# Why???!!!! So frustrating.



## limette (Feb 25, 2008)

I responded to an woman saying her doctor was planning a possible induction if baby isn't here by her due date (for no other reason).

Her response was;

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

Why are people so naive? Make the decision to induce by all means, but make it yourself and be informed about it.

Next week I'll be hearing about a failed induction, c-section and how the doctor saved her life.

Sorry for the vent.


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## lexapurple (Dec 24, 2006)

If you allow someone else to makes decisions for you, than you are not responsible for what happens and have somebody else to blame. It is a safe way to protect yourself.


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## swede (Nov 21, 2010)

I think that is a little harsh. I don't know that most woment who "allow their doctors to make all the decisions, or who trust their doctors" are thinking of who they are going to blame if somethign goes wrong. Sometimes there is just too much to know. Some women may not have the time to become "experts". Even with their own childbirth.


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## msmiranda (Apr 22, 2009)

I always get frustrated at those stories too, and I repeat, "not my baby, not my birth" like a mantra. I guess over time I have come to terms with the fact that most women do not care about birth the way the women on this board do. It's just not something they care to focus on (or don't have time, or whatever). There is nothing that we can do about it except maybe try to plant a small seed of doubt and hope they follow up on it. Most won't, but a few might. What's too bad is that after that first section, the rest of a woman's reproductive life can be complicated by her not having cared the first time around. I think that isn't a concern for most OBs in part because they focus on liability in the instant situation, and because most women only want 2 children. I always say, "I can't save anyone else. I can only save myself."


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## limette (Feb 25, 2008)

As someone who researches every decision I make (sometimes for years) it bothers me when people are willfully ignorant. Bringing a child into the world is the most important thing a person can do. To be so blase about it and let someone else make all the decisions about it is insane to me.


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## Full Heart (Apr 27, 2004)

Last year I was at a baby shower and the woman said she was having a c/s because the placenta was in the way (She had complete previa) and she had never heard of it. All the other women had never heard of it either. One of those women was my mother, who had 6 of her own. She looked at me and asked if I had ever heard of it and I must have had this look of shock on my face that here were all these mothers and not one had heard of placenta previa! There really are some women, obviously, who are just not educated about their bodies, pregnancy and birth. Its much easier for them to let their drs make decisions because they don't feel comfortable making decisions about things they really have no clue about. Yes, they could educate themselves but most don't even know they need to. For lots and lots of reasons, they have no clue that they should be educating themselves, they don't know what informed consent is or why they would need it.


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## Storm Bride (Mar 2, 2005)

Quote:


> Originally Posted by *Full Heart*
> 
> Its much easier for them to let their drs make decisions because they don't feel comfortable making decisions about things they really have no clue about. Yes, they could educate themselves but most don't even know they need to.


I really think this is one of the keys. When I was pregnant with my first, I talked to everyone I knew about their pregnancies (I was the first in my circle, so this was almost all women of my mom's generation and a few somewhat younger coworkers). I found out everything I could about how things worked out for them and what went wrong or right.

I read - viirtually memorized - a local publication called "Baby's Best Chance" (government publication, given free - with a prescription, of all things - to every pregnant woman in the province) and its information on possible interventions and why they might be needed, and on nutrition and self-care during pregnancy and labour positions, etc. etc. etc. It didn't mention any placental issues. It skipped a lot of things I've learned since. But, the major omission, imo, is that it didn't even refer to them. I can see that a smallish book doesn't really have room to go into placental issues, long-range issues from c-sections, etc. etc. But, the book could have included at least brief mentions of these things with a recommendation to do further reading if one was interested/concerned. Instead, the book always, always, always came back to "if you have any questions, please talk to your health care professional" (it was "doctor" in the original version, but midwifery was legalized by the time I had my second baby). How can I ask questions if I don't know something exists?

I read several other books, although I can't remember what they were all called. They were all pretty much the same - descriptions of a normal pregnancy, and normal in utero development, and a few mentions of the better known complications, interventions, etc (eg. Down's Syndrome, miscarriage, c-sections, epidurals, position changes...but with no actual mention that movement could actually ease pain). So...where does a person find information about placenta previa, if nothing that person is exposed to even acknowledges the existence of such a thing?

The one advantage I had was that I don't believe doctors are all-knowing. And, most of the things that could happen didn't. What did happen is something I've had "experts" repeatedly deny is even possible (my son turned breech during labour). I will say that none of the reading I did included the sentence, "if your medical team feels that a c-section is necessary, they won't care if you say "no" and you'll be on your way to OR". But...not sure what I could have done about that, anyway. I don't really think that my situation fell under the "if I'd known more" umbrella, but I could have been in those shoes very easily. I suspect the woman in the OP simply feels that doctors know everything about their field and she couldn't possibly acquire enough knowledge to matter over the course of a pregnancy. It's not uncommon.


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## Turquesa (May 30, 2007)

Paraphrased: If you don't know your options, you don't have any.

Quote:


> Originally Posted by *lexapurple*
> 
> If you allow someone else to makes decisions for you, than you are not responsible for what happens and have somebody else to blame. It is a safe way to protect yourself.


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## CI Mama (Apr 8, 2010)

Quote:


> Originally Posted by *swede*
> 
> I think that is a little harsh. I don't know that most woment who "allow their doctors to make all the decisions, or who trust their doctors" are thinking of who they are going to blame if somethign goes wrong. Sometimes there is just too much to know. Some women may not have the time to become "experts". Even with their own childbirth.












I thought I had educated myself well and was ready for child birth. HA! With the wisdom of hindsight (and a lot of harsh lessons learned through my 33-hour labor and eventual c-section), I realize how little I really knew or understood about this amazingly complex thing that is called "birth." I feel like I could keep reading & learning & hearing stories for the rest of my life, and I still wouldn't know everything there is to know about the great variety of ways that women bring their babies into the world.

We all have to put our trust in something as we journey from pregnancy to motherhood, and some choose to put that trust in their doctors. Sometimes that trust is misplaced; sometimes it's not. Some of us suffer on the road to motherhood; I wish it could be otherwise.

Some women are thrilled to be pregnant, ready to embrace all the challenges & responsibilities of that journey, and have access to great support and resources that help them feel confident and joyful every step of the way. Some women are terrified to be pregnant, feel overwhelmed by the challenges & responsibilities that they face, and don't have the support or the resources to manifest an ideal outcome. I would guess that most of us fit somewhere in between those extremes.


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## jeminijad (Mar 27, 2009)

Quote:


> Originally Posted by *limette*
> 
> As someone who researches every decision I make (sometimes for years) it bothers me when people are willfully ignorant. Bringing a child into the world is the most important thing a person can do. To be so blase about it and let someone else make all the decisions about it is insane to me.


"Willfully ignorant" does not seem to be the appropriate term for someone who has employed a professional deemed by society to be qualified to attend her birth. Neither does the blanket statement that bringing a child into the world is "the most" important thing a person can do. People can drastically change the world for good, in ways many would judge more impactful than childbearing- childless people, even!

Birth seems incredibly important to you. Do not make the mistake of deciding that others are lesser because they have different priorities, or have done the same reading you have and came to different conclusions (the boat I am in.)


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *msmiranda*
> 
> I always get frustrated at those stories too, and I repeat, "not my baby, not my birth" like a mantra. I guess over time I have come to terms with the fact that most women do not care about birth the way the women on this board do. It's just not something they care to focus on (or don't have time, or whatever). There is nothing that we can do about it except maybe try to plant a small seed of doubt and hope they follow up on it. Most won't, but a few might. What's too bad is that after that first section, the rest of a woman's reproductive life can be complicated by her not having cared the first time around.


I wish I could come to terms with it too. It makes me furious to think that *so many of these women are going to be ABUSED** by their care providers.* I have a hard time standing idly by while innocent, trusting people are likely to be physically & mentally abused by people they put their trust into - people who SHOULD be caring for them & putting their well-being as first priority, people who SHOULD be focused on "first, do no harm." I have a hard time zipping my lip and just thinking, "not my baby, not my birth." But I know that's what I SHOULD do - it's just a big struggle for me.

"Plant a small seed of doubt" is a good way to phrase it. & I do try to do that with people who don't seem to want to talk about it.

But the other thing that makes me just crazy is that so often, these women sincerely believe and tell others things like:

"Oh, I just never dilated. I NEEDED that CS. I just didn't/couldn't dilate."

"Oh my baby was seriously in distress! The doc saved us with that CS! My baby would have died had I not had that OB to save him."

"I just never would have gone into labor. My body just wasn't working."

"I just don't have a large enough pelvis. Baby never would have fit."

etc.

& they tell others these things and it just perpetuates the existing American belief that birth is horribly dangerous, our bodies are dreadfully flawed, and birth requires medical "management" by OBs in hospital (and... therefore... you are insane for making the reckless decision to risk your baby's life by birthing at home.)

Soooo - that kinda irritates me too about this whole situation.

Quote:


> Originally Posted by *limette*
> 
> As someone who researches every decision I make (sometimes for years) it bothers me when people are willfully ignorant. Bringing a child into the world is the most important thing a person can do. To be so blase about it and let someone else make all the decisions about it is insane to me.


I think there's a big difference between someone who is "Willfully ignorant" & someone who just doesn't know what they don't know. For example, I've read other mama's here on MDC mention that with their 1st babies, they read books... but things like "What to expect" & just never realized how detrimental "medicalized" CB is. They DID attempt to educate themselves, maybe with the free hospital-based CB class, etc. but they never realized that they need to dig deeper & question their docs.

Then, on the other hand, you have women who ARE exposed to "the painful truth about American maternity care" (subtitle of the excellent book "Pushed") & still don't want to bother to get educated & make their own decisions. So THAT does bother me.

**For the record - I consider the following types of things "abusive" - for low risk mothers that is (I know cEFM can be good in some cases)


Denying food & water in labor
unnecessary induction - particularly OBs presenting it as very low-risk & just for convenience, or insisting even first-timers are induced for being 'overdue' at 41W!! (When actual average for first-timers is 41W1D.)
Unnecessarily 'pushing' things along with AROM, pit
unnecessary episiotomy
Denying a laboring woman freedom of movement (via cEFM without telemetry) & access to hydrotherapy
Needless separation of mama & baby
CS for "suspected fetal macrosomia" (NOT recommended by ACOG, but done anyway)
CS for FTP when baby is fine & not that much time has passed (a mama I just met said with her 1st she was forced into a CS despite refusing to sign the consent form after only 14 hours.)

Those are the types of things I'm calling "abusive" but that happen every day & it makes me nuts.


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## Tumble Bumbles (Oct 15, 2009)

I agree that women need to take control over their own bodies. I get that sometimes a 'professional's' opinion is needed and maybe even right, but we aren't talking about the women who research and read, ask questions, ask for second opinions, take a couple days to think about something before a decision is made, then make the one they feel is in their best interest and their baby's best interest. We are talking about women who's doctors say X and they just do it because well, the doctor said so and 'doctor knows best'. Yeah, that's annoying. I remember one of the contributors in The Business of Being Born saying [paraphrased] that people research their cars, stereos, cell phones for weeks or months before committing to a decision, but yet don't know the first thing about the interventions and procedures they agree to every day. It's so sad.

I understand your feelings, OP. I've known several women like the woman you describe and I can't lie, it's so upsetting. I feel terrible when they have completely unnecessary c-sections for things like "the doctor said my pelvis was too small" (after having delivered vaginally before), or for failed inductions before the baby was even full-term, or "failure to progress" when babe was in no distress at all and the labor wasn't even outside the realm of normal...etc and so on...

The only thing you can do is detach yourself emotionally from these situations while also gently educating within the framework of your own experience so as not to seem like you're judging or lecturing. Otherwise, it could eat you up inside if you let it.


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## philomom (Sep 12, 2004)

I think for some women birth is just the price you have to pay for being someone's mom. I've heard college educated women tell me that they didn't even want to be at their own babies' births. I realize it is very sad, but there's little you can do except gush to folks how amazing your own births were.

There was one moment in my third birth where my son's heart rate dropped and the hospital nurse freaked out and tried to call "the alarm" for an emergency c-section. My midwife, who knew me and had been with me birthing before just sidled up to me and said very quietly "if you feel like pushing, now would be a good time". She managed to stall the hospital nurse.. ..I found a bar on the end of the bed that I grabbed onto and continued to standing. The midwife unrolled a sterile sheet.. sat on the floor next to me and caught my babe in three pushes. He pinked up and had perfect Apgars of nine and then ten, five minutes later. Never a clue as to what cutting me open would have "saved" him from.


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## ASusan (Jun 6, 2006)

So, if you were an educator or a public health worker or someone who could design a PSA, what would you do?


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## Bokonon (Aug 29, 2009)

Quote:


> Originally Posted by *MegBoz*
> 
> But the other thing that makes me just crazy is that so often, these women sincerely believe and tell others things like:
> 
> ...


It's awfully presumptuous of you to judge these women and their stories without having been there, and to assume that you know more than they do.

I was one of those that NEEDED a c/s. I had severe preeclampsia and my doctors felt there wasn't enough time for me to be induced. I was 32 weeks, not dilated in the least, and never had a contraction. My baby wasn't tolerating my condition well, and neither was I. His Apgars were 1 and 8.

I had to trust my doctors. It wasn't at all appropriate to second-guess the perinatologist and demand to be inducted instead of sectioned. I do believe that. I was educated. I knew that I wanted to avoid a c-section if at all possible. But I also wanted to have a living baby.


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## lsmama (May 27, 2009)

I think this is a really complicated issue. With my first, my midwife did an amazing job with a complicated delivery and a severe shoulder dystocia. In the 3 years since, I have researched and researched shoulder dystocia, the risks associated with it, and the likelihood of recurrence. My midwife is cautiously optimistic about my ability to deliver this baby vaginally. At first, this ambiguity drove me crazy. Ultimately, however, I've made my peace with the fact that I cannot predict how things will go. Frankly, I'm not sure any of us can. For those of us who choose to hire professionals to assist us, I think at a certain point we do have to trust those we hire and, if we don't, we need to seek other opinions. At the end of it all, yes I do have strong feelings about birth, but I don't necessarily value my strong feelings and philosophy over the wisdom and experience that my midwife has gained from delivering 500 babies.


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## starrlamia (Dec 28, 2010)

Quote:


> Originally Posted by *Bokonon*
> 
> Quote:
> 
> ...


 There is a huge difference from pre-e and the items listed above, which are commonly heard and used as excuses for interventions. The sad fact is that a lot of women are not aware of the birth process or how their bodies work (this is why i first started reading about birth, even though I have no plans for children), it is also a sad fact that obstetricians dont always fully inform or educate the women they treat, both IMO are caused by our current society. Slowly we are changing that!


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## mncowmom (Nov 4, 2010)

I'll just add a little something. I'm a researcher by nature, so I knew what was happening throughout my pregnancy, I was very in-tune to everything.

BUT, I wrongfully assumed because of my trusting/following nature that doctors always did what was in your best interests. Even during the induction and subsiquent c-sec I still felt that way. It wasn't till I was ready to have #2 that I started to do my research on labor and delivery and found out that the doctors did not have my best interests at heart.

I have a friend now that's due 5 days before me and she's me during my first pregnancy. I make sure to gently inform her what I've learned over the last couple of years, but she's pretty much oblivious.

I wasn't taking the "easy" way out or just letting someone else make the decisions for me. I was not ignorant or lazy, I just was too trusting. It's hard to remember that we can't judge other people decisions till we've been in their shoes.


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## Bellabaz (Feb 27, 2008)

The route of the issues brought up here is that our society sees doctors as GODS who can do no wrong, make no mistakes, have no prejudices. Who we have to listen to because they know best. Who are the authority. And when a patients questions something, even in a respectful gentle way, they are ofen responded to in a defensive or "how dare you question me" tone. It also is the result of the extemely saddening lack of education girls and women recieve about their own bodies.


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## akmbloom (Feb 18, 2005)

"Willful ignorance" might also be partly due to fear. On MDC I've learned a lot about possible complications and problems people go through with their births just by casually reading threads and then looking stuff up, and learned about some of these before my 1st daughter was born - and lots of them are scary as hell! I can imagine that many people just don't even want to think about what their options might be in case of some scary complications, and in the face of thinking about problems, would just prefer to believe that the doctors would do what is best for them. Being scared can shut you right down, sometimes. This is probably only even more the case with people who don't usually question authority...

Also - as the previous poster who mentioned shoulder dystocia mentioned - I had complications that I really hadn't foreseen with DD1, although I took a "women's bodies/sexuality/reproduction" class in the women's studies department at my undergrad and was pretty aware of the unnecessary medicalization of birth and the possibility of a cascade of interventions. I've since researched the complications that I did have and know what I would've done differently in that situation, and I've done my best to plan for contingencies as I make a birth plan for this upcoming baby, but there are probably situations I haven't considered and might have to decide whether to trust the MWs about pretty quickly. I think that the unpredictable nature of birth is a big part of the fear factor too.

Although of course we all hope for an uncomplicated, relatively pleasant birth experience! And doing research, questioning the norms, and listening to your own body/intuition is a big part of helping that to happen.


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## CBEmomma (Oct 24, 2010)

I also research a lot, it's just in my nature. I thought I could trust my first care provider, but in the end I realized that I was just another routine day and nothing more. I think that many women just rather do whatever their Doctor says and get labor over with. People always think I'm crazy for saying that I loved my second labor and can't wait to do it again. At the end of the day we're all different.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *Bokonon*
> Quote:
> 
> 
> ...


I grow weary of this particular discussion here on MDC. Seems to pop up often.

YES.. there ARE cases undoubtedly cases where a CS saved a baby's life. No question there!

*But the fact of the matter is that there are many CS being done unnecessarily.* I mean really, does anyone here actually doubt that??!? Sure, we can't pin point WHICH CS are the unnecessary ones - and we shouldn't TRY to do so - we shouldn't try to "armchair quarterback" someone's birth after the fact and say, "Hm, no, I think that fetal distress was iatrogenic." What good does that do anyone???

*I'm not talking about "these women"* as you put it --I had no specific people in mind-- *I'm talking in generalities here*. There are lots of women going around telling others that the medical establishment "saved" them & their baby from a pathological birth process that would otherwise have been deadly - & THAT IS NOT THE TRUTH IN EVERY CASE. Again, it absolutely IS the truth in many cases, but it is not ALWAYS the truth.

Let me restate this same point yet again - we can't know WHICH women are victims of iatrogenic, unnecessary CS, nor should we TRY to make that judgment. *But Iatrogenic, unnecessary CS exist* - and most women who were victims of said "unnecessarians" don't know they were victims of unnecessarians - they think the CS was necessary.

With the WHO (World Health Organization) stating that the CS rate should be 10-15% MAX in any population, and the US rate being more than double that at around 33%, AND there not being many purely non-medical- maternal-request CS (which means the vast majority of CS are because the doc says "this is what is best/ required") *WHAT ELSE CAN IT POSSIBLY MEAN other than Docs are telling lots of women they need/ needed a CS who actually did not?!* (or would not have needed the CS if it weren't for the other interventions that caused the cascade.)

So, let's recap again:


There are women having CS who did not need the CS (if you disagree that this is fact, then you disagree with WHO)
The doc convinced them they DID need it (or they did need it only because it was iatrogenic - doctor caused)
----> THEREFORE - there are some American women who think they needed a CS when they really didn't (or wouldn't have)
They go telling people they needed a CS (i.e. "The Doc saved me from this dangerous thing called birth that would have killed my baby otherwise.")
Other women who don't know "the painful truth about American maternity care" keep hearing these stories and it reinforces the message, "BIRTH IS DANGEROUS! So just trust your doctor! You wouldn't try to figure out how to do heart surgery --you'd trust the surgeon to know what he was doing-- so you should just trust the OB to manage things with birth too."

Any time I meet someone who had a CS, obviously I don't know if it was truly necessary or not, but I still argue that *the above 4 step process is occurring in the US today & this process only reinforces the existing believe that birth is dangerous & you should trust your doc* (i.e. 'YOU ARE NOT QUALIFIED, DEAR" - as they say in the famous Monty Python "PING" sketch.)

Now, the message I'm trying to convey in this particular post - I thought it would have been clear in my initial post #11 - my posts are WAY too long already for me to always hash this all out!


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## plantnerd (Aug 20, 2010)

Some women see no big deal in inductions and c-sections, so to them, they are not a big deal. To some, going natural is absolutely insane and unecessary. Not your birth, don't judge.

And honestly, birth can be dangerous, very dangerous. It's not all sunshine and rainbows like so many people like to believe.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *ASusan*
> 
> So, if you were an educator or a public health worker or someone who could design a PSA, what would you do?


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.

It sounds horrible but that is the fact of the matter. American women can't blindly trust their HCPs because American maternity care providers are, on the whole, not practicing evidence-based medicine. I'd say "OB" in the ad b/c that really is synonymous with "maternity care provider" in the US. & the fact is that I believe it's still 91% of births that are attended by OBs.

Then, to educate & offer, I'd suggest resources like movies BoBB, Orgasmic Birth, & books like Pushed, Thinking Woman's Guide. or maybe if it were a local ad (billboard, local TV only), I'd direct them to local resources like LLL & ICAN meetings, Baltimore has 2 local "birth circles," or websites that are good at summing up facts like childbirth connection, etc.

My MW has a bumper sticker in her office that says, "BIRTH IS NORMAL! The biggest secret in American obstetrics." I like this phrase too, but it doesn't elicit FEAR the way "You CAN NOT TRUST your OB" does - it doesn't give a WARNING the way that phrase does to entice people to TAKE ACTION in order to question what they're told & get educated to advocate for themselves & ensure they get evidence-based medicine.

So if I were to design a PSA, that's my knee-jerk reaction.

INSTEAD - what I really think would be great steps for improving America's dreadful maternity care:

1. changes in insurance (better FSBC & HB coverage, coverage for tub rentals, not allowing docs to bill extra fees for vaginal exams in late pregnancy, etc. - change things so that money will drive best practices.

2. Changes in medical care (even just shift-work is found to lower the CS rate, so docs have zero incentive to 'section' a woman before going home, since they're paid the same whether they are present for the actual delivery or not.)

3. Cultural changes.

I'd love to start "birth story day" where we go tell birth stories in high schools. The only exposure I had to birth before getting pregnant was the typical stuff- stupid movies, the birth movie in high school which I think was intended to be gross & awful to discourage sexual activity, etc. I'd NEVER EVEN HEARD OF THE CONCEPT of birth as being joyful (even if still painful.) It was a totally foreign idea to me, & that is sad! I think that should have been addressed in high school health class. It's a start.


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## stik (Dec 3, 2003)

The WHO rescinded their recommendations for c-section rates last year. The ideal at this point is not to hit a target number, but to provide surgery for women who need it and reduce maternal/infant mortality rates. Which makes sense, honestly, as there were plenty of ways for nations to hit the c-section "target" without providing anything like adequate healthcare infrastructure for pregnant women and newborns.

Not every woman in the world wants to share her pregnancy and birth decisions with every other woman in the world. Many women view these matters as intensely private. There's no good reason to walk the earth questioning other women's choices for pregnancy and birth. In a perfect world where women have every possible option open to them, a lot of women might still make choices that other people disapprove of.


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## WildKingdom (Mar 26, 2008)

Quote:


> Originally Posted by *MegBoz*
> 
> An excellent Q. From an advertising perspective, if I were to design an advertisement (& I am in marketing full time), you need to follow the guidelines: "Interrupt, Engage, Educate, & Offer."
> 
> To interrupt (grab attention) I'd start with, "You CAN NOT TRUST your OB." Maybe with an image of a wolf in a doc's lab coat (i.e. "wolf in sheep's clothing.") Something deliberately controversial to grab attention & generate interest. This also elicits fear, which is a good advertising concept to get attention & get interest so people read the ad.


I'm a doctor. Words can not describe how offensive I find this.


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## Bokonon (Aug 29, 2009)

Quote:


> Originally Posted by *MegBoz*
> 
> Quote:
> 
> ...


I am aware of all that - and you should note that in your original post, you used the term "these women". It was how you put it, and I was using your words.


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## liz-hippymom (Jul 17, 2003)

we cant know which woman were given an "unnecessary" c section because those c section babies are alive and kicking. while babies like my daughter are buried in the ground.

some people wish to God they had had a c section


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## WildKingdom (Mar 26, 2008)

Quote:


> Originally Posted by *liz-hippymom*
> 
> we cant know which woman were given an "unnecessary" c section because those c section babies are alive and kicking. while babies like my daughter are buried in the ground.
> 
> some people wish to God they had had a c section


Liz- I just went to your blog and watched the video you posted today. I am in tears. My heart breaks for you and your beautiful family.


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## hippymama23 (Jan 2, 2011)

I think mothers need to be gentle with each other - to be a mother is an intense job and there is too much judgement. Mothers judge themselves so harshly as it is. Mothers do not need others mothers judging them. People do the best they can with the cards they're dealt. I think that some of the comments on here are finger pointing and guilt inducing. There is already enough mom guilt inside the heart of every mom, let alone more mom guilt that you didn't birth your baby right. I understand about getting educated and doing the research. I was overwhelmed with the whole pregnancy and information overload. There are a lot of books out there that are pretty THICK and in a language that is very formal and difficult to understand. I was also very lucky to have had a doctor that a dear friend of mine suggested, who is a home birth advocate. I had gest. diabetes and was told that I would have to be induced if I did not go into labor by the due date. I hated it. I cried the whole way to the hospital and felt like I was forcing my son out of the womb and changing his celestial birth date. I was very close to going home. But I trusted my doctor when he said that he has seen too many still born babies in women with GD. He has birthed 10,000 babies so I felt comfortable with him. He was also a very gentle man and he and his family are very natural.

I had an epideral too. And you know what, I admit it proudly. I wish I could be brave like you amazing women that birth your babies at home, without pain meds, but I am not there yet. Please don't judge me or any mother. You just have no idea what is going on in their head or body.

memomuse


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## Tumble Bumbles (Oct 15, 2009)

This thread has veered way off topic. This isn't about necessary vs unnecessary c-sections. That was only a mere example of what happens when women give up their own power of choice and place it in the hands of surgeons, who were trained to do surgery, and trust these surgeons to advocate for them and their desire to birth babies naturally (or at the very least, vaginally).

Yes, there is too much judgment and it can get ugly. However, there is also too much defensiveness on the part of women who have had interventions (whether necessary or not) that often leads to a shutdown of conversation on both sides and intense feelings all around. This isn't mother vs mother here. This is a conversation that needs to happen. If we continue to blindly trust the advice of OBs without so much as questioning procedures, researching decisions, and going as far as to allow doctors to make our decisions for us, we have truly handed over all autonomy which can be extremely, extremely dangerous.

No, all OBs are not evil cut-happy birth rapists. However, not all of them are advocates for the choices of mothers, not all of them respect patient rights, not all of them truly have the best interest of mama and baby at heart (above their own liability) and not all of them use caution when considering serious abdominal surgery. The evidence of that is a nearly 50% c-section rate in some areas and at some hospitals. *Yes, some c-sections are truly needed, but no, 50% of all women of child-birthing age are NOT intrinsically flawed in their very reproductive design.*

The initial point of this thread (well, from my perspective) was the frustration that those of us who research, read, ask questions, gain second opinions, and make our decisions with the consideration of our caregivers' professional opinions feel toward situations where women who don't willingly place their entire fates (because things like c-sections can be life or death) into the hands of doctors who may or may not be advocating for the best interest of women, their babies, their reproductive health, or in some cases, their lives. It creates a situation of the God-complex you see with many doctors and the idea that our bodies are not our own and we are ultimately not in charge of them...which is dangerous.

This is a conversation that needs to continue to happen, in my opinion.


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## stik (Dec 3, 2003)

I think the conversation quickly begins to feel antagonistic when people allow themselves to be frustrated by other mothers' personal, private choices about health care, pregnancy and birth.

If someone else chooses to place her own personal fate in the hands of her own personal HCP, that's her choice. Women make these choices based on a lot of factors. It's useless, and often hurtful, for bystanders (who aren't in the situation, and often aren't aware of all the factors and issues under consideration) to criticize. The feelings of others about the medical-industrial complex are really completely irrelevant to any one person's personal choices.

And, gently mamas, what is the point of allowing yourself to be frustrated by other women's private, personal choices? What will getting angry at these allegedly poorly informed and apathetic mothers accomplish?


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## Tumble Bumbles (Oct 15, 2009)

I disagree. I think women who allow their personal fates to be decided by their HCPs, though their personal choice yes, leads to the climate we are living in today where many more women suffer due to the larger 'monster' that's been created from those women making "personal" choices.The whole point is, they are NOT making "personal choices". They're not making choices at all, that's the problem.

It's not about the individual women, they can choose what they will choose, (which essentially, is not choosing) but what's left in the wake of that are thousands of HCPs, hospitals and legislators who begin to form their policies, behaviors, and laws based on the idea that women should not have the final say (or sometimes, a say at all) in what happens to their bodies. And yeah, that is dangerous and it does frustrate me. If more women researched, questioned, sought second opinions, thought before making fear-based decisions, and kept their autonomy rather than blindly handing it to their OBs (no matter what they ultimately decided), we wouldn't have the current situation we do regarding women and obstetric "care". It's not about the ACTUAL choice (like the OP said, be induced or not, but make it your decision). That's the issue here.


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## stik (Dec 3, 2003)

The women you're talking about did make a decision. They chose an OB they trust and then they chose to follow their OBs recommendations. A lot of women feel confident of a good outcome from that approach.

And, a lot of women are genuinely treated well in hospitals. I don't wish to discount the experiences of women who are treated badly, but I think it's important to remember that neither positive or negative experiences are universal.

Consequently, there are a bunch of women who chose an OB, accepted their OBs recommendations, and are perfectly content with the results. This is not an evil thing. It does not make things worse for other women. There will always be people who really don't want to invest a lot of time and energy in what they see as a brief experience that is amenable to safe management by their chosen experts. There is no point in getting frustrated with them. They aren't making choices for you.

I am a very informed consumer of health care services, and I love to do research. But none of my research about childbirth has been needed in the hospitals where I had my dds. I think it's possible, and even likely, that Many of the women referred to in this thread as willfully ignorant are very happy with their birth experiences and outcomes.

No individual woman is responsible for the state of the system. If you want to see more change in that, look at insurance companies, regulatory agencies, and medical schools.


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## Hannah32 (Dec 23, 2009)

Quote:


> Originally Posted by *stik*
> 
> The women you're talking about did make a decision. They chose an OB they trust and then they chose to follow their OBs recommendations. A lot of women feel confident of a good outcome from that approach.
> 
> ...


I completely agree. I had a vaginal birth after a successful induction and an epidural. Other than the nasty nausea, it went pretty darn well. I trusted my OB before the birth and nothing happened during the birth to make me seek a different course next time. I'm happy with how things went. And the hospital staff treated me like a human being at all times.


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## swede (Nov 21, 2010)

Quote:


> Originally Posted by *liz-hippymom*
> 
> we cant know which woman were given an "unnecessary" c section because those c section babies are alive and kicking. while babies like my daughter are buried in the ground.
> 
> some people wish to God they had had a c section


Liz - I just looked at your blog. Aquila was beautiful. I am so sorry for your loss.


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## Storm Bride (Mar 2, 2005)

I find these scenarios frustrating, too. It's not because I really care if some women want or need an epidural (and I'll be honest - just the idea of an epidural freaks me out more than labour has ever even come close to...pain, for me, is just pain - numbness is terrifying). I don't have anything women trusting their HCP, either. The reasons these scenarios frustrate me are:

1) I've had way too many people lecture me about the "realities" of labour, birth, the dangers involved, possible complications, etc. - and not one of those people (other than the doctors involved) have done even a fraction of the research that I've done. Don't parrot back at me what your doctor told you - about your specific case - and expect me to enjoy being lectured like a child, yk? It's not my idea of a good time.

2) While many of these women will end up quite happy with their births, I know there are going to be some of them who are completely unhappy and who have a really bad time, and it's really, really, really hard to watch that happen.


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## Storm Bride (Mar 2, 2005)

Quote:


> Originally Posted by *liz-hippymom*
> 
> we cant know which woman were given an "unnecessary" c section because those c section babies are alive and kicking. while babies like my daughter are buried in the ground.
> 
> some people wish to God they had had a c section


I'm so sorry for your loss.

However, this goes both ways. I'll wonder for the rest of my life if my son would have lived if I hadn't already had three (unnecessary - any one of them may have become necessary, but not one of them was necessary when it was done - not one) c-sections.


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## liz-hippymom (Jul 17, 2003)

can you explain

#1 why you think/feel all your c sections were unnecessary?

and

#2 why you wonder if having three sections might have caused your sons death/

Quote:


> Originally Posted by *Storm Bride*
> 
> Quote:
> 
> ...


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## MeepyCat (Oct 11, 2006)

Quote:


> Originally Posted by *Storm Bride*
> 
> Quote:
> 
> ...


I have to agree with this, particularly in regards to placenta previa. I had never heard of the condition until I *had* it. The only person I actually knew who knew what it was right off was my mom, who is a doctor. After being diagnosed, I went to the bookstore, and checked the index of every pregnancy book they had for the condition. Some of those books gave it as much as a paragraph. Most gave it a sentence or two, but some didn't mention it at all. So I went through a medically complicated pregnancy with no reliable source of information about what was going on, what the likely outcomes were, or how I should prepare for them. I couldn't get much of that info from my midwives - they kept assuring me that the problem would go away and I could plan for a vaginal delivery.

The end result of this was that I wound up with very few choices. Now, as it happened, I was lucky: the ambulance took me to an excellent hospital, where the processes for saving my life and my daughter's kicked efficiently into motion, and it turned out that all of the things I would have wanted to ask for (as much contact between babies and moms post c-section as medically possible, kangaroo care and constant parent access in the NICU, exclusive breast milk for preemies) were hospital policy. There are no words to say how very fortunate that means I was.

The point I keep wanting to make is that, when we only talk about how bad c-sections are, and how much they are to be avoided, we rob women who need surgery of choices that they might otherwise have. If we don't talk about these things realistically and pragmatically in advance, we're stuck trusting our care providers, and we may not even get to choose those.


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## Storm Bride (Mar 2, 2005)

Quote:


> Originally Posted by *liz-hippymom*
> 
> can you explain
> 
> ...


1a) My first was done for breech. My membranes hadn't ruptured yet, and there was no issue except that he was upside down. While there may have been issues if labour had continued, there weren't any issues at the time. (I personally feel that the staff panicked when they realized they had a "missed" breech on their hands. It wasn't "missed" - he turned after labour started.)

1b) My second was also done for breech. For a lot of complicated emotional reasons, I panicked and caved in when my doctors wouldn't listen to me. She was found to be breech at 39w, 3d (surgery was two days later), because "the baby is too big, and it's not possible for her to turn before labour". Not necessary. As I say, maybe it would have been once labour started (and subsequent births with dh as the father suggest it would have probably been at least another week). In any case, it wasn't necessary, and it was my only labour-free section, and it sucked in every respect, including dd1 being my only baby with jaundice and my milk being quite delayed.

1c) Post-dates. He was fine. There was no issue whatsoever, except that I'd had two prior sections, and he was "overdue" (as was dh, as were all three of his siblings - seems that post-dates and big babies are in his genes). That's it. OB threatened to drop me at 41w, 4d, if I didn't cave and have the surgery, and for some reason, I actually thought that would be loss of some kind. (DS2 was obviously suffering greatly from his extended stay in my toxic uterus, as his initial apgar was only a 9.)

1d) This was my stillborn son. Obviously, things had gone wrong, so I guess the c/s was "necessary". But, he was engaged in the birth canal - since he didn't live, anyway, I'd have much preferred to grieve without the hideous surgical recovery on top of it.

1e) There's no question this one wasn't necessary. DH wasn't willing to have another bab if I didn't have a c/s, and I certainly wasn't up to dealing with it if the cops and/or CPS showed up again if I tried to homebirth. So, I just caved, and climbed on the stupid table. The only indication for a section was that I'd already had a bunch.

2) It's complicated, and there are many factors, physical and psychological. However, I believe that if my uterus hadn't been hacked up three times previously, and if I didn't have nerve damage in my pelvis from the third one, Aaron would have survived. I've also come across some things that indicate that both miscarriage and stillbirth are increased in women who have had c-sections. But I've got about 6 years of research on these issues under my belt, and rarely bookmark anything, so I can't give you any more details than that. (I tend to weigh what I find, make my decisions, and then forget the details of how I got there.) The psychological aspects are more complicated, and I don't like talking about them, because I know I blew it...but without my previous experiences, I might have been slightly more willing to transfer to the hospital for medical "care".

This is all purely speculative, of course. I don't even know what actually killed him. It's possible he had something wrong, and if he'd survived the birth (either a successful VBA3C or a scheduled c/s), he would have died, anyway. I have no idea. (They don't release the autopsy results to "unqualified" people, and I haven't yet reached the point where I can stomach talking about Aaron with a doctor.)

I hate that I ever had a c-section, let alone five. My entire "birth" history has completely broken me, and I have pretty serious doubts that I'll ever be fully emotionally functional again.

FWIW, I was also "born" by scheduled c-section (after my mom's midsection was butchered getting my brother out) and I hate that, too. It's creepy.


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## Storm Bride (Mar 2, 2005)

Quote:


> Originally Posted by *MeepyCat*
> 
> The point I keep wanting to make is that, when we only talk about how bad c-sections are, and how much they are to be avoided, we rob women who need surgery of choices that they might otherwise have.


I know very few people, even in ICAN, who only talk about how bad they are. There are a few people like that, but the vast majority realize there are times when they really are necessary to save the mother, the baby, or both. This is just one of those things. I can hear anywhere about how great, convenient (puke), and easy (puke again) c-sections are, but there aren't that many voices saying they have downsides. When I joined MDC almost six years ago, I had Googled "c-section support". Every hit I got, except for here and ICAN, was someone raving about how amazing c-sections are. Are the people on the other side of that just supposed to shut up?


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## MeepyCat (Oct 11, 2006)

Quote:


> Originally Posted by *Storm Bride*
> 
> Quote:
> 
> ...


My cesarean was the least disturbing thing to happen to me all night, but it was one freakin' *disturbing* night. I'm completely at peace with the surgery I had, but I'm not going to go on about how they're convenient and easy, nor am I going to tell people who have bad experiences to shut it. Your surgery was not my surgery, your surgery was different, and also, it was yours, and your feelings about it are the ones that matter. There are, nonetheless, habits of conversation that I've seen here and elsewhere that are counterproductive. There are a ton of books and websites that mention c/s as a possible necessity once or twice and say nothing at all about what choices women have when having c-sections, what complications and controversies might arise, or what usual procedures and best practices are (See "Your Best Birth", and "The Thinking Women's Guide to Better Birth" for especially egregious examples). It's all very well to say that surgical delivery is not the desired outcome so we're not going to talk about it, but if you need a surgical delivery, where does that leave you? Even talking about how convenient and easy they are (and I want everyone who has ever claimed that her c/s was easy and she never hurt a bit to report on her first unaneasthetised fart post-surgery, in the interests of full disclosure) doesn't cover the territory - those are basically marketing claims. They have nothing to say about what you should expect, or what choices you will need to make.

That's the pragmatic conversation that I think would be useful to have, the one I don't think we're having, the one I worry may be impossible while some of the judgments I've seen on this thread about women who trust their doctors are tossed around.


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## Lisa1970 (Jan 18, 2009)

I know exactly what you mean. I get so sick of that too. It frustrates me to death. It is one of the main reasons that I don't outside of Mothering really while pregnant. The people here are more mature and less likely to just mindlessly obey their doctors and worship them like they are Gods.


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## Storm Bride (Mar 2, 2005)

Quote:


> Originally Posted by *MeepyCat*
> 
> There are a ton of books and websites that mention c/s as a possible necessity once or twice and say nothing at all about what choices women have when having c-sections,


I think a lot of the things you mentioned are a good idea - talking about what complications can arise, etc. But, I did want to address this one...because, ime, one of the reasons that people don't talk about the choices women have when facing c-sections is because a lot of women, for all practical purposes, don't have any. I managed to get my way - even though the staff self-evidently thought I was nuts - on most things I wanted when I had dd2. But, I can almost guarantee (having talked to the people involved, some of whom I'd dealt with in prior pregnancies) that the only reason anybody paid any attention to anything I said or wanted is because I had that gigantic "mother of a dead baby" note in my file, and they tiptoe around us. Seriously...if every woman got the kind of care I got after losing a child, maternity care would be light years better than it is. But, before that? No choices. Hospital policy or nothing.


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## happysmileylady (Feb 6, 2009)

In relation to the OP and being frustrated that women don't take a more active role in something that is supposed to be THAT important (on post even says THE MOST important thing.)

Why is birth and the method of birth supposed to be THAT important? Why is any woman supposed to care so much? Why is it a bad thing if the most important thing to them is a happy healthy baby and they don't care how they get to that point?


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## GOPLawyer (Mar 21, 2005)

Quote:


> Originally Posted by *happysmileylady*
> 
> In relation to the OP and being frustrated that women don't take a more active role in something that is supposed to be THAT important (on post even says THE MOST important thing.)
> 
> Why is birth and the method of birth supposed to be THAT important? Why is any woman supposed to care so much? *Why is it a bad thing if the most important thing to them is a happy healthy baby and they don't care how they get to that point?*


Because the birth can mean life or death. I am sick, sick SICK to death of the "a healthy baby is all that matters" line. It is horrible on several levels. 1) It is usually used to justify a c/s which may not have been necessary and very possibly more dangerous. 2) It is used by many HCP and bystanders as a way to bully a Mama into a particular decision. 3)It is equivalent to sticking gyour head in the sand and passing the responsibility of birth decisions onto someone else. 4) It ignores the fact that there are TWO people involved in the birth. The end result may be a happy, healthy baby but a very scarred (mentally and/or physically) Mama.

And yes....it does work both ways. My unnecessary 2nd c/s for breech presentation (as was the 1st) ended up almost killing my son. I am absolutely, 100% sure that it was due to the c/s. Not a day goes by that I don't wish that I had fought as hard for a VBAC for DS2 as I did (successfully) for DD.

The absolute, most important thing was that DS2 be happy and healthy...and that still didn't matter a bit when it came right down to it. He almost died and I will forever have terror filled memories of his birth.

That fun little, quippy quote sure didn't mean a darn thing to us.


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## happysmileylady (Feb 6, 2009)

It didn't mean anything to you. If it DOES mean something to another woman...if that really is ALL that matters to her, why should anyone else care?


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## GOPLawyer (Mar 21, 2005)

As to the OP...

I completely understand where you are coming from. There are so many times I want to bang my head on the wall (or keyboard) in frustration. However, I've been on both sides so I do try to be understanding. When I look back at how ignorant of all things birth related going into my first birth...ugh. I so wish I could go back and change things.

Generally, we're taught to take a doctor's word at face value. They are always looking out for us and they are the professional. Women, especially, are trained to think this way. And really, the massive availability of research and information is such a new thing for the general public. My Mom was just amazed at the info I ended up gathering....it certainly hadn't been available to her when she was having babies.

When it comes down to it, I am significantly more frustrated with the current medical model. I am more frustrated with the doctors who don't check their egos at the door and the ones who feel it is perfectly acceptable to bully a Mama. I am more frustrated with the amazing amount of NON-evidence based medicine that is currently practiced.

I am also more frustrated with a society that tries to beat down any woman that dares to push back against and even completely reject the medical model for obstetrics.


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## GOPLawyer (Mar 21, 2005)

Quote:


> Originally Posted by *happysmileylady*
> 
> It didn't mean anything to you. If it DOES mean something to another woman...if that really is ALL that matters to her, why should anyone else care?


Because it's a false premise. Birth does mean something to her. If all goes well, she has the luxury to say it didn't. If it doesn't, it will mean the world to her.

Further, it matters to every woman as how we, as Mamas, react to non-evidence based medicine has a wide impact. I no one does anything...nothing will change...the status quo continues. However, if Mamas reject the unnecessary interventions, they will eventually cease to exist except when truly necessary.

As someone who has had to fight very hard in the birth arena, each step forward becomes another step back when someone else accepts the bullying/lies.

Do I say something when I hear these stories...no. My purpose is not to hurt someone. However, just as she is absolutely entitled to feel however she wants about her child's birth, I am absolutely entitled to be quietly frustrated by yet another step back.


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## elisheva (May 30, 2006)

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. Now, I hang out here and on the ICAN list so I realize my sample is a little skewed.

I'm not angry at the mamas. I'm angry at the docs and the "expertization" of our culture - we need an expert to organize our homes, help us organize our thoughts and emotions, help us get physically fit, parent our children...the list goes on. Yes, it's sometimes useful to get an "expert" opinion. BUT, I've found more and more that an "expert" often...isn't. What would happen in Western culture if people all of a sudden *really* thought for themselves and made decisions based on real info instead of "expert" advice???? I bet a lot of Big Business (Agri, Pharma, etc.) would be wringing their hands trying to figure out how to bring us back under control.

This isn't an issue about birthing women. It's an issue about self-reliance and accepting responsibility for one's own decisions. I hated my c/s but it was physically very easy. Emotionally and psychologically, it was awful because I realized after-the-fact that it was not necessary in the moment. Perhaps it would have become necessary - who knows? Now I've done my research and I'm no longer afraid of being duped again. If I end up back on that table it will be for a d%mn good reason - it's just too bad that I didn't do my research and take responsibility for my body and my baby the first time around.


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## swede (Nov 21, 2010)

Quote:


> Originally Posted by *happysmileylady*
> 
> It didn't mean anything to you. If it DOES mean something to another woman...if that really is ALL that matters to her, why should anyone else care?


yes. exactly. and some women can have a really terrible and what would seem to be, traumatic births, and still not care. I mean, I have a friend who was, what I consider, bullied into a cs. She really doesn't care. She doesn't look back on that birth and feel sad or angry. She really is just happy to have her son. And so, does that make her a sheep, or ignorant, or unfeeling? Or does it just make her someone who doesn't happen to care about that particular 'thing'? She is social worker who now stays at home with her kids. she loves to read, and is very active in an animal rescue. She's not an unfeeling, dumb, emotionless idiot. She just doesn't happen to get worked up about birth. So what??


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## swede (Nov 21, 2010)

Quote:


> Originally Posted by *GOPLawyer*
> 
> *Generally, we're taught to take a doctor's word at face value*. They are always looking out for us and they are the professional. Women, especially, are trained to think this way. And really, the massive availability of research and information is such a new thing for the general public. My Mom was just amazed at the info I ended up gathering....it certainly hadn't been available to her when she was having babies.


And generally, this is true. Despite the perceptions in this board - most of the doctors in the US are professional and are looking out for us, the patient.


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## swede (Nov 21, 2010)

Quote:


> Originally Posted by *elisheva*
> 
> 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. Now, I hang out here and on the ICAN list so I realize my sample is a little skewed.
> 
> ...


I happen to be really grateful for experts like the surgeon who performed life saving open-heart surgery on one of my children. I guess as I've gotten older, I've realized most doctors don't have sinister reasons for what they do, they really do care about their patients and want the best outcome in most situations.


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## liz-hippymom (Jul 17, 2003)

"This is all purely speculative, of course. I don't even know what actually killed him. It's possible he had something wrong, and if he'd survived the birth (either a successful VBA3C or a scheduled c/s), he would have died, anyway. I have no idea. (They don't release the autopsy results to "unqualified" people, and I haven't yet reached the point where I can stomach talking about Aaron with a doctor.)"

i am so sorry you do not have your answers mama. but i had no problem getting my medical report. i even was able to get a private meeting with the medical examiner just by asking. you might want to dig a little deeper. but seeing that you have never vaginally birthed you do not 'know' your c sections were unnecessary. many babies do get stuck in breech deliveries. and a baby that turns during labor is at a VERY high risk for a cord accident. i *personally* would have chosen a c section in each of those scenarios- what i am am sorry for is that *you were not able to chose ..that sucks*. you should have been allowed to try. but again, you just don't know that the c sections were unnecessary or that the c section was a factor in your son's death. please try to get those records-for your own peace of mind.

after i got mine and talked to the M.E. i felt weight lifted just to *know* what had happened to my baby.


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## liz-hippymom (Jul 17, 2003)

but you do not get it- it IS about a healthy baby and mama! i am now of the opinion that if they need to take the baby out of my nostril, they can-so long as i dont have to bury another child.

Quote:


> Originally Posted by *GOPLawyer*
> 
> Quote:
> 
> ...


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## GOPLawyer (Mar 21, 2005)

Quote:


> Originally Posted by *swede*
> 
> Quote:
> 
> ...


It's about more than just intent. It's also about method...and much of what is practiced in NOT evidence based. And yes, most doctors are very professional if gyou go along with their game plan. As soon as gyou choose a different path, it's amazing how many drop all professionalism.

Quote:


> Originally Posted by *liz-hippymom*
> 
> but you do not get it- it IS about a healthy baby and mama! i am now of the opinion that if they need to take the baby out of my nostril, they can-so long as i dont have to bury another child.
> 
> ...


I absolutely do get it. It's not about what is necessary...it's about what is not necessary.


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## MeepyCat (Oct 11, 2006)

Quote:


> Originally Posted by *Storm Bride*
> 
> Quote:
> 
> ...


But here's the thing, Storm Bride: there was nothing they did for you after you lost a child that they couldn't have done for you before. You *thought* you didn't have choices, it *appeared* that you didn't have choices, because the hospital put that front forward for you. The care you received with your last section should have been the care you began receiving from the first. I am so sorry that it didn't happen that way. My care was awesome, and I really think that the sensitivity of the doctors and nurses is a major reason why I'm so at peace with my section. I am not being at all flip or sarcastic when I say that everyone should have it so good.

When we don't talk about choices, when we say that there are no choices, we find ourselves in the same situation that birthing women were told they were in forty to fifty years ago. That changed, and this can too.

If you think about it in advance, you can express a ton of preferences - how soon do you want to see the baby after delivery (before or after s/he's examined and cleaned up)? are you willing to have residents involved in your surgery? How much do you want to hear about what they're doing on the other side of the blue drape? Do you have any opinions about suturing methods? What procedures and exams will the baby be subject to after birth, and when and where should those happen? Can they be done later and in the room with you? How can it be arranged that s/he can accompany you to recovery? If the baby needs to leave the OR before you're ready to (for, say, medical necessity), can your partner go with? If this is likely to happen, can you have a second support person in the OR, ready to step in so you aren't left alone? Can you bring baby clothes of your own so that the baby doesn't wind up in a hospital johnny? Can your partner or support person take baby pics in the OR? Who would you like to meet you in recovery? How do you feel about the Foley catheter - remove asap, or leave it so you don't have to get up to use the bathroom for a few hours? Is there anything or anyone that would make your remaining time in hospital easier, or help you deal with this experience? Can you schedule a post-surgery debrief with the surgeon, to discuss what led to your surgery, whether there were any complications (or whether complications should be expected), and what you should expect in recovery and (as far as can be predicted) subsequent pregnancies?

If you're scheduling a section in advance, you should be able to pick the surgeon and have some input on the rest of the team - if you have had prior bad experience with a nurse or anesthesiologist, you should be able to exclude them.

If you have a choice of hospitals, you can go policy shopping, and pick the most reasonable and flexible option. That may mean switching OBs, but that's okay.


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## Storm Bride (Mar 2, 2005)

Quote:


> Originally Posted by *liz-hippymom*
> 
> i am so sorry you do not have your answers mama. but i had no problem getting my medical report. i even was able to get a private meeting with the medical examiner just by asking. you might want to dig a little deeper. but seeing that you have never vaginally birthed you do not 'know' your c sections were unnecessary. many babies do get stuck in breech deliveries. and a baby that turns during labor is at a VERY high risk for a cord accident. i *personally* would have chosen a c section in each of those scenarios- what i am am sorry for is that *you were not able to chose ..that sucks*. you should have been allowed to try. but again, you just don't know that the c sections were unnecessary or that the c section was a factor in your son's death. please try to get those records-for your own peace of mind.
> 
> after i got mine and talked to the M.E. i felt weight lifted just to *know* what had happened to my baby.


I have no desire to meet with anybody. I just wanted the report. I requested the report, along with all my medical records. It wasn't given to me. I may ask for it again (even though that means dealking with the hospital again), but I was told at the time that they don't release them to lay people - you have to go over it with a doctor. I got pregnant with dd2 right around the same time, and simply wasn't up to dealing with it.

And, yes - I do know that my c-sections were unnecessary. I already said they may have *become* necessary, but they were not necessary when they were done. There's a huge difference. They were convenient for the OB, and the hospital. They may have even been prudent. However, they were not necesasry, and I would not have chosen any of them, except Aaron's (and there was a lot of stuff that happened there that, in retrospect, was just effing bizarre). And, the OB flat out lied to me (or doesn't know what he's talking about) when he told me it was "impossible" for dd1 to turn that late in pregnancy. DD2, who was almost exactly the same size (3oz. lighter, but bigger than they thought dd1 was) and she was changing presentation at least weekly right up until the end of my pregnancy. DS1 turned in labour, which I've also been assured is "impossible". It happened, but something actually happening doesn't carry any weight compared to the experts. The only circumstance under which I'd choose a c-section, without immediate medical indication, is the one where I finally did - I gave up. I no longer even care about my own mental or phsyical health...period. I just don't care. I fought long and I fought hard, and I lost, every single time. I'm done. The doctors got what they wanted...a "good outcome". I could actually vomit, if I still had the energy.

There's also no guarantee that they even know what happened with my son. It's possible they found something in the autopsy, but nobody had a clue at the time. The coroner, pediatrician, etc. were all completely baffled. The pediatrician even told me that her impression, after assessing him in OR, was that he'd died a couple of hours previously...and I heard his heart stop on the monitor, so whatever it was, it was something odd, yk? Knowing what killed Aaron, at this piont, wouldn't give me peace of mind, anyway. It's too late.

To be completely honest, if i'd known, when I was planning my family back in the late 80s/early 90s, what my reproductive future was going to look like, I'd have begged for a tubal. I love my children, but there's no way I'd have knowingly subjected myself to any of this...no way at all. Every single day since I got pregnant with ds2 has been a struggle to make life even look like it's worth it. And, the years before that, when I tried for ten years to have a second baby, and wondered every single day if my primary section had rendered me incapable of doing so, weren't too great, either.


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## Storm Bride (Mar 2, 2005)

Quote:


> Originally Posted by *MeepyCat*
> 
> But here's the thing, Storm Bride: there was nothing they did for you after you lost a child that they couldn't have done for you before. You *thought* you didn't have choices, it *appeared* that you didn't have choices, because the hospital put that front forward for you. The care you received with your last section should have been the care you began receiving from the first. I am so sorry that it didn't happen that way. My care was awesome, and I really think that the sensitivity of the doctors and nurses is a major reason why I'm so at peace with my section. I am not being at all flip or sarcastic when I say that everyone should have it so good.
> 
> ...


I had most of those opportunities...and in almost all cases, I got hospital policy. Period. I could express preferences until the cows came home - that doesn't mean anybody actually listened. Choice of surgeon has been automatic, as they've been scheduled by whatever OB I was seeing at the time. (DD2 arrived on a Friday, instead of the Monday I'd been hoping for, because my OB had OR privileges on the Friday.) There's no choice of anesthesiologist. I even arranged an anesthesiology consultation, specifically to see if dh could come in there with me, which meant I wasted an hour of my day, was unexpectedly given a massive negative emotional experience (because of a video I had to watch when I got there), only to be told, "we can't tell you - it will depend who's on duty that day" (fortunately, I got one who cut me slack and let dh come in - but that was, almost certainly, again only because I had the "mother of dead baby" note in my file). You can't have a second support person in OR - period. I've asked.

And, switching OBs is not necesarily okay. If I ever absolutely have to go see an OB/GYN again, it will be the one who did my last section. I'm sure there are some others who have compassion, but I haven't met them, and I'm not taking chances. Is that rational? No - but, from my perspective, trusting an OB isn't rational, either. Technically, I have a choice of hospitals, but going to most of them would preclude visits from dh and my kids, and that offsets any benefits they may give me.

This is what I mean. It's not about not being told I had choices, and not knowing to ask. It's about having everything I say routinely dismissed by hospital staff, who either think they know better than I do what I need, or simply follow policy, not matter what. Women should have more options. That doesn't always mean we do. Your post above looks to me like an obstetrician's fairy tale.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *elisheva*
> 
> 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.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *WildKingdom*
> 
> Quote:
> 
> ...


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.*


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## texmati (Oct 19, 2004)

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.


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## msmiranda (Apr 22, 2009)

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.


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## jeminijad (Mar 27, 2009)

Quote:


> Originally Posted by *texmati*
> 
> Well... i'll just address the op.
> 
> ...


Thank you!


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## jeminijad (Mar 27, 2009)

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.


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## limette (Feb 25, 2008)

Quote:


> Originally Posted by *MegBoz*
> 
> Quote:
> 
> ...


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!


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## Turquesa (May 30, 2007)

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.


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## stik (Dec 3, 2003)

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.


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## MeepyCat (Oct 11, 2006)

Quote:


> Originally Posted by *Turquesa*
> 
> 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.


----------



## CI Mama (Apr 8, 2010)

Quote:


> Originally Posted by *MeepyCat*
> 
> 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.


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## stik (Dec 3, 2003)

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.


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## stik (Dec 3, 2003)

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.


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## mmaramba (May 17, 2005)

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.


----------



## MegBoz (Jul 8, 2008)

Quote:



> Originally Posted by *stik*
> 
> 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 (Jul 8, 2008)

Quote:


> Originally Posted by *mmaramba*
> 
> 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*
> 
> 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.
> 
> ...


*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.


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## Turquesa (May 30, 2007)

Quote:


> Originally Posted by *stik*
> 
> 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.


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## happysmileylady (Feb 6, 2009)

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.


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## stik (Dec 3, 2003)

Quote:


> Originally Posted by *Turquesa*
> 
> Quote:
> 
> ...


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?


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## stik (Dec 3, 2003)

> "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.


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## Turquesa (May 30, 2007)

Quote:


> Originally Posted by *stik*
> 
> 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.


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## Tumble Bumbles (Oct 15, 2009)

Brilliant reply Turquesa, I totally agree.

Quote:


> Originally Posted by *Turquesa*
> 
> Quote:
> 
> ...


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## elisheva (May 30, 2006)

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.


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## stik (Dec 3, 2003)

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.


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## jeminijad (Mar 27, 2009)

Quote:


> Originally Posted by *stik*
> 
> 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.


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## Tumble Bumbles (Oct 15, 2009)

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.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *stik*
> 
> 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*
> 
> 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*
> 
> 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!"


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## stik (Dec 3, 2003)

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.


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## Tumble Bumbles (Oct 15, 2009)

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.


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## stik (Dec 3, 2003)

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."


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## Agatha_Ann (Apr 5, 2009)

I have to say I am really excited and grateful to see this discussion. I have to admit that I have often felt feelings of judgement towards people who have had csections here on these boards. I can't help but imagine people reading posts that mention a necessary c/s and rolling their eyes thinking, "yeah right". I also will confess that there have been points where I wish I hadn't ever found these boards over this topic. I dreamed and prepared for my all natural birth with my first, and when it wasn't meant to be I was ok with that. Followed by the second, third, and fourth. All of my kids, I have had a 10 minute panic attack before I go to the OR where I plead with DH to take me home and I'll have the baby and I swear I'll clean it up







But then it happens and I am fine. Now, I found MDC and found out I was robbed of my womanhood and I should be traumatized. Now I sometimes feel this way, and it makes me sad I won't ever have the birth I originally wanted. Maybe I just hadn't ever grieved it before I realized I should?

That being said, I am one of the few women who has to have a csection. At least with my first four I did. I have a super rare (like I'm in a textbook) birth defect that I physically could not give birth to the first four. This pregnancy, I theorectically could have a vaginal birth. DH and I have discussed it at length, I have discussed it with my Dr's and the decision was ultimately left up to me. I have decided to go ahead with c/s number 5. This is the section that is really hurting me. One through four weren't an option, this one really is and I'm still choosing this way. It's hard. I don't know if any of that makes sense, I'm happy to share more about my condition if anyone wants to know for clarification.

It just makes me so happy to see a conversation about this being hosted in such a respectful way, even though there are very different opinions. It also makes me happy to hear so many people on here mention that some c-sections are necessary. I wish we could all have the birth experiences we hope for, and I hope we can all support, celebrate, comfort, each other with whatever we end up with.


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## Viola (Feb 1, 2002)

Quote:


> Originally Posted by *Full Heart*
> 
> Last year I was at a baby shower and the woman said she was having a c/s because the placenta was in the way (She had complete previa) and she had never heard of it. All the other women had never heard of it either. One of those women was my mother, who had 6 of her own. She looked at me and asked if I had ever heard of it and I must have had this look of shock on my face that here were all these mothers and not one had heard of placenta previa!


That does seem odd, but at the same time, my mom had 7 kids, my younger sister had 6 kids, and I was close to another one of my sister's who had 3 children, and I've known a lot of other pregnant people throughout my life, so until I got pregnant myself, pretty much everything I knew about pregnancy came from friends and family. No one ever had previa, so I had never heard of it. I didn't hear about it until I was participating in pregnancy message boards and some one in my pregnancy circle had it. I didn't read a lot of childbirth books the first time around. I read parts of What to Expect When You're Expecting, The Baby Book by the Sears, and all of the Nursing Mother's Companion. If I read about certain things there, they didn't stick in my mind. If hadn't been on all these Internet sites, I probably wouldn't have known what it was, but of course online you encounter people with all these different experiences. My preconceived notions about pregnancy back in 1999 when I was having my first was that infertility was not that common, most babies came after the due date, inductions were rare, episiotomies were common and you couldn't really avoid one, some women had c-sections because their hips were too small. Thankfully I did a lot of reading on my own, and online was a whole new world, so I discovered my families experiences weren't necessarily representative. But some people just have e-mail and they don't even go on message boards and chat rooms, so I could see how placenta previa might not have stuck in their mind, even if showed up in an episode of A Baby Story or a medical melodrama.


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## GoBecGo (May 14, 2008)

Which is sadder, that the doctor will put the mother and baby at increased risk to manage his work schedule and potentially increase his revenue, or that if he does so all of us women blame the MOTHER for that?

Why do women hate women so? If a woman follows the doctor's advice, however terrible, and the baby dies, most of mainstream society will say how sad it is that sometimes babies die, and how brave the mother was and how hard the doctor tried. If the woman ignores the doctor's advice, however terrible, and the baby dies, most of mainstream society will say "look at that terrible mother, ignored her doctor and killed her baby because she thought she knew better". The problem with the way women are treated in society and by one another runs WAY deeper than this little issue of whether to trust the doctor or not. Patriarchy divides us, we judge and attack one another. Divided we fall, and fall, and fall.


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## Tumble Bumbles (Oct 15, 2009)

I don't 'hate' women at all. I love women, which is why it stinks to see women handing over their power and choices to someone because they wear a white coat (or in the case of midwives, a flowing skirt and hemp necklace jk). This thread was never about c-sections, inductions, or any of the details surrounding the (largely unnecessary) interventions that take place when a woman is in a hospital situation. It was my understanding of the OP that there was a lot of frustration surrounding women who don't take the time or effort to read, research, evaluate, gain second opinions, or so much as do a cursory Google search before automatically (as the OP quoted the mother) "allowing the OB *to make that decision for her*".

That's the topic. That's the frustration. The fact that people research what cell phone they are going to buy far more than they research whether or not an induction, c-section, whatever is indicated in their particular situation in conjunction carefully evaluating the advice of their HCP, seeking a second opinion if necessary is the root of frustration here. The OP clearly said it wasn't about inductions, it was about educating yourself and making the decision with some informed consent and knowledge, even if that decision includes taking your OB's advice.

Sheesh, I know women who will mull over a pair of shoes for 45 minutes but won't take 45 minutes to research things that pertain to their own bodies or babies. I refuse to be labeled "woman-hater" because that brings about a level of frustration in me. I don't assault women on the street for their choices, I am mature enough to keep the vast majority of my feelings surrounding these personal topics inside, but that doesn't mean the feeling isn't there.

Geez, of all places the OP should be allowed to vocalize what is a very, very common feeling many of us have when we hear women who seem so quick to remove themselves from the equation in a decision-making process that directly effects her health or well-being.

If being a feminist means I have to agree with and support every woman's decision, well let me just hand in my card right now...because I don't, and I'm okay with that.


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## Super~Single~Mama (Sep 23, 2008)

Quote:


> Originally Posted by *CI Mama*
> 
> 
> 
> ...


This is a great post. I just don't put energy into other people's pregnancy's. If they have questions, I'm an open book. But its not my place to tell people who to trust, or who not to trust. It's my place to be supportive when that support is wanted and asked for.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *stik*
> 
> 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.


I agree with you that it's no one's business & to pry would be horribly rude & inconsiderate. But I'm not sure why you seem to assume many people ARE prying. Lots of women happily offer up their stories - often horror stories with lots of gory detail - I hear it all the time, as do we all! Actually, the OP probably didn't pry at all, I mean how would the OP even KNOW the woman had a scheduled induction if she hadn't first offered up that fact? So clearly the woman WAS comfortable sharing some private medical info.

Besides, as I & numerous other posters have stated repeatedly, this isn't about specific cases. Yes, indeed, we can't possibly know all the facts in cases we hear about, so there is simply no point in "Monday-morning quarterbacking" someone else's birth.

But in aggregate, it's clear that American maternity care is intervening WAY too often. *It's a fact. To say, "There are lots of birth interventions happening that ought not to be." is a fact. Plain & simple. Yes, we can't pinpoint which women had unnecessary interventions ---nor should we TRY to--- but that doesn't change the facts.*

Quote:


> Originally Posted by *stik*
> 
> You make a good point. There's a lot of research on obstetrics out there, much of it contradicted by other research.


I absolutely agree that research is mixed & can be confusing on many things, such as homebirth, even induction for post-dates (I find it hard to believe but there IS research indicating induction leads to lower perinatal mortality rates over "expectant management" even as early as 41W.)

*But this is NOT the case* for certain things like epidurals**, liberal use of episiotomy, induction for ZERO cause prior to 41W, freedom of movement in labor, and pushing in any position you darn well please (if possible). Therefore I state yet again, that women ought not to trust HCPs who do these things.

**For the record, I'm not against epidurals & I do think the risks of them are low, but there ARE risks, so it is just absurd for HCPs to act like not only are epidurals risk-free, but women are crazy and even endangering their babies to attempt to birth without one. That is craziness! And yes, it happens! Here's a link about a recent birth show: http://thefeministbreeder.com/lifetime-tv-shows-theres-one-unnecessary-intervention-born-every-minute/#comment-9669


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## GoBecGo (May 14, 2008)

But you KNOW that society celebrates the compliant women, and that pregnancy sees women made into children who must be regarded as hysterical, unintelligent and a potential danger to their unborn child. Why does the individual woman have to stand against that ridiculous standard and be resented if she does not? Females are raised from being tiny to obey, to acquiesce (and yes, maybe not the little girls of the MDC mamas, but the majority of little girls), to "depend" on men or, in a patriarchal society, the representative of authority.

Why be angry at a woman who didn't try to care for herself when she has lived her whole life in a society which tells her she isn't fit to do so and will be unfeminine if she tries? One might as well resent the bird who imprinted on a dog at birth, for not flying - he doesn't know he's a bird!

I don't think feminism means agreeing with and supporting the decisions of every woman, but i do think it's worthwhile examining HOW those decisions were made and to what extent they were actually conscious decisions.

Quote:


> Originally Posted by *Tumble Bumbles*
> 
> I don't 'hate' women at all. I love women, which is why it stinks to see women handing over their power and choices to someone because they wear a white coat (or in the case of midwives, a flowing skirt and hemp necklace jk). This thread was never about c-sections, inductions, or any of the details surrounding the (largely unnecessary) interventions that take place when a woman is in a hospital situation. It was my understanding of the OP that there was a lot of frustration surrounding women who don't take the time or effort to read, research, evaluate, gain second opinions, or so much as do a cursory Google search before automatically (as the OP quoted the mother) "allowing the OB *to make that decision for her*".
> 
> ...


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *Tumble Bumbles*
> 
> I refuse to be labeled "woman-hater" because that brings about a level of frustration in me.


Well said & I agree 100% & feel the same way.

Quote:



> Originally Posted by *Tumble Bumbles*
> 
> If being a feminist means I have to agree with and support every woman's decision, well let me just hand in my card right now...because I don't, and I'm okay with that.


Ya know, it's funny, it has occurred to me that we have people on this thread saying, "Support other women's decisions, & don't judge."

Well.... we are on the "Birth & Beyond" forum, so maybe not everyone here knows this, but you are actually not allowed to post anything here on MDC in favor of spanking, routine infant circumcision, and "cry-it-out" sleep training, among other topics I believe. (Please, mods jump in if I've misunderstood.)

*Why is it A-OK for us to be so judgmental of those choices that we (MDC community) don't even allow people to state differing opinions, and yet we're supposed to be hunky-dory with every birth choice a woman makes? That's a little absurd- a bit lop-sided.*

And while you could easily say my analogy is flawed - CIO, spanking, and circ are more dangerous & damaging to children than birth choices- I don't think that would be entirely accurate. Unnecessary interventions such as induction, augmentation with pit & AROM, unnecessary CS and even purple pushing DO damage babies! They're shown to put babies at risk, deprive babies of oxygen. AND... there are doctors, even whole medical organizations who have either a positive-view, or neutral view on CIO and circ! So I don't think it's really all that different. (The popular book, "Baby 411" is pro-CIO. I'm just making the point that women could say, "I trust my doc" when choosing CIO & yet we as a community do NOT support that.)

& finally, I get frustrated when women don't get at all educated about birth & blindly trust their OB *because the sheer fact that one-third of all births in the US are CS should tell you something has gone awry*. Whether you believe it's the result of God, evolution, or a combo, *how can any reasonable person think that human women & babies are so flawed -- the birth process is so flawed-- as to make major abdominal surgery preferable to the natural pathway as often as one-third of the time?* I don't get it.

I really don't get how reasonable, intelligent, & educated women aren't standing up & thinking, "HM, that doesn't seem quite right, so let me peek under the curtain here...."

THAT - and that alone is what got me investigating... In my first trimester, I honestly said - and meant - "Of course I'll get an epidural! Why go through all that pain if you don't have to?" But that sheer fact of 32+% CS rate alone got me suspicious, which got me investigating, which made me run screaming from the medical model. I still had a hospital birth, but switched to care providers & at a facility that practiced evidence-based medicine. (Whereas the hospital at which I started out had "nothing by mouth" & cEFM as standards for all births. Things I personally think are in such astounding opposition to evidence, that they should make all women run screaming!)

Sure, not everyone thinks like me, not everyone will or SHOULD have the same journey & make the same choices I did. But, again, I can't help but feeling like it's strange to *not have some degree of skepticism of American maternity care.*


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## GoBecGo (May 14, 2008)

Quote:


> Originally Posted by *MegBoz*
> 
> Quote:
> 
> ...


I really liked your post. But look at this - you are HERE, on MDC, NOT on a mainstream site, because however illogical or downright CRAZY it seems, in fact it ISN'T the norm to consider as you have and fell as you do about the whole birthing thing. To the extent that most (many?) of us, on other sites, have encountered very angry people who are furious with us for even SUGGESTING they should ignore the authority and do their own research. We are all here because we CAN stand up against that insanity and research and decide for ourselves. It is not a matter of intelligence but of ingrained TRAINING of people NOT to question authority (and men suffer from it too, patriarchy damages both sexes). It is like being rendered eternally in the early phase of childhood where what mother says is True and Right and it's only when you go to your friend's house you realise that actually, some of what she said is borderline or wrong. It simply does not enter the thoughts of some that the doctor would NOT know the truth, or would twist the truth or only give one version of it or outright LIE, even though it's been going on for generations.

I'm reading a book right now called "maternity letters of working women" which is as it sounds, letters from working class women, from before 1915 (which is when it was first published), on how they got on during the birthing year. The letters are tragic. The numbers of women bottle-feeding because the mill wouldn't allow a visiting baby or a break long enough to get home to nurse even once a day, the numbers of women with prolapsed wombs following birth "because i got up too soon, dr says" (and NOT because dr dragged said womb out along with the baby when using forceps on the chloroformed woman who was too weak to be trusted to push it out on her own), the numbers of women doing heavy washing, painting and lifting as few as 5 days after birth because to not do so would mean their families starved due to the general lack of interest in those people except as an exploitable commodity. It still happens now. And the "fix" of this, when it was so graciously handed down from the middle classes, was a maternity grant and milk depots! To make bottle feeding and paying for the doctor, the very things which were injuring and killing so many women and babies, were easier to afford! And working class women DID survive more, simply because the saved money meant they didn't have to literally starve during pregnancy in order to save enough for the doctor's fee and the post partum home nurse. Even in those letters there are many from women saying they ate well when pregnant and nursing and made sure to breastfeed the babies for at least 2 years and that they know that is how to optimise health, and yet they, then, and now, ignore all that real knowledge to follow the "wisdom" of authority. Authority which was then more interested in keeping the mill open and the (middle class) doctor paid than the working classes healthy, authority which is now more interested in selling formula, drugs and surgery to support the economy than in the health of women and their babies.

It is not intelligence which women lack. It is something else. It is the ability to question the very foundations of everything they know to be true and is held to be true by their society. And we are not on MDC away from the rest of those people because it's so easy to be so different. Just my thoughts. I'm not accusing any individual of being a woman hater, i just mean that society encourages this hatred of the individual when things are perceived to have gone wrong, and women suffer so much from it.


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## CI Mama (Apr 8, 2010)

What I see happening in this thread are 2 different conversations, both of which harken back to what the OP posted.

The first conversation is the "this is so frustrating" conversation. That's the part of the conversation that's rehashing the sorry state of affairs with regards to birth in America & lamenting the fact that some HCPs and some women contribute to the problem in their own ways. It's the part of the conversation that's full of stats & research & facts, and the gist of that conversation seems to be justifying the frustration that things are so messed up.

The second conversation is the "why would women behave this way?" conversation. That's the part that's about trying to get inside the head of the woman who made the comment to the OP, trying to figure out why she would say that and/or why she would choose to trust her OB to the degree that she does. That's the part of the conversation that's not about facts, it's entirely about subjectivity. The gist of that conversation is taking up the part of the women quoted in the original post, trying to see things from that woman's point of view, seeking some insight into why a woman might have that perspective, or at the very least why she might say what she said.

Those are 2 separate conversations, and they are both valuable. If we want to see change in the world, we have to understand research and facts, the "aggregate" view. AND it is very valuable to try to get out of our own perspective and look at things from the point of view of someone else. Because let's face it, women are not all the same, nor should we be. We don't all want the same things and we don't all have the same realities to work with as we make our journeys. If we want to understand why things look the way they do from the bird's eye view, we also need to understand how they look from many different women's individual views. That gives us the opportunity to examine important issues that have already been brought up by PPs, for example, privilege and how it impacts us differently.

These 2 conversations can seem like 2 opposing sides, but they don't have to be. If we can be clear about which conversation we're contributing to, hopefully we can be more open to listening to each other.

I completely agree with the PP who said, "divided we fall." Regardless of what we believe, can we *listen* to one another?


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## philomom (Sep 12, 2004)

Quote:


> Originally Posted by *CI Mama*
> 
> The first conversation is the "this is so frustrating" conversation. That's the part of the conversation that's rehashing the sorry state of affairs with regards to birth in America & lamenting the fact that some HCPs and some women contribute to the problem in their own ways. It's the part of the conversation that's full of stats & research & facts, and the gist of that conversation seems to be justifying the frustration that things are so messed up.
> 
> The second conversation is the "why would women behave this way?" conversation. That's the part that's about trying to get inside the head of the woman who made the comment to the OP, trying to figure out why she would say that and/or why she would choose to trust her OB to the degree that she does. That's the part of the conversation that's not about facts, it's entirely about subjectivity. The gist of that conversation is taking up the part of the women quoted in the original post, trying to see things from that woman's point of view, seeking some insight into why a woman might have that perspective, or at the very least why she might say what she said.


To the first conversation... I realize that the state of American health care is not so great. Not just for having babies but for many other ailments. But this was not my experience for birth. I had amazing births in a hospital with my CNM at my side. No Iv, no drugs, no cuts, no wires, no staying in bed, no extra personnel other than one hospital required nurse. I trusted my midwife and she trusted her back-up. I and my partner had taken Bradley... everything unrolled perfectly. I was empowered and in control. I and my partner still talk about those nights we birthed as good ones.. with smiles on our faces.

To the second conversation. I don't want to be confronting pregnant women. I think women are highly vulnerable at this time. I keep my comments or statements to one or two mild but thought provoking bits and then I back off unless they ask me more. Or, if asked... I might tell them about my glorious natural births. But yes, I do meet those women who ..

won't take a childbirth class because they want drugs during labor

who want to choose the baby's birthday not to coincide with other birthdays or major holidays

who won't even try to nurse because its gross

And notice... none of this is about the doctor or caregiver!

I do try to remain calm in person but inwardly.. most of this makes me seethe. I think that's where the OP's frustration comes in.


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## CI Mama (Apr 8, 2010)

Quote:


> Originally Posted by *philomom*
> 
> To the second conversation. I don't want to be confronting pregnant women.


Just to clarify....

I don't see the 2nd conversation as being about confronting pregnant women. I agree with you completely that that would be inappropriate.

I see the 2nd conversation as an exercise in empathy. Basically, trying to imagine where another woman is coming from by putting yourself in her shoes. I believe this can be done without asking intrusive questions, or without even knowing the woman in question! (we've done it here in this thread by just working with the one quote this is in the OP) It's more about being curious and trying to picture where someone else is coming from, while acknowledging that none of us has a perfect window into someone else's life.


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## limette (Feb 25, 2008)

Quote:


> Originally Posted by *CI Mama*
> 
> What I see happening in this thread are 2 different conversations, both of which harken back to what the OP posted.
> 
> ...


I'm glad that I started this thread. The conversation is really interesting. I wanted to clarify that there was no prying involved. The woman posted her details on Facebook. She finally got in to have her induction and gave birth two days later. All went well as far as I can tell.

In regards to what CI Mama said; I think the first question is pretty obvious and one that gets discussed often on Mothering. The second is the more interesting one because as I've said previously I research things thoroughly before I make a decision especially important ones involving my body for example;

I started my period when I was 11. From the get go it was horrible. I was wearing several of those super huge depends diaper like things at a time and changing them every couple of hours. My period would last weeks and once it lasted two months. The pain was like labor pain for me. I spent a lot of time at home from school in bed dosed up with tylenol to take the edge off the pain. My family doctor had died and was taken over by a new guy fresh out of medical school. He was cocky and condescending. I complained about my periods numerous times that year and he fobbed me off saying all women get periods and that's just the way they are. I insisted that this wasn't right. Being a book nerd I eventually took my frustration to the library and started checking out books on women's health. I found out about endometriosis and it fit what was going on with me. I knew my mom had had a hysterectomy after my sister and when questioned she told me she had had endo too. I also read that the average time for a diagnosis was around 7 years because it took that long for a woman to realize it wasn't normal and then several years to get her doctor to take her seriously. Armed with this new info I went to the doctor's again. I asked him straight out if he thought that this was the problem. He said no you're fine. I pointed out that my mom had it. He said that didn't mean anything. He was getting a little bitchy at this point so I got bitchy right back. I was twelve and I fired my doctor and insisted he recommend me to a gyno. I got in pretty quickly and after a quick try on the pill I was scheduled for surgery to see what was up. My diagnosis? Endometriosis

Now I've had some good doctors over the years, but I've had many more bad ones. I also do my own research into my health and take what my doctors/midwives say as advice and go from there.

Am I coloured by my own experiences? Of course. But who ever said self-education was a bad thing?


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## CI Mama (Apr 8, 2010)

Quote:


> Originally Posted by *limette*
> 
> But who ever said self-education was a bad thing?


Your story shows the power of self-education in the most poignant way. Thank you for sharing.

I think a lot of women aren't "turned on" to the need to self-educate until they have an experience like yours...butting up against the limits of the system, encountering "bad actors" in that system, not getting the help they need, having to rely on their own resources to solve the problem. It's a shame it has to be that way.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *GoBecGo*
> 
> It is not intelligence which women lack. It is something else. It is the ability to question the very foundations of everything they know to be true and is held to be true by their society.


Thanks, and I really liked this post of yours too.

Yeah, I see this point. & I guess it made me reflect on my upbringing. I was raised by a line of strong, independent, outspoken women. I was raised to think for myself, speak up for myself, learn things, and not blindly follow the pack. (I joke that I've always been "impervious to peer pressure" - even as a pre-teen I remember thinking it was stupid to go along with the crowd ONLY because that's what everyone else does.)

So it was easy for me to question authority & think for myself. So your post has made me reflect on how dreadfully difficult it could be for someone raised in the exact opposite way. (Even though I don't think chauvenism is that strong in America anymore, I know it still exists and I definitely agree that it's very common for everyone to be taught not to question doctors.)

Finally, I really see that point about how hard it can be to "question the very foundations of everything they know to be true." That took me back to the time I learned "THE TRUTH" about American maternity care. I started my PG with a practice of OBs who deliver at Johns Hopkins. Johns Hopkins is WORLD CLASS when it comes to medical care. I remember walking the halls of the hospital when I went down there for my 1st trimester screening (prior to my education & switch) & seeing posters with the cover of US News & World Report listing top hospitals. I remember thinking how lucky I was to live so close to one of the best hospitals in the nation. I remember feeling proud of my little town of Baltimore. (We're often in the shadow of DC & have few claims to fame (well, few positive ones!).)

Then I remember how shocked I was to read "Thinking Woman's Guide" & see how INSANE "nothing-by-mouth" & cEFM are, and then I confirmed that they were standards at Hopkins.

*The chasm between evidence & practice shocked & angered me. It still does. Having been raised to question authority & the views of "the masses" I was still able to deal with this shock & find better care. But if I hadn't had such an upbringing, I can certainly understand how this reality would be too much for me to endure* - too distressing to consider it might be true (& therefore too distressing to EXPLORE the possibility in the first place)- just plain too upsetting to face, let alone actively deal with. I can get that now that I think about it. I can get why people don't want to open their minds to the truth that they can't just blindly trust their OB. It is a very scary truth.


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## CI Mama (Apr 8, 2010)

Quote:


> Originally Posted by *MegBoz*
> 
> *Having been raised to question authority & the views of "the masses" I was still able to deal with this shock & find better care. But if I hadn't had such an upbringing, I can certainly understand how this reality would be too much for me to endure* - too distressing to consider it might be true (& therefore too distressing to EXPLORE the possibility in the first place)- just plain too upsetting to face, let alone actively deal with. I can get that now that I think about it. I can get why people don't want to open their minds to the truth that they can't just blindly trust their OB. It is a very scary truth.


I would take this one step further and say that you cannot put your *blind* trust in *anything*...not an OB, a midwife, or your body. Birth is not a 100% predictable or controllable process, and there is just a wild card factor that can pull the rug out from underneath anything that you place your trust in. The best we can do is play the odds, mitigate risk, and take a leap of faith.

But that truth is so terrifying that I think most of us don't have the courage or strength to face it. As I stated earlier...we all put our trust in something, whether it is the available information/resources right in front of us accepted completely as they are offered, or our own "alternative" path.

I would also like to gently offer up the idea that women who are raised with strong role models and are encouraged to think for themselves might still have an uneasy relationship with "THE TRUTH" (as you put it). THE TRUTH interacts with our own personal truths in ways that are unique for each individual.


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## stik (Dec 3, 2003)

Quote:


> Then I remember how shocked I was to read "Thinking Woman's Guide" & see how INSANE "nothing-by-mouth" & cEFM are, and then I confirmed that they were standards at Hopkins.


I just wanted to affirm this. I live 3000 miles away, and I hear that Hopkins is a horrible place to give birth. I don't know of anywhere else that does NPO for laboring women. The nurses where I had my first dd fed me a bagel while I was pushing. I hear that's a little unusual. The hospital where I had my second dd had a selection of clear liquids in minifridges at refreshment stations around the floor - soda, juice, water, ice, tea, coffee, and chicken broth. I don't believe in clear fluids only either, but at least, given the policy, they had a good selection. I could see a way to solve most problems I thought I might encounter in re. nutrition in labor with those fluids. Likewise cEFM. Many hospitals don't place a scalp monitor unless you have an epidural, and don't have women on monitors continuously.

It's my understanding that Hopkins is geared for high risk births and pretty much nothing else, so they are pretty extreme in their policies even for patients who aren't high risk at all.

One frustration I have with discussing birth on MDC is that I see a tendency to assume that nothing has changed in re. obstetric management of hospital birth in the last 50 years. There's a lot of fear about things that people are convinced doctors must be insisting on. In some parts of the US, those fears are justified. In those places, you might as well trust your OB blindly, because there are no other meaningful options. You can argue until you're blue in the face and still wind up fighting a hospital with an outdated approach to NPO and bizarre policies about separating moms and babies "for observation." But in a lot of places, those things are gone. I think a focus on women's weakness, and allowing ourselves to be distracted by other people's birth choices and coping strategies makes women feel persecuted twice - once by inflexible medical management and once by other women. And it ignores the success that women have had in changing the birth climate and the efforts that are going on to create even more change.


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *stik*
> 
> I just wanted to affirm this. I live 3000 miles away, and I hear that Hopkins is a horrible place to give birth. I don't know of anywhere else that does NPO for laboring women.
> 
> ...


LOL, well yeah, within NCB circles, Hopkins & GBMC are the places in greater Baltimore to avoid like the plague. But since I had zero exposure to any NCB-circles at the time, it was totally news to me.

Wrong on not doing NPO - see the link I posted earlier about the new show inside the L&D ward at Riverside Methodist Hospital in Columbus, OH, called "One Born Every Minute", "The moms aren't allowed to eat during their labors." & actually even at the baby-friendly hospital I chose of of Upper Chesapeake in Bel Air, "official policy" was only clear liquids (although the CNMs I saw told me explicitly they don't agree with that- so it's not in practice.)

Also from that article, "Every woman is tied to her bed with continuous electronic fetal monitoring, and an IV,"

I'm not 100%, but nearly certain that it is standard at GBMC too. I wish I had my copy of "Born in the USA" on hand, since I believe it lists those stats, but I don't think cEFM is all that rare.

Interesting you should mention the fact that, "Hopkins is geared for high risk births." That is exactly what the nurse said to me when I asked about NPO & cEFM. When she confirmed they are standards, I said I wanted to transfer my care elsewhere. I've posted this before on MDC & I think it bears repeating here in this context. She replied - and these are her exact words - I'll never forget -

"Yes, that would probably be best. If you're looking for more of a natural birth, it's probably best that you switch. We're a high risk facility. We're not used to healthy patients! I mean, we can care for them, but we're not used to them."

Now, I will give her credit for being so honest with me.. HOWEVER - this wasn't until AFTER I SAID I WANT TO TRANSFER that this info was provided. I was over 20W along at the time!!!!!!!!!!!!! & I had been going all along - called them up as soon as I got my + test. Why not tell me earlier?! I was the picture of health.

Not only that, but this is pathetic & a miserable excuse for poor, anti-evidence based care. *Can you imagine if you went to your dentist, he pulled a tooth, then said, "Whoops! I didn't need to pull that tooth. It was fine! Oh, well, I'm not used to healthy teeth! I've been pulling rotten teeth all day the past several weeks."*

No, that's no kind of excuse!!!!!!! It's the same thing. It's disgraceful & there's no way around that.

You are absolutely right that things aren't as bad as they were in the 1950s or even 1970 re: enemas, shaving, & denying women the birth support people she wants present with her. HOWEVER - I still think it's pretty bad. *"Better than horrible" doesn't necessarily equal good.* So when I rant & rave about the dreadful state of American maternity care today, I really don't see a point in acknowledging the fact that it's better than it used to be. It's is still dreadful (in aggregate.)

Besides, the CS rate is only rising - steadily - and has been for a while. I think it was Henci Goer who wrote that once medical advancements such as anesthesia & antibiotics made CS relatively safe, "the genie was out of the bottle."

Finally, I don't think we are "allowing ourselves to be distracted by other people's birth choices" as you said. It's hard to control emotions - we can't help the fact that we feel frustrated & we're just discussing it. We also don't SAY to anyone's face that we find it frustrating! I don't think anyone who reads MDC really falls into the category of women who are "willfully ignorant" so such women aren't even seeing this conversation. so I don't see how our feelings & our discussion of them on this thread "persecutes" anyone.


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## stik (Dec 3, 2003)

MegBoz, I'm deeply frustrated with your analogies. They're hyperbolic, illogical, and dismissive of the experiences of many women who have benefited from obstetric care.

There are problems in the US healthcare system (that are in no way limited to the state of OB care), but despite these problems, many women have had good, safe experiences within the system. I don't think the system is dreadful in aggregate. I think that's a myth put forward by an angry minority that isn't particularly well-versed in the history of OB and maternity care in the US (or that misreads it, as a poster did on the last page when she blamed doctors for problems that were caused by poverty and poor industrial working conditions), and that isn't aware of conditions worldwide. If you think the state of maternity care is bad in the US, take a quick look at the birth climate in France or read the latest stats on perinatal infant/maternal mortality for low risk moms in the Netherlands. Problems with the infant mortality rate in the US (the stat on which international comparisons make the US look especially lousy) are still being studied, but are more likely a result in disparities in access to care than a consequence of the care itself.

Does this let doctors off the hook for unnecessary inductions? Heck no. But more and more research is telling doctors to back off and they are doing it - new studies last year led to a virtual end to the scheduling of elective sections before 39 weeks gestation in hospitals across the US. ACOG has issued a statement encouraging hospitals to reconsider VBAC bans and softening their guidelines for limitations on trials of labor. More and more hospitals are finding that rooming in not only lowers costs (no nursery to staff), but improves outcomes and maternal satisfaction with the hospital experience. Hospitals in many areas are deeply invested in providing moms with good birth experiences because they recognize that mothers make most health care decisions for their families, and will not to return to a facility where they were treated poorly.

MDC is the largest parenting board on the web. It has thousands of posters and even more lurkers. You may not be criticizing the woman in the OP to her face (although she's on the web enough to have a facebook page, it's within the realm of possibility that she's dropped by and seen the thread) but you are criticizing thousands of lurkers who made similar decisions and similar statements for their own personal reasons.

In most forums on MDC moms are not allowed to criticize those who have made different decisions. Homeschooling moms aren't allowed to criticize families that choose school, and vice versa. Anti-vaccination threads can list millions of reasons to not vaccinate, but cannot criticize those who choose to do it. There are some fairly significant limits on criticism of circumcision even on the anti-circumcision board. Exclusive breast-feeders are not allowed to criticize moms who use formula, and can you even imagine the chaos that would ensue if the vegans and the TFers were allowed to go at each other on the forums? I don't know exactly what the limits are in Birth and Beyond, and I'm happy to live with them whatever they are. That said, expressing frustration with another woman's choices is criticizing her on a decision that is deeply personal, and as a feminist, it bothers me that people would feel compelled to do it.

If you take the statement "I let my doctor choose for me" at face value, and if you feel frustrated about the process it implies, aim your ire at the doctor who slept through the class on patient rights, not the mom who is, like all of us, just muddling through.


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## Turquesa (May 30, 2007)

Quote:


> Originally Posted by *GoBecGo*
> 
> It is not intelligence which women lack. It is something else. It is the ability to question the very foundations of everything they know to be true and is held to be true by their society. And we are not on MDC away from the rest of those people because it's so easy to be so different. Just my thoughts. I'm not accusing any individual of being a woman hater, i just mean that society encourages this hatred of the individual when things are perceived to have gone wrong, and women suffer so much from it.


An excellent point. It explains why so many of us feel FRUSTRATED by this state of affairs.

You lamented earlier: "Why do women hate women so?"

Two points come to mind. First, I and other posters in this thread have taken care to emphasize that women, (including--and perhaps especially!--the one in the OP) are largely the victims of anti-evidence obstetrics. They trust their providers, yes, but by engaging in anti-evidence interventions, their providers exploit this trust. So what you're hearing isn't hatred or anger. It's criticism. And in my mind, it's a fair and well-founded criticism.

Second, you stated:

Quote:


> Why be angry at a woman who didn't try to care for herself when she has lived her whole life in a society which tells her she isn't fit to do so and will be unfeminine if she tries? One might as well resent the bird who imprinted on a dog at birth, for not flying - he doesn't know he's a bird!


But there's a difference between feeling angry at somebody and feeling frustrated by their behavior. I love my sister. I'm not angry at her for having chosen sleazy boyfriends, opportunistic friends, and massive debts. But it's perfectly valid for me to feel frustrated by her choices precisely because I love her and care for her.

On a similar scale, I have tremendous compassion for women under the "care" of providers who establish and then exploit a relationship of trust. And like Limette (the OP), I want to shout from the moutaintop: "So FRUSTRATING!!"  It's frustrating on a personal level because I wonder what makes a woman completely surrender her rights and power to somebody who doesn't always have her interests at heart. (And obstetrics, like all medicine, is fraught with numerous built-in conflicts of interest--e.g. profit, defensive practice, personal power, and even the desire for fewer and more predictable work hours). It's frustrating on a grander, societal level because...well, read any of Meg Boz's rants on modern obstetrics to learn why


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## MegBoz (Jul 8, 2008)

Quote:


> Originally Posted by *stik*
> 
> MegBoz, I'm deeply frustrated with your analogies. They're hyperbolic, illogical, and dismissive of the experiences of many women who have benefited from obstetric care.


For the record, the dentist analogy was a rephrasing of what the Hopkins nurse said. I did NOT intend that to apply to American maternity care on the whole. SHE was the one who said, "We're not used to healthy patients [and that's why we require NPO and cEFM for all births.]" I don't see the dentist removing healthy teeth as the least bit of a hyperbolic & illogical statement to rephrase exactly what she said. What Hopkins is doing with NPO and cEFM for all births is *doing things that are known to be damaging to healthy people and using "we're a high risk facility" as an excuse* for those protocols that damage the normal process for healthy women. That is EXACTLY the same as the dentist removing healthy teeth because "that is what we're used to here." He is damaging healthy people in the name of "habit."

I agree with you that the dentist analogy WOULD be 'dismissive" of the good maternity care many women have received if I'd used it to describe all American care, but I did NOT use it in that way.

*QUOTE:*

"There are problems in the US healthcare system (that are in no way limited to the state of OB care), but despite these problems, many women have had good, safe experiences within the system."

If you'd like to continue this debate with me personally, please use the quoting feature. Never have I ever said that every single solitary American woman has a bad experience. As a matter of fact, I've "typed until I'm blue in the face" saying it is "in aggregate" that the US system has problems. To call it "dreadful" on the whole doesn't mean there aren't many women who, nonetheless, have had fantastic experiences. Just as I've written REPEATEDLY that of course many CS that happen are necessary (I'm not an idiot - I don't honestly think everyone can or should have an unmedicated vaginal birth.)
Not only that, I had my own DS in a hospital and it was a great experience & I highly recommend the hospital!! So please stop these attempts at putting words in my mouth. If you have an issue with words I have stated, please quote.

*QUOTE:*

"I don't think the system is dreadful in aggregate. I think that's a myth put forward by an angry minority that isn't particularly well-versed in the history of OB and maternity care in the US (or that misreads it, as a poster did on the last page when she blamed doctors for problems that were caused by poverty and poor industrial working conditions), and that isn't aware of conditions worldwide."

As I said before, *I don't see the relevance of history*. I'm honestly baffled at your continuation of bringing history into it. *The issue should be comparing modern American maternity care with modern evidence-based practices,* not comparing modern American vs. historical American care. Just because it's better than it used to be doesn't necessarily make it good. I would say the same thing of sexism or racism. Both issues are infinitely better now than decades past, but does that mean there are no more problems?! Of course not! & just because we have it better than we used to have it, doesn't mean we ought to shut up & be happy.

Likewise, I know maternity care is much better in the US than many other nations, but I don't see how that possibly negates the presence of any problems. There are still problems with maternity care in the US - *the fact that it's better here than elsewhere doesn't change that. Again, better than horrible doesn't equal good. *

As for calling it a "myth" that American maternity care is dreadful in aggregate - that is based on stats! Please- open up a copy of "Born in the USA" by Dr. Marsden Wagner & look at the chart with evidence-based rates vs. actual US rates (it's within the first several pages.) *The numbers don't lie - there is a chasm between evidence & practice.* *There is no "myth" at play here* - unless you think all all the evidence-based rates are unreliable & inaccurate, but an abundance of research studies from many different nations have contributed to those numbers.

*QUOTE:*

"Hospitals in many areas are deeply invested in providing moms with good birth experiences because they recognize that mothers make most health care decisions for their families, and will not to return to a facility where they were treated poorly."

I'm growing weary of this discussion & I probably ought to just zip it, because I'm fairly certain I keep repeating myself. It's one thing for me to repeat points in new threads, but when I keep repeating the same points on the same thread, it's probably time to step away. But anyway--- here goes.

I don't think the majority of HCPs have any negative intentions. Quite on the contrary, most of them probably want to do the best they can to ensure a healthy baby & mama first & foremost, and provide compassionate care as well. The problem is they are uninformed & out of touch with research! I think the title of Marsdan Wagner's article "Fish can't see the water they swim in" describes it best... they are so immersed in medicalized birth, they think the danger lies in being more hands off.

That Hopkins nurse I spoke with confirmed my suspicion that she'd be very nervous not being able to "see" my baby on the EFM continuously (as she put it.) I have no doubt that she believes cEFM is best & is necessary & she's just doing her job the best way she knows how. No malicious intent present. No desire to teach the crazy hippies a lesson. No mysogynist desire to punish women. Nope.

In other words... I agree with you that hospitals & HCPs WANT to provide Moms with good birth experiences.... but I also still say that American maternity care is dreadful.

Lack of malicious intent shouldn't excuse poor care. I'm sure we all know the cliche, "Good intentions pave the path to hell." Good intentions aren't "good enough." HCPs need to practice evidence-based care, and that means they must be familiar with evidence.

*Being better than the past, being better than some other nations, and being based upon good intentions all don't excuse away anti-evidence based care.*

Frankly, I find these 3 points all utterly irrelevant on the question of the quality of American maternity care.


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## stik (Dec 3, 2003)

As fascinated as I am by the many systems that provide obstetric care in the US, I really am not in this thread to debate that. I'm here to point out that there are a wide variety of contextual forces shaping that care, and that problems in the system are not caused by women who choose to (say that they) trust their obstetricians. I'm arguing for compassion and empathy, rather than frustration and blame.

It's OK for an individual woman to choose to trust her personal obstetrician. Even in a flawed system, for many women, choosing to trust an OB is a rational choice.

MegBoz, I'm here posting at this particular moment because your post addressed mine directly, but I really don't see this as a debate that I am having with you personally (if I was, this post would be much longer, and say much more about the importance of history, my opinion of Marsden Wagner, and the many ways statistics can lie). But just so you know, I'm not a fan of the quoting feature and I use it as little as possible.


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## matte (Dec 26, 2010)

stik:

I agree that there is nothing necessarily wrong when a woman says she trusts her OB to make a decision for her. I researched my OB, I researched birth [I attended my younger siblings' births, I grew up spending summers at midwives' collectives in the forest, I was homeschooled... etc], I've had several discussions with my OB, and I believe that I can and should trust her. I would even trust her to make a decision "for" me, because I have made the conscious decision to work with her. I know that when I say I trust her to make a decision that I have placed that trust in her, and that it was my decision. I also know that I place that trust in her in part because I know that she has far more experience with birth than I do, because she is well-trained and experienced as an OB and also because she has four children of her own.

I know that if I said what the OP quotes another woman as saying, this is what I would mean by 'trust.' Is it possible that this isn't what was originally meant? Sure.

I don't know... I am a professional in what I do, and I ask that people I work with put their trust in me (knowing that the decision to work with me is their own). I respect the trust that my clients put in me. I try to have the same relationship with my doctors.

That said, I have had doctors I couldn't say this about (when I was forced to use a student clinic, for example). Sadly, in those situations my own education about the situation, and my objections, were not enough to change the shape of the care I received... there's so much context that goes into these things. If a woman says she trusts her doctor, can we respect the trust she has placed in that doctor?


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## Arete (Aug 1, 2010)

Would anyone mind if I went back to a much earlier post? (I just found this thread!) Someone said way back that "I never went into labor" is a non-reason, or un-educated, or something. I really want to know (not offended at all, I swear) if that would apply to me. After membrane rupture I went about 60 hours, and tried everything my midwife could possibly think of (acupuncture, nipple stim, herbs, castor oil) but never had one single contraction. (I was 39 weeks.) At that point the non-stress test wasn't looking so good. So she sent me to the hospital, and the rest is history. Were we wrong? What else could I have done???


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## stik (Dec 3, 2003)

It sounds like you tried a lot of things. Sometimes nature doesn't work perfectly. I don't think you were wrong at all. Sixty hours is a long time to wait, and with un-reassuring NSTs, it makes sense that you would not continue sitting around for nature to take its course at that point.

I think the assertion that "I never went into labor" is a poorly-informed, non-reason for seeking medical intervention is highly problematic and fails to acknowledge that all bodies are unique.


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