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In response to a recent post by an obstetrician out of Coral Springs, FL, which has since been deleted (he’s also done some really nice “damage control” by deleting comments from all of his posts on his Facebook page, per the last time I checked), I offer you my thoughts and opinions. They are based on actual, factual information, which is used to educate, not instill fear or show dominance.

Now, before you dismiss this blog post, realize that this is for you if you have ever been, wanted to be, or are pregnant. This is for you, if you know someone who is expecting a child, or even, have been birthed, yourself. Basically, just read his statements below and tell me that it doesn’t outrage you. (If it doesn’t… “Houston, we have a problem.”)

If you can’t read the small text in the screen shot, here is what was originally posted. I copied and pasted it into this screen as I instantly knew that I needed to write about it. Because this sort of thing should. not. ever. be told to patients.

“IN response to the new study, the American College of Obstetricians and Gynecologists (ACOG) developed a sample birth plan, printed below. There was a study conducted at 2 hospitals that showed the longer a woman’s birthing plan is the greater the likelihood she will end up with a C-Section that she didn’t want. ACOG has this as a recommended birthing plan for all expectant mothers! This is a great plan, it keeps it simple. The longer and more complicated your birthing plan is the less likely you will be happy! I want all of my patients to discuss their birth plans with me as soon as possible, way before they would go into labor so we are on the same page, if not then I encourage them to find someone else, because I know what I am doing & my patients trust me with my vast experience of having delivered 5600 babies that I will do the best thing for them. I highly recommend this ACOG birthing plan, you don’t need anything else! And please take hospital sponsored birthing classes which are much better than outside classes like Bradley Method which oftentimes causes more problems than it helps and don’t want my patients to do Bradley Methods, water births which can be very dangerous and you do NOT need to waste money on a DOULA ! For the best OB care call (redacted) office or (redacted) to begin your pregnancy journey!

ACOG birthing plan only 4 bullet points brilliant and practical !

Deliver baby vaginally

Epidural for pain control if pain too bad

Be flexible if issues develop

Listen to OB/GYNs and labor nurses for recommendations”

While I agree that simple, concise, and easy to read birth plans are, perhaps, best, in no way do I judge your thoughts, values, or opinions regarding your birth. The doctor stated: “The longer and more complicated your birthing plan is the less likely you will be happy.” Of course, we all know if you set ferociously high standards or expectations for anything, you may experience some degree of disappointment. In addition, I believe that, for the most part, birthing people go into their pregnancy and labor with the general understanding that things can and may go awry, and that, sometimes, they can’t be helped. In those cases, sure, please use your expertise because that’s what you were trained to do. But to tell a patient straight away, “Do not question me, I know what I am doing,” not only brings attention to your unwillingness to hear the thoughts and ideas of others, it shows that you are insanely insecure in your position.

This doctor’s disdain for the Bradley Method of childbirth education, specifically, may be due to the Bradley Method’s premises being those of “Active participation by the husband as coach.” aka “WHOA! Another man in the room, trying to take charge!” and “Most women with proper education, preparation, and the help of a loving and supportive coach can be taught to give birth naturally.”

This translates to:

  • No c-section
  • No extra pay check to the doctor or hospital
  • The doctor having to wait around for you to birth on your own time, which leads to
  • Missing that 5pm tee time at the country club.

What’s this extra paycheck, you might ask? Well, according to Medscape.com:

“Average total payments for maternal and newborn care with cesarean births were about 50% higher than average payments with vaginal births for both Commercial payers ($27,866 vs. $18,329) and Medicaid ($13,590 vs. $9,131).”

Source: Medscape¹

Ouch. That’s a big difference.

Now, let’s talk about his unfounded “water births which can be very dangerous” statement. I, personally, would like to hear his arguments as to the reasons for calling water births dangerous. I can make projections all day long like, “he can’t be all up in that vagina.” Or, “he doesn’t like to get his scrubs wet.” Whatever. I don’t know where he’s coming from. However, there have been many studies released that, in general, only end up calling for more research and information to “improve safety and informed consent,” per Evidence Based Birth’s review on waterbirth.² That’s it. None of them call for the cessation of the practice because none of them have found any negative outcomes. Not one. Boom, Doc. Seriously.

On this same site, you can read, under “What is the bottom line?their final sentiments, after reviewing many, many, MANY studies, which reads:

“New research evidence on waterbirth is continuing to emerge. For women, there are several benefits associated with waterbirth. There is strong evidence that waterbirth is associated with a lower episiotomy rate, and that women who use waterbirth will have higher rates of intact perineum and use less medicine for pain relief. The benefits or risks for the newborn are less clear, but so far the evidence shows fewer or equal NICU admission rates for waterbirth babies compared to babies born on land. There have been rare case reports of breathing problems or infections in infants after waterbirth, but these risks have not been seen in the large, recent, prospective studies on waterbirth. The ACOG/AAP opinion statement on waterbirth contained major scientific errors and was an inaccurate and incomplete review of the literature. Their opinion statement should not be relied upon to make informed decisions about the availability of waterbirth for women. Based on the data that we have, waterbirth is a reasonable option for low-risk women during childbirth, provided that they understand the potential benefits and risks. If women have a strong desire for waterbirth, and there are experienced care providers who are comfortable in attending waterbirths, then at this time there is no evidence to deny women this option of pain relief. Although we need more research on waterbirth, the available research shows that universal bans on waterbirth are not evidence-based.”

Therefore, this doctor’s fear-mongering words are not based on any real evidence.

So, my last point is about his “you do NOT need to waste money on a DOULA” statement. Sure, I’m a doula, so I may be a bit biased. However, I KNOW that doulas aren’t for everyone. And I’m ok with this. What is a doula, you ask? Well, we take on so many roles, it’s hard to really nail it down, but I’ll try… A doula is a professional birth companion or labor coach. We offer continuous, one-on-one care, providing information, physical, and emotional support to the birthing individual and their birth team. Our role and intention is to aid in creating and help to adhere to the agenda of the birthing person. With the help of a doula, both parents and babies are, statistically, more likely to have better outcomes, than without.³ According to Evidence Based Birth,

“When continuous labor support was provided by a doula, women experienced a:

  •         31% decrease in the use of Pitocin*
  •         28% decrease in the risk of Cesarean*
  •         12% increase in the likelihood of a spontaneous vaginal birth*
  •         9% decrease in the use of any medications for pain relief
  •         14% decrease in the risk of newborns being admitted to a special care nursery
  •         34% decrease in the risk of being dissatisfied with the birth experience*

For four of these outcomes,* results with a doula were better than all the other types of continuous support that were studied.”

Personally, I’d say those numbers are pretty dang significant! If you think about it, in terms of every 100 patients, 28 less people to have cesarean sections can be a pretty hefty pay cut when you realize that they are billed at 50%-100% more than natural, unmedicated, vaginal births.

Ouch. Doulas probably really hurt his paycheck.

Especially seeing that this “doctor” who knows what he’s doing has a cesarean section rate of 82%, NOT including Medicaid cases, which would elevate that even more! EIGHTY TWO PERCENT. Around here, that’s pretty scary. Honestly, I believe that to be criminally negligent, unless he is a high risk doctor with the majority of his cases needing cesareans. Numbers like that remind me of the doctors in recent years who have been prosecuted for falsely diagnosing and prescribing cancer medication and treatments. One, in Michigan, particularly.

What happened to their Hippocratic oath? Do no harm? Practices and misconceptions like these certainly do more harm than good.

 

Sources:

1. Medscape – (https://www.medscape.com/viewarticle/803426_2)
2. Evidence Based Birth: Waterbirth – (https://evidencebasedbirth.com/waterbirth/)
3. Evidence Based Birth: The Evidence for Doulas – (https://evidencebasedbirth.com/the-evidence-for-doulas/)
4. Medscape – (https://www.medscape.com/viewarticle/803426_2)

Bradley Method – (http://www.bradleybirth.com/faqs.aspx)