Thursday, July 15, 2010

A Kinder and Gentler OB-GYN

An article in the New York Times raised a New York State assemblywoman's fight to grant independence to midwives, who currently are required by law to associate themselves to a physician or doctor with a written hospital agreement. Not surprisingly, obstetricians and gynecologists are not in favor of this, and their reasoning might evoke cynicism or agreement depending on how you feel about your past experiences in childbirth (or my in case, being the supporting husband for a wife giving birth).

I insisted that we use a obstetrician for the birth of our first child. Being in a family with an affinity towards the medical profession (my mother was a nurse and my brother's a physician) and high regard for the discipline of scientific technical knowledge (my father was a microbiologist), I didn't want to leave anything to chance - I wanted what I thought was the highest level of technical ability and medical expertise. Sarah didn't object, so we moved forward with our obstetrician.

When Sarah went into labor with Daniel, our obstetrician was out at a conference, and one of her partners was assigned to us. The doctor would come in, do a quick check on how far Sarah was dilated, and then disappear for a few hours with hardly a word. Then he'd repeat the same thing a few hours later, leaving against almost as soon as he arrived, leaving most of Sarah's question to be answered by the resident and nurses. The obstetrician was summoned in when Sarah was ready to do her final push, told Sarah to push hard, out came Daniel into his hands. He clamped the umbilical cord, invited me to cut the cord, and then disappeared out of our lives. It had a little less personal touch than our FedEd delivery guy.

So when Sarah strongly suggested that we use a midwife, I didn't object - provided that the birth still happened at a hospital, given my "always prepare for the worst case scenario" mentality. I have to admit that the experience was night and day. Sarah's midwives were encouraging, they walked her through her labor and patient answered every question and coached her through every turn. They were able to exude competence and confidence without being aloof. After our experience using a midwife for the birth of our second child, I didn't hesitate repeating the practice for our third.

I'm a fan of midwives. Whether the proposed legislation is truly a fight for patient safety as opposed to an anti-competitive measure in the same spirit of physicians fighting against prescribing and practice right of LPN's and physicians assistants, I can't say. I would muse that if obstetricians provided the same sensitive touch and "patient care experience" as midwives did, there wouldn't be much of a market for midwives, would there?

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