Posted by My OB said WHAT?!?.
Aug
30
Posted by My OB said WHAT?!?.
“Well, That Depends On What You Mean By Natural..”
“Well, that depends on what you mean by natural? We require an IV be placed upon admission, and we need to have continuous monitoring so you won’t be allowed to move any further than the length of the wires, and we prefer you stay in bed so we can get the best readings.” -OB to mother expressing her desire for a natural childbirth.
There are 27 comments to this post.
I wonder if the OB was as frustrated with the hospital policies as anyone else and was trying his best to warn this mother that she better birth elsewhere?
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Brige Reply:
August 30th, 2010 at 5:46 pm (Quote)
our OB was the same way… he mentioned that his hands were tied by hospital protocol, which was determined by the insurance companies… I appreciated their honesty… but they also went on to refuse to care for me because I wouldn’t to the GTT and didn’t do the QUAD screen… ?
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Cmat Reply:
August 30th, 2010 at 6:49 pm (Quote)
Really? I understand why the GTT is important (though I can also see why you would refuse it) but the quad screen in the first trimester is supposed to be optional. It always has been for me and no one has ever given me crap for that. That’s a load of crap to drop you for that.
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Brige Reply:
August 30th, 2010 at 7:14 pm (Quote)
Sure the GTT is important for someone to take if they are presenting with GD signs, but there are numerous less “stressful” ways to test for it… IDK how often during pregnancy you’d down a quarter cup of sugar, but on the advice of my completely anti-natural childbirth/anti-midwife FIL who said that there was no need to make a pregnant woman put her body through that kind of duress when you can eat a normal meal and test blood sugar two hours afterward… I akin the GTT test to saying hey we know you do well with a beer or two so hey finish this 24 pack and we’ll see what your body does…
personally I am super sensitive, stomach wise, to sugar while I’m pregnant, like can’t drink root beer without upchucking to the point of breaking blood vessels in my face… now the office I was at didn’t ask why, or if there was an alternative I was willing to try, they just stated that based on my refusal to do those two tests, and I hadn’t seen them in 6 weeks (I went home and saw my FIL for care while there) that I was too high risk and that the hospital they deliver at wouldn’t be able to handle something if it went wrong… fortunately the other part of why I wouldn’t take the test that day was because we we’re in the middle of packing for our PCS across the country the next day… and I really didn’t have an hour to waste…
The GTT gives sooooo many false positives, I also believe that what is normal for you or sally joe may be horrible for me, and vice versa… Ultimately I don’t really believe in standardized testing… I believe in individualized patient care…
PS. I also test my peepee (technical term I know) everyday for ketone, glucose and protien overspill, not to mention the other 7 factors on the test, I keep a food diary, and compare what I eat to differing results… I know its probably not the norm, but I am very aware of what is going on in my body, and refuse to be treated like a child who has no clue… and is incapable of participating in dictating care…
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Lauren Reply:
August 31st, 2010 at 12:42 am (Quote)
I heart you Brige. 
With my second baby I refused the GTT and the midwives at the birthing center were all of a tizzy LOL! At every appt they checked urine anyway, and with my lack of personal or family history for diabetes…I wasn’t worried. Plus I think GD is insanely overdiagnosed, seeing as how they are harassing pregnant women for readings of 120 a couple hours after eating!! The tests/protocols also fail to take into account that ethnic groups like Asians and Hispanics tend to have higher blood glucose as a norm, and that we NEED to hold onto glucose longer to grow our babies in the first place. It’s so frustrating.
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Erin Reply:
August 31st, 2010 at 7:25 am (Quote)
I hear you guys. I had hyperemsis during my pregnancies and it’s not exaggeration to say that my GTTs were excruciating. The second time, I was so nauseous I turned gray and was afraid to move. I looked so terrible that the phlebotomist actually said to me “Please don’t throw up on me.” I managed not to, but I vowed I’d never take one again, even if I “failed” it. Luckily, my midwife (who was different than the one I saw for my first pregnancy) said, I’ll never make you take one again, after seeing my results: 67 (and I did *not* fast before the test). I could tell everyone that I had low blood sugar ’til the cows came home, but they were determined to make me take that stupid test (even in my first pregnancy, when I was almost passing out every ten minutes because of my low blood sugar, which the midwife *diagnosed* as low blood sugar).
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Serene Reply:
September 1st, 2010 at 8:45 am (Quote)
I refused the GTT in my last one because well, I have type 1 diabetes already.
I had this one midwife for 3 appointments running because my reg midi was away at a conference and I had weekly appointments all through the pg because I was so unwell. She just happened to be the NUM, so that made thing so much harder 
Anyhoo, she never bothered to read my file. Just insisted on the GTT and had a fit when I said no. Well, I already *have* Diabetes, so how can I get GD too? Top it off, I refused iron supplements she demanded I take for anaemia because the supplements themselves say they are not to be taken by people with IBS, and I have IBS. Duh. I was reprimanded for my weight and BP being too high, though she never bothered to notice that my weight is high because of corticosteroid use, and my BP is high because of a thyroid condition. I was questioned every visit by her as to why I was not off “all that medication yet, it cant be good for the baby” even though it was keeping me ALIVE! Every single visit she would harp on about the same things, things I could not change and things that were dangerous and unnecessary.
All this together is why I had the weekly visits. I was so glad when Fiona came back from her conference! But the kicker was watching her face when I told her that if she wanted me to have the GBS screen she could stick the swab up my arse herself. My regular midi (Fiona) was there for that appointment and she told me afterwards that she had to bite the inside of her cheeks to keep from laughing.
Sometimes you honestly have to wonder WHY people are in this job if they cannot listen and cannot read.
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Just switching to saline lock and intermittent monitoring would be a HUGE difference for this mom. It still wouldn’t be perfectly natural but it would give her a shot of doing it ‘drug free’ without having to leave the OB’s care.
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Stephanie P Reply:
August 31st, 2010 at 6:53 am (Quote)
Exactly! Who does it help to have mom and baby kept in one place? Labour goes on longer than it should when we’re required to lay flat. I remember a nurse bringing in one of those little heartrate monitors and using it on me IN the tub so I could be as comfortable as possible and the baby still had hourly monitoring. She was happy, and I was happy. I LOVE hearing my baby heart-rate. Plus, you can guarantee that she’s working for the right place whereas if you move a milimetre the strapped on monitors lose the signal and then they can say all sorts of things about dips in the heart rate…!
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I’d say this is a major policy fail, but I’m pleased the doc at least knew that “natural” does not just mean “no epidural”. He could provide “no epidural” but he knew that that was setting the mom up for a hard time.
I hope the mom found somewhere else to deliver!
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What the OB fails to do is tell the mom that if she insists on doing without those things, all she has to do is agree to sign AMA waivers. That’s what I had to do with my last hospital birth. Of course, if her experience ended up being like mine, the hospital staff would end up doing everything in thier power to undermine it, but at least she would have a better chance than just giving in from the start because of ” policy”. However, even though I ended up with way more interventions than were needed, there was a silver lining- I had every nurse on the staff coming in to ask questions about why I wanted as few interventions as possible. None had ever seen anything like what I was doing, much less a truly natural birth. So the ones who were willing to be open-minded discovered there was more to labor than what they were taught.
I hope this mom ended up getting what she wanted,though- even if it meant finding another doctor.
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Alyson Miers had this to say,
Aug 30, 2010 @ 6:22 pm (Quote)
I can’t fault this doc’s honesty. It’s far more mature and humane than the old bait n’ switch.
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Points for honesty, maybe.
When I spoke to docs about this, they told me it was up to hospital policy. But when I called the hospital to find out their policies, they told me it was entirely up to doctor’s orders.
Sooooo…..
I think one hand feeds the other, here.
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She was being honest, but I think she was really trying to discourage me from staying in her practice. She had been my OB for years, but with my first pregnancy I did not have insurance, so I never went to see her I went directly to a home birth midwife. When I came in at 6 weeks post partum to get birth control, I think she was extremely upset I had had a baby ‘without’ her prenatal/delivery care. So when 2 years later, I have great insurance and come in to see her, she was less than pleasant. She did not want to deal with a natural birth, and made it clear up front.
She also mentioned all the tests she ‘required’ me to undergo, and I told her that I was not interested, which made her upset. She even went so far as to ask me how would I know if I needed an abortion without these tests? Really you are mentioning abortion to a newly pregnant mother in your office for prenatal care?
I ran, as fast as I could, right back to my midwife. And we all lived happily ever after.
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CCindy Reply:
August 31st, 2010 at 10:00 am (Quote)
Glad you all lived happily ever after.
Now here is a female OB who is undergoing a crisis of faith in her profession. Remember in Pushed how all the nurses left after the they saw how birth works natually during the hurricane? How much harder must it be for an OB who may have $100k in student loans to figure out that her “standard of care” does more harm that good. You can bet your bottom dollar that she never wants to see your face again. It is a mirror to her of everything her profession is doing wrong. Pray for her that she will find a way to practise as God intended rather than as her malpractise insurance company dictates.
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Sarah Dorrance-Minch Reply:
August 31st, 2010 at 1:07 pm (Quote)
To me, it seems almost as though your OB/GYN took your decision to go with homebirth and a midwife as a personal rejection, rather than as a choice made for reasons both philosophical and pragmatic.
If that is indeed the case, how bizarre and nonsensical.
I don’t understand my fellow humans. Truly, I don’t.
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Sarah Dorrance-Minch had this to say,
Aug 31, 2010 @ 1:01 pm (Quote)
This is a perfectly natural way to give birth.
If one happens to be the Bride of Frankenstein.
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“So, no, then.”
But again, some women define “natural” as “the baby emerged through the vagina,” so for them, this might be perfectly fine. At least the doctor was being honest about what a woman in this practice could expect.
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