Breech bub at 20wk scan....

[BellyBelly]

chelleg - just a theoretical because I am not sure if you could answer... but do you think there would be so much litigation if an Ob said to a woman something like... 'You have a breech baby / VBAC / etc... These are the risks, this is what could happen (pros & cons) and what would you like to do? I will best support you with the elements you choose...' unless they of course think it is dangerous in which situation they would make their case clear. Do you think that would work better rather than the Ob decide, given the Ob has offered unbiased, factual information? If we can inform women and point them to where / how they can inform themselves, do you think we would have less intervention and women unhappy with the way their births went? I just think women need better access to information to become better informed.

[chelleg]

Hi Kelly
Hmmm, that is a difficult one and ultimately i think it depends on the ob. I mean legally speaking a woman can always refuse any intervention at which point the ob would discuss with the woman all of the risks (don't know how much they'd say about the benefits!!) and if the woman continued to refuse treatment and this would be documented and thus stand up well for a Dr in court should litigation occur. Like i said, it really does depend on the ob. In my expereince so far i have found most of the Dr's to be fairly flexible. I'm lucky enough to work at a hospital where our director of obstetrics is a firm believer in what a woman wants for her birth experience and will support her and stretch the 'rules and regulations' to do this where the majority of obs wouldn't. I tend to find the more junior the Dr the more rigid they tend to be - i think this is due to the fear of a poor outcome, litigation and too much faith in the 'medical model' of pregnancy and birth, Luckily the midwives are the bosses and can usually get their own way! I also tend to find that the private obs are the ones that are more fearful of litigation and have a stronger need to be 'in control'. I don't wanna step on any toes because i know alot of women truely love their obs but in my experience they control pregnancy and birth. They make all of the decisions and they class all women as 'high-risk'. So i kind of think that your suggestion just wouldn't even wash with a private ob because their view of pregnancy and birth is just risk, risk, risk!!! I don't think a private ob could adequately inform the woman of pros and cons because too much emphasis would be placed on the cons iykwim
I am a true believer in midwifery care for all women. Midwives believe in the woman and her ability to birth babies - even those women medically defined as 'high-risk'. Midwives are more likely to discuss pros and cons in a non-biased manner and continuity of care will also help to promote womans rights - especially where negotiation is required to reduce intervention. The battle at the moment is thay midwives are described as 'experts in normal birth' and thus all of the midwifery led care tends to focus on 'uncomplicated' women however my little pet project at the moment wants to see midwifery led care available for all women even those defined as 'high risk'. I believe this will decrease things like continuous monitoring and reduce intervention and that continuity of care and belief in the woman will enable her to have the birth she desires.
There is no denying that sometimes birth is complicated and risky and we do need medical expertise but the mistake is believing this is the norm.
Hmmm sorry i completely got off the track there but i get a little passionate about this subject
I should also add that since i've just been a bit of an 'ob basher', i do know that there are obs that are exceptions to the rule just as their are midwives who put too much faith into the medical model so i guess it just comes down to choosing the right type of care and standing up for your rights as a birthing woman!