Week 23: Meeting with hospital OB

This OB is amazing. He said the specific words “patient rights trump protocol” and he really, really meant it.

I walked into my meeting with him fully expecting to get some bland reassurances, maybe some talk about how every doctor there is just fine, home birth transfers are treated just like everyone else, etc. Instead I got an empathetic, down to earth guy who is apparently trying to change the culture of the entire hospital.

Not only does he firmly believe in patient rights and the right to informed consent and refusal, he is trying to infuse the hospital culture with that belief, down to every resident.

During our meeting he told me a story about a woman wanting a VBAC after multiple c-sections. He ended up taking it all the way to the top to make sure she would not be coerced or forced into a repeat c-section unless it was necessary. (She got her VBAC.)

He gave me a bit of a puzzled look when I asked about nurses – he thought it was an irrelevant question because nurses aren’t the ones doing most of the procedures I would refuse such as vaginal exams. In retrospect, it makes sense that some doctors don’t know a lot about the coercion and abuse that nurses perpetrate in the name of hospital policy. But he said informed consent is “sacrosanct” among hospital staff: “If you don’t have consent, you can’t do it.”

I feel like I have just met someone who actually wants to take care of patients. He wants to take care of people and meet them where they are. He sees himself as a steward of good medicine and good relationships and is trying to spread that throughout the hospital.

He said the hospital hasn’t had much opportunity to test how it handles home birth transfers because so few midwives feel like it’s a place they want to bring their patients. He acknowledged that “a lot of hospitals still have a reflexive negative reaction to transfers from home that is frequently unjustified… It’s a clash of cultures.” But he is actively trying to change that. Because the change is in process and nascent at this point, he gave me his cell number in case I have to transfer, and told me it would be a good idea to make a written birth plan.

For the first time since my birth experience, I feel held, supported, heard by a human being within an institution. I feel like the professionals, the technicians, that I am working with now have a sense of me as a person, a sense of me as being important and of my unique desires being important.

This has been a serious breakthrough.

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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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