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Tuesday, January 4, 2011

The Obstetrical BS Series: "He's the doctor ... you have to listen to him."

When I was 22, I visited the Dreaded Gynecologist for the first time. I was young, naive, and totally stupid when it came to seeing the OBGYN. My doctor proceeded to tell me two things: That doctors should always put gloves on before examining you, and that they should always tell you - or ask - before they did something to you.

For some reason, people would never tolerate having someone aggressively approach their genitalia in any situation - but because you're at the OB's office, whatever he does to you is suddenly okay.  It's like your care provider has free reign over your body parts, and it's just too bad if you don't like it.

While we should be able to trust our physicians, I'm no longer under the delusion that I necessarily can. As a result, I've become increasingly skeptical when hearing "emergency" birth stories and in dealing with my own OB.

Many people are under the impression - especially when it comes to labor - that doctors are always well-meaning, know what they're doing, and are doing whatever it is to you because it's necessary. I'd like to say that were always true. Unfortunately, largely because a lot of people are totally uninformed about birth, they don't know what's truly necessary and what isn't. Sometimes even when you are informed, it doesn't make a difference and you get railroaded into something terrible. I hate to say it, but that aspect of birth advocacy really depresses me.

Because of that lack of information, and the blind trust in the physician to be overseer in all aspects of our care, some people think that mothers who consider their experience 'less than perfect' are going to extremes when making claims of birth rape or assault. They think you're exaggerating, that you are being dramatic, that you care more about the "experience" (gah - I hate that description) than a "healthy baby!" Fervent anti-natural birth advocates like Dr. Schizo often make those claims, as do those diehard women who run in her circles. To say that a healthy baby doesn't matter to any pregnant woman is utter BS. But to some of us, the process of getting there means more than to others, and can greatly shape our definition of "health" both for mother and child. I hate how those "anti" people tend to completely disregard the emotional and physical well-being of the mother in favor of the baby, as if it means nothing. How can we even consider for a moment that mom's overall emotional and physical health don't play a role in how she cares for her newborn?

Many times I've run across comments like, "Just listen to your doctor, he knows what he's doing," or "You are not a doctor and you can't possibly know anything." Totally downplaying mom's (completely relevant) fears and concerns as if she's some kind of idiot. When she dares to question the doctor, suddenly she's treated with disdain, as if to say, "How could you" One mom, when confronted with the comments of a knowledgeable labor and delivery nurse, basically said, "You're not a doctor, and I won't listen to you." That degree and white coat mean so much to some people that they're totally willing to overlook huge red flags, like My doctor treats me like sh!t, belittles me, makes me feel like my concerns are meaningless, and doesn't treat me like a human being.

Our often well-meaning, completely birth-stupid culture devalues mom and her individual labor and birth needs, essentially seeing her as nothing but a vessel - an incubator who holds that baby in for 10 lunar months and suddenly ejects it in any way possible, whether she likes it or not. Then they either turn around and accuse you of being uninformed, or being selfish - even though your baby is no doubt just fine.
OB:  “If I’d known the baby was so big, I would have done a cesarean section.”
Mother:  (holding her just birthed baby) “I wouldn’t have let you!”
OB:  “It wouldn’t have been up to you.”  (Courtesy My OB Said What?!?)
So, mom is perceived as selfish and superior because she would have had the audacity to question her doctor. And her doctor is basically implying that he would have done a cesarean without her permission. Many women called it as they saw it, except this one:
"u ladies need to be a little less sensetive, hes an OB.. part of their job description is to come into contact with female genetalia.. birth rape? give me a break.. i have had 5 kids, and have suffered some pretty traumatic birth experiences ((ie. heamorraging and having the OB use her hand to mannually remove the clots from my uterus))… but thats birth, its dirty, its hard, and its not pretty… if ur not ready for that, then adopt, or buy a puppy…get over yourselves…."
So in other words, even if your vagina was forcefully entered into with a hand, fingers or other tool, or even the mere suggestion was made of doing something without your consent, you're just supposed to get over it. Because he's the doctor.

Yes, an OB's job is to come into contact with vaginas and whatnot. But it's the contact part we need to examine: did he ask first? Did he tell her what he was planning on doing before he did it? Did he preface it with a comment that suggests her rights were completely irrelevant to him, as the above post suggests? (As a side note, I bet you ten bucks that the second commenter's "traumatic birth" was likely due all or in part to her overzealous physician. What say you?)

Further down in the comments section, another poster mentions how yes, it's assault; but it would be awfully hard to prove in court. Of course it would, because we have a whole generation of sheeple who think the doctor is always right and only does what's good for you.

Awhile back I read the comments of a mom who was nervous about her doctor inducing her with Cytotec. She was planning on standing her ground if the doctor insisted on using it, but "didn't want to make him mad." I nearly swallowed my teeth.

As usual, the old "He knows what he's doing" crap came out. And while I was happy that she had done some reading on Cytotec and the concerns surrounding it (more than likely because she's used to hearing about Pitocin and this sounded different, thus prompting her research), I'm sure she had no reservations whatsoever about Pit and didn't question that one iota.

Your OB is not the boss of you. He is not God. He is not your dad. He is a medical advisor, and you are free to seek another opinion regardless of what he says. Yes, sometimes unpleasant and painful things must be done to us for the safety of ourselves and our babies, but he or she should do so with compassion, dignity and respect. And if he's not giving it to you, then you need to demand it, because it's your right.

Do not let anyone tell you to disregard or ignore your feelings of inadequacy, spiritual, emotional and physical pain, and other complications that might be hard to concretely identify but you know they're there. You are not just a holding tank for this child; you are a human being with feelings, emotions, and rights.