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mphitheaters
and cold white lights. Women screaming and hollering. Moments of soft glows from
an expectant mother’s face. “Where’s Dad and the
rest of the family?” Back in the room. “Is it over already?” I remember those days in medical school with women screaming in pain,
the lack of privacy and the mechanical nature of delivery.
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hat atmosphere has now been replaced by immaculate rooms with ornate interior design, “hotelesque a la hospital,” stirrups hidden, and monitors sequestered like a home stereo. Prenatal classes allay the anxiety of natural childbirth.
Bonding and joy
Such has been the evolution since the 1960’s toward natural childbirth, and, in some cases, home delivery.
What? She squatted and had two kids outside the hut? She went into the room and the kids were having breakfast and Dad was at her side. The doc gave her support. All of a sudden, the crying - new life! Yes, we have all changed. And certainly doctors have changed - or are changing. Women in America too have wanted different experiences.
With our lives more planned and the expectations for more personal control, we use contraception linked with the components of estate and tax planning and have come to expect the “perfect little baby” each time one is created.
This is coupled with high medical malpractice insurance of over
$130,000/year, the evolution of genetic testing, ultrasound,
and fetal monitoring as our scheduled, planned technological society strives
for perfection with a profit.
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esarean sections in the state of Florida are now running 27%; that is, one out of every three to four children born. And yet, we hear that 95% of all births have the potential of being normal and spontaneous.
“Gee, I went to that obstetrician, and boy! I just couldn’t stand him anymore!” Or, “I’m not going to have them put me up in stirrups with those bright lights in that shiny operating room. They won’t even let me see my baby after it’s born! I don’t want to be put to sleep.” “Would you deliver my baby at home? How much do you charge? Oh, that’s a lot less than the hospital. Okay - we’ll go with you. Oh, by the way - how much insurance do you have?”
Birthing centers have become an alternative and hospitals have changed their orientation over the years. Healthcare is more consumer oriented.
Unfortunately, Cesarean section rates are often as high in the hospital birthing
centers as before.
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remember
doing home births in another state, and an obstetrician/ gynecologist who had
agreed to work with me was allegedly threatened by his professional college with
being summarily rebuked and possibly excommunicated if he continued to offer his
referral services. And interestingly, in Massachusetts, lay midwives can deliver
babies at home while nurse midwives, who work under the auspices of a doctor,
cannot. How can we have a society
where midwives’ insurance costs are extremely low (some can’t get any) or in
some cases they don’t pay for it at all, while obstetricians, in order to feel
comfortable, must pay over $130,000?
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xtending relationships builds, whereas denying others involvement creates an aura of omnipotence. The polarity between the obstetrician/gynecologist and the woman, yet, is understandable.
Says the obstetrician, “But I’m the one getting sued, and I want the rules to be played my way.” And the patient replies, “But I want to have my baby this way, and I don’t like your attitude.”
If more OB’s cease to deliver infants, this may be compensated by the
lower fertility rate, but finding a way to ensure peace between the
mother’s gleam and the doctor’s need to help and provide is really what so
many of us are searching for---even doctors.
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ow
we have an evolving public - more informed, more critical, more desirous of
choices in the ways of approaching their personal lives. Of course, we all want safety, and a physician certainly feels the duty
to provide a responsible and safe
delivery where it is at all possible.
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ut
how do we meld the balance between high malpractice for obstetricians and the
fact of life that babies are going to be with us, and will be born on a regular
basis – most without complications? How do we separate and build into our
society a way which protects even the most unprotected infant or neonate, and yet at
the same time offers to all people the opportunity of a comfortable, satisfying,
and emotionally enriching experience?
Our country is a land of opportunity, efficiency and excellence, as
well as choice and security. How do we build our institutions to
respond to our needs and still preserve responsibility, public trust and
personal choice?
Table of Contents, What's Up , Doc? / Home
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his
anxiety associated with birth may always be with us, generating the energy which
hopefully shall lead us to a solid, balanced solution. For all eventually
depends on trust - trusting in the outcome of the natural progression of a
natural action.
Eh….What’s Up Doc?