Doctor Feedback
I really appreciate everyone's input on the birth plan. All of your unique perspectives are so valuable to me as Jake and I sort through how best to comport ourselves at the hospital. Please email or post any additional thoughts or comments you have that you think might be helpful to us.
My doctor sat and actually read my birth plan this morning, which really surprised me. I assumed she would take it to read later, and I had planned to bring another copy to my appointment next week under the assumption that she wouldn't actually get around to reading it, etc. But, she stopped everything this morning to read it, and discuss with me on the spot many of the points in it. Here were the items that she chose to comment on, and her responses to them. (I tried to quote her as accurately as I can, and used most of her own words.) I'm still allowing the exchange to bubble around in my head, so my feelings about her responses will probably surface later.
1. Desire for natural delivery: "Pain medication is totally up to you. But, since you have chosen to give birth in a hospital, you have to realize that intervention is part of that environment. I cannot stand by and do nothing if a problem arises."
2. Rejection of the use of labor augmentation medications: "I'm willing to let you labor on your own, but if things become stalled for quite some time, I'm going to suggest we rupture your membranes. It's the least invasive method (ie: compared to pumping me up with Pitocin) and I think you'll find you'll be more comfortable without all that pressure from the bag of water."
3. Rejection of continuous fetal monitoring: "It's fine to do intermittant monitoring, but if we see some disturbing patterns, I'm going to want to put you on continuous monitoring. If I don't know what's going on with the baby, I can't make the most informed decisions for your care. I don't want to just be guessing."
4. Rejection of episiotomy: "That shouldn't be a problem. We very rarely perform those anymore."
5. Rejection of forceps or a vacuum: "If you have been pushing for a while and the baby's heart rate is taking big dips, I will use the vacuum to deliver him. I understand you want to avoid it, but I can't allow him to go into distress and not do anything about it."
I summarized Jake's and my position by saying, "I realize there is a fine line between what we would like to do and what must be done. I want to make sure that I am always on the right side of that line, with regard to Snippet's and my safety, but I also want to make sure that those attending to our care respect our wishes as much as possible. We really just want to keep communication open. It's a scary thing to have people doing things to you and around you without telling you what's going on. We want to be actively involved in what's happening to us."
She replied, "I will always tell you what I'm thinking, not just what I'm doing. I want you to know what I'm observing and what events I feel might be unfolding and how we should address them. I will make sure you know if I'm anticipating a certain course of action, like c-section, for instance. I will review this information with Dr. Other O.B. and we will also give a copy to the birthing center so they have it in advance of your arrival."
Her tone of voice as she spoke was soft and respectful, but firm. The entire exchange is a lot for me to digest, and I imagine I'll spend the next few days hearing her voice looping in my head. What are your impressions of her replies?
My doctor sat and actually read my birth plan this morning, which really surprised me. I assumed she would take it to read later, and I had planned to bring another copy to my appointment next week under the assumption that she wouldn't actually get around to reading it, etc. But, she stopped everything this morning to read it, and discuss with me on the spot many of the points in it. Here were the items that she chose to comment on, and her responses to them. (I tried to quote her as accurately as I can, and used most of her own words.) I'm still allowing the exchange to bubble around in my head, so my feelings about her responses will probably surface later.
1. Desire for natural delivery: "Pain medication is totally up to you. But, since you have chosen to give birth in a hospital, you have to realize that intervention is part of that environment. I cannot stand by and do nothing if a problem arises."
2. Rejection of the use of labor augmentation medications: "I'm willing to let you labor on your own, but if things become stalled for quite some time, I'm going to suggest we rupture your membranes. It's the least invasive method (ie: compared to pumping me up with Pitocin) and I think you'll find you'll be more comfortable without all that pressure from the bag of water."
3. Rejection of continuous fetal monitoring: "It's fine to do intermittant monitoring, but if we see some disturbing patterns, I'm going to want to put you on continuous monitoring. If I don't know what's going on with the baby, I can't make the most informed decisions for your care. I don't want to just be guessing."
4. Rejection of episiotomy: "That shouldn't be a problem. We very rarely perform those anymore."
5. Rejection of forceps or a vacuum: "If you have been pushing for a while and the baby's heart rate is taking big dips, I will use the vacuum to deliver him. I understand you want to avoid it, but I can't allow him to go into distress and not do anything about it."
I summarized Jake's and my position by saying, "I realize there is a fine line between what we would like to do and what must be done. I want to make sure that I am always on the right side of that line, with regard to Snippet's and my safety, but I also want to make sure that those attending to our care respect our wishes as much as possible. We really just want to keep communication open. It's a scary thing to have people doing things to you and around you without telling you what's going on. We want to be actively involved in what's happening to us."
She replied, "I will always tell you what I'm thinking, not just what I'm doing. I want you to know what I'm observing and what events I feel might be unfolding and how we should address them. I will make sure you know if I'm anticipating a certain course of action, like c-section, for instance. I will review this information with Dr. Other O.B. and we will also give a copy to the birthing center so they have it in advance of your arrival."
Her tone of voice as she spoke was soft and respectful, but firm. The entire exchange is a lot for me to digest, and I imagine I'll spend the next few days hearing her voice looping in my head. What are your impressions of her replies?
posted by deanna at 12:24 PM
11 Comments:
Frankly I think her replies were entirely appropriate, and very thoughtful. Her first concern is your health and Snippet's health, and her second concern is your desires. That said, I think that she soulds like she totally respects your desires and will do what she can to balance both.
I also really like one commenter's recommendation to get a Doula. That gives you more advocacy.
I think the exchange was spot on. She was upfront and honest with you. There are so many uncontrollable variables to delivering a baby that she cannot say for certain all your wishes will be realized.
I've worked with good and bad doulas. Some are more about the mission of natural birth than being an advocate for the patient.
I think she is going to err on the side of caution because that is her job. She doesn't want a law suit and she wants you both to get out alive - which is a good thing. It didn't come across to me as though she was dismissing your wishes, which would be a BAD BAD thing in my book. It just sounds like she is cautious.
I totally agree with Roni's comment. I think you got an honest conversation - and you can move forward knowing that you have made your preferences known.
Here's wishing for a healthy labor and delivery for both you and Snippet!
I think she sounds very reasonable in her requests for you and your care. Bottom line is healthy mommy, healthy baby and that's all that matters. Good luck and I'm excited to see how it turns out!
Sounds like you have a good doc. I have a more specific post brewing about my doc and how much I appreciated during delivery him talking to me about the things that were happening, what concerned him, etc. Even though it didn't go exactly the way either of us would have planned (he is pretty against episitomies but had to do it) I'm happy with everything.
Glad she respects what you want..it is so important to go into something this big having that trust and open communication
I agree with everyone who said the doctor seemed quite appropriate. What I want to know is, did you tell her that the nurse already told you she wasn't going to read your birthing plan? Because it's great if the doctor is respectful of your wishes, but you will spend 10X more time in the company of the nurses.
She sounds direct, but compassionate, respectful and open to your wishes, which is the best you can ask for in a hospital/medicalized setting.
I'm hoping everything goes as close to your plan as possible and that you have the kind of birth experience you're hoping for.
31 days to go??! Oh my gosh! That is so exciting! I can't imagine what I will be feeling when I get to the 31-day mark.
I agree that your doctor sounds great. Very respectful, very appopriate and I like that she makes everyone's (read: yours and the baby's) health a priority. It sounds like you are in good hands.
Good luck to you!
She sounded honest and open to listening to you, which is really something I've seen lacking in a few doctors lately. Good luck!
Your doctor sounds very reasonable. She's not letting you live under the impression that just because you want something one way means that it'll actually happen that way, but she's also letting you know that she'll do her best to abide by what you want.
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