Saturday, February 27, 2010

Sometimes not giving unsolicited advice is HARD.

I try very, very hard not to give advice unless it is specifically asked for. This usually isn't a problem.

Sometimes, it is.

A friend of mine is pregnant with her second daughter. She has scheduled a c-section a week ahead of her due date. She says she doesn't want a c-section, but with her first daughter she was induced and stayed something like 3cm dilated for two days and wound up with a c-section anyway, so her doctor wants to just do the surgery.

This is what I want to say:

"Well, were you induced for a legitimate reason the first time around? Generally speaking, the cause of a failed induction is your body and your baby weren't ready to go into labor. I've seen a lot of women induced for no other reason than they are past their estimated due date (which, as the very name states, is just an estimation of when the baby will be born). If this was the case with you, why don't you decline the c-section you don't want and wait to go into labor on your own, with close monitoring if that will make you feel more comfortable?"

This is what I actually said:


I am aware of the fact that it is very much not my business. Chances are no one will die or be severely injured by having a slightly early c-section--and at least it's only one week before her due date. And I certainly don't want to come across as if I have judged her last birth and her plans for this upcoming birth and found them wanting.

I do think the situation sucks, however.

We are conditioned to accept whatever our doctor says without question. There are certain medically unnecessary--and possibly even detrimental--practices that surround pregnancy and birth that are so common we think that's the way things have to be.

I just became a fan of a Facebook page called "An EDD is an ESTIMATED Due Date, not an EXPIRATION date!" Many moms and doctors treat it like it is the latter. The most common outlook is "Well, if mom and baby get here okay, does it really matter?"

To which I would say: "Well, not if you are an 'ends justify the means' sort of person. And I would certainly not want to make any mom feel bad about herself. But this is part of me wanting the world to be better. Generally speaking, isn't it better to avoid creating a false impression? For pregnant women and their husbands to have one less thing to worry about? And is it really wrong that I don't want to settle for 'good enough'?"

I went 11 days past due with Esther. She was my VBA2C (vaginal birth after 2 cesarians) baby. Both of these are pretty far afield, but it's the past due part that seems to trip more people up. The conversation always seems to go something like this:

"Oh, and Esther, she was eleven days overdue."
"Your doctor let you do that?"
"What is this 'let' of which you speak?"

Sigh. Can we at least all agree that women should feel free to say to their obstetrician "What's the medical reasoning behind your desire to ______?"


Anonymous said...

Amen! I typically keep the same thoughts quiet but I always think to myself why on earth would I want to miss the "natural" part of childbirth which includes your body deciding when it's time! I will admit, I went early with both my kids but I would have never let them induce me without good reasoning. I have a friend right now that scheduled a C-section on a particular date just because she liked that date! I had to bite my tongue so many times.

Matt G said...

Our boy Ambulance Driver just wrote a nice post about the foolishness of backboarding patients who don't need it, and how some EMTs and parameds will tell patients that they won't transport without a board. (Uh, coercive treatment, much?)

You have the right to dictate how your medical treatment will go. You have the right to say "No. I don't want you to touch me, Doctor." You can say, "No. I don't want you to perform any more 'service' to me, medical staff."

And while we're at it, how about asking people that are pushing stuff on us how much it's all going to cost? Good luck getting a straight answer. (Because they don't know.)

You're right to withhold unsolicited advice. This is very hard for me to do, too.

Anonymous said...

From what I've observed with MD's, is their need to control.
When you question them, they do tend to get defensive.


Mikee said...

My wife, a pediatrician, had our 2nd child induced at the very earliest date she could convince her OB to do it. That she had been flat on her back for 4 months trying to keep the baby inside may have had something to do with it, but our joke together during the last month was, "Stop doing jumping jacks until at least week 39!"

I finally stopped telling mothers in grocery stores to make their toddlers sit in the grocery cart, rather than stand, because most (well, 9 out of 10 or so) resented the intrusion into their parenting, no matter how badly they were doing it.

Test word: rammicki: the mess left on a grocery store floor by a small child's head, after it falls from a cart because it was standing up.