Is it normal for OB to ask NO prenatal questions? - Page 2

[the_lissa]

Originally Posted by Individuation

The_lissa, I think it's wonderful that you were able to find someone to spend an hour talking to you about "anything and everything," and I'm glad that option obviously exists for the women who need it. I just question whether it should be the standard of care.

Sheesh, I can't talk to my own husband about being pregnant for an hour straight. Different people have different needs. I'm not saying there's anything wrong with women who need a lot of interaction and emotional support from their practicioner during their pregnancies, but I found it viciously unfair and strange that this doctor (and by extension ALL practicioners with a similar style) were being decried as "heinous" and "awful." There are women who would be thrilled at a hands-off style.

Well it isn't like they lock the door and make you talk for an hour.

Hands off is good, but I think that for most obs, it more of a way of being dismissive, and it doesn't bode well for the labour or birth.

[Individuation]

Originally Posted by the_lissa

Well it isn't like they lock the door and make you talk for an hour.

Hands off is good, but I think that for most obs, it more of a way of being dismissive, and it doesn't bode well for the labour or birth.

That's probably true--if you're in the position of making birth plans, etc., it's nice if the OB has some interest in what sort of person you are.

(In my case, a ridiculously private, "none of your business," "I'll call YOU if I have a problem, thanks" type of person! : )

[the_lissa]

Yep.

I think for some care providers, they are hands off because they don't respect you enough to tell you things. That, and they know that they are going to determine what happens at your birth and not you.

While for other care providers, they are hands off because they trust you, will defer to you at your birth, etc.

[bryonyvaughn]

Individuation, could you tell me what kind of questions you found invasive and irrelevant?

I ask because as a CAM HCP I often ask questions that might seem irrelevant but are pertinent to my grasp on the case. If I get the slightest pause or bristling from any question, I immediately explain *why* I'm asking the question. I like to think it builds trust between me and my client and teaches them more about how their bodies work.

I think too many HCPs consider their technical skills and knowledge base sufficient to be excellent practitioners while not considering how much a lack of inter-personal skills can negatively impact the care their clients receive.

If I were to whip down a list of questions including things like "Do you wear a seatbelt on every trip?", I can easily imagine a woman feeling I was wasting her time and *assumed* she was stupid or irresponsible. I wouldn't do that. I'd ask something like, "How's your car seatbelt working for you this pregnancy?" A woman would then be free to share if she didn't use them, if she thought they would do more harm to a baby in an accident than no seatbelt use, if it was riding over her belly and breast and across her neck, etc and I'd be free to clarify study results and offer positioning tips and devices for seatbelts that were designed for the non-pregnant body. I *like* to think my way comes across less as a pass/fail test and more as an opening for discussion. I'm sure I won't succeed every time but my desire is for my clients to view our relationship not as patient & HCP but as a health care partnership.

BV, who rambled but isn't going to edit as kids are hungry

[the_lissa]

You ask about seatbelts?

[guest9921]

I have to agree with both individuation and the_lissa very equally.
Unfortunately when I made my first prenatal appointment, a few days later - I had a nurse call me, whom asked hundreds of some not-so personal and some quite-personal questions. I was on the phone with her for 30-40 minutes.
A lot of questions were a personal intrusion - and I told her to bugger off, in a lot more respectful terms.

It just shows a complete lack of intimate care in this industry. A nurse whom I'll never meet is asking me these questions - I understand OB's are busy, I'd rather just fill out a form.

I am like you, extremely private about many things - but I still absolutely need to build a rapport with the individual who is supposedly coming to birth my child - an extremely vulnerable time (where frankly, I don't feel they belong) that I need them to be a bit in tuned with me, and understand my wishes.

If they never give women a chance to speak these wishes or needs, these women get left by the wayside. I'm not talking about coddling, I'm talking about one on one real conversation about what is going to happen in the 'delivery room' or 'OR'. I don't need my OB to hold my hand, but I need her to absolutely respect me as a person and not as another person processed in the babymaking factory.

Its just another example of authority railroading women to suit their preferences and conveniences.


Ramble ramble. Hunger calls, bbl.

[bryonyvaughn]

Originally Posted by the_lissa

You ask about seatbelts?

No. I'm not a MW or OB but could imagine one asking because seatbelts are not designed for the pregnant body so many pregnant women end up not wearing them or wearing them incorrectly. I used to work for Physical Medicine and Rehabilitation and was continually saddened by steady stream of patients whose injuries were 100% preventable.

I can understand how, presented the wrong way, someone could easily think the HCP was a nosy, judgmental busybody. I tried to give an example of the same topic approached in a non-judgmental way through an open ended question.

FTR, if I were a pregnancy HCP and asked my version of the questions, these would be my responses. If someone said they weren't wearing them because of babies injured from seatbelts, I'd explain how that happens from improperly positioned lapbelts and how you need to maneuver it into position properly. If they complained about the shoulder harness riding over their belly and breasts and across their neck (VERY DANGEROUS!), I'd talk about shoulder belt positioning devices designed for short people which can help a pregnant woman position the shoulder harness over the belly and between the breasts. If the woman said she wasn't having any issues with her seatbelt, I'd say "Good. Often they can become troublesome women's shapes change during pregnancy and, if it becomes a problem, let me know and I'll have some suggestions for a safer more comfortable ride."

My goal is to be respectful and practice the Golden Rule in all areas of my practice. If people disregard the information I present and end up suffering because of it, I'll feel bad for them but not guilty. I probably reexamine my approach and see if I could make my message easier to receive, remember, or implement but I wouldn't feel responsible for not preventing a preventable injury.

Just my 2c.

~BV

[bryonyvaughn]

Originally Posted by Katfka

I have to agree with both individuation and the_lissa very equally.
Unfortunately when I made my first prenatal appointment, a few days later - I had a nurse call me, whom asked hundreds of some not-so personal and some quite-personal questions. I was on the phone with her for 30-40 minutes.
A lot of questions were a personal intrusion - and I told her to bugger off, in a lot more respectful terms.
<snip>
Its just another example of authority railroading women to suit their preferences and conveniences.

Please humor me here. I have only had prenatal care from one DEM over a decade ago. Other than quite-personal and not-so personal, can you give me an idea of what kind of questions you find intrusive?

It's frustrating for me to engage in a conversation with people who won't explain WHAT is the problem. If I knew what it was I might agree completely, or disagree with the irrelevance of the information but agree it was presented tactlessly. I can't know what to think if the facts are never presented.

~BV

[AlexisT]

The lack of time has less to do with the "American model of prenatal care" or OB training than with the financial reality of modern medicine. OBs simply do not have the time. Doctors in general don't have the time. Most homebirth midwives are operating under a different set of financial constraints. If they operated under HMO rules, they might not have as much time to devote to you either.

Most doctors will actually say they would prefer to spend more time talking to their patients--a clear patient history and good questioning can provide a great deal of information. A good doctor isn't dazzled by technology. It can provide useful information, but it may not tell you what you need to know. Unfortunately, the way insurance billing works, doctors don't get paid to talk. They get paid for procedures.

The midwives here never took time to talk to me either: they had too many patients to see. The consultant OB would ask me a couple of general questions, but that's all she had time for.

[thefreckledmama]

Wow. It never occurred to me how fortunate I have been in the past with my old OB, at least when it came to prenatal care. She would come in and do all the technical stuff (weight, BP, listen to the heartbeat), and then she would sit down and ask if there was anything I wanted to talk about. If I didn't have anything specific, she would start asking me about my energy level, appetite (and what types of meals/snacks I had been having, and give me suggestions for keeping them well rounded), types of activity I'd been doing, and also if I had anything going on emotionally-how I was feeling about this or that in regards to my pregnancy and life in general, and then we'd talk about anything that would be coming up in regards to the pregnancy, and things to keep an eye on in terms of possible problems-what to do, when to call, etc.

It makes me very sad to realize so many women DON'T get that. : The only issue I really had with her, and it was only in hindsight, was that she was much too quick to resort to interventions during labor, and didn't let things progress naturally, and with my second, she induced at 39 weeks for the convenience of it. At that point, it didn't even occur to me to not just say ok to whatever the doctor suggested-you live and you learn.

My new OB is also very good about prenatal care...we've spent at least 25-30 minutes discussing things after all the routine care is out of the way at each of my appointments-including my first appointment with her when I went for my yearly, before I was pregnant-and what nutritional/lifestyle changes would be best before even actually being pregnant. Plus, she has 2 children, and had natural childbirth with both. For an OB, I think she's awesome.

My last appointment was with her midwife, because she's on maternity leave. She was great too. We got to talking about the political climate in the area (and state for that matter) when it came to midwives in general-not being able to attend hospital births, CPNs being felons, etc. What really made me super happy was when she said that my doctor was 'one of the good guys' when it came to supporting midwives, and said she wishes that all OB's were more like my OB, because there would be so much less 'medical junk' to pregnancy and childbirth. :

[lyttlewon]

Originally Posted by Beppie

I mean, this guy is in and out of the room in less than 2 minutes. Checks heartbeat, checks where uterus is, asks, "how are you feeling?" (my answer has been, "fine") and is pretty much gone after that.

Is this NORMAL???!!!

I'm switching to a homebirth midwife, I'm totally unhappy with this doctor, but just was wondering if this is a standard thing.... If so, that's terrible!!!

Anyone else experienced a doctor like this? How can he be giving NO prenatal evaluation of his pregnant patients? (like nutrition, exercise, sleep, etc.) I'm interested in hearing what others have to say!

Yep totally normal. A midwife on the other hand asks lots of questions.

[lyttlewon]

Originally Posted by SeekingJoy

I really like my two OBs, and from the ones I interviewed, they were the most supportive of natural, intervention-free childbirth. Unfortuntately, they are still in and out with very little discussion of diet, exercise, life, etc.

However, I have found that if I initiate discussion or have questions, they both have been very responsive and informative. Working within this paradigm of medicalized care does require mamas to ask more questions and advocate more for themselves.

Maybe it is because most mamas don't care or aren't interested in making different lifestyle choices?

I have an intern and he asks me more questions than my OB. I don't think it is an issue with most people not being interested. Many women don't even know what to ask and an OB knows. I was given a crap load of magazines and pieces of paper at my first prenatal. I think that is my OB's way of interacting with all that stuff.

[nmoss]

My experience has pretty much been what everyone else has shared...except my back-up OB doesn't even measure me. I don't think she, or any of the other OCs in her practice, have ever touched my abdomen with their hands...only wit the Doppler, our ultrasound wand. It's nutty.

Total contrast to my midwife, who's super-engaged, interested and involved. Love her!!:

[lyttlewon]

Individuation here is an example of the difference.

MW: How was your weekend?

Me: Good

MW: Did you do anything fun?

Me: I went to a huge neighborhood garage sale and walked around for about 2 hours. Speaking of which my hips started hurting really bad here (I point to round ligaments). I don't know how I am going to survive at Disneyland all day in a couple of weeks.

MW: Your ligaments are stretching from the weight of your stomach. If you want you can buy a belly support band that goes here (demonstrates how brace works).

So I follow her advice and buy a stomach support and last 9 hours a Disneyland with NO PAIN! That isn't a conversation I would have had with my OB. For one I wouldn't have remembered to ask about it until my MW asked about my weekend. In fact the longest conversation I had with my OB was when she was trying to talk me out of a homebirth. I used to wonder why people were so gaga over their midwives and once I got one I totally appreciated the difference in relationship.

[gcgirl]

That wasn't normal for either of my OBs - not for the first one who was more rushed, and not for my current one who is very patient-oriented. Both of them asked a lot of questions and asked me often if I had any questions etc. etc. etc...had I thought about X,Y,Z...blah blah blah...

I'd be concerned about an OB who rushes in and out like that.

Lyttlewon - it's funny you presented that example about MW communication. I personally don't want to make small talk with any of my care providers. I see your point - of course - you're saying a provider can learn more about your needs and health status through some friendly questions than a by-the-book Q&A. I'm just the kind of person who would tell my provider to "stay on topic" if they asked me about my weekend. That's my personal preference, of course. My OB would surely chat me up if I wanted him to - he's that kind of guy - but I'm a "get in, get it done, get out" kind of patient.

[chlobo]

My OB doesn't really ask questions. And he doesn't really explain thigns either, even when I ask. He's only measured me once and at that point (36 weeks) I was measuring small so then he ordered an u/s, even though his gut feeling is that I just carry small. Then he gives me the same speech that I should let him know about any crampings, aches, etc. Then when I mention this pain in my leg he just blows it off. It's really discouraging.

My midwife is much the opposite. She does ask questions that seem irrelevent but I suppose they fall under the category of "getting to know me" and I don't mind. But I can understand why some people might consider that too invasive.

[Beppie]

Originally Posted by the_lissa

Yep.

I think for some care providers, they are hands off because they don't respect you enough to tell you things. That, and they know that they are going to determine what happens at your birth and not you.

While for other care providers, they are hands off because they trust you, will defer to you at your birth, etc.

:

This is why I am disturbed by the OB I was seeing. I don't want my "hand held", rather I have a strong suspicion that the OB doesn't talk to me for 2 reasons ---

1. Because he thinks he's the one entitled to make decisions about my pregnancy/birth. and

2. Because he doesn't respect me enough to care what I think about it. Either that, or he thinks I'm ignorant enough to not have an opinion.

I am always gabbing with friends about pregnancy/labor/birth/children. I'd like to be able to have a relationship of TRUST like that with my midwife, too. She doesn't have to be my "new best friend," but I DO have to trust her and her knowledge/abilities! How else to know if I can trust her than by having conversations with her to see where she's coming from and whether what she says raises any red flags? It's the OB's behavior that raised red flags with me. In his eyes, I could just be another opportunity for him to try out his surgical expertiese, that could be why he doesn't talk to me. After all, what's the worst that could go wrong for him? A c/s.

No, thank you!

[Selesai]

Originally Posted by starry_mama

I think thats fairly "normal" for an OB.

It was not normal for my OB. She was a DO and was more "midwifey" in her care than a typical OB.
But, if I recall, I usually saw the CNP for prenatal appointments.
There are decent OBs out there. They will never be midwives, but they are not evil, either.

[ksera05]

wow - that isn't normal for my OB *or* my perinatologist. Odd.

[gcgirl]

Originally Posted by Beppie

1. Because he thinks he's the one entitled to make decisions about my pregnancy/birth. and

2. Because he doesn't respect me enough to care what I think about it. Either that, or he thinks I'm ignorant enough to not have an opinion.

And as you know, these are two very good reasons to go elsewhere!