd loose all power and worse, patients would question their decisions. Heavens, we can't have that now can we! Where would patriarchy be if we had that?

[cottonwood]

Exactly. You can't have have it both ways, i.e., patients who trust you implicitly, and who also take responsibility for their own care. People simply are not going to see the need for taking responsibility for their own care until they begin to face up to the fact that medical professionals are not infallible, perfectly wise, and all-knowing.

[grnbn76]

Originally Posted by doctorjen

One lady was so defensive at our first interview visit, that it was great fun to see how shocked she got every time I agreed with her about things that every other doc in town had told her were crazy (you know, really radical things like no episiotomy for a primip, or laboring upright, sarcasm intended.)
?

I haven't read past this post, but I have to say this....
This is me!!!!!!!
Everytime I go within 100 yards of our base hospital, it makes my bp rise! I am so prepared for a fight about everything. I'll never forget meeting the MW there and showing her my birth plan. I was prepared (I actually had a binder of studies, research, etc. to back up my choices) for a fight. She looked at me and said "This looks like a normal birth plan. It's all doable." I burst into tears.
And when I said to her that I have every reason to believe that I "won't get to the hospital in enough time", she said "Good for you." All she asked is that I would continue to come in for prenatals and come in with the baby within 48 hours.

Yep. I cried.

[momto l&a]

What makes you want to take responsibility for your own pregnancy and birth?

The way I was raised. I was taught that we are responsible for ourselves.

I was also taught not to have herd mentality, just because people do it one way or the other doesn’t make it right.

In other words for me I was taught to think and that is what caused me to take responsibility for pregnancy and birth.

[luvmylittleman]

Doctorjen,
I took responsibility for my decisions because as a labor and delivery nurse I saw what happened as I worked. Between a doctor that humiliated a patient because she had a small yeast infection and other doctors in which informed consent was far from informed, I decided to do things more my own way. I think many women hear that labor is not progressing or the baby may be "too big" and give up hope. I've seen CPD diagnosed so many times without trying other options (besides going right for the c-section). Prime examples are turning off or turning down an epidural for more effective pushing and changing pushing positions. So what could change this? More informed patients. How do you get more informed patients? Perhaps an office nurse (educated on childbirth options) can take more time to discuss a birth plan during an office visit. Perhaps, your patients will feel more comfortable discussing things in this manner. Perhaps, running a video in the waiting room about birthing options or making choices during childbirth, etc. would help. Maybe, setting up a networking system where former patients can contact current patients (of course within privacy guidelines).
Hope you get the answers you seek from someone out there.

[Changed]

There are women like us in every city looking for a Doctor Jen.

[nuggetsmom]

NAK so gorgive me. What motnivated me to accept responsibily this tiem is that my last irth was such a nightmare. I got the standard "what to expect", and took the class from the hospital and that was taht. What more did I need? Well, I didn't realize how much of an experience birth was and had I realized, I would have done things differently.
This time I was still with an OB and i a hospital, but it was a wonderful experience. And I was much more involvrd in the decision making process. At first i wasn't because i do tend to act like a deer in the headlights, but when i realix=zed what i really wanted the dr and i worked with that and what he, with responsibilkity, was also comfortable with. i got lucky with the dr in the end i think, because with insurance i did not have much choice.

[MelMel]

Originally Posted by doctorjen

So, what motivates you mdc mamas to assume responsibility? What do you think I could do to encourage mamas IRL to do the same?

mine's easy, and a bit irrational....I just distrust 'authority' (as if a doc is an authority ) see there i go again.....anyway, and dont like being told what to do. I cant help it.

also, I think the world is getting outta wack because of all the control we try to take of it. I like leaving stuff to nature and instinct.

you sound like a nice doctor, though

[supervee]

Comparing myself to friends who don't take responsibility for such things, I think I am older, more feminist, more self-reliant and less inclined to trust authority or experts, more of a researcher than just listening to what my friends say/do, and less willing to go with the mainstream flow. HTH!

Meant to add... so I think it's personality. I don't think you can directly motivate people to do anything. They have to decide for themselves. I think you can educate people, but they have to make the decision. Maybe get people involved in writing a birth plan so they see all the choices they can/need to make. My birth center had this as an upfront requirement, the taking responsibility.

[IntoTheRoseGarden]

I just wanted to add that before dd's birth, I was educating myself, but I'm sure my OB was not aware. I felt so intimidated that I couldn't speak up even when I disagreed. Part of the problem was that he did not seem to have much respect for me as I was (gasp!) 21 and single . I ended up with a c/s after going along with all his suggestions, even when I knew better. I was just raised not to "talk back," to be a good little girl and do as I was told. I know better now, and I'm actually in training to become a doula so that I can help to empower other mamas.