Friday, October 16, 2009

Patient power ... or not?

Yesterday I stumbled across a CNN story entitled "Mom won't be forced to have C-section." Of course, because of my areas of interest, this immediately grabbed my attention. As it turned out, the reason the expectant mother in the story won't be forced to have a C-section is because she is traveling 300-odd miles to go to a hospital with a policy that allows for patient choice. You see, she is hoping to have her fourth child VBAC, meaning she has previously had a Cesarean section and now wants a vaginal delivery. (To make the situation even more appalling, it was her second child who needed a C-section. Her third child was delivered VBAC at the very hospital that then threatened her with a court order if she refused the C-section for the fourth child. Apparently their policy changed.) Rather than explain the story here, I'll just direct you to the link I've provided and say it's interesting reading.

Stories like this have really intriguing implications when we examine the ways technology and culture intersect. (I wouldn't be surprised if race plays into this as well ... I'll keep my eyes open for more on that.) And the rhetoric of the hospital adminstrator appears to have been quite problematic, which is really scary when one considers how we give doctors in our culture an almost god-like status. But perhaps more interesting than anything I could say here is the rhetoric in the comments on the story! Here are a few:

"C-sections are done in the US more routinely than in any other developed country but our infant mortality rate is not lower but higher. Doctors do not want to deliver on weekends, at night, if the mother is one week over her electronically determined due date."

"I think it is a little pretentious for doctors to get on here and give their speeches about how she should just listen to her doctor... there is a reason why they call it 'practicing' medicine and family 'practice.'"

"Did anyone else notice that when they list the risks of a C-section, they failed to mention that the mother is 4-7 times more likely to DIE than with a vaginal birth.?!?!?!"

"From many of these comments, it seems like many people do not grasp malpractice and insurance companies. This is not about the hospital, but about medical professionals and hospitals not wanting litigation. Can you blame them? After spending tens of thousands of dollars on an education before making a dime, I would do what I needed to to avoid a lawsuit, too! And to Tamara, we go to doctors because they DO know what is best for our health! Like another poster said, in health care, the customer is NOT always right."

"Good grief, get the lady to sign a waiver regarding rupture and give her the VBAC."

And here is the one I found most shocking ...

"I worked in the hospital for 5 years and then in a birth center for the last 4 years. I had to get out of the hospital because I started feeling guilty about my complicity in that system in which so much goes on behind closed doors of which the patient is never informed.

I've had docs tell me in the lunch room that they are doing a c-section because they have an important golf game, fishing trip, or hot date. Then they go into the room, lie to the woman and say, " oh your baby is too big, your progress is too slow, it's never going to happen." the woman believes them and thanks them so much for saving their babies lives. Over and over and over again. In Miami we have over 50% c-section rate, and it's way more convenient for the docs. If VBACS are not allowed at more and more hospitals, the rest of the country will soon be like it is here.

Women need to start demanding more informed choices, more providers, more options, not just from their local hospital, but from their insurance companies, representatives, etc. we will continue to be 22nd in the world for number of babies we lose in childbirth.....many of them from unneeded c-sections."

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