Doctors are not the enemy…

In fact, a good doctor is worth their weight in gold.

I propose…if you were to do a “man on the street” interview with random people and asked the question “Why do you think babies die?” the most common answer you would get would be:

“The Doctor made a mistake”

With very few exceptions  this is almost never the case.  Granted, humans are a goofy group and there are people who can do anything badly, but for the most part, from what I have seen in hundreds of deaths, Physician/Nurse error is rarely the cause.

Throughout the continuum of pregnancy, there are a lot of different things that cause a loss…I’m not a physician, so I don’t want to get too technical except to say that there are many things that can go wrong:  genetic problems, ectopic implantation, hormonal imbalance, infections, effects of maternal disease, domestic violence, fetal malformations, incompetent cervix, sick placenta, cord defects/knots/entanglements, blood clotting disorders, high blood pressure, placental abruptions and more things that don’t come to mind.

There are things that mothers and doctors can work on together to keep the pregnancy as healthy as possible, but whether or not a baby can get to a viable gestation is an unknown until it happens or not.

I encourage moms to work with someone who they feel listens to them and will work together as a team. It is hard when the stakes (and emotions) are high and Doctors are very busy, but I think there are things that women in general can do to help this work better.

I have observed that the enemies of a good Doctor / Parent  relationship are : a demand for perfection and quickness to blame. Our society has created an unbelievably intense insistence of perfection in the outcomes we want. We might verbalize that we understand that not every pregnancy will end perfectly and we’re comfortable with that as long as the bad outcome is for someone else.

In our culture of blame…we’re so afraid to admit that bad things simply happen, that we’re much happier figuring out WHY so we can blame someone. I remember caring for a baby in a NICU, he was sick but would likely get better, go home and be fine, but for that moment he was sick. Both of the parents were lawyers and they asked me whose fault it was that the baby was sick. “Its nobody’s fault” was not the answer they wanted.

I wish that OB physicians had more time to devote to each person and that each of them were good communicators, but most of them are pretty smart and super smart people are not always known for their talking skills (I know a few really great ones, I appreciate them so much).  I honestly don’t blame them for being a bit standoffish when so often they get blamed for horrible tragedies that simply weren’t their fault.

I wish that perinatal death (of every sort) was discussed more openly in society so that the average person had a reasonable understanding of what the real possibilities are. I don’t blame OBs for not discussing it in detail with pregnant women … the women are already so tightly wound, that conversation would lead them to be splatted on the ceiling of the exam room. I wish that the average pregnant women would worry less about minutiae that they can’t control and pay more attention to decreased fetal movement at the end of pregnancy (go to the March of Dimes website and read about “kick counts”).

In Ricki Lake’s documentary on childbirth “The Business of Being Born” , they demonized OB Medicine saying that it exerts severe control over women’s births for power and money…eeek, no !!    That docu-flick totally missed the whole point that OB physicians are forced to practice the way they do because anytime anything goes wrong ever, the question of why a C Section was not done is thrown at them with accusations and lawsuits. They are blamed if the don’t do surgical deliveries and they are blamed if they do.  I’m sure there are butt-heads out there who are lazy and do things for the wrong reasons, but the vast majority of OB docs I have worked with are decent people who want the best for their patients…if we quit throwing boulders at them, maybe we would appreciate how flexible they would be .

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