SG: What is your view on the doctor's role in the birthing process?
OB1: My job is to ensure the safety of you and your baby.
SG: What happens if I don't go into labor by my due date?
OB1: You will be scheduled for an induction on your due date.
SG: What is your view on pain relief in labor?
OB1: I recommend an epidural; I just don't like for the whole family to look like they have been hit by a truck by the time all is said and done; modern medicine is here for a reason. In fact, if a patient walks in and refuses the epidural, my nurse will ask her to relinquish her cell phone as well since we are talking about having a medieval-style birth here.
SG: What can I do to avoid having to have a C-section?
OB1: I find that the moms that come in with birth plans, thinking they don't want pain relief, are usually the ones that end up with things going wrong for them. Letting me do my job is your best bet at the best possible outcome.
SG: What is your view on episiotomies?
OB1: I find that many women need them.
SG: What is your C-section rate?
OB1: 35%.
SG: What is your view on the doctor's role in the birthing process?
OB2: Your body knows how to give birth; I am here to make sure you get the help you need in case something goes wrong.
SG: What happens if I don't go into labor by my due date?
OB2: I believe that labor proceeds best if given a chance to start naturally. If both you and the baby are doing well, we can evaluate with you on a frequent basis as to if the induction is needed, up to 2 weeks past your due date; by that time, the vast majority of women will go into labor on their own. Also, I will not perform voluntary inductions before 39 weeks.
SG: What is your view on pain relief in labor?
OB2: The pain relief you need is up to you; if you request it, it is my job to help you choose appropriately and provide you with what you need. I encourage you to consider your options well in advance and write a birth plan of what and why you prefer; feel free to ask me any questions along the way and I will do my best to help you have the birth you want.
SG: What can I do to avoid having to have a C-section?
OB2: If the baby is breech, we will try our best to turn it, but if that doesn't work, a C-section will be necessary. There are a few other medical circumstances under which you would have to have a C-section, but they are rare in a healthy pregnancy. Your best bet is to hold off on the epidural as it frequently slows down labor, possibly necessitating the use of Pitocin and potentially leading to a C-section.
SG: What is your view on episiotomies?
OB2: We don't perform episiotomies.
SG: What is your C-section rate?
OB2: 11%.
I semi-randomly picked OB1 as my doc years ago, when babies were not at all in the picture. It was not until we started considering having a child that I asked her all these questions. As a healthy female with a good chance at a healthy pregnancy, I didn't think that I should have had the odds of 1 in 3 of ending up with a major abdominal surgery instead of my body going through a perfectly natural process. So I started reading, and realized that I am not the only one that thinks those odds are a bit too high. And while I can't fully predict what happens to me in labor, I made the point to pick OB2 who thinks that labor is a natural process and surgeries should be reserved for complications. So while I will be delivering in a hospital just in case something does go wrong, I reserve the right to hope for an uncomplicated delivery. And having a doctor who trusts my body to do its thing rather than trying to control a natural process is quite reassuring.
SG: What happens if I don't go into labor by my due date?
OB1: You will be scheduled for an induction on your due date.
SG: What is your view on pain relief in labor?
OB1: I recommend an epidural; I just don't like for the whole family to look like they have been hit by a truck by the time all is said and done; modern medicine is here for a reason. In fact, if a patient walks in and refuses the epidural, my nurse will ask her to relinquish her cell phone as well since we are talking about having a medieval-style birth here.
SG: What can I do to avoid having to have a C-section?
OB1: I find that the moms that come in with birth plans, thinking they don't want pain relief, are usually the ones that end up with things going wrong for them. Letting me do my job is your best bet at the best possible outcome.
SG: What is your view on episiotomies?
OB1: I find that many women need them.
SG: What is your C-section rate?
OB1: 35%.
SG: What is your view on the doctor's role in the birthing process?
OB2: Your body knows how to give birth; I am here to make sure you get the help you need in case something goes wrong.
SG: What happens if I don't go into labor by my due date?
OB2: I believe that labor proceeds best if given a chance to start naturally. If both you and the baby are doing well, we can evaluate with you on a frequent basis as to if the induction is needed, up to 2 weeks past your due date; by that time, the vast majority of women will go into labor on their own. Also, I will not perform voluntary inductions before 39 weeks.
SG: What is your view on pain relief in labor?
OB2: The pain relief you need is up to you; if you request it, it is my job to help you choose appropriately and provide you with what you need. I encourage you to consider your options well in advance and write a birth plan of what and why you prefer; feel free to ask me any questions along the way and I will do my best to help you have the birth you want.
SG: What can I do to avoid having to have a C-section?
OB2: If the baby is breech, we will try our best to turn it, but if that doesn't work, a C-section will be necessary. There are a few other medical circumstances under which you would have to have a C-section, but they are rare in a healthy pregnancy. Your best bet is to hold off on the epidural as it frequently slows down labor, possibly necessitating the use of Pitocin and potentially leading to a C-section.
SG: What is your view on episiotomies?
OB2: We don't perform episiotomies.
SG: What is your C-section rate?
OB2: 11%.
I semi-randomly picked OB1 as my doc years ago, when babies were not at all in the picture. It was not until we started considering having a child that I asked her all these questions. As a healthy female with a good chance at a healthy pregnancy, I didn't think that I should have had the odds of 1 in 3 of ending up with a major abdominal surgery instead of my body going through a perfectly natural process. So I started reading, and realized that I am not the only one that thinks those odds are a bit too high. And while I can't fully predict what happens to me in labor, I made the point to pick OB2 who thinks that labor is a natural process and surgeries should be reserved for complications. So while I will be delivering in a hospital just in case something does go wrong, I reserve the right to hope for an uncomplicated delivery. And having a doctor who trusts my body to do its thing rather than trying to control a natural process is quite reassuring.
11 comments:
This is a great post.
I have this cool book called Birthing from Within. Maybe too late for you to read it now and I haven't read much of it since I figure a lot of what is talks about won't be relevant until I'm actually pregnant. But there is a good part of the book that talks about expectations and how sometimes being too strong on your view of how the birth will go can effect the natural process. Bad summary, but having a birthing plan is key, plus having flexibility in the plan (obviously I have no experience here, just what I read).
I hope you are in blue state when the baby arrives.
Jennie - I was actually just handed that book recently; not sure if I will get through much of it at this point (I seem to be accumulating enough literature for a dissertation!), but I have already flipped through a few books that have a similar idea. I know I can't control all the variables in the equation, but I can shift the odds in my favor by picking a doctor who respects my preferences. I wonder if there are blue/red state statistics, but after interviewing a handful of OB's in both types of states, I am definitely glad that I will be in a blue state when this baby comes!
When I read what OB1 was saying all I kept thinking was RUN AWAY SG RUN AWAY. It is amazing how those who are supposed to being looking out for women's health can be so disrespectful of women and their bodies.
Glad that you found OB2, wishing you an uncomplicated birth.
I second BFW. Great book.
I used a Midwife since I was freaked by the surgery happy OB vibe I was getting. I am glad I did since I delivered med/IV/intervention free (in a hospital) 14 days past my due date and it was great!
But if that isn't an option or you choose not to use one, definitely get someone who is a tough cookie to be your advocate. That will make all the difference in the world.
Best of luck!
35% sounds scary. I'm glad you found OB2. Not sure where mine stands on such a scale, but I first need to get pregnant before this becomes relevant...
That sounds just crazy! My MIL knows a bit about OBs and she always tells me these horror stories about OBs that are C-section happy. (Apparently, it's easier for the OB-- no middle of the night page-- and it costs more-- surgery makes more money that natural delivery.) I'm glad you went with #2.
what ScientistMother said! (completed in full monty python voice, preferably with minstrels and coconut hoofs)
i'm so glad you went with #2!!!!
SM - thank you, keeping my fingers crossed!
LM - I hear you the midwife, but since my OB is pro natural birth (and all the staff at the hospital apparently knows it and treats his patients accordingly), we decided we didn't need to go that route. Hubby is a tough cookie and a strong advocate for me, so I trust him to make the decisions when I am indecisive.
Amelie - 35% sounded horrible to me, but apparently it is not much worse than average. Definitely recommend inquiring when the time comes! (but not too late into the pregnancy to change!)
Amanda - once I started reading about it, I realized there was a national outcry for this. After talking to OB1, I was deliberately looking for OB2!
Quiet - this is where I wish Blogger had video comments ;)
PD - I am so glad I found him after looking around for awhile, it is not as trivial as one would have thought!
I was given episiotomy for my first 2 children (was't even asked!). The new doc for baby#3 never asked me my feelings on it. When I got to pushing, I asked her when she was going to do it. She replied "Oh- I don't believe in episiotomy- didn't I tell you that?" The next push birthed the head which ripped me right to the rectum. The stitches took much longer to heal & I have a huge knotty scar that still aches sometimes. Needless to say, we had a different doc for #4- and I got an episiotomy.
I agree on birth plans & avoidance of surgery- but a small cut heals better than a ragged tear.
Do your homework, make your decisions-but keep your options open in case situations change.
BTW- I had to fight to have my first child birthed without my being medicated many years ago.It meant getting permission from hospital administration-but I got it! Times have truly changed.
Good luck to you!
Anfa - I don't even know what to say about the "wasn't even asked" part! It is so sad they (used to?) treat women like this; I am glad that things are changing. Thanks for the good wishes!
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