Monday, January 3, 2011
Obstetric Lie # 97- Your Care Provider is Psychic!
I hate to break the bad news to everybody- but somebody has to do it. No, your care provider is not psychic. He/she can not see the future. He can not predict outcome flawlessly. He can not tell you what your pelvis is capable of or when your baby MUST be born or even when it was conceived.
This topic actually covers many topics that I will delve into more in-depth at a later date. But, to start, here are a few things that your doctor/midwife/nurse CANNOT know for sure before they happen: (although believing they will happen can have an amazing impact on MAKING them happen)
1) They can not know how big your baby is near term-
This study found that, "approximately 40% of estimates were off by more than 10% of actual BW" (birth weight).
Here is a very sad story of a real life mama convinced by her care provider that he knew beyond a doubt that she had a baby much too big to birth. It happens every day folks. The truth is, even if the baby is 10 pounds, that doesn't mean you can't safely birth it vaginally.
This is not to say that the wonders of modern medicine and your doctors unique skills are not amazing and capable of gathering information. Diagnostic medicine is pretty neat right? I mean, they can actually see inside your body. This appears to be a miracle beyond compare right? It is a miracle to see inside the human body. It is not however always perfectly indicative of things like baby size or all aspects of development.
2) They can not know the size of your pelvis or if it is capable of birthing that particular baby.
During a vaginal exam your care provider can get some idea about he shape and size of your pelvic outlet. This is why we sometimes hear that a first time mom is scheduled for a c-section by 32 weeks. Her doctor has decided that she is too small to birth.
There can be some information gathered this way- it is not however fool proof. I have no idea how many women are told this and then go on to birth BIGGER babies vaginally than the one cut out of their abdomen. There is great harm done with this procedure, even if a healthy baby results. Sometimes this is diagnosed while pregnant, and it often happens after a short trial of labor or induction. Run away if your OB is already talking about your ability to fail.
3) They can not know exactly when your baby is supposed to be born.
Due dates just make me want to spew my lunch. It is an estimate of average gestation. It is not the only date that your baby can be born healthy. Nobody knows when your baby is fully ready except for- THE BABY!
4) They can not know exactly when you got pregnant.
Sometimes mama knows this, but all other calculations are a guess or an estimate based on averages (unless in-vitro is used.)
Even if the conception date date is known, refer to number three.
5) They can not know how long your labor will be. Even if they check your vaginal dilation, they can not know when the baby will get there.
Dilation does not tell you when baby will be born. It simply tells you how far dilated you are. That is all. I don't know how many women have told me that they were checked and measured five centimeters and had a baby 5 minutes later. There are also countless women who are "stuck" at a particular dilation number for hours and yet go on to have their babies vaginally much later.
The care provider/patient relationship should be one of trust and respect. It should not be one in which you feel bullied, pushed around, scared, uncomfortable, or guilted into doing things that feel wrong to you.
Yes, science, medicine, and diagnostics can sometimes predict outcome very well- but not always. Birth is a powerful and emotional time, don't let the doubts of others determine the kind of birth you will have.
We may appear as a culture to worship medicine and the apparent miracles that occur because if it. It is not however our church and those that practice it are not prophets. They are men and women doing a very hard job and trying to do it well, but they can not read the future.