Friday, April 30, 2010

Should You Switch Doctors/Hospitals?

If you are asking yourself this question, whether it is at the end of your pregnancy or the night before a surgery, the answer is probably yes. At the very least, you owe it to yourself to explore your options and the the issues that are making you uncomfortable. Intuition is a powerful tool. If something doesn't feel right, it probably isn't.

Sheridan of the Enjoy Birth Blog, just had a series of posts about comparing two births that were similar, but had two very different results based on the hospital's policies and the OB's approaches: one had a vaginal birth and the other a cesarean. Fortunately, the doctors were kind and inclusive during the cesarean so the mom still feels good about it, but she probably could have avoided the surgery had she followed her intuition and switched providers. We all do the best we can with the information we have at the time. There are things that I wish I would have done differently during my first pregnancy like try an ECV or research vaginal breech birth and look harder for a provider who would let me try or at least wait until I went into labor before having the c-section. I felt like I didn't have any realistic choices at the time so I focused on having a good c-section experience. I did have a good experience, but it was still major surgery which will effect every pregnancy after and have future consequences that I can't predict.

Sheridan's post is timely, because this topic has come up on the forum recently. I made a long response which I thought,"Hey, this would make a good blog post!" So here it is with personal details removed:

If the doctors won't answer your questions at appointments, you can bet more of the same during your birthing time. Docs like this do not want patients to be involved in their own care. It is a sign to change doctors/hospitals.

If you leave the appointments crying, it is a sign to change doctors/hospitals.

If they flat out tell you that you cannot have what you want, despite scientific evidence that what you want: movement in labor, no iv, no continuous EFM and skin-to-skin bonding with baby immediately after birth, is best for baby, it is a sign to change doctors/hospitals.

The best case scenarios in these cases, do not have you getting what you want. It may seem like an overwhelming prospect to travel to give birth, but if you can't get what you want locally, it is well worth it. I flew halfway around the world and then drive two hours to have the birth my baby and I deserved. It was worth it. All that effort just to let nature take its course. Nature's course is pretty awesome. I just let my body do it and I knew I didn't have to fight. Fighting/stress interfere with your natural processes.

Sometimes women worry about their husbands missing the birth, but if your birth goes so fast that your husband can't get there (as mine did) you won't care. I am so glad that I had a fast, easy, doula and midwife-supported birth that my husband missed by 1.5 hours (because he was driving and his phone didn't work in the US, otherwise, he would have made it) than a traumatic experience where I was bullied, disempowered and separated from my baby, or in my case, forced to have a repeat c-section that I did not want.

If you settle for a hospital/doctor that is less than what you want and you have a bad experience, your husband will pay the price for that. He will be the one that will have to deal with your trauma and possibly resentment towards him.

Why is feeling good about the experience important? Because feeling bad about it can be haunting and traumatizing. It can trigger or make worse post-partum depression and interfere with bonding. Not everyone is negatively affected by being bullied or not even bullied, but simply excluded from the decision-making process, but if you think you might be (I know I would) then refuse to accept it.

Also, ALL doctors say they only do c-section when they are medically necessary, but the rates at which some doctors find it necessary are very high. Being flat on your back and restricted from eating and drinking and getting fluid overload from an iv are all ways to increase problems that may cause your doctor to find a c-section necessary.

As foreigners, it is hard to find an ideal situation where location, language-ability and care practices are exactly what we would want. However, if you are calm, firm and persistent in interviewing doctors and stating your wishes both before birth and during birth, you can get what you want.

This message might sound harsh, but I just want to stress the importance of choosing a care provider. It is one of the most important choices you can make. You need someone you can communicate with and who will include you in the decisions. No matter what the result, if you are informed and participate in the decision-making, you can feel good about the experience.

At the very least, you owe it to yourself to explore your options. You have choices. Explore your options, both near and far and then make a decision. Listen to yourself and your intuition. Details such as where you will stay can be worked out. Sometimes payment can be worked out.

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