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Monday
Jun012009

Suspected Macrosomia? Better Not Tell the Admitting Doctor.

 

I picked up my medical records on Friday. All I can say right now is that the study Suspected macrosomia? Better not tell is so aptly named. Better not tell Dr. Chavez, who proudly documented how he stood in front of me while I was in the throes of labor to loudly sing all 50 Ways to Maim or Kill Your Baby by Giving Birth Vaginally.

All fifty ways were fantastically fact-free.

Dr. Chavez, in typical obstetric episodic fashion, vanished and did not return on that high traffic August evening in the hospital. He made sure to corner my husband (within earshot of me, naturally) before he left to tell him the reasons why his wife was endangering his baby by showing up in labor and refusing the recommended cesarean and gave him a form to sign. My husband was so petrified that he doesn’t even remember what he signed.

That whole experience can be best described by a compound word that begins with “cluster” and ends with an expletive. It’s been nearly four years and I can still remember the “medical” idiocy like it was yesterday.

Dr. Chavez was out to protect someone with his cesarean sales pitch. The only problem was that it was not me or my baby that he was trying to protect.  Instead, he lied with a goal of scaring us into a cesarean and so did his colleagues I met with the week before.

So-called defensive medicine ceases being medicine the minute it becomes defensive. At that point, I didn’t even need medicine! I needed a safe place to give birth. When I look at how close Dr. Chavez came to inflicting iatrogenic injury on me and my baby and taking us from low-risk to high-risk for no justifiable medical reason, I wonder how all of these smart doctors can collectively and individually act so stupid. I feel very bad for all of the good obstetricians and obstetricians-to-be that I’ve met over the last few months whose profession’s reputation is being sullied by the cesarean epidemic.

 

 

 

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Reader Comments (8)

"So-called defensive medicine ceases being medicine the minute it becomes defensive." Yes, Yes, Yes. And when the general obstetric community embraces defensive medicine it can be called organized white collar crime and premeditated assault. Jail is the answer. Stripes are the new white.

June 1, 2009 | Unregistered CommenterAnon

Better not tell Dr. Chavez, who proudly documented how he stood in front of me while I was in the throes of labor to loudly sing all 50 Ways to Maim or Kill Your Baby by Giving Birth Vaginally.
OMG, seriously?

Hmm, isn't it interesting how aggressive defensive medicine is?

June 2, 2009 | Unregistered Commenterlabortrials

Anon is back! I've never thought of it that way because it gets sugar-coated with terms like common practice and medical consensus. When you systematically ignore evidence and unethically take patients from low risk to high risk for no reason, what *do* you call it? The appeal to common practice argument only goes so far.

Hey, would you like to write a guest post on what the heck is going on in Oz right now? You can submit it through the contact form linked on the sidebar so you can remain "anon." I've been wanting ot hear your thoughts.

June 2, 2009 | Registered CommenterJill

LT... ha! I'll never look at "defensive" medicine the same. I'll always be thinking "aggressive medicine."

June 2, 2009 | Registered CommenterJill

I love the agressive defensive medicine idea. It makes perfect sense!!

One of my best friends had her daughter by 'emergency' cesarean almost a year ago. She was fully dilated within 4 hours of starting labor, and because her contractions were so strong and working so well, the minute they got to the hospital, they strapped her to a bed, which made the baby go into distress and even though she was at a -1, the doctor wouldn't let her off the bed to squat to get the baby out. He decided to butcher her stomach instead.

It's crazy how they think that you are endangering your child by bringing it to the world the way God intended. Instead, it's safer to cut open your abdomen and pull the child out through the hole? I can understand if it is really an emergency, but if it isn't, you are putting everyone at unnecessary risk.

June 2, 2009 | Unregistered CommenterKayce

Thank you so much for the comment you left on my blog. When I wrote it I never expected to get the response that I did from so many people. I definitely did not expect to find out that I wasn't alone. We, as women put ourselves "out there" so much. We're such open-hearted vulnerable people!

But I've learned something really important since then... I now share what I WANT to share, not what I think I should. And each day and with each 'intrusive' question, I get stronger and better at it.

Thank you again Jill.

June 2, 2009 | Unregistered CommenterJanelle

My first was born at 10lbs and my 2nd 10lbs 10oz. I saw two different midwives. With my second pregnancy the midwife tried to scare me into a cesarean when I was 5 months because of the shoulder dystocia with my 1st. I wasn't going for that. I went home and typed in' finding another midwife during pregnancy' and came back with homebirth links. That is how we came to have our 1st homebirth. I wouldn't have had it any other way.

Love your blog!

June 2, 2009 | Unregistered CommenterDarcel

Hi Darcel! Welcome. =) I am glad that you weighed the risks of SD recurrence and made a decision that worked for you. I'm curious... did she present you with evidence or just tell you you'd have to have a c/s or [insert terrible consequence here]? There *is* evidence of increased risk that SD will reoccur. One tiny study showed 1.25% and another was 13.8% with one permanent injury out of 747 patients. Here's Zamorski and Bigg's review of the research:

<blockquote cite="Two observational studies have examined the risk of recurrence of shoulder dystocia in subsequent deliveries. One study of 93 patients showed a recurrence rate of 1.25 percent. Another study of 747 patients showed a recurrence rate of 13.8 percent with a single permanent birth injury. These studies, when interpreted in the context of the uncertainty of the effectiveness of interventions for suspected macrosomia, suggest that for most women with a history of shoulder dystocia, expectant management usually is the most appropriate option.".

Expectant management is still what is recommended, not elective c-section. Your first midwife's tactics had fear of litigation written all over them if you ask me.

I'd love if you'd share your birth stories! Thanks for your comment.

June 2, 2009 | Registered CommenterJill
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