Why???!!!! So frustrating. - Page 3 - Mothering Forums

Forum Jump: 
Reply
 
Thread Tools
#61 of 115 Old 01-24-2011, 12:15 PM
 
MegBoz's Avatar
 
Join Date: Jul 2008
Location: Baltimore, MD
Posts: 2,063
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

 

Quote:
Originally Posted by elisheva View Post

I, too, have wondered WHY I get angry when other women talk about trusting their OB/HCP and taking all their recommendations. I think it's because, at heart, I'm really mad at so many OBs/HCPs I hear about out there who don't put their patients' best interests first and who don't practice evidence based medicine. 

<emphasis added>

THIS - exactly! THAT is why I get mad. I'm a lot MORE mad at the way many American OBs practice. Just open the book, "Born in the USA" and look at the chart that describes evidence-based rates of things like CS & episiotomy vs. the US rates. How can you NOT find the massive differences infuriating?

 

How can I NOT be frustrated at watching women move forward on their way to likely becoming victims of abuse?

 

Seeing people abused bothers me. I find it strange *I'm* the one defending this position here....

 

Finally, I don't disagree for a second that lots of women are perfectly happy with birth experiences that WE on MDC would consider negative (unnecessary CS, unnecessarily highly-managed & medicalized vaginal birth.) BUT... those same women usually go around believing their medicalized birth was necessary - and they therefore further spread the myths that:

1. Birth is a miserable experience (it's awful, just take the drugs ASAP, trust your OB & focus exclusively on the baby because that's all that matters)

2. Birth is dangerous and ALWAYS REQUIRES medical management by OBs in hospitals.

 

& when the above 2 myths are perpetuated time and again, that is going to make reforming American maternity care even more difficult.

 

So I find that annoying too.

MegBoz is offline  
Sponsored Links
Advertisement
 
#62 of 115 Old 01-24-2011, 12:45 PM
 
MegBoz's Avatar
 
Join Date: Jul 2008
Location: Baltimore, MD
Posts: 2,063
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by WildKingdom View Post

Quote:
Originally Posted by MegBoz View Post

 

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.

MegBoz is offline  
#63 of 115 Old 01-27-2011, 09:38 AM
 
texmati's Avatar
 
Join Date: Oct 2004
Posts: 6,760
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)

Well... i'll just address the op.

 

Often I'll use a line like that as a polite way of saying MYOB. Unless you are really close to a woman (like her partner) and have been in her Dr's office, and know everything about her pregnancy, you just can't know how well read she is, or what her ob is like, or what her pregnancy is like.

 

When questioned about my choice to vbac, I use the same line-- well my doctor says it's safer. and I trust him.

 

I regret the few times that I poked my nose in someone elses pregnancy without an invitation. Now I know better that the best way to support women in birth is to actually be supportive.


Texmati-- Knitter, Hindu, vegetarian, WOHM. Wife to superdadsuperhero.gif and mom to DS babyf.gif24 months, and DD boc.gif 8 months! .

texmati is offline  
#64 of 115 Old 01-27-2011, 10:15 AM
 
msmiranda's Avatar
 
Join Date: Apr 2009
Location: Virginia
Posts: 412
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Re the discussion above about trust, I think that for me the most trust-shattering thing has been hearing so many stories of  women being lied to, bullied, coerced, and even abused by OBs for reasons such as personal convenience and retaliation (as opposed to an OB's genuine concern about a bad outcome and conceptualizing risk differently from the patient).  I hope that overall the number of such occurrences is low, and we just hear the bad stories the same way we hear bad stories on the news of things happening that are very rare.  But there is no doubt that there are some bad actors out there, and it's hard to deal with the idea that something like that could happen to you at such a vulnerable time.  Instead of being offended, I think doctors should just make as much of an effort as they can to build trust relationships with their patients.  All of us know that there are OBs out there who are great, and my trust can definitely be earned ... but it can't be taken for granted.  It's not the fault of every doctor out there that a few are bad apples, but it will still understandably affect patients' perceptions of doctors as a group and may necessitate additional effort on the part of the physician to establish trust.

 

As for the other stuff -- the way OBs perceive birth and intervention differently than midwives (usually) do -- that's a tougher issue to deal with because most OBs probably believe with complete sincerity that the way they practice is in the best interest of their patients.  And because many women who want to have normal births go to midwives, they rarely have any opportunity to witness the physiological birth process absent interventions. 


SAHM to Bird (6/07) and Bear (7/09), and now enjoying our newest additionbabyboy.gif, born June 1, 2011!  bfinfant.giffamilybed1.gifsigncirc1.gifcd.gif

msmiranda is offline  
#65 of 115 Old 01-27-2011, 12:31 PM
 
jeminijad's Avatar
 
Join Date: Mar 2009
Posts: 896
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by texmati View Post

Well... i'll just address the op.

 

Often I'll use a line like that as a polite way of saying MYOB. Unless you are really close to a woman (like her partner) and have been in her Dr's office, and know everything about her pregnancy, you just can't know how well read she is, or what her ob is like, or what her pregnancy is like.

 

When questioned about my choice to vbac, I use the same line-- well my doctor says it's safer. and I trust him.

 

I regret the few times that I poked my nose in someone elses pregnancy without an invitation. Now I know better that the best way to support women in birth is to actually be supportive.



Thank you!

 


Mother to R- 2/09, & C- 5/11

jeminijad is offline  
#66 of 115 Old 01-27-2011, 12:46 PM
 
jeminijad's Avatar
 
Join Date: Mar 2009
Posts: 896
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

At this point, if someone had the gall to tell me that they were "frustrated" or otherwise inappropriately concerned with the choices I make when I give birth- even if those choices include picking an OB in the best way that I could, and trusting them- anything they may say from that point onward is immediately and totally discounted.

 

You can dislike the fact that we are at a 30something% cesarean rate nationwide without describing physicians as "abusing" their patients... many, many factors have contributed to a birth culture in which a doctor feels they must 'do something,' when a midwife wouldn't.

 

To this community, posting here, the notion of a surgery that is Monday morning quarterbacked as "unnecessary" is anathema, even when it is done to avoid an unlikely but posssible catastrophic event (breech babies being decapitated following head entrapment.. catastrophic uterine rupture and fetal demise... unresolvable shoulder dystocia with fetal demise, yes it can happen and did recently to an Australian HB midwife.) That is fine- that is the value of this community. I'm glad this side of things is discussed, for those who would rather do without the overly cautious approach.

 

 Where it crosses a line is when people allow themselves to think less of another woman for coming to different conclusions.


Mother to R- 2/09, & C- 5/11

jeminijad is offline  
#67 of 115 Old 01-31-2011, 08:27 AM - Thread Starter
 
limette's Avatar
 
Join Date: Feb 2008
Location: Canada
Posts: 2,424
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by MegBoz View Post

 

Quote:
Originally Posted by elisheva View Post

I, too, have wondered WHY I get angry when other women talk about trusting their OB/HCP and taking all their recommendations. I think it's because, at heart, I'm really mad at so many OBs/HCPs I hear about out there who don't put their patients' best interests first and who don't practice evidence based medicine. 

<emphasis added>

THIS - exactly! THAT is why I get mad. I'm a lot MORE mad at the way many American OBs practice. Just open the book, "Born in the USA" and look at the chart that describes evidence-based rates of things like CS & episiotomy vs. the US rates. How can you NOT find the massive differences infuriating?

 

How can I NOT be frustrated at watching women move forward on their way to likely becoming victims of abuse?

 

Seeing people abused bothers me. I find it strange *I'm* the one defending this position here....

 

Finally, I don't disagree for a second that lots of women are perfectly happy with birth experiences that WE on MDC would consider negative (unnecessary CS, unnecessarily highly-managed & medicalized vaginal birth.) BUT... those same women usually go around believing their medicalized birth was necessary - and they therefore further spread the myths that:

1. Birth is a miserable experience (it's awful, just take the drugs ASAP, trust your OB & focus exclusively on the baby because that's all that matters)

2. Birth is dangerous and ALWAYS REQUIRES medical management by OBs in hospitals.

 

& when the above 2 myths are perpetuated time and again, that is going to make reforming American maternity care even more difficult.

 

So I find that annoying too.


This.

Like it or not everyone's choices affect everyone else. It may take many women to make the same choice and it may take awhile for the effect to be seen. But there is an effect. Judgement, frustration, education (even if it's a brief comment) incite change. Just look at the history of feminism. Lots of choices frustrate people make frustrate me and rightly so. Anyone would be lying to say otherwise.

And for the record. I didn't say anything directly to the woman that could be construed as rude or offensive. Her induction was postponed due to the hospital being too busy. Hopefully it works out for her.

Now for me, I have to get back to my own babies; chicks, bunnies and hopefully goats soon!



limette is offline  
#68 of 115 Old 01-31-2011, 02:59 PM
 
Turquesa's Avatar
 
Join Date: May 2007
Posts: 4,038
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 45 Post(s)


It's interesting how every time there's a thread about somebody frustrated over women not receiving adequately informed consent (or not exercising their right to get it), somebody else runs away with the deeply misguided message that these women are being judged for their birthing choices.  You have a right to choose what you choose in childbirth.  We get it.  But it's not unreasonable for women to demand thorough, accurate, and evidence-based information on risks and benefits of all birthing choices...something that the woman in the OP didn't do.


In God we trust; all others must show data. selectivevax.gifsurf.gifteapot2.GIFintactivist.gif
Turquesa is offline  
#69 of 115 Old 01-31-2011, 04:39 PM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

It's *not* unreasonable for a woman to demand thorough, complete, accurate information.  It is unreasonable to judge a woman for not demanding that information if she doesn't feel it's of any use to her. 

stik is offline  
#70 of 115 Old 01-31-2011, 08:40 PM
 
MeepyCat's Avatar
 
Join Date: Oct 2006
Location: Boston, MA
Posts: 3,674
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 56 Post(s)


Quote:
Originally Posted by Turquesa View Post


It's interesting how every time there's a thread about somebody frustrated over women not receiving adequately informed consent (or not exercising their right to get it), somebody else runs away with the deeply misguided message that these women are being judged for their birthing choices.  You have a right to choose what you choose in childbirth.  We get it.  But it's not unreasonable for women to demand thorough, accurate, and evidence-based information on risks and benefits of all birthing choices...something that the woman in the OP didn't do.


I agree with Stik's point, but I wanted to add:

 

There is a huge volume of information on the risks and benefits of birthing choices.  It could take years to get through, and after that, there is a huge volume of information on every possible child-rearing decision.  We all must make choices about how much information we want, and how we prefer to receive it.  We cannot possibly absorb it all.  There is not time, and the human brain can only hold so much. 

 

One solution to this problem is to choose an OB you like, develop a relationship with him or her throughout the pregnancy, and take the advice you are given.  It is completely reasonable to do that, if that's what you prefer to do.

swede likes this.
MeepyCat is online now  
#71 of 115 Old 02-01-2011, 10:45 AM
 
CI Mama's Avatar
 
Join Date: Apr 2010
Location: Wisconsin
Posts: 792
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by MeepyCat View Post

There is a huge volume of information on the risks and benefits of birthing choices.  It could take years to get through, and after that, there is a huge volume of information on every possible child-rearing decision.  We all must make choices about how much information we want, and how we prefer to receive it.  We cannot possibly absorb it all.  There is not time, and the human brain can only hold so much. 

 

One solution to this problem is to choose an OB you like, develop a relationship with him or her throughout the pregnancy, and take the advice you are given.  It is completely reasonable to do that, if that's what you prefer to do.

 

This point certainly resonates with me, but I think this gets to exactly the problem that the OP & others who agree with her are trying to make. As I understand it, the point they are trying to make is that we have a responsibility not only to make the best decisions for ourselves, but we also have to recognize that our choices affect other people. The "climate" in which we give birth is shaped and forged by the decisions that all of us make. The stories we tell, the information that we share, and the direct or implied messages that we send to our HCPs and other women contribute to this "climate." So if we choose badly or wrongly, or if we don't correct our ignorance on a number of issues, we risk hurting other women. To put it as a cliche: If we're not part of the solution, we're part of the problem. And those of us who are "doing right" by other women have a right to be frustrated & annoyed by those who are making things worse.

 

I don't know how I feel about this personally. On the one hand, the vision of strong, empowered, educated women making good choices and changing the world is certainly seductive. On the other hand, on a personal level I found it challenging to make good choices for myself (even with a wealth of information at my disposal), and it's overwhelming to think that everything that I do has such far-reaching consequences. I wish I could say that giving birth made a strong, empowered, educated woman out of me, but since it didn't, I deeply wish that my experience could really just be MY experience, not something that anyone else has to be impacted by for better or for worse.

 

There IS a judgment implied in all of this. If we are holding each other accountable, then we are asking to judge and be judged for what we do and how it impacts the whole system. Is there room to both hold each other accountable and to be compassionate with one another?

 

This is a difficult conversation, but one worth having. 

 


Living in Wisconsin with my partner of 20+ years and our DDenergy.gif(Born 10/09/08 ribboncesarean.gif). Why CI Mama? Because I love contact improvisation!

CI Mama is offline  
#72 of 115 Old 02-01-2011, 11:23 AM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I feel strongly that it is not the responsibility of a woman in labor to consider any concerns other than her own concerns for herself and her baby.  I really feel it's cruel to expect that a woman would take a second to reflect on how her personal choices might impact the birthing climate for a broader "sisterhood" of people who aren't in her personal situation in a moment of extreme physical and emotional stress.  And besides being cruel, it's pointless.  

 

I live in a community with high intervention rates, and a lot of available medical intervention.  Nonetheless, I personally had no trouble having an intervention-free hospital birth surrounded by respectful and supportive health care providers.  This isn't because all the women in my community knuckled down and made decisions that would impact the local birth climate.  It's because of the privileges I carried into the healthcare system with me - I am generally healthy, I have decent health insurance, and I live in a densely-populated urban area where hospitals and doctors compete for patients.  

 

Suggesting that more women choose the low-intervention route oppresses just as many women as insisting that they all choose the high intervention route.  If you truly want an improved birth climate for all women, you should complain about factors that take choices away from women - poor insurance, rigid hospital policies, disrespect for women's autonomy, and a million other systemic factors - not about the choices that women freely make.  

swede and matte like this.
stik is offline  
#73 of 115 Old 02-01-2011, 11:32 AM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

And while I'm here, how would you "hold a woman accountable" for her birth choices?  Scold her?  Make her apologize to women who had unnecessary c-sections?  Revoke her Mama License?  

 

I think the drive to find a way to "hold women accountable" for birth choices suggests that women don't choose for themselves, they choose for all the other women too.  And that's simply not true.  

swede likes this.
stik is offline  
#74 of 115 Old 02-01-2011, 11:43 AM
 
mmaramba's Avatar
 
Join Date: May 2005
Location: Washington, DC
Posts: 255
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

MegBoz, I generally and usually agree with you, but I think your "controversial" hook would seriously backfire.  Many times when the subject comes up and I am speaking with more "mainstream" women, I realize that some of what I say ALREADY sounds like crazy hippy tinfoilhattery-- even though I am really very evidence-based in my views, and quite moderate among natural birth advocates.  I'm very much not anti-doctor (my mom is an MD), I do not believe profit is a primary motive for many OBs and often say just that, etc., etc.  But just the suggestion that OBs aren't practicing in an evidence-based way all or even much of the time is enough for many to tune you out (or become hostile) when the vast majority of the population won't even consider that possibility.

 

THAT is already an "extreme" attention-grabber.  Really, just the idea that MAYBE OB is not being practiced in the most evidence-based way is plenty "inflammatory" and "controversial."  The wolves in sheep's clothing is way way way beyond the beyond.

 

That said, I still don't fundamentally blame women for perpetuating fear and myths, etc., even though they are harmful.  I have decided that when people are making poor choices (WHEN they actually are), the best thing you can do is to present them with better options.  And while I agree that some women don't give a fig about birth and that's their prerogative, I also don't believe that as long as people "don't know" they're being abused, oppressed, etc. (again, WHEN they are) that means they aren't being abused, oppressed, etc., and don't know it on some level.  Even when they arguably don't know it "on some level," it's not a bad idea to share almost-universally-better alternatives.

 

Bottom line, we all know that birth in the US (and many other places) is effed up.  Like most issues of oppression, it's hard to nail down to specific cases, but it's obvious in the aggregate.  There was a very unrelated study done in the recent past about negotiations that I keep thinking about.  Forgive me if I'm not telling it exactly right, but I think I have the gist.  It was a variation on classic game in behavior economics, where someone is given $10 and must offer some amount to a partner.  If the partner agrees, they both get whatever amount of money was agreed to.  If the partner disagrees, no one gets anything.

 

So, the thing is, any "rational" partner is going to agree to even $1 (and the first subject keeps $9), right?  Because otherwise, she doesn't get anything, and $1 is more than $0.  And a "rational" subject should be offering just $1, so as to keep $9.  But there's a sort of "spite" level under a $3 offer, as you can imagine, and all kinds of other factors come into play as well, so offers tend to be between $3 and $5, for the most part. 

 

Anyway-- this experiment has been done a bajillion times with different variations.  Once, it was done with envelopes, and the "partners" didn't have to agree to anything (IIRC).  Subjects got two envelopes with 10 $1 bills and 10 worthless pieces of paper of the same size and shape, etc.  They put however much they wanted to keep in one envelope and put however much they would be willing to give away in the other envelope.  Because the cash and paper looked similar (and social stigma for greed didn't come into play as much), observers couldn't really tell how much actual cash the individual subjects were giving or keeping, and subjects tended to keep more for themselves.  But I don't believe anyone actually gave $0, because there was still some unspoken pressure not to totally stiff any of the envelope-openers (partners). 

 

THEN they tried a variation where everyone was told that ONE of the envelopes that ONE of the subjects would be given would contain 20 pieces of useless paper (so their partner would have no choice but to give them 10 pieces of paper and no cash at all).  Now, with plausible deniability, tons of the subjects completely stiffed the envelope-openers.  Because none of the envelope-openers could say for SURE that THEIR subject-partner had intentionally stiffed them.  But when you have 10 people opening up envelopes and 6 of them contain nothing but paper, you know at least 5 of their partners intentionally kept all $10 for themselves.  Thing is... which 5?  Bottom line, something's rotten in Denmark.

 

That's what's going on here.  Each individual story could be legit, could be not.  Which is why we can't be Monday-morning quarterbacking even the stories that are HIGHLY suspicious.  But when we hear 6 out of 10 stories like this (maybe even 8 out of 10 or more), it's hard not to be thinking 5 or 7 of them involved unnecessary trauma and/or non-evidence-based practice.  The thing is, it just doesn't help us to try and pick apart each individual story, even in our own heads-- what we need (as in the experiment) is more accountability and more transparency in the process as a whole.  Oppression thrives on ignorance and keeping people ignorant, spreading fear and misinformation (whether intentionally or unintentionally).  THAT is what we have to counteract, YKWIM?  I do know it's frustrating.  I have to bite my tongue constantly.  But I try to keep the greater goal in mind and find the most effective ways of reaching it.

mmaramba is offline  
#75 of 115 Old 02-01-2011, 12:32 PM
 
MegBoz's Avatar
 
Join Date: Jul 2008
Location: Baltimore, MD
Posts: 2,063
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Quote:

Originally Posted by stik View Post

Suggesting that more women choose the low-intervention route oppresses just as many women as insisting that they all choose the high intervention route.  If you truly want an improved birth climate for all women, you should complain about factors that take choices away from women - poor insurance, rigid hospital policies, disrespect for women's autonomy, and a million other systemic factors - not about the choices that women freely make.  


"insisting that all women choose the low intervention route" is a total straw-man argument. Do you really, honestly believe that there is a sizable contingent of birth-activists who think all women should have low-intervention births? Because that is a silly idea.

 

I don't think I've EVER heard anyone say such a thing-- that "Every woman should have a low intervention birth."


Instead it's about evidence-based care. (It just so happens that evidence-based care IS low-intervention (unless needed.) Evidence is very clear. When things are progressing well, there's no need to 'intervene', and doing so without cause simply leads to worse outcomes.) But again, the point is that HCPs should be practicing evidence-based care- which includes interventions as needed.


Of course interventions should be available as needed or desired - and there are lots of discussions here on MDC on how to have the best experience with interventions. When people post here on MDC to ask about having the best possible induction or CS, for example, they are generally given help. We don't just say, "NO, JUST SAY NO to interventions." That's ridiculous. No one is saying that.

MegBoz is offline  
#76 of 115 Old 02-01-2011, 12:47 PM
 
MegBoz's Avatar
 
Join Date: Jul 2008
Location: Baltimore, MD
Posts: 2,063
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by mmaramba View Post

MegBoz, I generally and usually agree with you, but I think your "controversial" hook would seriously backfire.  Many times when the subject comes up and I am speaking with more "mainstream" women, I realize that some of what I say ALREADY sounds like crazy hippy tinfoilhattery--

 


LOL @ " tinfoilhattery"!
 
Oh, I totally agree with you that the controversial hook would backfire in conversation. Totally, completely agree! Yes, IMX, people ALREADY dismiss my input as the crazy hippy - so they shut down & won't listen. i.e. I must be a super woman to have not had an epidural, so I'm therefore a freak-of-nature & there's no point listening because my experience & input can't possible be at all relevant to mortal-human-women.. :( Yes, I've had that exact thing happen.
 
But a billboard on the highway? Hm - The approach I'd use with a TV commercial, online banner ad, or highway billboard is a totally different approach than one I'd use at a party (or any IRL conversation, or even an online discussion forum conversation). As I said, in advertising, you have to "interrupt" first - and sometimes that means scaring or shocking people. Whereas when I want to get someone's attention to engage them in a conversation at a party, I wouldn't say, "LOOK OUT! SPIDER ON YOUR HEAD!" LOL - but that IS the sort of approach that can work well in advertising. 
 
But I see your point that even for an advertisement it still might backfire, but I think my hope was that it would be so controversial as to get attention and make people wonder to want to look into it more... Yeah, maybe not though, it was just my initial thought. & the wolf in sheep's clothing could convey visually - therefore quickly - that maybe the OB doesn't truly have your best interest in mind.
 
I also think the message about OBs not practicing evidence-based medicine is controversial & summarily rejected MORE by mainstream women who are PG or who have already, recently had regular, medicalized-OB care. Wanting to feel confident that we are making/did make the best choice can contribute to this rejection. But a billboard would have an audience of the general public - an audience that might be more open minded. (since PG and new-moms are just a small % of the general public.)
 
But again, yeah, I see your point. I'd brainstorm other ideas & do some focus groups before investing in graphic design & media buying, LOL. All still hypothetical, of course!
 
Quote:
Originally Posted by mmaramba View Post

Bottom line, we all know that birth in the US (and many other places) is effed up.  Like most issues of oppression, it's hard to nail down to specific cases, but it's obvious in the aggregate. 

 

<snip>

 

That's what's going on here.  Each individual story could be legit, could be not.  Which is why we can't be Monday-morning quarterbacking even the stories that are HIGHLY suspicious.  But when we hear 6 out of 10 stories like this (maybe even 8 out of 10 or more), it's hard not to be thinking 5 or 7 of them involved unnecessary trauma and/or non-evidence-based practice.  The thing is, it just doesn't help us to try and pick apart each individual story, even in our own heads-- what we need (as in the experiment) is more accountability and more transparency in the process as a whole.  Oppression thrives on ignorance and keeping people ignorant, spreading fear and misinformation (whether intentionally or unintentionally).  THAT is what we have to counteract, YKWIM?  I do know it's frustrating.  I have to bite my tongue constantly.  But I try to keep the greater goal in mind and find the most effective ways of reaching it.


I love you you phrased this - "obvious in the aggregate." Yes, exactly! Which is why, as I said, for 'proof' that you can't trust your American OB, just look at the charts in the book "Born in the USA" comparing US rates to evidence-based rates of lots of things. Also excellent points on oppression thriving on ignorance.

 

& actually I'm not so sure that "we all know birth in the US is effed up" is true. It seems that is sometimes considered a controversial statement even here on MDC, which really confuses me. Really REALLY confuses me.

MegBoz is offline  
#77 of 115 Old 02-01-2011, 01:28 PM
 
Turquesa's Avatar
 
Join Date: May 2007
Posts: 4,038
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 45 Post(s)

 

Quote:
Originally Posted by stik View Post

It's *not* unreasonable for a woman to demand thorough, complete, accurate information.  It is unreasonable to judge a woman for not demanding that information if she doesn't feel it's of any use to her.

 

Every consumer needs to take responsibility for learning about what s/he's about to consume.  And it sounds like you agree with me::

 

 

Quote:
I feel strongly that it is not the responsibility of a woman in labor to consider any concerns other than her own concerns for herself and her baby.

 

Fair enough.  Let's work with that.

 

Imagine a consumer going to a lot to buy a used car.  She declines the Car Fax and test drive because "she doesn't feel it's any use to her?"

 

Imagine a consumer who goes to buy a house.  She declines the inspection and appraisal report, and she agrees to pay contingency-free whatever the seller is asking.  After all, none of that is "of any use to her."

 

Now imagine a consumer who goes to have a baby.  One way of having the baby poses greater risks to herself and her child, but she declines to investigate her options or question her doctor because such information "isn't any use to her." 

 

No, these scenarios aren't "the same thing."  But they do illustrate that by not advocating for ourselves, by willfully surrendering ourselves to ignorance and our power to those who profit from our decisions, we stand the risk of making a foolish mistake.

 

Are the bad decisions entirely the consumer's fault?  Not necessarily.  The car dealer who tinkers with the odometer, the realtor with a referral incentive from the home inspector, and the obstetrician who withholds information and practices anti-evidence medicine ALL share in  the blame.  We definitely need to hold them accountable and stay ever-vigilant.

 

Look, I have a sister who makes a lot of foolish mistakes.  They're her choices, yes, and she has to live with the consequences.  But like anybody with a conscience who hates to see otherwise-innocent people get bruised, I feel frustrated that she keeps making them.  By that same token, the OP is perfectly reasonable in feeling frustrated by women who choose ignorance over critical thinking when it comes to maternity care.

 

By the way, I think the hyperbolic rhetoric of punishing women goes a bit over the top.  Bad decisions result in bad natural consequences, not Mommy License revocations.

 

 


 


In God we trust; all others must show data. selectivevax.gifsurf.gifteapot2.GIFintactivist.gif
Turquesa is offline  
#78 of 115 Old 02-01-2011, 01:29 PM
 
happysmileylady's Avatar
 
Join Date: Feb 2009
Posts: 1,193
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

I don't think you can have it both ways.  You can't say that every woman should get the birth she wants, then turn around and say that those who don't care are supposed to consider how another woman might want to birth when making her own choices (even if her own choices are to not make the decisions herself.)

 

 

You know, I have had 3 kids, all 3 vaginal deliveries, 2 of the 3 without epidural.  And you know, I just can't figure out what's supposed to be so special about med free birth.  Giving birth simply isn't that special to me.   People here often talk about how it's empowering or blissful or wonderful or whatever...I genuinely don't get it.  It is none of that to me.  It's a means to an end, being a parent. 

swede likes this.
happysmileylady is offline  
#79 of 115 Old 02-01-2011, 02:33 PM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by Turquesa View Post

 

Quote:
Originally Posted by stik View Post

It's *not* unreasonable for a woman to demand thorough, complete, accurate information.  It is unreasonable to judge a woman for not demanding that information if she doesn't feel it's of any use to her.

 

Every consumer needs to take responsibility for learning about what s/he's about to consume.  And it sounds like you agree with me::

 

 

Quote:
I feel strongly that it is not the responsibility of a woman in labor to consider any concerns other than her own concerns for herself and her baby.

 

Fair enough.  Let's work with that.

 

Imagine a consumer going to a lot to buy a used car.  She declines the Car Fax and test drive because "she doesn't feel it's any use to her?"

 

Imagine a consumer who goes to buy a house.  She declines the inspection and appraisal report, and she agrees to pay contingency-free whatever the seller is asking.  After all, none of that is "of any use to her."

 

Now imagine a consumer who goes to have a baby.  One way of having the baby poses greater risks to herself and her child, but she declines to investigate her options or question her doctor because such information "isn't any use to her." 

 

No, these scenarios aren't "the same thing."  But they do illustrate that by not advocating for ourselves, by willfully surrendering ourselves to ignorance and our power to those who profit from our decisions, we stand the risk of making a foolish mistake.

 

Are the bad decisions entirely the consumer's fault?  Not necessarily.  The car dealer who tinkers with the odometer, the realtor with a referral incentive from the home inspector, and the obstetrician who withholds information and practices anti-evidence medicine ALL share in  the blame.  We definitely need to hold them accountable and stay ever-vigilant.

 

Look, I have a sister who makes a lot of foolish mistakes.  They're her choices, yes, and she has to live with the consequences.  But like anybody with a conscience who hates to see otherwise-innocent people get bruised, I feel frustrated that she keeps making them.  By that same token, the OP is perfectly reasonable in feeling frustrated by women who choose ignorance over critical thinking when it comes to maternity care.

 

By the way, I think the hyperbolic rhetoric of punishing women goes a bit over the top.  Bad decisions result in bad natural consequences, not Mommy License revocations.

 

 


 


A better analogy for a woman who hires an OB she trusts and then follows her OBs advice would be a customer who declines the carfax, but has the car inspected by a trusted mechanic.  The car buyer might know little about cars, have difficulty making sense of the report, not usually need to know much about cars, and feel the need for an expert's assistance to choose a safe, reliable vehicle.  

 

Alternately, the consumer buying the house might decline the appraisal report because he or she feels extremely confident in his or her own ability to appraise the property and doesn't need the input of an outside expert.  And in this thread, that might be an analogy for a woman who chooses UP/UC.

 

I'm glad you see my point about the Mommy Licence revocation - bad decisions lead to natural consequences.  Judgment from other mothers is not a natural consequence.

 

Let me phrase my objections another way:

 

At what point do you, as an outside observer, become satisfied that someone else HAS done sufficient research, and her decisions are valid and should not be criticized?  What evidence would you have to see to make you feel that a woman who had a c-section or an induction had considered the decision carefully enough to be considered a thoughtful consumer?

swede likes this.
stik is offline  
#80 of 115 Old 02-01-2011, 02:37 PM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


"insisting that all women choose the low intervention route" is a total straw-man argument. Do you really, honestly believe that there is a sizable contingent of birth-activists who think all women should have low-intervention births? Because that is a silly idea.

 

I don't think I've EVER heard anyone say such a thing-- that "Every woman should have a low intervention birth."


 



Yes, I do think there is a sizable contingent of birth-activists who think all women should have low-intervention births.  They are quite vocal.  And yes, that is a silly idea.  But I have heard it many times.  

 

swede likes this.
stik is offline  
#81 of 115 Old 02-01-2011, 04:33 PM
 
Turquesa's Avatar
 
Join Date: May 2007
Posts: 4,038
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 45 Post(s)


Quote:
Originally Posted by stik View Post

Let me phrase my objections another way:

 

At what point do you, as an outside observer, become satisfied that someone else HAS done sufficient research, and her decisions are valid and should not be criticized?  What evidence would you have to see to make you feel that a woman who had a c-section or an induction had considered the decision carefully enough to be considered a thoughtful consumer?

 

I don't see those as objections but fair questions.

 

There's no one measurable place to draw the line, but it would certainly have to go beyond what the woman said in the OP:

 

Quote:
"I trust my doctor to make the decision for me."

 

Well, clearly that woman should NOT have been trusting her doctor because (assuming the story is accurate, which is admittedly a "maybe" since none of us were actually at that doctor's appointment),recommended something that goes against the evidence and poses unnecessary risk--namely, an induction based solely on Naegle's Law with no medical indication.  Whom we choose to trust is based on our personal feelings and not always what is ultimately best for us.  The most ethically minded physician with the world's greatest bedside manner could still go against the evidence.

 

To answer your question, I think I would have been satisfied with anything other than the aforementioned quote. 

 

"What if I did wait until I went into labor naturally?  What would be the risks and benefits?"

"Do you see something medically wrong with me or my baby that would require this?"

"I've been your patient for many years, and I really respect your opinion.  So I hope you don't take it personally if I seek a second opinion and get back to you with my decision."

 

There's no Magic Bullet question to ask, and there's no universal measure for savvy consumerism and healthy skepticism.  But it certainly goes beyond letting other people, who may or may not share your interests, make monumental decisions for you.  You'll never hear me or any other critical thinker say, "I trust my car dealer to make that decision for me."

 

Questioning somebody's advice or decisions doesn't make you fundamentally distrustful or cynical.  It doesn't mean you dislike your doctor or think all doctors are evil.  If Mother Theresa herself were my car dealer, I would still ask to see the Car Fax.  

 


 


In God we trust; all others must show data. selectivevax.gifsurf.gifteapot2.GIFintactivist.gif
Turquesa is offline  
#82 of 115 Old 02-01-2011, 05:10 PM
 
Tumble Bumbles's Avatar
 
Join Date: Oct 2009
Posts: 740
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 4 Post(s)


 

Brilliant reply Turquesa, I totally agree.


 

Quote:
Originally Posted by Turquesa View Post



Quote:
Originally Posted by stik View Post

Let me phrase my objections another way:

 

At what point do you, as an outside observer, become satisfied that someone else HAS done sufficient research, and her decisions are valid and should not be criticized?  What evidence would you have to see to make you feel that a woman who had a c-section or an induction had considered the decision carefully enough to be considered a thoughtful consumer?

 

I don't see those as objections but fair questions.

 

There's no one measurable place to draw the line, but it would certainly have to go beyond what the woman said in the OP:

 

Quote:
"I trust my doctor to make the decision for me."

 

Well, clearly that woman should NOT have been trusting her doctor because (assuming the story is accurate, which is admittedly a "maybe" since none of us were actually at that doctor's appointment),recommended something that goes against the evidence and poses unnecessary risk--namely, an induction based solely on Naegle's Law with no medical indication.  Whom we choose to trust is based on our personal feelings and not always what is ultimately best for us.  The most ethically minded physician with the world's greatest bedside manner could still go against the evidence.

 

To answer your question, I think I would have been satisfied with anything other than the aforementioned quote. 

 

"What if I did wait until I went into labor naturally?  What would be the risks and benefits?"

"Do you see something medically wrong with me or my baby that would require this?"

"I've been your patient for many years, and I really respect your opinion.  So I hope you don't take it personally if I seek a second opinion and get back to you with my decision."

 

There's no Magic Bullet question to ask, and there's no universal measure for savvy consumerism and healthy skepticism.  But it certainly goes beyond letting other people, who may or may not share your interests, make monumental decisions for you.  You'll never hear me or any other critical thinker say, "I trust my car dealer to make that decision for me."

 

Questioning somebody's advice or decisions doesn't make you fundamentally distrustful or cynical.  It doesn't mean you dislike your doctor or think all doctors are evil.  If Mother Theresa herself were my car dealer, I would still ask to see the Car Fax.  

 


 


Christ-centered loving wife & mama to 2 unschooled miracles! One & one . We live simply and mindfully. Expecting another blessing Feb 2015 Praying for another
Tumble Bumbles is offline  
#83 of 115 Old 02-01-2011, 10:49 PM
 
elisheva's Avatar
 
Join Date: May 2006
Location: BC
Posts: 1,432
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)

I think all the car dealer/OB analogy is misleading. In Western culture, car dealers (and not a few mechanics) are known to be slimy. OBs? Baby-saving gods. 

 

If a woman has an OB she has known and trusts, I can see her putting her faith in the OB's decision-making capacity. BUT, many women see an OB for the first time when they are already pregnant and therefore are vulnerable to the cultural belief that doctors are infinitely wiser than anyone else on the planet...

 

And (forgive me as I'm not as handy with the rhetorical devices most of you seem so comfortable with), the idea that a woman's decisions affect other women? Not so far-fetched. OBs aren't going to change their practice. ACOG is going to support OBs. Who exactly is responsible for affecting change if not patients themselves? As long as doctors hold an unnaturally superior place in our society, nothing will change. It's up to women to speak up for themselves. I could go into why I think we all have such trouble speaking up for ourselves (CIO, institutional public schooling), but then I would really have to dig out my tinfoil hat. 


"So let us be loving, hopeful and optimistic. And we’ll change the world." - Jack Layton
 
 
 
   

elisheva is offline  
#84 of 115 Old 02-02-2011, 05:04 PM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Doctors *are* changing their practices.  Practices that were common in the 1950s and 60s are almost completely unheard of now.  How many hospitals in the US deny laboring women a support person of their choosing?  How many still routinely shave women and administer enemas?  Episiotomy rates have declined dramatically in response to research showing that they usually cause more harm than good.  Change is happening.

 

And even women who trust their doctor's decisions are not brainwashed automatons.  And I don't know if you'd noticed, but society in general is not exactly held captive by the belief that doctors are infinitely wiser than everyone else.  I don't know where people get the idea that doctors occupy an unnaturally superior place in society.  They are experts on a topic, and they don't get treated substantially differently than any other set of professional experts. 

swede likes this.
stik is offline  
#85 of 115 Old 02-03-2011, 06:34 AM
 
jeminijad's Avatar
 
Join Date: Mar 2009
Posts: 896
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)


Quote:
Originally Posted by stik View Post

Doctors *are* changing their practices.  Practices that were common in the 1950s and 60s are almost completely unheard of now.  How many hospitals in the US deny laboring women a support person of their choosing?  How many still routinely shave women and administer enemas?  Episiotomy rates have declined dramatically in response to research showing that they usually cause more harm than good.  Change is happening.

 

And even women who trust their doctor's decisions are not brainwashed automatons.  And I don't know if you'd noticed, but society in general is not exactly held captive by the belief that doctors are infinitely wiser than everyone else.  I don't know where people get the idea that doctors occupy an unnaturally superior place in society.  They are experts on a topic, and they don't get treated substantially differently than any other set of professional experts. 



Excellent post.

 

I tend to be troubled by the agression that women are greeted with here when they choose to follow the advice of a recognized (by the govt, licensing bodies, and much of the public) expert in a field. No one here comes on and rants that they disagree with their architect, or chemical engineer... it is recognized that the consumer does not have the expertise to do so (or the ability to gain such expertise via Google.) The types of reading available to me- Henci Goer, Ricki Lake, or even an uninformed reading of extracts of PubMed studies does not make me an expert. If other women feel that such reading does make them an expert, that is their prerogative, no matter how strongly I disagree with them... so give women choosing to trust an expert the same courtesy.

 

It is not ignorant, it is not lesser. It is just their choice.

swede and matte like this.

Mother to R- 2/09, & C- 5/11

jeminijad is offline  
#86 of 115 Old 02-03-2011, 07:46 AM
 
Tumble Bumbles's Avatar
 
Join Date: Oct 2009
Posts: 740
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 4 Post(s)

No one once said that evaluating and choosing to follow the advice of a trusted professional was a bad thing. Not once, in this entire thread -- so I don't know where anyone got that idea.

 

The thread was about a woman letting her doctor make decisions for her in lieu of her actually making a decision herself or taking responsibility for it without any consideration that it may not be the best thing for her or her baby, and without even taking the responsibility of making the decision herself based on his advice. There is a huge difference between carefully considering your caregivers' advice and choosing to take it and blindly saying you are allowing your caregiver to "make the decision for you". 

 

The situation in the OP was a woman agreeing to an arbitrary induction for no other reason than it was to be on her "due" date which anyone who has researched even the very basics of human gestation time knows can vary up to 5 weeks or more and that the vast majority of babies, when allowed to come on their own time, come after the alleged "due date". You don't have to be an "expert" to know that very basic information. The fact that people are crying "what's wrong with her trusting a professional" knowing that the most basic of information he is giving her is potentially harmful worries me.

 

So yeah, that's what's wrong with women blindly trusting their OBs to make their decisions for them -- because they aren't always the best or even most informed or "expert" decisions, and it does help shape maternity "care" at large, like it or not.


Christ-centered loving wife & mama to 2 unschooled miracles! One & one . We live simply and mindfully. Expecting another blessing Feb 2015 Praying for another
Tumble Bumbles is offline  
#87 of 115 Old 02-03-2011, 09:25 AM
 
MegBoz's Avatar
 
Join Date: Jul 2008
Location: Baltimore, MD
Posts: 2,063
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by stik View Post

And I don't know if you'd noticed, but society in general is not exactly held captive by the belief that doctors are infinitely wiser than everyone else.  I don't know where people get the idea that doctors occupy an unnaturally superior place in society.  They are experts on a topic, and they don't get treated substantially differently than any other set of professional experts. 


I totally disagree with this. I think the view of, "Ask your doctor" is very ingrained in American culture. One thing pops to mind is a magazine advertisement I saw (from the corn grower's association.) One woman says, "My hairdresser says high fructose corn syrup is bad for you - worse than sugar."

The other woman replies, "When did you start having a doctor cut your hair?"

Um, yeah, the average American MD actually has very little education in nutrition. But it's something medically-related, so we associate docs as the experts.

 

& how many books state, "Ask your doctor"? You read it all the time. People even SAY it! "Oh, your doctor is going to LET YOU go to 42 weeks??!" etc.

In other words, they don't view the doc as merely "an expert with specialized knowledge" like they would an engineer - they view doc's word as law & you are considered crazy to even THINK of disagreeing. I think the typical American view of docs is quite different from that of other professional experts.


Heck, I had the care of hospital-based CNMs with my DS & so far as my Mom & MIL know, I'm seeing the same practice this time around. MIL still occasionally says, "What does the doctor say?" Baby #2 and she still can't wrap her head around the fact that midwives are my care providers. It's all about what the doc says!

 

Quote:
Originally Posted by jeminijad View Post

No one here comes on and rants that they disagree with their architect, or chemical engineer... it is recognized that the consumer does not have the expertise to do so (or the ability to gain such expertise via Google.) The types of reading available to me- Henci Goer, Ricki Lake, or even an uninformed reading of extracts of PubMed studies does not make me an expert. If other women feel that such reading does make them an expert, that is their prerogative, no matter how strongly I disagree with them... so give women choosing to trust an expert the same courtesy.

 

It is not ignorant, it is not lesser. It is just their choice.

 

Well, I haven't done any investigating of the issue, but so far as I know, there's not currently an epidemic of architects & chemical engineers doing things that are known to cause harm & are not in their client's best interest. If such an epidemic DID exist, then I would also advocate not blindly trusting these professionals.

 

& while you are correct that reading Henci Goer doesn't make us experts, reading that sort of literature CAN provide us with an abundance of knowledge about normal healthy birth-- and the fact that interventions have negative effects. I have no doubt, & feel absolutely & completely confident stating that I'm an "expert" about the fact that "nothing by mouth" & cEFM for all low-risks births are bad things. The science is abundant & clear. Even other national Ob/GYN organizations like NICE guidelines in the UK and the Canadian OB org discourage these practices!

 

THEREFORE... if an HCP follows those 2 things (and bans, or strongly discourages doulas), then that is a doc that ought not to be trusted, IMO. 

 

In other words, in some cases, it really is not that hard to pick out bad advice. And there is so much bad practice & bad advice being done in American maternity care.

 

 

Quote:
Originally Posted by Tumble Bumbles View Post

anyone who has researched even the very basics of human gestation time knows can vary up to 5 weeks or more and that the vast majority of babies, when allowed to come on their own time, come after the alleged "due date". You don't have to be an "expert" to know that very basic information. The fact that people are crying "what's wrong with her trusting a professional" knowing that the most basic of information he is giving her is potentially harmful worries me.

 

So yeah, that's what's wrong with women blindly trusting their OBs to make their decisions for them -- because they aren't always the best or even most informed or "expert" decisions, and it does help shape maternity "care" at large, like it or not.


Yes, exactly! That's the point I was trying to make - sometimes bad advice is very obviously bad advice, even coming from a "trusted expert." so I'll add recommending induction on due-dates for ZERO medical reason as another issue that would make me cry, "DON"T TRUST THAT HCP!"

MegBoz is offline  
#88 of 115 Old 02-03-2011, 03:04 PM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

Women in all kinds of situations make decisions for themselves that are contra-indicated by the research on an issue for populations in aggregate.  It's not just women who have OB care - women who choose home birth or midwifery care also choose to ignore some research-supported recommendations because of their views on their personal situations or because of the advice of their HCPs.  Research indicates that home birth with a qualified midwife leads to higher rates of perinatal infant and maternal mortality in low-risk pregnancies.  Why is it peachy keen for a woman to evaluate her situation with a midwife and choose home birth despite these increased aggregate risks, but a cause for concern if a woman chooses a scheduled induction on her doctor's advice?  

 

Further, people tend to keep the reasoning behind their health care decisions private.  It's a lot easier to say, "I trust my doctor" than it is to say, "Well, my blood pressure is starting to climb a bit, three of my sisters had pre-eclempsia, and I've got a bad feeling about this, and when I talked to my OB she said there was no indication that an early delivery was called for, but she agreed to induce on my due date in response to my medical concerns and my obvious anxiety."  And no one deserves that longer explanation unless the woman making the decision voluntarily chooses to share it with them.  I'm kind of boggled that anyone would ask a mother to share personal information, like why she's having a scheduled induction, in the first place.  

 

Ammaarah, Mamja, swede and 1 others like this.
stik is offline  
#89 of 115 Old 02-03-2011, 04:56 PM
 
Tumble Bumbles's Avatar
 
Join Date: Oct 2009
Posts: 740
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 4 Post(s)

The "research" you cited is from an incredibly flawed and inaccurate study that has is highly debated and completely contradicts lots of earlier studies, one published in the British Journal Of Medicine as recently as 2005 to name one. So you pick your "studies" to suit your argument and I'll pick mine. They are all moot, really.

 

The point is, and the KEY words in your reply were: (bolded mine)

 

Quote:
 Why is it peachy keen for a woman to evaluate her situation with a midwife and choose home birth

 

Evaluate. Choose. Two things that aren't being accomplished when someone says they allow their OB to choose for them, the point of this thread.

 

If someone told me they allowed their midwife to "make that decision for them" no matter what it was, it would be met by the same level of annoyance, from me anyway.

 

I am always miffed when a person (especially a woman, since I am one) completely removes herself from the equation in a decision that directly effects her health or well-being.


Christ-centered loving wife & mama to 2 unschooled miracles! One & one . We live simply and mindfully. Expecting another blessing Feb 2015 Praying for another
Tumble Bumbles is offline  
#90 of 115 Old 02-03-2011, 06:56 PM
Banned
 
stik's Avatar
 
Join Date: Dec 2003
Posts: 1,860
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)

You make a good point.  There's a lot of research on obstetrics out there, much of it contradicted by other research.  It can be confusing.  You really can't blame an over-whelmed anxious mom for doing whatever her doctor says usually works out OK.  What else can she turn to?  A good birth experience is all about having a trusting relationship with a supportive care provider, and at least the mom in the OP has that.  I wish her all the best.     

 

The other key point that I'm trying to make is that most women consider information about their health care decisions to be very private.  I don't know what actually took place between the woman in the OP and her doctor in the privacy of the doctor's office.  Despite what the woman said, the OP doesn't know either.  

 

Regardless of the language a woman uses to end a conversation about her very private decisions, she did, in fact, make a choice.  Even allowing a doctor to choose for her is making a choice.  But IMO, what a woman is really saying when she says that she trusts her doctor to choose for her is, "this is very private, and I'm not going to discuss it with you." 

swede likes this.
stik is offline  
Reply

User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off