"I completely trust my OB" bit of a rant

emmyloustu · September 2009

I see this quite a bit on this board and the recent post about declining internals has me thinking a lot about this topic. Honestly, I am really surprised how many people in general trust a doctor's opinion 100% without a doubt. Docs are human beings and they are not always right! You have a say in your care and treatment - especially when it comes to childbirth.

Obs do things everyday that are NOT in the best interest of mom or baby!

Regardless of which type of birth you want to have (unmedicated, epi, csection etc...) you really need to educate yourself about what will be happening to you! Everything has risks and benefits.

I think a lot of the fear about L&D comes from not knowing what is going to happen to you and just trusting your OB blindly is not going to help.

I urge pregnant women to read and learn and figure out what is important to you about your childbirth experience. Pushed, Your Best Birth, & The Thinking Woman's Guide to a Better Birth are all a good place to start.

Just my 2 cents...

Stepping off my high horse now and zipping up my flame retardant suit!!!

NiniJ55 · September 2009

Yes

You are absolutely right. I love my OB but I do not trust anybody 100%. They are human just like me and there is always room for error.

Randa&Jerm · September 2009

While I understand where you are coming frm and agree with you for the most part, I think you need to have some trust and faith in your healthcare provider since they are the ones who have been way more educated in manners of health than the average Jane. Now, if something doesnt seem right to you or you arent comfortable with the care you are receiving I definitely wouldn't be opposed to seeking a 2nd opinion or doing something different than what my doc recommends.

mrswags05 · September 2009

I mostly agree, but I have also said (in the H1N1 posts) that I trust my midwife and will be following her advice on the topic at hand.

I think there's a difference between blind, 100% trust just because of someone's credentials, and confident, educated trust based on what you know of the person and their expertise/experience. I trust my midwife because I *have* done the reading, know what kind of birth experience I hope to have, and know that she will do her best to provide that -- and yet, she has much more experience in this area than I do, and sometimes I just have to default to her experience, which means trusting her judgment.

adriennevla · September 2009

While I am listening to my OB and she's really a great doctor (even though only a few years older than me), I'm also reading a ton and doing my own research. I'm pretty strong-willed so she'd be hard pressed to get me to do something I don't want. I think I lucked out, though, as because she's quite young she seems extremely open-minded.

I did have some fear about labor and delivery until I read about it and it was only after reading a ton that I decided I am going to try and go natural

CTri17 · September 2009

liv97 · September 2009

ditto the OP. Most people spend 10-20 minutes with their doctor at each appointment. for the most part, your doctor doesn't know you at all.

It shocks me how many people blindly follow their doctor without doing any independent research or thinking.

emmyloustu · September 2009

Randa&Jerm:
While I understand where you are coming frm and agree with you for the most part, I think you need to have some trust and faith in your healthcare provider since they are the ones who have been way more educated in manners of health than the average Jane. Now, if something doesnt seem right to you or you arent comfortable with the care you are receiving I definitely wouldn't be opposed to seeking a 2nd opinion or doing something different than what my doc recommends.

Absolutely! I probably should have pointed that out too. I do trust my midwives and my OB, but that doesn't mean that I just accept everything they have to say and never ask ?s. Personally, I feel many things are done that just aren't necessary and I have found that by discussing things with my Ob we are able to find common ground. Ex - I want a lot of freedom of movement during my labor and if I decide to deliver in the hospital instead of the birthing center, my OB has agreed to reduced fetal monitoring as long as things look good. Had I not asked, I would have literally been strapped to the bed throughout my labor - unnecessary, but done in L&D every day!

emmyloustu · September 2009

mrswags05:
I trust my midwife because I *have* done the reading, know what kind of birth experience I hope to have, and know that she will do her best to provide that -- and yet, she has much more experience in this area than I do, and sometimes I just have to default to her experience, which means trusting her judgment.

EXACTLY! This is what I was getting at.

heyhay82 · September 2009

I agree with you that women need to educate themselves, and should voice how they feel. But, I am one that trusts and has faith in my dr 100%, 1) my fertility specialist told I need to have 100% trust and faith in him, I did. I did everything he wanted me and my DH to do, and now we?re pregnant with twins. 2) I have gotten to know my ob very well, and she knows the type person my DH and I are, and she takes that in consideration, when seeing us. I have not had any problems since becoming pregnant; I follow her dietary, exercise, medicine and etc. suggestions and everything has been great. But, I believe you need to trust your OB otherwise, why are you seeing that particular one.

fenway2010 · September 2009

I agree that OBs are human, just like everyone else. I also agree that we should all make informed decisions, and not just follow blindly. That being said, my dad is an OB, and I have heard his side of this issue as well. He 100% wants his patients to be educated, to make informed decisions, etc. And he wants his patients to ask questions.

BUT, he said that when it actually comes time for the delivery, a lot of things happen really fast, and sometimes decisions need to be made quickly...for the health of the mother and baby. He says that his job, at this point, is to deliver a healthy baby and to keep the mom safe -- and that is where is focus is. It's not about comfort, or birth plans, etc. etc. He says that he -- and his colleagues -- do not take c-sections lightly (it's major surgery), or the need to induce lightly. In fact, in his practice, they will not induce for convenience, or schedule c-sections when not medically called for. And he has spent far too many nights at the hospital and time away from our family on birthdays and holidays for me to think that he would ever suggest either just so he could go home. And too many times,when it comes down to it, he says that he has had patients question his judgement as to whether a c-section is "really necessary" in the heat of the moment...not questions, mind you, about why it is necessary, but calling into question his medical judgement. All the while wasting precious time for the mom and/or baby.

And, in fact, he's had some bad outcomes because of patients that wouldn't follow his advice. He had one baby nearly die (and have resulting brain damage) because the mom refused an induction...even though she was almost 42 weeks, and the baby's vitals weren't stable. She was adament that "nature would take its course."He said if she had induced when he had suggested, the baby's vitals indicated that it was perfectly healthy.

I guess my point is that I think this is a two-way street. I try to be as informed as I can about decisions about me and my baby. But there's a reason I go to a doctor, and when delivery is imminent, my birth plan is to do what my doctor recommends, unless something seems really off-kilter.

Just my opinion....

MFalor · September 2009

YAY! I'm definitely an advocate for being in charge of your medical care! Do the research, use your intuition, and get second/third/fourth opinions if you want. I'm paying the physician to give me a service. If they don't want to play by my rules, I'll find someone else who doesn't think they're God -- though, with doctors, that's probably impossible!

(as an fyi, I work in a hospital with doctors and nurses and know all too well how incredibly fallible they are. Sometimes all that education just snuffs out any humanity or humility they might of had once upon a time.)

soontobecapek · September 2009

I totally agree, my OB made a pretty poor decision that could have killed my DS... so I definitely didn't keep him this time...

mdepping · September 2009

Tess12 · September 2009

You need to trust your OB. I've always said that and I believe it. But that doesn't mean blindly handing your life over to him/her. You need to take some responsibility for the health care you receive.

Married2MrWright · September 2009

Amen sista!

Anna&Matt · September 2009

fenway2010:
I agree that OBs are human, just like everyone else. I also agree that we should all make informed decisions, and not just follow blindly. That being said, my dad is an OB, and I have heard his side of this issue as well. He 100% wants his patients to be educated, to make informed decisions, etc. And he wants his patients to ask questions.

BUT, he said that when it actually comes time for the delivery, a lot of things happen really fast, and sometimes decisions need to be made quickly...for the health of the mother and baby. He says that his job, at this point, is to deliver a healthy baby and to keep the mom safe -- and that is where is focus is. It's not about comfort, or birth plans, etc. etc. He says that he -- and his colleagues -- do not take c-sections lightly (it's major surgery), or the need to induce lightly. In fact, in his practice, they will not induce for convenience, or schedule c-sections when not medically called for. And he has spent far too many nights at the hospital and time away from our family on birthdays and holidays for me to think that he would ever suggest either just so he could go home. And too many times,when it comes down to it, he says that he has had patients question his judgement as to whether a c-section is "really necessary" in the heat of the moment...not questions, mind you, about why it is necessary, but calling into question his medical judgement. All the while wasting precious time for the mom and/or baby.

And, in fact, he's had some bad outcomes because of patients that wouldn't follow his advice. He had one baby nearly die (and have resulting brain damage) because the mom refused an induction...even though she was almost 42 weeks, and the baby's vitals weren't stable. She was adament that "nature would take its course."He said if she had induced when he had suggested, the baby's vitals indicated that it was perfectly healthy.

I guess my point is that I think this is a two-way street. I try to be as informed as I can about decisions about me and my baby. But there's a reason I go to a doctor, and when delivery is imminent, my birth plan is to do what my doctor recommends, unless something seems really off-kilter.

Just my opinion....

this, exactly. That said I do run everything by my dad and I plan on having him present during labor and delivery to advocate for me. And no, he will not be delivering my baby like everyone always asks.

IlovemyGeek · September 2009

I take what my OB says with a grain of salt. There are things that I am adamant about like not having an episitomy and hell hath no fury as a pissed off Italian/Irish pregnant women who is not listened to.

ktang · September 2009

I posted a reply to this in the declining internal exams thread, but I think the discussion has since reached more of a compromise. I no longer practice OB, but as someone who used to be an OB, and who continues to care for patients as a surgeon, I always feel as though I have to defend physicians and our reasoning for the suggestions/decisions we make.

Statements such as those made in the original post are extremely hurtful, as we spend our days (and sacrifice decades, and sometimes the sanity of our spouses, to medical training) trying to offer patients options for what we believe is best for them and their families. We can't force anyone to do anything, we can only discuss our own experience, the literature as we are responsible for knowing it, and what we believe will be best for you. Virtually nothing I do is 100% non-negotiable, I am constantly telling patients that these decisions are up to them, and there are often several options available. Patients should place their trust in medical providers and make medical decisions as they see fit, but at some point they have to trust that I'm not lying to them, or doing something completely flaky or nonsensical.

As in the case of the poster above, whose father is an OB, I've had or heard of cases where the OB strongly suggested immediate delivery, i.e. forceps/vacuum/C/S, based on a bad fetal heart rate pattern, and the patient refused, thinking they "knew better" - and had something bad happen. These cases are VERY rare, but in general, if your doctor/MW/etc says that something NEEDS to happen for your health or the health of your baby, I would hope that you would have enough faith in his/her judgment to trust them. At some point, having read a few books does not stack up to years and years of experience and medical training, and ultimately that is why we have OB's/MW's, and not everyone is at home "freebirthing" on their own.

epphd · September 2009

Emmylou I love you I totally agree, of course! I definitely trust my Ob in her capacity as an Ob. But she is not an infectious disease specialist; she is not an immunologist, and she is not a research scientist. So as a research scientist myself (with a Ph.D. and everything), I will not defer to her pat endorsement of the H1N1 vax (for instance).

That said, I don't find the need to be adversarial with her - as other posters pointed out, being educated and asking questions has helped her understand my point of view and me hers - so we are now on "the same page." She understands my concerns about the vax, and supports my decision to decline it (if that is what I choose) She will ensure that if I do get sick she will provide me with agressive treatment and monitoring.

WRT to labor and delivery - when I first mentioned natural childbirth she recoiled... we talked more and as I explained what I wanted and what I did not want, she was able to understand that I am not anti-medicine at all... and she was able to provide me with information that me comfortable continuing treatment with her.

So - yes, educate yourself; ask questions, and demand to be treated like a sentient, empowered person!

PiPhiRN · September 2009

I know nothing about birthing babies, I am pg with my first, and I trust my OB, this is why I picked him. However, I am an RN and I do see how patients or their families sometimes think they know what is best for them, when they have no idea, and can make things far worse for themselves in the long run and waste precious time arguing. Anyone can read a book, and I have read a lot of literature on the subject since becoming pregnant, but when it comes down to it, I am not an expert. I am paying someone else to make those decisions for me. I have ways I hope things get to go, but I do not expect this to happen. Plans in general, especially medical plans, hardly ever go 100% as expected. So you can be bullish or hot headed, but you are just hurting your baby or yourself in the long run.

emmyloustu · September 2009

ktang:
I posted a reply to this in the declining internal exams thread, but I think the discussion has since reached more of a compromise. I no longer practice OB, but as someone who used to be an OB, and who continues to care for patients as a surgeon, I always feel as though I have to defend physicians and our reasoning for the suggestions/decisions we make.

Statements such as those made in the original post are extremely hurtful, as we spend our days (and sacrifice decades, and sometimes the sanity of our spouses, to medical training) trying to offer patients options for what we believe is best for them and their families. We can't force anyone to do anything, we can only discuss our own experience, the literature as we are responsible for knowing it, and what we believe will be best for you. Virtually nothing I do is 100% non-negotiable, I am constantly telling patients that these decisions are up to them, and there are often several options available. Patients should place their trust in medical providers and make medical decisions as they see fit, but at some point they have to trust that I'm not lying to them, or doing something completely flaky or nonsensical.

As in the case of the poster above, whose father is an OB, I've had or heard of cases where the OB strongly suggested immediate delivery, i.e. forceps/vacuum/C/S, based on a bad fetal heart rate pattern, and the patientefused, thinking they "knew better" - and had something bad happen. These cases are VERY rare, but in general, if your doctor/MW/etc says that something NEEDS to happen for your health or the health of your baby, I would hope that you would have enough faith in his/her judgment to trust them. At some point, having read a few books does not stack up to years and years of experience and medical training, and ultimately that is why we have OB's/MW's, and not everyone is at home "freebirthing" on their own.

I apologize, if you found my post to be hurtful, but I stand by what I wrote. It sounds like you are a wonderful doctor who encourages her patients to converse openly, be educated about their care and have a say in their options (when it is reasonable) , but not all medical professionals are of that mindset. My new OB and MW are, but I have not always had that experience.

When having a conversation with a male OB in my last practice about my desire for a natural childbirth experience, I asked about freedom of movement - walking, ball, shower, etc.... He looked me dead in the eye and said, "Trust me, you are not going to want to be up walking around or on a birthing ball. You are going to be in pain and much more comfortable in a bed." REALLY??? That theory makes no sense to me and is contrary to everything I have read and learned (in my childbirth class) about unmedicated birth.

Of course I trust my MW, I could never even consider having my baby in a birthing center if I did not. Trust comes up in your first appt with the MW and they are pretty straight forward that it is a necessity to be their patient and there are things that are non-negotiable.

I think you and I have more common ground on this issue than it first appeared!

BabyGurlE1 · September 2009

MFalor:

YAY! I'm definitely an advocate for being in charge of your medical care! Do the research, use your intuition, and get second/third/fourth opinions if you want. I'm paying the physician to give me a service. If they don't want to play by my rules, I'll find someone else who doesn't think they're God -- though, with doctors, that's probably impossible!

(as an fyi, I work in a hospital with doctors and nurses and know all too well how incredibly fallible they are. Sometimes all that education just snuffs out any humanity or humility they might of had once upon a time.)

Oh, this is such an old and tired statement, are you serious?

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