Home Birth OB/Gyn Experience

[SoonerTexan]

You never see men in rabid fights about whether their wives are breastfeeding.

Nope--but I would kind of like to because I think it would be a little hilarious

[SoonerTexan]

Oh, and another med student we know just posted this on facebook. It doesn't deal with home births, but talks about midwives. It's an interesting read, especially the parts about liability, etc.--I wish he had links to the studies he cited.

http://www.boston.com/yourtown/cambr...:share:article

[PrincessFiona]

So...I was more stuck on the fact that she seems crunchy, pro-homebirth, but was bottle propping repeatedly so she had her hands free to read in her most recent post. LOL

I think, based on her description of her behavior (particularly in the waiting room) that she went in kind of expecting a bad experience and so she got one.

Also, why couldn't her midwife prescribe b/c? Are they qualified to provide prenatal care and home birth but not b/c?

All that being said, the latest first time pregnancy C-Section figures have come in at nearly 30%. Seriously....It's no wonder people are running for home births. What is UP with such high section rates in some hospitals in this country? Also, many hospitals are now refusing to allow people to do VBACs...

Kris

[TulipsAndSunscreen]

So I admit that I didn't read thru all the posts but her comment that the MD had commented her child was cute and she called that "an obvious comment" seemed a little strange to me. And perhaps a wee bit combative. Does she take off everyone's head who tells her that her child is cute? I mean it's an infant, does she want to hear it's good at math??

Maybe that's stupid but her whole tone seemed combative to me.

[Pollyanna]

So...I was more stuck on the fact that she seems crunchy, pro-homebirth, but was bottle propping repeatedly so she had her hands free to read in her most recent post. LOL

Goes to my perception that she is exceedingly self centered.

All that being said, the latest first time pregnancy C-Section figures have come in at nearly 30%. Seriously....It's no wonder people are running for home births. What is UP with such high section rates in some hospitals in this country? Also, many hospitals are now refusing to allow people to do VBACs...

There are a variety of reasons for a 30% c-section rate. A small percentage of those are done at maternal request (some women want absolutely nothing to do with a vaginal delivery). Another larger percentage is repeat sections where women who could do a trial of labor refuse. Not everyone is interested in VBAC even if they are a candidate. There are lots of rules that have to be followed to VBAC for the safety of the mom and baby and because of lawsuits. As unfortunate as it is, physicians and hospitals have to do CYA medicine a lot of the time. I don't remember all the hospital guidelines for VBAC but I know a physician has to actually be present in the hospital. For a training program that is not a big deal but for many community hospitals there is not 24 hour in house coverage in the event of a uterine rupture. Its not simply a case of docs not wanting to VBAC, lots of things have to be in place. and of course there are also the cases when a section is absolutely necessary for a variety of reasons. I know the media and public like to believe that the rate is high because doctors just want to get to their golf game. Funny thing is that most of the private practice OB/GYNs don't even have time for hobbies let alone dinner with their family on a regular basis. Just like everything, it is far more complex than it may appear on the surface.

[poky]

There are a variety of reasons for a 30% c-section rate. A small percentage of those are done at maternal request (some women want absolutely nothing to do with a vaginal delivery). Another larger percentage is repeat sections where women who could do a trial of labor refuse.

The 30% quote was FIRST TIME PREGNANCY c-sections. That can't include repeats, by definition.

I had the same thought initially re: bottle, but then I gave her the benefit of the doubt and assume it was expressed breast-milk. However, I did find the "tweeting on the way home from the appointment b/c I was so mad" to be really silly.

As for the higher rates of c-sections, I *do* think there is a bit of a push from some docs for c's, or they give the option over to the mom with a "well, you could try but would end up with a section anyway" schpiel. I've got 2 friends who had sections with their first baby, and had been given the option by their doc (2 different docs, BTW). Both had babies that looked big on a late term u/s (and we know how much those puppies can be off!). One ended up being nearly 10lbs, the other was in the low 8's. We'll never know if these babies could have been delivered vaginally b/c the moms were given the choice before labor ever started, and were scared by the idea of laboring and pushing for 3 hours and THEN having a section ... which is what could happen to any of us.

As with everything, there are always two sides.

[Vishenka69]

Some men do take very strong stands re c-sections and breastfeeding. While still pregnant, I was lectured by my good friend's husband against vaginal birth and breastfeeding. For some reason he decided that both are outdated practices and are pushed on women against their will. My friend had a c-section and pumped for a couple of weeks before fully switching to formula.

A number of our friends had complications with hospital births and I was completely freaked out. Luckily everything went very smoothly and I absolutely loved the OB that delivered DD. Although I guess I can see how some truly crunchy women would choose to do home birth, I don't get the pick and choose approach. As in, when it comes to delivering doctors are evil, but when I want a prescription, then they're ok. I wouldn't feel comfortable with a random doctor just prescribing whatever, it's just not safe. I don't think patients should demand any particular medications without discussing pros and cons of that drug for their particular case. But that's a whole other debate of advertising prescription medication directly to consumers.

[mommax3]

Home Birth OB/Gyn Experience

Funny thing is that most of the private practice OB/GYNs don't even have time for hobbies let alone dinner with their family on a regular basis. Just like everything, it is far more complex than it may appear on the surface.

This, absolutely. As of this evening, my husband has worked 70 hours since Friday morning. He was on call all weekend, but I am only counting the hours he was actually in the hospital. He will easily work 30 more hours this week, even though he has Friday off. This is not unusual. His job IS his hobby.

The program where he trained prided itself on its low section rate, but he also saw some HORRENDOUS tears during those years and is sure many of those patients would have opted for a section instead if they had been given the choice. He will do a trial of labor if patients want to VBAC....about 10% of eligible patients try it....and he stays in house for their entire course of labor. Truth is, docs don't get sued for doing sections, but if they don't, and something goes wrong, the immediate conclusion is that they should have.

[SoonerTexan]

So I admit that I didn't read thru all the posts but her comment that the MD had commented her child was cute and she called that "an obvious comment" seemed a little strange to me. And perhaps a wee bit combative. Does she take off everyone's head who tells her that her child is cute? I mean it's an infant, does she want to hear it's good at math??

She said "commenting on how cute T1 is (an obvious statement)"

I REALLY don't think she meant at as a rude remark against the doc at all--just saying that she thinks her kid is cute and so "obviously" the doctor agreed. Maybe it's hard to understand her tone without reading for awhile. But I do think it is interesting how easy it is to pick and choose certain things from someone's blogs (or online comments, facebook, etc for that matter) or even a news story about them and make sweeping generalizations about their intelligence, behavior, or mothering (or other) qualities--I'm guilty myself. In fact, this blogger is probably guilty of it with the OB (though I still feel he shares some of the blame). It's something I'll keep in mind the next time I jump to a snap judgment about someone.

And now, because I am getting way too emotional about this and jumping on my husband of only 2 weeks about this subject, I really truly am going to try and tear myself away and let it go for now.

[MrsK]

I agree that the "obviously" thing was probably an attempt at levity.

I'm wondering why you are so emotional about this? We are not even debating the home birth issue regarding which you have already stated your position. While homebirthing is not for all of us, we have been supportive of your position. The topic at hand is the doctor/patient relationship and when it is appropriate for a doctor to decline to see a patient.

[SoonerTexan]

1. Yesterday was just one of those weird emotional days--I think all the change and worry from the wedding, moving into a new place, starting a new job, figuring out how we are going to do this in general etc. just finally caught up to me. Like I said, I bit my husband's head off about random things and I just should have stayed away in general

2. It wasn't the position on homebirthing that bothered me, just the comments that picked her apart and labeled her in a certain way based on one thing that she wrote. I thought it was unfair and really just kind of mean--though I understand emotions from those who could have a husband in the doc's situation get involved as well. If it was a random person, I probably wouldn't have taken it as personally, but since it is someone I sort-of-know (and feel like I know because of her blog) it is hard not to take it a little more personally. I read her because in some ways I am a lot like her (though certainly not in every way--not as forthcoming with details of my life and opinions as she is) so I guess that's an additional factor? And probably something I should have considered before I posted it, though I really did want to hear "medically minded" opinions.

It really did make me realize how easy it is to judge someone based on one thing they say or do, or one aspect of their life, if you don't know more about them, though. At any rate, sorry for being the overemotional freak yesterday.

[GrayMatterWife]

Rapunzel: Thanks for posting! Very informative re: the LDS world. Interesting!

Personally, I think it's just looney to care that passionately and deeply about OTHER people's choices. It's fine to be passionate about something (breastfeeding, homebirthing, cloth diapering, co-sleeping, whatever) and to share your positive experiences, but it's so weird to me that people get self-righteous about the decision or be judgmental of others who choose differently. Why would anyone really care? Sounds to me like people who do that are somehow actually a little insecure about being judged themselves.

[Pollyanna]

She might just be opening herself up to a libel lawsuit. I know if this was my husband being named by a blogger in such a negative fashion we would be exploring a legal option against her. Because, she is definitely intending to harm his career and livelihood by posting what he might consider to be false and defaming information. SoonerTexan, you might want to warn your blogger friend about that. She might reconsider given this perspective and remove the doctor's name from her post.

This is very true. I would encourage her to remove his name ASAP.

[Ladybug]

Great post, Rapunzel. What you said about her defensiveness is very interesting and probably true about where she is in her journey off the beaten path.