Week 8: Interviewing the system

The Receptionist

Receptionist: Hello, this is [Big City University] Med OB/GYN department, how may I help you?

Me: Hi, I’m pregnant and I’d like to schedule a consult appointment with Dr. [Good Reputation]. When can he see me, and how do consult appointments work?

Receptionist: Ok, you’ll come in and see the nurse first, you’ll do a pregnancy test and ultrasound, do some paperwork, and then see one of our doctors.

Me: I’m not sure whether I want to sign up with your practice yet. I’d like to interview Dr. [Good Reputation] to find out how the practice works first.

Receptionist: What do you need to know? The nurse will tell you all about how it works when you come in.

Me: Well, I have some special requests for my care and if your hospital cannot accommodate me, I would have to go elsewhere.

Receptionist: What kind of requests?

Me: I’m a rape survivor and don’t want anyone touching me without permission.

Receptionist: Hmm… I don’t know if they do that here. You know we’re a teaching hospital, right?

Me: Are you telling me that you believe anyone will be able to touch me anywhere, without my consent?

Receptionist: You are going to have a baby, after all. Is this your first baby?

Me: No, it’s my second. Can you please give me an appointment with Dr. [Good Reputation]?

Receptionist: I don’t know if that’s possible.

Me: You’ve never had anyone call just to interview the practice, to see if they wanted to choose that practice or a different one?

Receptionist: Let me ask the nursing manager. Can you hold? ….[10 minutes later] Ok, I spoke with the nursing manager, we can schedule a consult with the doctor. I could give you an appointment next week with Dr. [Unknown Quantity].

Me: No, I said I wanted to see Dr. [Good Reputation].

Receptionist: Let me see… His first appointment is 10 weeks from now.

Me: Please book it.


The Midwife

Me: …I have some specific questions.

Midwife: Please, ask away!

Me: This is a difficult question – I want to know how it would go if you recommended a particular course of action and I wanted to do something different. Say, for example, I went into labor at 36 weeks but thought I wanted to stay at home.

Midwife: Well, you wouldn’t have to worry at all. I’ve got great collaborative relationships with hospitals here, and we would work really hard to get everything in place for a good hospital scenario. We would have our backup plan all set up.

Me: But if I decided I wanted to stay home?

Midwife: You would really have nothing to worry about. We would talk about your fears, and we would get everything out in the open, and you’d realize that this time wouldn’t be like last time, and the hospital would be a good experience for you. I and my assistant have lots of experience accompanying clients in the hospital.

[For the record, that wasn’t the point of the question. I will make a hospital plan with whoever I hire, but the decision on whether or not to go there is a critical point in and of itself. I am in no way decided on what I’d do in that particular situation – I chose it deliberately because it’s a huge decision in a grey area. I would hope that a midwife would answer that we would have discussed it beforehand, with all the risks and benefits and alternatives, and we’d hopefully have enough information by that time to have a productive discussion on the risks and possibilities to help me make my OWN decision. My body, my choices. I actually felt unsafe for a moment, as though I were in the room with someone who disregarded that fact.]


About investigatingbirth

My investigations of birth began in 2009 when I was trained as a doula. I helped women consider the evidence on common interventions, and helped them prepare for the physical and emotional challenge of giving birth. After some time it became clear to me that there was another type of challenge that I was unable to adequately prepare them for, the challenge of the maternity system. But it was only after my own traumatic birth in 2013 that I realized how little I had understood. I began to ask questions that few around me - doulas, nurses, midwives, doctors - were comfortable hearing. Questions like: Under what circumstances, and for what reasons, do doctors not practice informed consent? How do hospitals deal with other patient populations vulnerable to abuse? How does loss of professional autonomy, for obstetricians, and professional authority, for midwives, impact the quality of care they are capable of providing - regardless of their training? This blog will collect noteworthy information that attempts to answer these and other questions. Most of what you see here will be aggregated from other sources and analyzed. You will also see original interviews, and the occasional opinion piece or personal story, as I try to piece together a clear picture of the system in which American women give birth.
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