Saturday, January 5, 2008

Obstetrician Proposition

Hey Doc. I have a proposition for you. You say that birth is dangerous and needs you to save the mothers and babies. You say birth is a medical event which requires a hospital. Many of you believe that birth "from below" (vaginal) is old-fashioned and that birth "from above" (abdominal) is superior.

Why did you decide to become a doctor? Why a doctor who "delivers" babies? I know that none of you would admit it's for the money. I'm sure your answer is something like "I want to help women and babies". That is admirable. But what if (humor me here), just what if it could be proven to you... and to the world, really... that you aren't helping mothers OR babies? What if your famous Hippocratic oath is making you hypocrites? You vow that you will "do no harm". Does that really mean you will "do no harm" to your bank account? Your practice? Your staff? Or are you honestly, truly, unabashedly committed to doing no harm to mothers and babies?

Now, my proposition:

The cesarean rate in the United States is horrific. According to the WHOs standards, at least half (if not more) of the sections in this country are unnecessary. Also, our infant mortality rate is shameful. Of all developed countries the United States has the second highest infant mortality rate, and more and more mothers are dying in childbirth as well.

In some countries, such as Sweden, the standard of maternity care is a midwife. Every woman sees a midwife for maternity care unless and until her pregnancy or labor becomes a threat, danger, or emergency to the life of the mother or baby. *GASP*, you say? How can they do something so DANGEROUS you say? Well, if a section rate of 15.4% (Peristat) and an infant mortality rate of 3 per 1,000 live births (Globalis) is dangerous... then let danger be my middle name!

If you truly have the best interests of mothers and babies in mind, then give up your fear-mongering, money-hungry death grip on maternity care in the United States. Afterall, there will still be a need for you. It's just that you will only see the mothers who truly NEED to see you. Aren't those the mothers you really want to help, anyway? Why not try it? Do your little studies. Give it, say, ten years. Five, even.

If the IMR and section rates remain the same, or get worse, I will gladly stand corrected, and you can again take your place on the Obstetric Throne.