Thursday, May 13, 2010

OB Peeves

You know what bothers me? When I talk to women about their birth stories and learn they had c-sections because their doctors said something along the lines of, "let's just make you guys parents right now! Huh?"

Essentially, these doctors make it sound like a big party that needs to get started a lot sooner, like the c-section will jumpstart parenthood, kick the family into high gear. Meanwhile, mom can't get up to change a diaper or sneeze without fear for days or weeks or months.

I don't know when we as a society lost the concept that labor takes a long time. Maybe when we started seeing babies born within the confines of 30-minute sitcoms? I guess this pervasive media imagery of quick birth can make moms feel they are abnormal when their labor takes more than a few hours. Combine this societal pressure with the authority of the white-coated doctor suggesting your body is taking too long and you have all the ingredients you need to get bullied into a c-section.

In the past few weeks, I've talked to moms who actually had their OB say to them, "We could be here all night...or we could make you guys a family in a half hour!" Now, I am not a doctor and I was not in the room monitoring the babies' or mothers' condition. But it strikes me as odd that a doctor would offer the option to continue laboring if there were indeed eminent danger.

Pressure like this from doctors really gets me angry. I understand that it's easier for OBs to operate for a few minutes than to linger at the hospital for an unknown period of time waiting for a vaginal birth. But those OBs aren't the ones who then spend weeks gingerly hosing an incision with a peri-bottle or having to buy granny panties because regular underwear irritate your scar. Worse, those OBs aren't dealing with scar tissue or bowel obstructions or difficulty bonding with their new infants. Not that recovery from a vaginal birth is a trip to the just seems insensitive to me for doctors to suggest major abdominal surgery as a means to a quick family photo.

I know that, in the throes of labor, many women are anything but ready to question suggestions by their doctor. That's why I hope labor support partners would ask a few questions upon hearing such a suggestion. Namely:
  • What are the side effects and complications of a c-section compared to laboring and delivering vaginally?
  • Is my baby in distress or danger?
  • Am I (or is my laboring partner) in distress or danger?
If the OB is honest, she or he will indicate that there are "33 areas where cesarean section was found to involve more risk than vaginal birth," and only "4 areas where vaginal birth was found to involve more risk than cesarean section," according to research conducted by the Childbirth Connection. In other words, it might be worthwhile to "keep going all night" if it means avoiding psychological trauma, limited early contact with the baby, infection, your baby's chances for developing asthma, or any of the other high risks associated with a cesarean.

It is my wish that doctors would stop suggesting major abdominal surgery so flippantly, but if they don't, I hope mothers and labor supporters will read some evidence-based materials and not take such a decision lightly.

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