OB-GYN-L Messages for June, 1997: Re: birth plans

Re: birth plans

From: dahmd

dahmd@gate.net

Sat Jun 28 11:21:06 1997

> let's not forget that many/most patients who demonstrate distrust of
> medicine by rigid birth plans, use of alternative medicine, etc., do so
> because of previous negative experience with physicians.

You got it. Last night I was asked to cover for an ill colleague. I introduced myself to his patient, who was in active labor, and sat down to talk about her pregnancy and wishes. She was initially very anxious about the "birth plan" and doctors in general, but soon realized that she and I had the same outlook on things. It turns out that she had helped her sister through the birth of her baby, and had experienced a physician enter the room, nod at the patient, and proceed to cut a third-degree episiotomy without anesthesia (or informed consent or even an explanation). After he delivered the baby, all he said was "good job" to the mother, then left. My new patient's only experience with physician-assisted childbirth was certainly negative.

I had a bad day yesterday, with a number of demanding and belligerent patients (which is pretty unusual). While I provided this nice lady with the childbirth experience she desired, she also reminded me, through her extraordinarily pleasant and appropriate attitude, that it's because of people like her that I work 90 hours a week and deliver babies at 3 am!

I still won't sign a statement giving away my right to make appropriate medical decisions, but I will listen more carefully to the birth plan ideas of my patients, since I'm discovering that while some are pretty "wacky", most are simply an attempt to gain control of an intimidating situation.

Ashley D. Ashley Hill, M.D. dahmd@gate.net Orlando, FL

by rejecting, > belittling, demeaning these plans and suggesting that their best use is an
> entry to the unconscious, we miss an opportunity to instead begin a
> dialogue. why not a cliche'd, "why mrs jones, it sounds like you've had
> difficult time with doctors in the past....." but then, that might begin a
> lengthy discussion with little chance for reinbursement. i admit; i get
> defensive when a patient seems to be telling me how to run my
> business, whether it's a birth plan or a demand for a hysterectomy. but
> down deep (really deep on some days), i know that my patient is not my
> competitor; she's best viewed as a partner and does not deserve a cold
> shoulder
>
> david hunter, md, tacoma, wa

Women's Insurance Checklist from Auto Insurance Quote

use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
	Returns per screen: Require all keywords: