Wasting our lives and glorifying God

Wasting our lives and glorifying God
Notice God's unutterable waste of saints, according to the judgment of the world. God plants His saints in the most useless places. We say - God intends me to be here because I am so useful. Jesus never estimated His life along the line of the greatest use. God puts His saints where they will glorify Him, and we are no judges at all of where that is. ~Oswald Chambers, My Utmost For His Highest, August 10

Saturday, July 30, 2011

Deep Philosophical Differences--UPDATED




Today I read in a Baby Center newsletter, supposedly tailored to my 28th week of pregnancy, "expert opinions" in response to this question:

How Do You Feel About Birth Plans?

Erica Breneman
Obstetrician in Oakland, California, and mother of one

I'm not a big fan of birth plans because I think they're often too detailed and specific about things that are unpredictable. However, I do think it's a good idea for women to discuss their wishes with their providers before delivery. A birth plan might facilitate this discussion. It's certainly reasonable to bring a brief written description of your general birth philosophy and wishes to the hospital so that on-call doctors and nurses who haven't met you get a sense of your desires.

MaryJane Lewitt
Certified Nurse-Midwife in Atlanta, Georgia, and mother of two

I love birth plans. They help me understand what you want from your birth and what your perfect delivery would be like. Every person is different and has different needs, wants, and expectations for their birth experience. A birth plan allows me to start assisting you with your birth without having to quiz you about your desires while you're in pain. Also, if things happen during labor that result in changes from your plan, I can provide options that keep us as close to your ideal birth as possible.

Samantha Maplethorpe
Family Physician in Issaquah, Washington, and mother of three

I like birth plans very much. They're wonderful communication tools. I usually suggest that my patients attend a labor education and support class for first-time parents and develop a birth plan around the beginning of the third trimester. This gives us enough time to discuss the plan and for patients to modify their expectations if need be. I try to tailor my supervision of pregnancy and labor and delivery to the style of the new parents. I usually send a copy of the birth plan to the hospital for inclusion in a patient's chart so the nurses can read it, but patients shouldn't assume it has been read. My only tip is to prepare for the unexpected and be flexible to any necessary change at delivery.

Notice that the family practitioner and the midwife like birth plans because birth plans help them better serve their clients.  Notice that the obstetrician doesn't like birth plans because they are too specific about what the client wants. 
 
Ummmmmm..........
 
Who here still thinks a surgeon is the best person to help you achieve the kind of natural and empowering birth experience you want?  Anyone???? 

9 comments:

Andrea said...

I gotta say... I think the whole thing is looney!! My husband's dear grandmother had eight children & lived on a farm. She worked both in the field & in the house everyday... and when it was time to have a baby, she plopped on the bed and had a baby. She made no "birth plans"... nor did she care about feeling "empowered".

She cared about whether it was going to rain with the clothes still on the line. She cared about getting supper done in time. She cared about whether her homemade catsup was going to last until the next year's harvest of tomatoes.

Just my .02 on the whole thing. Whether you choose to have an obstetrician deliver your baby or whether you want to homebirth or whether you want to do whatever else... just do what you feel comfortable with & get on with it.

"Birthin' babies shouldn't take up so much ponderin'-n-thinkin'."

That's what I believe Grandma Lewis would have said. :-)

Gombojav Tribe said...

I don't think any woman should go into a hospital or birth center to have a baby and not have a birth plan. No one cares what she wants so she better be empowered and stand up for what she wants.

Birth plans may be a modern construct, but they are necessary now that surgeons are the primary care giver at births.

Andrea said...

From my personal experience as an OB nurse & Lamaze teacher for 11 years, I must say that the time to discuss any sort of "birth plan" is with the physician during one of the many prenatal office visits. The physician yields the "yay" or "nay" as far as any birth plans go... so by first introducing a birth plan when you arrive at the hospital or birthing center is just too late, for the most part. The time to get "all your ducks in a row" is way before labor begins.

I'd have patients come in to the hospital with a laundry list of demands, never having discussed any of it with their physician beforehand, and then expect me to wave a magic wand & work miracles between them & a physician I *knew* would nix every single idea on the list! I'd do everything in my power to make a couple's delivery be what they had always dreamed it to be but... my hands were tied on most issues. If I had known about their wants & desires beforehand (like 6 months beforehand), I would have told them to find another physician or another hospital cos the guy/gal they were working with just wasn't going to go along with their "birth plan". Sadly enough.

And things are even worse now than they used to be. That's one of the reasons I'm not working anymore. Just can't stand half the stuff that goes on. Makes me sick actually. But this system is what we've got to work with & there's going to be no changing it, that I can see. Medical malpractice insurance costs are driving most obstetricians out of business... and the ones that are still delivering are scared to death to try vaginal breech deliveries or VBACs. One brain damaged baby from a footling breech vaginal delivery or one exploded uterus after a VBAC attempt, resulting in a dead baby or mother or both... and that doctor might as well hang up his gloves cos he's going to be sued out of practice... left with $300,000 worth of school loans to pay off. And the very people who scream for the VBACs & the footling breech vaginal deliveries are the first ones to sue, believe me. Brain damaged or dead babies just aren't in their "birth plan".

So, as in all things, my sweet Daja, there are two sides to every story and the extreme of either is just not the answer. Believe me, I long for the delivery days of 1980 when I graduated from nursing school & first started in OB. But, as I long for the 1950s era of stay-at-home moms too, neither one of those things is coming back anytime soon.

And I don't have the answer on how to change what's going on now. All I do know is... I don't care how "empowered" you feel or how much you "stand up for what you want"... if the doc says no, the doc says no & his/her word stands. Period. That's why I say.... just go to the hospital (if that's your choice of delivery places) & have the baby & then go home again. Get out of the hospital as fast as you can & then start your "birth plan" in the privacy of your own home. Cos most of the time birth plans just do not fly in most hospital settings... unless you've got a really special doctor who understands your plan way in advance & has agreed to it.

PS~ Obstetricians, for the most part, have always been surgeons too. You don't want a doctor who is overseeing your labor to have a medical emergency with either you or baby & then have to wait around while another doctor (a surgeon) comes in from home in order to do an emergency procedure, like a c-section, to save your life or the life of your baby. That spells trouble to me... and I've seen plenty of trouble, believe me. Situations that you can hardly imagine! :(

Gombojav Tribe said...

I've always encouraged my students to go over their evolving birth plans with their doctors and midwives throughout pregnancy. And by the end of pregnancy to have the care giver sign it with them. It should be a team thing.

Have you seen the documentary "Pregnant in America"? I highly recommend it. In one part it shows the obstetric care in Holland where about 85% of births happen at home, attended by doctors. And they have a low c-section rate, a low infant and maternal death rate, and a very high satisfaction rate. Their model is so practical and workable.

"Remember the Dutch!" It's my new mantra. LOL!

Andrea said...

But we're not in Holland... we're in America. That's my point. If you want things to be like Holland, I guess you have to move there.

"Birthin' babies shouldn't take up so much ponderin'-n-thinkin'."

LOL

XOXOXOXO

Christine Fiscer, Birthkeeper said...

This is one of the main problems in our medical system now. The "patient" actuallu DOES have authority to refuse anything she wishes, regardless of what her care provider or staff says. Shoukd she do her research and choose the best care provider for what she wants? Absolutely! But to say that women should basically not care about what ends up happening to their body and baby during birth is awful. This attitude is why there is a growing distain for hospitals, hospital staff, and doctors to begin with. There is such high disregard for what is DONE to women and babies in birth, and women are told to get over it. It is sickening.

Daja, I have to say though that I hated Pregnant In America. Lol. It was a complete contradiction to spend 2 hours speaking of how pregnancy and labor are normal and should proceed physiologically, only for the producer's wife to choose an unnecessary induction at the time of her due date. :-/

And as to the comment about wanting a surgeon to attend you...we should all have ambulances as escorts anytime we drive, according to that thinking. ;)

"A highly trained Obstetric surgeon attending a normal labor is analogous to hiring a pediatric specialist to babysit you perfectly healthy 2 year old."

Christine Fiscer, Birthkeeper said...

This is one of the main problems in our medical system now. The "patient" actuallu DOES have authority to refuse anything she wishes, regardless of what her care provider or staff says. Shoukd she do her research and choose the best care provider for what she wants? Absolutely! But to say that women should basically not care about what ends up happening to their body and baby during birth is awful. This attitude is why there is a growing distain for hospitals, hospital staff, and doctors to begin with. There is such high disregard for what is DONE to women and babies in birth, and women are told to get over it. It is sickening.

Daja, I have to say though that I hated Pregnant In America. Lol. It was a complete contradiction to spend 2 hours speaking of how pregnancy and labor are normal and should proceed physiologically, only for the producer's wife to choose an unnecessary induction at the time of her due date. :-/

And as to the comment about wanting a surgeon to attend you...we should all have ambulances as escorts anytime we drive, according to that thinking. ;)

"A highly trained Obstetric surgeon attending a normal labor is analogous to hiring a pediatric specialist to babysit you perfectly healthy 2 year old."

Gombojav Tribe said...

I haven't seen all of Pregnant in America yet. Been snagging it bits at a time as time has allowed. So, I guess I haven't gotten to the part of her electing to be induced. That's pretty disappointing!

Sara said...

We had a very detailed birth plan for our first birth (hospital with certified midwife). The midwife was very accommodating, the hospital staff was NOT. They treated me like a child, and if I hadn't been sure of what I wanted, I'm sure I would've gone a long with some of their stupid ideas. I distinctly felt that my child was hospital property and was very glad to leave. Every birth after that, I felt much more confident and faced less trouble with the nurses.

However, I'm glad I was flexible to an extent. The things that really mattered to us (no Hep B shot, and no nursery) were honored, but I did end up getting an epidural after number 1 being natural. My natural birth was hellish. And I've since found out I have a condition which compresses my brain stem (Chiari 1 malformation) and the strain of labor and esp. pushing really aggravates it. So for me, being willing to be flexible and get an epidural even though it wasn't my first choice, was much better for me considering my condition. Which I only found out about later (after my fourth birth had made the symptoms much more pronounced).

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