The doctor isn't always right

Not long ago, I wrote my birth story up, and I got a lot of web traffic from it because I turned down pitocin four times, believing it to be an intervention that wasn't indicated for my labor and that having my labor medically managed would increase the bottom line cost of my birth and increase the chances that I would have a cesarean section.

A couple of weeks ago, I had my 6-week followup with the woman who _should_ have delivered my baby. She often shares anonymized birth stories with me, almost like case studies that help me better understand what is rapidly becoming my vocation. She told me about a recent night on call, when she had a woman with a scheduled cesarean successfully VBAC because she arrived at the hospital fully dilated and ready to push, and a woman having her fourth vaginal delivery go wrong because she had insisted on getting the epidural at two centimeters, well before the baby was engaged; when the baby finally did descend, it did so in a brow presentation, and got hung up, and she wound up having a c-section.

In other words, it's not as important to have a birth plan as it is to be fully prepared. A birth _plan_, especially if you've never given birth before, quickly goes out the window when things don't go to plan--and they usually don't.

But by being prepared, you can spare yourself a lot of agony. One tip I don't hear mentioned much, but one that helped me when I was fighting the OB for a natural birth, is to talk to other women in your family, if possible, about their birth experiences. One of the objections my OB had to allowing me to progress naturally was that I was clearly carrying a big baby. My retort was to list off the birth weights of my aunts and uncles, my own and my brother's and several of my cousins. It hadn't helped that K had showed up at a funny angle and gotten his shoulder hung up on my pelvis back in 1992--but not seriously so. Another objection she had was that if something *did* go wrong, she wanted it to happen during daytime hours when there were "a lot more people here." Staffing issues on the late shift?

But as I continued to talk to my midwife at my 6-week checkup, she explained to me that the doctor--new to the practice--had never had a patient question her judgment. Remember her comment during my birth story, that she was accustomed to a certain process? During her medical school and internships in India, and her residency in an inner-city hospital, she had never faced a strong-willed, well-informed patient who was prepared to advocate on her own behalf.

So here's where my birth "plan" went wrong. Not only did I get a stranger delivering my baby--I got a stranger who had never encountered a birth she hadn't medically managed. Had I put blind trust in this woman, it was possible I'd have wound up with a c-section.

Now, for the post-script. It turned out that the OB called the senior doctor in the practice, the one that I thought would deliver me if my midwife wasn't available, and asked her what to do with this stubborn patient who kept refusing treatment. The senior doctor responded, "Get used to it." As my midwife explained, our community has a lot of intelligent, strong women who don't want to be treated under an assembly-line process. By fighting the new doctor, I taught her something new about the kind of doctor she could be--one that listens to her patients, one that resists a rote process, one that doesn't hunt down a pathology or use fear tactics to bully her patients into interventions they don't need.

What of all the doctors who never get this lesson?