Home Birth OB/Gyn Experience

[SoonerTexan]

But this goes back to the he said/she said - did he refuse to treat her because she wouldn't even answer basic questions and therefore really only wanted him to write her a scrip?

You know, I really don't know. The way she wrote it made it sound like she cut him off when he started to look incredulous and he wouldn't continue the appointment from there. She also stated there were other issues that she wanted him to check out as well. But of course, no one but her and the doctor really know for sure. I have a feeling it was probably handled poorly by both sides. Either way, it's interesting to hear perspective from all of you.

But this goes back to the he said/she said - did he refuse to treat her because she wouldn't even answer basic questions and therefore really only wanted him to write her a scrip?

Exactly. I have a hard time believing that she said "I don't want to discuss it, could we please just finish the appointment?" and he said "You're free to leave." Also the "I switched providers because I didn't want to be lectured" vein could have been said / interpreted in many different ways. I didn't get the impression that she was willing to go through the H&P and felt that he should just write her the script (as did many, many people commenting on her blog!) Many of those people are acting as though BCP is just another OTC kind of pill. Lots and lots of people can have very extreme reactions to it, and then she'd probably be back complaining "He just gave me the script to get me out of his office, and now my hormones are all whacked out."

Yes, in her "poor little me with my off-the-beaten-path choices" it would sound like the overreacted, but I doubt we got the whole story. Or perhaps he's a jerk and we did -- but her story just doesn't ring true to me.

[medpedspouse]

You know, I really don't know. The way she wrote it made it sound like she cut him off when he started to look incredulous and he wouldn't continue the appointment from there. She also stated there were other issues that she wanted him to check out as well. But of course, no one but her and the doctor really know for sure. I have a feeling it was probably handled poorly by both sides. Either way, it's interesting to hear perspective from all of you.

This is why I think the doc was in the right to walk away. Posting his name on the blog and the way she described how she acted in the reception area makes me think "stay away" from her. Again, from HER description, I think the "baggage" from her previous experience clouded her discussion with her new physician. I know you said that she is no "drama queen" - maybe she just had an off day then. I can only go by HER side of the story and her side does not paint her very nicely.

[Pollyanna]

Yes, in her "poor little me with my off-the-beaten-path choices" it would sound like the overreacted, but I doubt we got the whole story. Or perhaps he's a jerk and we did -- but her story just doesn't ring true to me.

I completely agree.

FWIW: I think the title of the blog alone is insulting.

ETA: "and you plan on educating yourself and taking charge of your own medical care" this statement from her reads, "hey doc, I will tell you what I want and you follow my direction because clearly I know what is better than you do". She talks about looking for OB/GYNs that are open minded but she never even gave this guy a chance, she shut him down before he could barely speak and then publishes his name on her blog. He did the right thing in not taking her on as a patient, IMHO.

[GrayMatterWife]

I **heart** drugs, medical staff in scrubs, and nearby crash carts. And not having to personal clean up/hose down the mess. And, I do cord blood donation, which you can't do at home.

My mom taught L&D nursing for 20 years and is way into the whole LaMaze-no-drugs-do-it-naturally-feel-the pain version of birth. Whatever. NFW. She was extremely annoyed at me for choosing an epi. To each their own, I say. But don't give me crap because I don't want to undergo a major medical procedure in an inflatable wading pool while breathing deeply.

[Meenah]

Well, I used to think that home birth was great. I have my own bias, DH is an Intensivist (ICU/Critical Care) and they are the ones who are called when there is a problem with the mother. Needless to say, he has a lot of experience with L&D disastors, because that is the only time he is called. Unfortunately, it happens way too often. Given that, my thoughts are home birth if you live in the neighborhood of the hospital, or hospital / birth center birth if you are REALLY CLOSE.

[Ladybug]

Exactly. I have a hard time believing that she said "I don't want to discuss it, could we please just finish the appointment?" and he said "You're free to leave." Also the "I switched providers because I didn't want to be lectured" vein could have been said / interpreted in many different ways. I didn't get the impression that she was willing to go through the H&P and felt that he should just write her the script (as did many, many people commenting on her blog!) Many of those people are acting as though BCP is just another OTC kind of pill. Lots and lots of people can have very extreme reactions to it, and then she'd probably be back complaining "He just gave me the script to get me out of his office, and now my hormones are all whacked out."

Yes, in her "poor little me with my off-the-beaten-path choices" it would sound like the overreacted, but I doubt we got the whole story. Or perhaps he's a jerk and we did -- but her story just doesn't ring true to me.

ITA. She just wanted the script without any cooperation or questions. She's a big risk both medically and legally. I don't blame him one bit although he probably could have presented his reasons more clearly.

[SoonerTexan]

She just wanted the script without any cooperation or questions.

I think that is way too much and unfair to assume based on her post. Maybe that's the attitude the doc had as soon as he heard "home birth" and walked out on her? Saying that you "Appreciate not being lectured on a homebirth choice" does not automatically imply she wasn't willing to answer any questions about her home birth or her history, just that she rightfully didn't want to be lectured about them. I took her comment about the birth control to be more of the, "Please stay and finish the appointment so you can prescribe me birth control as I am almost out of it" not necessarily demanding it no questions asked. She stated earlier in the post she needed a pap smear as well. If you read later in the post, she was upset that the doc told her husband that she refused to continue with state mandated questions, which I assume means she would have been okay with continuing as long as the doctor didn't openly mock her for her choice.

I cant tell from her post whether she said what she did politely or not, though I honestly hope she did. Still, would it have been the doctor's business to lecture her if she said she wasn't monogamous or if she didn't plan on using birth control? Both are choices that could be potentially seen as "harmful" but I have a feeling no OB/Gyn would go there. (well, maybe they would)

I guess I wasn't expecting such complete "villiification" of her, but I'm still glad I posted. If and when we ever get there and decide to go a non-hospital route, it will probably be in our best interest to make sure we don't make our decisions too public, lest it affect DH's future career.

ETA: Though I'm not saying she is without blame in the situation whatsoever.

[MrsK]

Still, would it have been the doctor's business to lecture her if she said she wasn't monogamous or if she didn't plan on using birth control? Both are choices that could be potentially seen as "harmful" but I have a feeling no OB/Gyn would go there. (well, maybe they would)

My doctor "goes there" when I discuss my birth control and reproductive choices with her. If she's prescribing birth control, I expect my doctor to explain the risks and benefits of my choosen birth control method. I'm not sure how "lecture" is defined here but generally if a patient is making decisions regarding her health -- and especially if those choices are harmful to her health -- the doctor should educate the patient. For instance, if a patient reports smoking, drinking excessively, domestic violence, or poor nutritional choices, it's part of the doctor's job to inform the patient of the potential risks of these behaviors. Likewise a doctor can educate a patient about the risks of not being monogamous or not using birth control without making a moral judgment.

[SoonerTexan]

Likewise a doctor can educate a patient about the risks of not being monogamous or not using birth control without making a moral judgment.

Yes--educate without judging. I agree and think what you described is perfectly appropriate. But I just don't think that is what happened in this case.

[MrsK]

What happened in this case: The doctor was surprised that she choose a homebirth and he asked whether she had any prenatal care from an OB/Gyn. That's perfectly reasonable. She states in her blog that "Anticipating what was coming I told him that I had switched from a previous provider because I had been lectured on my choice to birth at home and that I was just there to get some birth control and would appreciate not receiving a lecture on my choices." It appers that she is very defensive about her choice, that she expected to be judged, and she colored him with the same brush as the previous provider. Perhaps she would have been surprised by "what was coming next" but she didn't give him a chance. Telling him that she "would not appreciate a lecture" and that she is "just there to get some birth control" basically says that she is not interested in his professional judgment or advise and just wants the script.

[SoonerTexan]

It appers that she is very defensive about her choice, that she expected to be judged, and she colored him with the same brush as the previous provider. Perhaps she would have been surprised by "what was coming next" but she didn't give him a chance.

I agree, but I don't think he gave her a chance either.

[MrsK]

It was too late. She shut him down before he could give her a chance. If I had an initial interview with a potential client and they told me that they just wanted me to write a contract that said X without being "lectured" regarding whether it was enforceable or legal and that they fired their last lawyer because he refused to write the contract, I'd walk out. Doctors, like lawyers, provide professional services -- not products and not guaranteed outcomes. They are hired for their knowledge and expertise. If a patient comes in and says "I'd appreciate not being lectured" that's a big red flag. Yes, patients should be able to make informed decisions about their health but it's dangerous for doctors to work with patients that are defensive and combative. "I'd appreciate not being lectured" is like the phrase "with all due respect." It's rarely said politely and is usually a battle cry.

[Sheherezade]

I'm late to the party on this thread! I read the blog posts and I don't think the woman sounds like a horrible person - but I do think that she is expecting a doctor to assist her in executing her own medical choices. I'm not sure that is a doctor/patient relationship that suits all doctors. This is the part of the blog that stuck out to me:

Oh sure, because saying that you don’t want to be told you are a stupid idiot for choosing to birth at home and not use an OBGYN for your pregnancy is EXACTLY the same as refusing to cooperate with state mandated questions. Did his little form have on it somewhere: Be sure to treat patients like you know everything and they know nothing.

My bolding. It is one thing to have a home birth -- it is another to opt out of prenatal care entirely and then have a home birth. If she said to the doctor what she posted in the blog, I can see that he may have made the assumption that she had gone it alone and was now cruising doctor's offices to get a prescription for BC. If that is how she wants to handle her medical care, she would be better off going to Planned Parenthood or a similar birth control related program.

I suppose seeing the doctor was kind of like signing up for Jenny Craig meal delivery because you really like the Jenny Craig lasagna. When they hit you up with all the other weight loss information and programs, you can't be offended or surprised. It isn't a la carte shopping. I could have easily had a similar experience with my own GP when I went in with a clear idea in my head what I needed prescribed. (Allergy meds) I don't think it would have gotten the relationship off on the right foot to just tell her I was there to get nasal steriods and please don't weigh me and tell me I can stand to lose a bit because I've heard it before.

Honestly, the post made me consider BC issues more than home birth issues. As for home birth, I think you should be legally allowed to do so - but all the liability should fall on you and only you. I have also seen the rare horror stories that could have been prevented if the mother or child had been within striking distance of emergency care. My father was a pediatrician born at home himself - and he became totally against home birth after taking on a baby with severe birth injuries that would have been fine if born in the hospital. I think what bothered him most was that the home birth had been a total "choice" were as his was due to lack of medical care in his rural community.

BC, though -- maybe that should be more readily available without going through an elaborate doctor's visit. I think it is in other countries. (Don't know for sure.) I know that many more of the OB/GYN's I've met have a positive view of this than home births. I'm not sure that she should have to go through all that emotional drama just to get the pill -- but then again she could just go to Target and buy some condoms and skip the whole medical thing. JMHO. Also, I'm not sure planning to go to the doc on the day your pill pack runs out after her previous experiences was truly "good planning".

[SoonerTexan]

it is another to opt out of prenatal care entirely and then have a home birth.

She didn't--she was under the care of a midwife with monthly and then weekly appointments throughout her pregnancy, though I guess some would consider this no prenatal care. I followed her blog during this time and her midwife kept a close watch on her weight gain, because they were worried about gestational diabetes, and she wrote she would have not had a home birth had she tested positive.

Also, I'm not sure planning to go to the doc on the day your pill pack runs out after her previous experiences was truly "good planning".

I'd have to agree, though based on her previous posts I think it was more a problem of getting an appointment on time and fear based on her last experience.

I'm going to try and back away now...it's just harder to read some of the stuff since I have met her, and while I don't consider her a friend necessarily, I feel like I know her somewhat well based on her blog. It just seems more personal, especially since I hate to think my mother ever experienced something similar (though since most of my siblings were home born but doctor delivered, I don't think she did), or that I will myself someday. I really wish I knew the details of what happened now. You all made some good points about what the doctor might have been thinking/assumed, and while I still think he is at least 1/2 to blame for the situation, I have a feeling there was a lot of misunderstanding. At any rate, it is time to get my name changed