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Monday, February 02, 2009

I Don't Not Trust Doctors...

...it's just the obstetricians that I am a bit leery of.

Last week we started a childbirth class given by another doula in our doula's group (our doula happens to be a loooong time family friend of Harmony's family and the owner of that group). Our homework assignment for yesterday was to find someone in our grandparents' generation and ask her for any birth memories or stories. From what we heard from class members, many grandmothers apparently shared many negatives memories from their births. Not coincidentally, many of those women were of the era when twilight sleep was "the cool thing to do" in labor and delivery.

As the title says, it's not that I am distrustful of all doctors. I'm not even distrustful of all obstetricians. There is a time and place for their role, and may they be blessed in times when they are absolutely necessary. But you know, women have been giving birth for a long time without OBs.

I think comparing OBs and other flavors of doctor is in order. Consider: the "field" of human childbirth is almost as old Adam and Eve themselves. Other specialized fields of medicine like cardiology, oncology, and neurosurgery have only been made possible through modern technology. Before the modern era, no one ever did brain surgery with folk medicine. No shaman ever did surgery to remove nasopharyngeal tumors. Before the modern era (whenever that began, anyways), no doctors ever said anything like "well, judging by your test results, your H2 receptors are malfunctioning and causing malabsorption of selective serotonin reuptake inhibitors this and that and btw your deoxyribonucleic acid is all whack and that's why your kids are ugly. ttyl kthxbye." But before OBs, women still had babies.

Much of my distrust comes from the fact that obstetricians have been wrong many times in the past, where if they had simply stepped back, things would have progressed just fine. Twilight sleep, knock-em-out-drag-em-out childbirths, the thought that formula is healthier than breast milk - those are a few examples. They have said "well, these are the best ways, and better than your body can do." Well, no, in fact, we find that they are not. They have been quite wrong in the past; what's to say that they are right to have cesarean rates of 39.6% (Piedmont Hospital, Atlanta, July 2006 - June 2007)!

(the hospital we chose had a rate of 22.8% - the lowest among Atlanta area hospitals, and not coincidentally, the one most friendly towards natural methods and the one recommended to us by our doula)

So I guess my problem is interference where interference is not necessary (and by not necessary, I mean "really" not necessary, whatever you take that to mean). Judging by various videos I have watched and the ramblings of at least one expert doula, I personally do not believe that the number of cesarean births need to be as high as 40% in some cases.* But I'm not the expert by any measure. Don't trust a thing I say unless you yourself know it to be true. Do your own research, find what you want for yourself, and trust in God and your own body, unless you are an untrustworthy person.

* - Insert "they are really really necessary sometimes and you are not wrong to elect for one if that's what you want" disclaimer here.

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9 have poured out their souls in electronic text:

  • Elizabeth

    JunkMale & Harmony,

    I think that you've got a good perspective on things. With our 3 births, we had one with midwives in a stand alone birthing center, the second when the midwives had moved into a tower of the local hospital (but were separate, kinda like just having a medical office building with a jacuzzi and Shaker furniture, and the third birth was co-managed by the midwives and perinatologist because of the twins.

    Throughout it all, the midwives were a voice of reason and comfort. We did end up with a few complications and two NICU stays, but neither one would have been avoided if we'd gone all formal ob/gyns. Rather, the midwives helped us to recover in those situations and take in the information at our pace, rather than the busy doctors' schedules.

    I'm glad to hear that Harmony, your little girl, and you can benefit from the blessings of having doula services. It is definitely something to be thankful for.

  • JunkMale

    Elizabeth,

    Your comment reminded me that we too will have midwives attending our birth. In fact, ever since we switched offices last year, we have not even seen the resident obstetrician once - just midwives.

    I don't know if we have any birthing centers nearby, but we'd probably be inclined to use them if there were. Maybe not for the first one though, since our losses have made us a bit paranoid.

  • Teresa Howard

    love it love it love it! you make me proud!

  • Laura

    This comment has been removed by the author.

  • Laura

    We lucked out by having a doula-in-training offer to attend our homebirth at the last minute. My midwives were fantastic, but they couldn't be there the whole time I was in labor. (28 hours of back labor meant I *needed* some support!) I am now a big fan of doulas! I had no idea beforehand how much I would need mine.

    As exhausting as those 28 hours were, I would never trade them for a c-section or an epi, but I know an OB would have offered, even insisted, and I'm afraid probably would have caved in. I was so vulnerable and trusting of everyone around me... that's why I think it's so important to plan to have people you trust looking out for you. I know Harmony will be in good hands; you chose the best doula I know of. :-)

    A friend of mine who delivered at a hospital a couple weeks after me said the OB yelled at her -- brought the poor woman to tears -- because she refused a c-section that was not medically necessary. (The OB just felt bad for her that she had been in pain for so long, said she was torturing herself.) That's not every OB, but it's enough to endear me even more to my wonderful midwives and doula!

  • Harmony

    Laura, that does make me mad, but it reminds me of something I learned in our class yesterday. Pam (our instructor) told us about one doctor in this city who most of the doulas won't work with, who has a ridiculously high c-section rate. She couldn't give us firm statistics, but she said it was probably around 75%.

    He talked with one of the doulas at Labor of Love once about why he did so many cesareans, and the answer was sort of surprising (to me). I hope I get the story right. He felt like he was saving the women. He had started practicing obstetrics back when twilight births were standard practice, and he saw what the women went through, being strapped to a bed flat on their backs, thrashing around in awful pain for hours and hours. They didn't remember it after it was all over (that's what scopolamine does, after all - it's an amnesiac), but he just couldn't stand the torture they went through. So he started doing cesareans to save them from it. And now, even though women don't go through such an awful ordeal with birth anymore, he still has this idea that he is saving them from the misery of childbirth.

    I still wouldn't touch his practice with a ten-foot pole, but at least now I can look at the situation and not accuse him of being a bad person.

  • Ginny

    Two words:

    Medical Industry

  • Headmistress, zookeeper

    Silent Knife is a scary book, and I didn't agree with everything in it, but one thing they said really made sense.
    Just as lawyers will typically see a need for a lawyer-ish, legal-eagle response to every conflict or possible conflict, doctors gravitate toward medical intervention over 'wait and see'- especially so with childbirth.
    and they KNOW that their interventions cause other problems, but that's actually comforting, because they KNOW what to do for that problem- more medical intervention, which causes different problems, but they know all the responses for that, too. They paid a lot of money and devoted a lot of time to their expertise, and they dislike just sitting back and not using it.

    And then, IMO, you have that whole male 'gotta problem? gotta fix it.' thing going on.

  • Homeschoolin' hot-rodders

    I love your plan! I too would be a bit skeptical of using a birthing center for the 1st. As much as we would LOVE to homebirth (if God choses to bless us with a full term pregnancy) it just scares me a little too much with all the losses that we have suffered.

    Harmony- good point... I am glad to see there is a reason behind his actions....thought he wouldn't be my 1st choice either lol