Mary - posted on 01/04/2010 ( 11 moms have responded )
So, this topic came up at work the other night, and I thought I'd seek the input of some non-medical mothers.
Many, many times in L&d, we have patients come in with some very elaborate and detailed birth plans. They specify a variety of preferences, including things like minimal intervention (such as no pitocin, no IV's, no continuous monitoring, no epis, etc.) or wanting to eat/drink while laboring. This is all fine and good, but often times we discover that we, the nurses, are the first to see this plan. The patient has never even discussed this with her doc...but rather assumed that all of her desires are going to be met, simply because she wrote it down. This becomes problematic when her OB is not ok with some/any of her preferences. I'm left astounded that this never came up during any prenatal visits, and that one of the most integral components of said birth plan was never included in it's formation. Had she discussed this earlier, she may have discovered that she and her doc had radically different ideas about labor management, and she could have switched to a practicioner who was more in sync with her philosophy.
This is not just an OB issue...it's true in all areas of medicine. I'm a firm believer in a patient's right in being an active participant in the care that THEIR body is receiving...but with that right comes a certain amount responsibility as well. I believe that when we are patients, it is our job to "interview" any prospective doctor, so that both parties know up front if they are on the same page when it comes to treatment of ANY kind, be it pharmaceutical, surgical, dietary, homeopathic, or whatever is an issue for you. Sadly, this does not seem to happen often enough.
You don't believe in vaccinations, or prefer an altered vaccine schedule for your child? That's your right as a parent, but you need to do your homework and find a ped that is comfortable with, and supportive, or at least accepting, of your choice. You want a birthing experience with minmal intervention? Again, that's your right, but then you may not want to keep seeing that OB who believes that all labors must be augmented with pitocin, an epidural is required, and all his patients get an episiotomy regardless of need. You can't always expect, or demand, that a doc radically change their practice just to suit your individual needs or wants.
I don't expect that many of you would (theoretically) disagree with this, but what I wonder is this...how many of you actually sat down with any of your doctors and thoroughly discussed these issues before determining that they were a good fit for you? Do you act as an advocate for yourself, and your family, or do you just expect that all doc's are the same, and your input isn't really valued, or even necessary? I see a lot of patients willing to tell me, as the nurse, all about their opinions, desires and beliefs, only to clam up and meekly acquiesce when the almighy physican enters the room. It frustrates the hell out of me...they have a right, and a responsibility to participate in their care, but only if they chose to exercise it.