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Tuesday, July 19, 2011

Always the pessimist

"We HAVE to do this
stuff to you because you
just MIGHT die during
childbirth. It's VERY
dangerous, you know!"
It seems that as pregnant women, we spend a lot of time worrying about things that might never happen. We're treated as fragile time bombs waiting to explode, and every medical test and ultrasound imaginable is ordered "just in case." (Conversely, it seems that when mom is truly worried about something happening and shows significant signs and symptoms, she's pretty much ignored.) Such is our climate of "fear-based obstetrics," where risk can be assessed in a nice, neat little box.

I've decided that in obstetrics - really, in most medical fields - our doctors are often very pessimistic. Classic examples include:

• "Well, your baby might get too big, so we'd better induce now." I didn't know that ultrasound machine was also doing double duty as a crystal ball!

• "You will not be able to birth a baby over 8 pounds." Really? How do you know? As our mothers always told us, "You never know until you try."

• "If you attempt a VBAC, you just might have to have a cesarean anyway." What a vote of confidence. When "attempting" a VBAC, women need to know accurate statistics so they can mentally prepare themselves, because nothing shoots down your plans more than being told there is a such-and-such rate of "failure." Just the way they word it, it makes it sound like few women are lucky to succeed (probably because few women are even allowed to) and the rest spontaneously explode. Technically, I had one failed VBAC attempt, because my baby was in an unfavorable position upon delivery - BUT I labored well and without pain medication on my own up until being prepped for surgery.

• "You better supplement with formula, just in case." Someone might have told you your nipples were too big, too small, or that "You'll never..." this that and the other just based on your physical appearance, which is obviously a load of garbage. Just because a certain percentage of women come in to their hospital and then don't nurse doesn't mean you won't - and who would want to with breastfeeding "support" like that?!

• "You should get the epidural since you'll never be able to have a baby without one." Again, that old "You never know until you try" adage. If more women knew how to cope with labor pain, and that many hospital policies actually make your pain greater, they might think differently about it. And if you're a first-time mom (and even if you aren't), you might find that it's really not as painful as everyone made it out to be.

• You're considered high-risk  just because you're 35. Never mind if you are healthy, active, don't smoke or drink and are in excellent shape. Just your age can mean - gasp! - that you're perceived as broken and treated like you'll never, ever get pregnant or that it will take you years. Once you reach that "magic" age you'll probably be bullied into more and more invasive tests (I know I was) even though you are healthy and have no other problems. Sure, certain risk factors increase with age, but that doesn't mean it's a given. Certain procedures such as amniocentesis carry more immediate risks to the baby than just having the baby already, so many women might be better off forgoing it altogether - but that's your decision.

Speaking of which, I recently read about "Kate Middleton's pregnancy plans" now that she and Prince William were married. The doctor basically says that they're not getting any younger, and now is the "perfect time" to start a family since she is approaching her 30s. He then went on to outline the "possibilities" of what can happen if women wait too long to get pregnant, including old eggs and lack of cervical fluid.

We don't know what Kate's "pregnancy plan" is or even if she has one. Technically speaking, it's none of our business. Who knows - she might have three sets of triplets before she turns 35. Who cares?!

• "Birth is the most dangerous thing a woman can do and is like an accident waiting to happen!" This is sort of the all-encompassing thought process of the majority of OBs. Do we walk around in a body cast just in case we get in an accident? No. How about driving in cars, going to the mailbox to check our mail, just living our lives? We do that every day - no problem. If a problem arises, monitor it and if necessary, treat it - but otherwise leave me alone. More interventions to head off potential "problems" often only end up creating more problems in the end!

You may have risk factors, but does that mean it's going to happen? Should you be treated like it's already happening even when it isn't? Nope!

And if it were really as dangerous as they say, then where are all these babies coming from?

More reading:
"Childbirth is one of the most dangerous things a woman can do today" - My OB Said What?!
Mama Birth: Your care provider is psychic! 
A Better Beginning with Natural Childbirth: Munchausen Obstetrics (scroll down)