Tuesday, February 20, 2007

Pregnant in America -- Oh I'm not finished yet.

Let me finish my thesis on C-secs now...

A woman tells us that "A Cesarean is very difficult to recover from." Well YEAH. It's motherfucking MAJOR SURGERY. They are slicing open your abdomen. I mentioned many attributes to elective C-secs last night, but we can't ignore the fact that it's a surgical procedure. And hence the entire controversy around elective cesareans. It really pisses me off when people say things that they think are BRAND NEW INSIGHTS into medicine when they're already issues doctors have been agonizing over for years.

"SURGERY is what it is!" Thanks for the 411.

Now there's a scary painting showing the profile of a wide-eyed woman with her finger to her lips looking at little mothers burning in fires. Hey I have that painting. I plan to hang it in my waiting room when I start my own practice. BECAUSE WE'RE TRYING TO KILL YOU AND YOUR BABIES. You should definitely take what I just said very seriously. Shhh.

Now a slide promises A search for the truth, followed by an image of a slowly turning windmill. Oh...the Dutch have the truth! How dare they.

Now a Dutch obstetrician tells us, "It's a natural thing, and sometimes you need assistance." I don't understand why they had to go to Europe to pay some guy to say this when the above statement is the VERY CRUX OF LOW-RISK OBSTETRICS.

Now a slide beseeches us, "So why are 98% of all US babies born in hospitals?"

A man answers that question for us: "Obviously these have become great machines for making money," followed by a swivel shot of pregnant women sitting around a waiting room. Oh yeah, the same way we try to profit on natural aging, well-child check ups, and routine physicals. It really burns me to think that people think we're just sitting around the hospital eating bonbons and laughing at all the sucker pregnant women who are throwing their money away with us when in actuality if you were to divide my future salary as a resident over the number of hours I'm actually working, it amounts to even less than minimum wage.

Now they're interviews of totally random people walking around Times Square. A man tells us that "Doctors should be more responsible in the actions that they do." Thanks for the tip. Nice do-rag, by the way.

Another woman tells us "There were 22 people in the delivery room with me." Who were they? Did you not know how to get rid of your family? Or did the obstetricians invite their friends in for the party? Or maybe it was a team of highly-trained neonatalogists, pediatric nurses, ob nurses, and your high-risk obstetrician trying to help you and your kid who was living on the edge.

Now set to some mournful wail-y generic Tori Amos knock-off music, a woman tells us, "When you're at the hospital they poke you a lot. They're always around you, giving you shots, taking blood." Yeah!! That SUCKS! I mean, leave me alone!! Stop FUCKING CHECKING ON ME!! And where the hell is room service? I ordered my steak, like HOURS ago. These people keep waking me up to ask me if I'm in pain or bleeding and then they wrap that stupid little velcro thing around my arm and pumping it up all tight. That is NOT how you do a Swedish massage, people! This is like, the WORST HOTEL EVER.

The doleful music continues as another woman warily tells us, "Doctors are very quick to give you antibiotics and pain medication." Those Satanic monsters!! I mean, it's like they think there's a WHOLE BODY OF VERY ELEGANTLY RESEARCHED LITERATURE SHOWING THE BENEFIT OF GIVING ANTIBIOTICS TO WOMEN COLONIZED WITH GROUP B STREP DURING LABOR TO PREVENT NEONATAL SEPSIS. And then they made you take PAINKILLERS? Those sadists.

Another woman looks to be on the verge of tears as she recounts how she "ended up having shoulder dystocia." Wait a minute. Is she implying that somehow the hospital or the obstetrician was responsible for the fact that the infant got stuck in the birth canal? Wrong. Wrong, wrong, wrong. So wrong. In fact, shoulder dystocia is a complication of vaginal delivery you really kind of want to be at the hospital for in case obstetric maneuvers fail to release the baby and you end up needing an emergency section.

After all the doom and gloom, a woman offers a solution: "I think you have to be your own doctor nowadays." I am totally comfortable letting people sort of fry without medical care if they're fully informed of the risks, however, when a baby's involved that might be incredibly irresponsible.

More women chime in and say that midwives are the answer. The Dutch obstetrician gets the final say, "Deliver at home, but within 15 minutes of a hospital."

Wow. Definitely, such a fair and balanced view of contemporary obstetrics is definitely what our field needs now. I mean, it's not like there's ALREADY a crisis of care where small-town obs in states with exorbitantly high premiums (Pennsylvania and Illinois) are driven out of practice, and women needing obstetrical care have to travel hours away to other states to receive their care. Thanks a lot.


Redspiral said...

Thank you for acknowledging that cesarean is major surgery! In the current birht culture women believe that having control (by choosing elective cesarean) helps them to *avoid* complications. I doubt that anyone tells them, "This is MAJOR SURGERY." They might reconsider after hearing that statement, and it's not even inflammatory, it's the truth!

Your description of the trailer makes it sound like propaganda and if that is the case I will be sorely disappointed. SORELY. We do not need propaganda which only makes the unmedicated-birthers look even more insane.

Maternity care in our country is in crisis and adding thick black lines between us certainly will not help anyone. :(

Anonymous said...

Now I want to see this movie, considering your extensive analysis.


Vacations said...

Best wishes you all from Istanbul...

David G said...

Your clear knowledge and strong views on obstetrics is strangely attractive

Anonymous said...

Just a pet peeve, interns and residents make way more than minimum wage. At an average yearly salary of between $34,000 and $46,000 for interns and an 80 hour work week that would be at least $8.17/hour. Even if you violate the 80 hour work week religiously it would still be way more than $5.15. Not that they shouldn't be paid more but minimum wage should be way higher.

trAcy said...

lurking. lots to read this week. thanks.
babies. ugh.
thanks for movie tip. most documentary drama expose things are full of emotional fact-wrenching and half-truths. it's entertainment, mostly. anyway, peg never fails to entertain, too!

Anonymous said...

I've always been very suspicious of the established medical community simply because it has power, and as the saying goes, power is corrupting while absolute power is absolutely corrupting. The trailer quoted 33% as a cesarean rate for the U.S., which includes hundres of thousands of home-births and birth-center births. So, most *hospital* births are in the range of like 50%. Crazy, crazy, crazy is what the medical establishment is and what they're trying to do those poor folks too ignorant to stay away from them is just wrong. Medical folks think they're right way too often and even if they have good intentions (most really do and do good work), they're still human and subject to influences from higher corrupted powers, like pharmaceutical companies, other "big-name" doctors with god complexes, and don't forget the insurance companies. I believe that medicine is great stuff when its used in small doses, so I think I'm probably going to really like what this film is saying. Maybe it will help doctors and especially medical schools change their approaches of treating everything as a frigging medical condition that can be treated with a scalpel and drugs. But what's really funny to me is how much like politicians many doctors are becoming... hmmm, I wonder what some of the ego/id researcher folks would have to say about that and how it relates to taking a natural act, uh childbirth, and making it a medical emergency.

Rupa said...

Hi, I wonder if you'll actually have enough time to read this, consdiering you already have seven other long stories to read. I was on google and put my name in the search bar and one of the links was your blogspot. My name is also rupa and after reading the first paragraph of the first blog on the page, I felt like I was the one writing this blog!
heh.. I gave my architecture thesis last year, but as all good Pakistani girls I was supposed to be doing medicine but I never understood chemistry. I felt as frustrated and wanted to jump off my balcony a lot of times during my so called enlightening years at college.
Anyway, I'm not a blogger, but I used to write. It's been five years probably since I've written a decent essay or article, but I think I just might now.
Thanks Rupa! and Good luck..

Anonymous said...

I hear what you are saying, the people that are performing medical care are not bad people. They are people doing what they know as right, from what they have been taught. One quote in the trailer you mentioned was "have the baby at home, but 15 minutes from a hospital" is actually "Have a baby at home and within 15 minutes you are in a hospital". I have met these people and they are sharing their experience as well as bringing attention to the fact that there are many options out there and we should be aware. I know personally, for myself my doctors never spoke to me or answered any personal questions regarding birth. I did ask, they never answered except to say we will know as it happens. One birth they knocked me out with gas, even though I was not showing pain and after my son was passed crowning. I was given NO choice, they restained me. Next birth they gave me drip to start labor, never telling me why, then did a epidural that went to the lower half. I've been there for many friends, delivered horses, dogs, cats and other pets while growing up at a ranch, working for a vet. No one gave me any choices, and I never concieved those were in the choices. This looks to me as if it's about time we will all participate in making choices and knowing what they are. I am sure intelligent Drs. and health care practitioners all want the same thing. Why can't we have it all in one great package?

Anonymous said...

1 in 20? Hahaha...you must be drinking a lot of the Kool-Aid that they give you in medical school. You should look up midwifery statistics. I bet they'd tell you that 1 in 20 is total BS and that hospitals might push that statistic to frighten women into hospitals, where inappropriate interventions occur everyday.

Anonymous said...

Quote "Another woman looks to be on the verge of tears as she recounts how she "ended up having shoulder dystocia." Wait a minute. Is she implying that somehow the hospital or the obstetrician was responsible for the fact that the infant got stuck in the birth canal? Wrong. Wrong, wrong, wrong. So wrong. In fact, shoulder dystocia is a complication of vaginal delivery you really kind of want to be at the hospital for in case obstetric maneuvers fail to release the baby and you end up needing an emergency section."

You obviously don't realize that many so called "shoulder dystocia" outcomes are the direct result of a woman on her back with her knees past her ears not because the baby is large. You must not have learned that the pelvis is restricted in this position and midwives are able to prevent most if not all shoulder dystocia cases by having the woman deliver on all fours allowing her pelvis to open up considerably than other birth positions can allow. OBs are not taught what REAL child birth consist of. They are taught that it is faulty and they are there to save the baby from the mother’s body. OBs in the beginning were taught great child birth techniques from midwives and then the field of obstetrics felt they were better than Midwives and started to leave these vital techniques out of the teachings. Now obstetrics are always trying to make birth better or easier when in all honesty you can’t perfect something that is already perfect. Yes some and I mean few women need help in child birth but when child birth is left to unfold without intervention (epidurals, pitocin, rushing the placenta etc) it is able to happen without complications. Most complications in childbirth happen because of things the OBs do not because child birth is inherently dangerous.

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