[aiyasmama]

My closest friend from childhood is an OB. I'm sure she is a wonderful doctor but she is still heavily influenced by her culture and of course she's concerned about my upcoming HBAC. She has never said anything that is outright unsupportive, but she has mentioned concerns about rupture and has questions about what my lay midwife is doing for prenatal care, etc. It is really hard for me to talk about my homebirth with her, and when I mentioned that in an email recently she wrote back that she is trying to be supportive and open-minded but that she doesn't feel that I am trying to be respectful of obstetrics. I'm sure I've said things that are offensive to her even though I try to tone it (way) down. But I don't know how to talk about it! I wish I could honestly say that I respect what she does but I don't know that I really do. I want to say things like...Why aren't you outraged that we are ranked so low in maternal and newborn fatalities?...Do you realize that so many common practices in obstetrics haven't been proven safe or effective?...Why is it ok with you that a pregnant woman's risk of major surgery goes way up just because she walks into the hospital?...Do you understand that control over her birthing is a fundamental woman's right that is being violated over and over in our country?...but I never do.
So, am I just unreasonably angry about these things, and is there a way that I could reframe my thinking so that I am being more respectful of my friend's career? Is there a productive way to talk about these issues with an OB? My friend is so important to me, but so is my integrity.

Thank you for letting me vent and I would really appreciate any insights/feedback!

 

[ShwarmaQueen]

Quote:

Originally Posted by aiyasmama I want to say things like...Why aren't you outraged that we are ranked so low in maternal and newborn fatalities?...Do you realize that so many common practices in obstetrics haven't been proven safe or effective?...Why is it ok with you that a pregnant woman's risk of major surgery goes way up just because she walks into the hospital?...Do you understand that control over her birthing is a fundamental woman's right that is being violated over and over in our country?...but I never do. So, am I just unreasonably angry about these things, and is there a way that I could reframe my thinking so that I am being more respectful of my friend's career? Is there a productive way to talk about these issues with an OB? My friend is so important to me, but so is my integrity. Thank you for letting me vent and I would really appreciate any insights/feedback!

Talk to her! But don't come across as blaming her. She's already brainwashed so I don't think it's possible to totally undo her mentality! Although as her friend, you do have the unique opportunity to get inside her mind and share your feelings/concerns with her. I wish I could openly dialogue with an OB! I don't think it has to come across as confrontational or hostile, just talk to her like you're talking about anything else! (Only keep it cool!)

 

[Ruthla]

Honestly, I think you should not discuss birthing politics/medicine with her right now. It's too volitile a topic for both of you, and you're not going to see eye-to-eye on this. Especially right now, when you're pregnant and vulnerable, is just not the time to try and "win over" a friend with a completely different approach to pregnancy.

She can't help but see pg as something doctors need to "manage", and she's probably honestly concerned about your safety. But there's no way she can express her concerns without it coming across as doubting you, and there's no way you can explain the midwifery model without coming across as defensive.

I think you should "agree to disagree" about this topic. Explain to her that you're pregnant and hormonal, and this just isn't a good time for you to spend energy defending your choices. Then focus on the things you DO have in common, how long you've been friends, etc.

Perhaps, over time, (especially after having your sucessful HBAC) she'll become more open-minded (less scared for you!) and you'll be more confident and less angry about the topic. But right now you really need to focus your energies on yourself, not on being defensive or educating anybody else.

 

[jennyfah]

I agree with Ruthla. I think that you need to create a really positive, encouraging birthspace for yourself, and spending a lot of time/energy debating birth practices in the US would be draining and bad for your serenity!

I know it's hard to not talk about something as incredibly important as your upcoming birth, but if you think it would be stressful for you to engage in that kind of talk, it's probably best at this time to just gently steer the conversation toward more neutral territory. You can save your homebirth talk for your midwife and supportive family/friends, and of course MDC!

Of course, after you have your beautiful HBAC, you can gently point her in the direction of all the great research about the safety of homebirth, and eventually get her to read "Born in the USA" by Marsden Wagner. . . maybe.

 

[MamaQuest]

I agree now is probably not the time to discuss birth at all with her. My sister is married to a wonderful family practice doctor who also delivers babies. She and I just do not, EVER, discuss birth and pregnancy now. When we planned for our first homebirth, she and I had enough arguments (very civil of course, but perhaps because of that even more hurtful) that now we just never even go there. She's under the impression we're playing russian roulette with our baby's life, and nothing I can say would change that. I still love her dearly, and we find many other things we have in common to discuss. In a way, it has helped deepen my relationship with her, as we both try harder to find more things to talk about and share.

It is hard sometimes to not share that particular aspect of my life with her. It's a huge part of who I am, over the last several years, and takes a great deal of my time and thoughts. And yet... I can say I am much happier in general, with my relationship with her now, when we stay on "safe" ground. I am a deeper person as well, as I try to add depth to my life that I can share with her.

 

[TzippityDoulah]

I think it may not be worth talking about. you both have such varying views on the subject, maybe you should agree to just NOT go there. you already know you disagree.

and maybe if she wnats to have a sit down and talk it through rationally once just to get it all out ont he table that might work... btu really? she has a lot invested in her career, so I doubt she would hve some life changing epiphany after talking to you. likely she'll just be defensive and so will you.

maybe agree to disagree and leave it alone.

 

[GoldmanBaby09]

While it might be best to stave off conversation when you feel so passionately about it, I think that your friend needs to understand that you have already seen it from her side. You have already had a c/s and I'm guessing by the fact that you are seeking a hb now, that that experience left you wanting something else for your next birth. If your cs was planned, and even more so if it wasn't and you got caught in the "cascade effect", it is understandable to want to see what else is out there once you have seen all that modern medicine has to offer. And at best, I think your friend should be able to see, hey, she did it my way the first time, and she is unhappy with what it brought her. Hopefully she can commiserate a disappointment as a friend, even if she can't understand it as a doctor.

 

[Comtessa]

Quote:

Originally Posted by aiyasmama I wish I could honestly say that I respect what she does but I don't know that I really do.

This, to me, is the key to your post: there's certainly no question that you respect your friend, but the culture to which her career choices have her bound is something that you have serious concerns about.

I have several friends who have chosen careers doing things with which I emphatically disagree. Their careers require them to make choices that really conflict with the values they claim to hold, and choices which certainly conflict with my values too.

It has been VERY hard for me to talk with these friends about their jobs, but it's equally hard for me to keep my mouth shut when I feel so strongly about what they're doing... for one thing, it would be inauthentic of me to avoid the topic with them, and I'd just end up building a wall between myself and my friends. This, I can't bear.

So, I understand your frustration here. The PP's are right, it would be most peaceful to not say anything (at least for the moment), but it can also become the elephant in the room, especially because your upcoming birth is so much a part of your life (and therefore hers, since she cares about you). The last thing you want is a friendship that is civil but can't talk about the things that matter the most.

So, I'm going to disagree with the PP's and suggest that you not avoid discussing the topic with her. Stay close to her, and be honest about your disagreement, but don't stay away from the topic just because you disagree on it. BUT, you have to find a way to have the conversation that is genuine, respectful and loving. Here's what has worked for me:

- I use a lot of "I" statements that avoid judgment of the other person. For example, "I am really afraid of having to go through another C-section." That's something she can sympathize with, because your fear is real, and it's personal.

- I often follow up my statements with a question about their experience. I ask a LOT of questions, and then really really try hard to Listen to the answers. Open-ended questions (rather than yes or no questions) can help. For example, you could say something like, "What is your experience with deciding to do C-sections? What sorts of things do you have to consider when you make that decision?" Then you can learn a bit more about how she feels about that specific thing. Sometimes it's easier to find common ground on a smaller issue (i.e., 'maybe we really do too many C-sections in this country') than a bigger one (i.e., 'maybe obstetrics practices medicine irresponsibly').

- I will try to find positive personal things to say about their choices, because usually that leads to them saying positive things about MY choices. I also try to suggest how I would feel if I were in their shoes. For example, "I really appreciate that you're in a field that saves babies' lives when they're at risk. It must be really difficult to lose babies and mothers even when you're trying so hard to keep everybody safe." That conversation can lead into an honest discussion, then, which is still personal. I.e., "Do you think that obstetrics is going overboard with dangerous interventions because the doctors are just trying too hard to keep people safe? Is it because it's so heartbreaking to lose a patient? Is there another way to handle this, do you think?"

- If things start to get heated or personal, I change the subject pretty quickly, or I say something like, "I guess I'm just struggling to understand your point of view, but I care about you and I really want to understand. I don't want to fight, though. Let's keep talking about this another time."

Good luck mama! Warm thoughts for you AND your friend as you navigate this difficult journey together!

 

[lisa_nc]

I would say something along the lines of "I hope you know how much I appreciate your support, even if you don't agree with my choices. We both know where we stand, but I am really thankful that our friendship is strong enough to be more important than our differences. I am so happy that I have my midwife but I hope that if I am ever in a high risk or emergency situation that I have an OB who cares as much about me as you do."

 

[Overthemoon]

Quote:

Originally Posted by aiyasmama My closest friend from childhood is an OB. I'm sure she is a wonderful doctor but she is still heavily influenced by her culture and of course she's concerned about my upcoming HBAC. She has never said anything that is outright unsupportive, but she has mentioned concerns about rupture and has questions about what my lay midwife is doing for prenatal care, etc. It is really hard for me to talk about my homebirth with her, and when I mentioned that in an email recently she wrote back that she is trying to be supportive and open-minded but that she doesn't feel that I am trying to be respectful of obstetrics. I'm sure I've said things that are offensive to her even though I try to tone it (way) down. But I don't know how to talk about it! I wish I could honestly say that I respect what she does but I don't know that I really do. I want to say things like...Why aren't you outraged that we are ranked so low in maternal and newborn fatalities?...Do you realize that so many common practices in obstetrics haven't been proven safe or effective?...Why is it ok with you that a pregnant woman's risk of major surgery goes way up just because she walks into the hospital?...Do you understand that control over her birthing is a fundamental woman's right that is being violated over and over in our country?...but I never do. So, am I just unreasonably angry about these things, and is there a way that I could reframe my thinking so that I am being more respectful of my friend's career? Is there a productive way to talk about these issues with an OB? My friend is so important to me, but so is my integrity. Thank you for letting me vent and I would really appreciate any insights/feedback!

My Uncle is an OB/GYN and my Aunt a retired labor and delivery nurse, and my Mom is a ultrasound sonographer for a high risk practice. So as you can imagine I've had some issues with family and them accepting me doing a homebirth. Though my Uncle is 2800 miles away, he has offered to deliver me anywhere I preferred (which I declined). All my family is very far so they will not be here for the birth. My Mom has been the most vocal with her worries and opposition. But I've told my family, this is my choice, it's the way I want to do things and I feel good about my choice. I did have to tell my Mom to back off and she has been respectful of that.
Maybe set boundaries with your friend and just agree to not talk about birth and where it's going to take place and agree to each have your own opinions.

 

[PassionateWriter]

Quote:

Originally Posted by aiyasmama My closest friend from childhood is an OB. I'm sure she is a wonderful doctor but she is still heavily influenced by her culture and of course she's concerned about my upcoming HBAC. She has never said anything that is outright unsupportive, but she has mentioned concerns about rupture and has questions about what my lay midwife is doing for prenatal care, etc. It is really hard for me to talk about my homebirth with her, and when I mentioned that in an email recently she wrote back that she is trying to be supportive and open-minded but that she doesn't feel that I am trying to be respectful of obstetrics. I'm sure I've said things that are offensive to her even though I try to tone it (way) down. But I don't know how to talk about it! I wish I could honestly say that I respect what she does but I don't know that I really do. I want to say things like...Why aren't you outraged that we are ranked so low in maternal and newborn fatalities?...Do you realize that so many common practices in obstetrics haven't been proven safe or effective?...Why is it ok with you that a pregnant woman's risk of major surgery goes way up just because she walks into the hospital?...Do you understand that control over her birthing is a fundamental woman's right that is being violated over and over in our country?...but I never do. So, am I just unreasonably angry about these things, and is there a way that I could reframe my thinking so that I am being more respectful of my friend's career? Is there a productive way to talk about these issues with an OB? My friend is so important to me, but so is my integrity. Thank you for letting me vent and I would really appreciate any insights/feedback!

why do you need to be respectful of her career at this point in time?

this is YOUR pregnancy. as YOUR friend, she needs to be supportive of YOU. If she isn't then change the subject. Period.

i cant even imagine. well, i guess i can, sort of. One of DP's very close friends is a Dr. and his wife is pregnant right now. i think they aren't spending as much time with us....for that reason alone. They like hospitals, believe the hype surrounding all the interventions, etc. etc. etc. However, this is HER pregnancy and other than seeing my rants on Face Book, she and I do not discuss child birth. I suggest making the same deal w/ your friend.

If she can't agree to that, i suggest backing off. Having a toxic person (even well meaning one) in your pregnancy and head at birth is NOT a good idea.

 

[Super~Single~Mama]

I birthed in a FSBC about 3 months ago, but when I was telling friends that i was using a midwife and not birthing in a hospital and they expressed concern I would say something like "I know that there are circumstances when OB care is very important, and I understand that there are pregnant women who b/c of complications or health problems need to birth in a hospital b/c it is the safest option for them - but for my healthy and normal pregnancy I've come to the conclusion that I will best avoid a c/s or other interventions that are unnecessary if I birth outside the hospital." (I would also mention some of the reading/research that I had done) They all seemed to get and understand that. As long as you make it clear to her that you respect and understand that OB's have their place caring for pregnant women in certain circumstances, and you just don't feel that you are in one of those circumstances I think you and your friend can respect each others positions on this subject.

 

[Malva]

I don't think I'd discuss it with her at all.

The way I think of it, getting an OB for a normal pregnancy is like hiring a neurosurgeon to do a routine physical exam - way overkill and not an optimal use of resources.

I feel the same way about peds: a child without any conditions requiring regular monitoring should be fine with a GP, freeing the ped for kids who really need them.

Funnily enough, our GP had midwifery care for her 4 kids's births.

 

[BtotheG]

I think if you do choose to discuss it with her, I would just stick to the facts, and leave out the emotion- and opinion-based reasons for homebirth. And the facts are that women who give birth in hospitals receive far more medically unnecessary interventions than women who give birth at home. These interventions pose increased risks to both mothers and babies.

Homebirth has been shown to NOT be riskier than hospital birth - and when all risks are looked at (not just death) homebirth is far LESS risky.

Your OB friend can argue opinions, or emotions, or fear, or birth politics, or hospital policies, or financial or legal concerns, but she cannot argue the facts.

For me personally, the more research I've done, the more I've decided it's a pretty black and white issue for me. I cannot, in good conscience, accept the increased risk for myself and my baby that giving birth in a hospital would entail. No matter what anyone thinks about it, or feels about it, or how much they would like to believe the "truthiness" that a hospital birth is safest - that's just not reality.

 

[Gena 22]

Quote:

Originally Posted by BtotheG I think if you do choose to discuss it with her, I would just stick to the facts, and leave out the emotion- and opinion-based reasons for homebirth. And the facts are that women who give birth in hospitals receive far more medically unnecessary interventions than women who give birth at home. These interventions pose increased risks to both mothers and babies. Homebirth has been shown to NOT be riskier than hospital birth - and when all risks are looked at (not just death) homebirth is far LESS risky. Your OB friend can argue opinions, or emotions, or fear, or birth politics, or hospital policies, or financial or legal concerns, but she cannot argue the facts. For me personally, the more research I've done, the more I've decided it's a pretty black and white issue for me. I cannot, in good conscience, accept the increased risk for myself and my baby that giving birth in a hospital would entail. No matter what anyone thinks about it, or feels about it, or how much they would like to believe the "truthiness" that a hospital birth is safest - that's just not reality.

:

Very well put, and good advice for talking to anyone! There are aspects to home birth I love, not driving during labor, better chance of early bonding, etc., but these and other "emotional" or "convenience" reasons are too personal to bring up as an advocate. The facts are plenty strong enough!

 

[billikengirl]

I'd be interested to know what you could do, besides start to fear birth and bring it into the hospital, that would be sufficiently respectful in her eyes.

I have a medical friend that deals with OB a lot and after she told me about their 80+% induction rate, how dangerous VBACs are, and patronizingly told me "there's a lot worse things than a c-section" in my first phone call to tell her I was pregnant, I've decided we just can't discuss it. Her truth and mine (on this subject) simply cannot meet up too much if we're to remain friends.

 

[MegBoz]

Hmm, I certainly can see how it'd be best to avoid the subject so as not to be stressed while PG.
As a lady who's not PG at the moment though, I would be tempted to say, "Please read the book Born in the USA by Dr. Marsden Wagner & then we'll talk"

His book sorta sums it all up, IMO.

 

[Romana]

I just wouldn't discuss it with her. However, if you were to discuss it with her, I would pull out the questions you have and rephrase them in a less confrontational manner, and then just go ahead and ask. You have to be able to have the conversation without getting emotional or upset, though. She feels certain in her knowledge because of what she's learned and how. However, you can both learn something if you can have a respectful discussion.

I would start with one question that you'd like to understand her perspective on. Take it from that approach - I'd like to understand your perspective on this issue and understand what you've learned about it. Would you please explain it to me from your point of view and level of knowledge? Then ask your question. Listen to what she says, and don't argue with her, but feel free to offer counter-evidence. See what your friend has to say about your counter-evidence.

It can be a learning experience. Really, there is no 100% right nor 100% wrong. We may get to a point where c-section is the safest way to give birth (i.e. results in fewest deaths for moms and babies). That doesn't necessarily mean that it justifies every woman undergoing major abdominal surgery to have a baby. However, her perspective is much more on the track of "If there's any doubt, go to c-section to make sure everyone gets through okay" versus your track of "Unnecessary surgery is bad for women and babies and should be minimized." She would agree with that assertment but still practice the way that she does because, to her, unnecessary surgery - even a lot of unnecessary surgery - is far less bad than a dead baby. We would probably agree in the specific instance, but not overall.

OBs practice defensive medicine and are always waiting for something to go wrong. They're also taught that the best defense is a good offense, so make sure that when in doubt, you intervene. Control is a big part of it - not in an egotistical way (though that may be true for some) but rather in an "I feel more comfortable with a set of factors I can monitor and control than with a set of more unpredictable factors that don't fall within my typical experience."

I hope that makes sense. I have a good friend from childhood who is also an OB. We've had many very interesting conversations about birth and the conversation is ongoing. We learn from each other and gain new perspective. I don't agree regarding many of the practices standard to her work, but can nonetheless understand why she does what she does and be respectful of the difference of perspective, training and experience.