Sunday, July 6, 2008

Haphazard Prenatal Care

Recently I've heard from women who call me for advice or who are changing from doctors to a midwife's care that providers in St. George are not giving them the prenatal care that they are looking for and deserve. Their recent complaints include; lack of urine testing at each visit, no palpations to find out where their baby's position is, overuse of ultrasound to determine position, lack of any kind of one-on-one with their doctor and just general feelings of "factory like" prenatal care or just plain lack of prenatal care altogther. One woman reported having gestational diabetes but hadn't been tested for glucose in her urine since last April. Another said she would walk out to her car and cry after her visit because she just felt like a "number on a conveyor belt". Women are starting to realize these docs are not giving them the time and thorough care they deserve.

As a midwife who takes an hour or more with each woman and who takes it upon herself to make these women and babies a priority, I am appalled at what is going on in our community! What is happening with the medical system's answer to prenatal care? Where is all of this apathy coming from? I believe it stems from the fact that these doctors are too busy trying to pay for their malpractice insurance and stack themselves too deep with patients trying to pay for it, not to mention, they rely upon the hospital's life-saving measuresto catch the women and babies who don't fare well with the lack of prenatal care.

Here's an example of this: A woman in her twenties chooses one of these popular doctors and goes to him throughout her pregnancy. She goes through the prenatal testing and the ultrasounds and then checks into the hospital near her due date for an induction, most likely. She is a fairly healthy woman with no health problems but becomes another statistic in the hospital due to the interventions of induction, epidural anaesthesia and the like. If she doesn't progress cervically and dilate a centimeter an hour then she may become another woman who undergoes a caesarean or even more likely, become one of the 70+% who has an epidural. If anything should go wrong with her during the labor or delivery the medical staff can perform life-saving measures to save her or her baby's life. The hospital is the doctor's safety net and these doctors feel very comfortable overlooking small things throughout the pregnancy because they know they have full access to the equipment and medications to make things turn out alright in the end. Maybe this is why they don't have any problem cattle-prodding women through prenatal care, knowing full well what lies ahead to cover their negligience.

I don't think docs are doing this on purpose, so to speak. Noone could be that haphazard, could they? They are dealing with mass numbers of women and can only spend so much time with each one, therefore reducing their quality of care dramatically.

The amazing thing to me is that the majority of women are continuing to choose and accept this type of behavior from their doctors. That's what really surprises and disappoints me. As consumers, can't we be a little smarter, demand better care for ourselves and seek out those care providers who will give us what we need?

I have empathy for women who call me or who want to change their care in the middle of their pregnancy, but you get what you choose. If you choose a doctor who spends five mins. with you every few weeks and who doesn't tell you what is going on with your baby or how to eat better and avoid complications, then you have to expect that this same person will treat your labor and delivery very similarily. You are a number to them and dollar signs float over your head as you walk through their office doors. The bottom line for this lack of care is the mighty dollar. I hate to be so blunt but these docs are up against a huge mountain of insurance premiums, leases, hospital privelege percentages, staff salaries, etc.... You are paying their bills in a small way, plain and simple. Its so backwards and negligent to practice with your back against a wall but that's where the American Medical Association has gotten themselves these days.

If you contrast that to a homebirth midwife or any care provider who limits their client base and puts their health and safety as priority number one, then everything changes. No huge overhead, no huge insurance premiums, just a simple, old fashioned, intimate, trusting relationship. Its a no-brainer for me and there are more women who are wising up each year, but doctor based, hospital birth still accounts for the majority in our country today.

The bottom line is you get what you get when you choose your baby-catcher. Whether that be a quality, thorough, un-rushed approach or one which takes the minimum amount of time and concern and has you jumping through preset hoops is all up to you. You are the consumer who pays the doctors or midwives....where will your dollar and pregnancy be spent more wisely?


Sarah S. said...

Thank you for this blog, I have birthed my 6 children at home and am planning my 7th in January. Our family moved to the St. George area 5 years ago. During my time here I have occasionally served as a doula and have been very disturbed with every birth I have witnessed at the hospital here. What limited "care" I have sought from local dr.s regarding my last 3 pregnancies has been very disappointing. As a birth consumer I feel the options in So. Utah are very limited. I would love to see that change.

I have been actively involved in homebirth for over 15 years, as a former student of the Utah School of Midwifery and a homebirthing mother.

Lori Wrankle, Traditional Midwife said...

I am always pleased to know that my blog is reaching a wider audience than I am aware of. Thank you for being one of those women who think deeply and who care enough to continue living and educating others with your choices. Keep up the passionate birthing!

Anonymous said...

What's so wrong with an epidural?

Lori Wrankle, Traditional Midwife said...

Dear Anonymous,
I have no problems with epidurals, per se, but I am actively promoting drug-free, natural childbirth and an epidural blocks the woman's sensations and keeps her from feeling her labor and working with her body to birth naturally. Epidurals are available for a reason but I believe women choose to have them much too frequently and by doing so, miss the most empowering and intense experience of their lives! The labor and birth process is a journey meant to be felt and an epidural masks the sensations leaving women feeling only slight discomfort. Thanks for reading...hope you continue on your natural childbirth educational pursuits.