Wednesday, December 17, 2008
Why don't women trust hospitals?
Gloria Lemay writes a response to a Canadian obstetrician who asks "When did we become the enemy?" I took an Advanced Doula training course online with Gloria and think she has some valuable perspectives to share. I like that she calls out the attitudes he demonstrates in his own op-ed to show the reasons that women who want normal birth do not trust the hospital. I particularly noticed his statement, "I have attended about 7,000 pregnant women and have a good idea how the complicated collection of things that must come together in just the right way for there to be a good outcome actually come together." This is how so much of the generic hospital attitude is towards birth: everything has to be just right - just perfect - for you to have a baby normally. You must have just the right strength of contractions, just the right amount apart, or you'll get Pitocin to make them right. You must have just the right amount of progress - not too slow, now! - to avoid Pitocin or artificial membrane rupture. Prolonged pushing? A little concern about the heart rate? Oxygen monitor, oxygen, fetal scalp electrode, vacuum extraction, etcetera. Ask a doctor whether you can avoid interventions - IV, continuous monitoring, and so forth - and he or she will often say, "As long as everything is proceeding normally." But normal is defined so narrowly that almost no one gets to fall in this range. (And then women who get these interventions say, "My birth wasn't normal - something was wrong with the heart rate - I had to get oxygen - birth is so dangerous.") This isn't to say I don't think nothing can go wrong at birth or that interventions are never necessary, but an OB who already thinks that birth is so complicated and will need lots of management to come together "right" is not one I'd pick.