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You Bet Your Life (and your baby’s life too?)

January 24th, 2010 by avatar

[This is Science & Sensibility's very first giveaway!  Instructions for how to enter are below.]

Through my involvement in the Society for Participatory Medicine, I’ve gotten to know and respect some pretty amazing patient advocates. Trisha Torrey (@TrishaTorrey on Twitter)  is one of these. After being misdiagnosed with a rare type of terminal cancer and coming close to risking her life to accept treatment she did not need, she discovered that many of her long-held assumptions about our health care system were dead wrong. She also realized that if she could make the mistakes she made, others could too.  She made a mid-life career change to become a patient advocate and now helps others become informed, engaged, and empowered through her About.com Patient Empowerment Blog, her patient advocate search site AdvoConnection, her popular series of columns and podcasts, and elsewhere around the web.

She has also written a book, and it’s excellent.

In You Bet Your Life! The 10 Mistakes Every Patient Makes, Trisha takes a critical look at our health care system and points out the incorrect assumptions and other mistakes we make that ultimately compromise our safety and wellbeing. More importantly, she builds the reader’s confidence and gives clear instructions for how to fix or avoid each mistake. The book is organized intelligently into chapters for each “mistake”,  followed in turn by chapters on how to “fix the mistake.”  It is peppered with true stories (of both the tragic and triumphant variety) as well as tools such as checklists and recommended resources.

With a title like this book has, it is easy to assume that Trisha blames patients for things that go wrong. But quite the opposite is true. Trisha sees that no one has more at stake in healthcare than the consumer herself, and although the system erects barriers, an informed and engaged consumer can overcome them. Our biggest mistake is assuming that our healthcare system should function as it is intended, which is sadly far from the case.

Here are Trisha Torrey’s 10 Mistakes:

You Bet Your LifeMistake 1: Thinking the Healthcare System is Focused on Helping Patients

Mistake 2: Thinking Doctors Put Patients’ Needs First

Mistake 3: Not Confirming Your Diagnosis

Mistake 4: Thinking You’ve Been Told About All Your Treatment Options

Mistake 5: Thinking You’re Safe In the Hands of the Healthcare System

Mistake 6: Not Understanding the Influence of Your Medical Records on Your Health and Your Wallet

Mistake 7: Spending Time in the Hospital Unless It’s Absolutely Necessary

Mistake 8: Using the Internet to Find Health Information Without a Compass

Mistake 9: Thinking Medical Research Is Searching for Cures

Mistake 10: Letting the Media Influence Your Decisions Without Reading Between the Lines

When I saw this list I wrote to Trisha, only a little bit jokingly, that she could copy and paste this list into another book about pregnancy and birth and call it, You Bet Your Life, and Your Baby’s Life, Too! Well, it turns out that plans for a follow-up book about pregnancy and birth are in the works!  So, dear readers, here’s where you come in.  Trisha Torrey has graciously offered to send a free copy of her book to one of you. To be eligible to win, please leave a comment on this post with one of the following:

1. An anecdote (or link to a story posted elsewhere on the web) that demonstrates how one of the “10 mistakes” can play out – or be overcome – in maternity care, or

2. A maternity care mistake that belongs on the list but isn’t.

Please do not share an unpublished anecdote unless it is about your own experience or you have removed all personal details that might enable someone to learn the identity of the woman and/or baby involved. Published anecdotes are fair game. If in doubt, I will delete the comment and the entry will be voided.

Additional Rules: You can leave multiple comments for multiple entries. A winner will be chosen randomly from all entries. The book can be sent to U.S. addresses only. The deadline is 11:59pm EST Wednesday, February 3. Use a valid email address when you register your comment so we can contact you if you are the winner. (Your email address will be kept private but will be visible to me as blog administrator.) Comment contributors may be contacted as well for permission to feature anecdotes in a forthcoming pregnancy and birth edition in the series.

For full disclosure: I received a free review copy of You Bet Your Life! The 10 Mistakes Every Patient Makes. I also may be involved in the forthcoming pregnancy and birth edition of the You Bet Your Life series.

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  1. January 24th, 2010 at 22:25 | #1

    I’m one of the lucky ones. I figured out quickly that the obstetrician on call had no experience putting patients’ needs first, and later on, I even got her to admit as much. She was rattled when I refused Pitocin not once, not twice, but four times. She argued with me. She gave me at least a half-dozen reasons why she wanted to Pit me. But it turned out the real reason was that it was how she had been taught to manage labor, and she didn’t know HOW to handle a birth without resorting to her all-too-comfortable process. In fighting her, I taught her a valuable lesson, and learned a few lessons of my own that tie directly with mistakes 1, 2, 4 and 5.

    The birth story is in three parts, at these links:
    Part 1: http://bit.ly/5muTAk
    Part 2: http://bit.ly/7jkFiw
    Part 3: http://bit.ly/5cjCJB

    And there’s a post-script post on the “lessons learned” and some of the behind-the-scenes I didn’t know about that also got a lot of attention, titled “The Doctor Isn’t Always Right:
    http://bit.ly/52FwUl

  2. January 24th, 2010 at 22:28 | #2

    What a wonderful idea! The recent case of Samantha Burton illustrates many of these mistakes: what’s shocking is that she tried to avoid them all and her doctor got a court to force treatment on her!

    http://www.huffingtonpost.com/jacob-m-appel/medical-kidnapping-rogue_b_434497.html

    Mistake 1: Thinking the Healthcare System is Focused on Helping Patients- Sadly, in this case Ms. Burton was not treated as the patient.

    Mistake 2: Thinking Doctors Put Patients’ Needs First- What of her needs to take care of her family, including the 2 children she had at home?

    Mistake 3: Not Confirming Your Diagnosis- asking for a second opinion got her confined to the hospital by court order.

    Mistake 4: Thinking You’ve Been Told About All Your Treatment Options- or knowing that you’ve been given only one option.

    Mistake 5: Thinking You’re Safe In the Hands of the Healthcare System- if doctors have lawyers before they treat patients, do patients need lawyers before they seek treatment?

    Mistake 6: Not Understanding the Influence of Your Medical Records on Your Health and Your Wallet- I wonder if she’ll receive the bill for the hospital stay and the emergency c/s?

    Mistake 7: Spending Time in the Hospital Unless It’s Absolutely Necessary- see all of the above.

  3. avatar
    Gretchen Malone
    January 25th, 2010 at 08:51 | #3

    I was unlucky and ended up with a c-section when it was not truly needed. I was so happy that I had gone 30 plus hours w/o and pain meds and I was still strong enough to walk and talk. I was slowly broken down with you don’t have to go through this you know. I later found out that my waters were broken against my wishes, I was put into the worst position possible for me while laboring, and for me the worst part was believing that I would be able to have a baby the way I had planned to without any issues the next time. That was the biggest slap in the face. I am so tired of being lied to and of hearing the lies other women are being told.

    One lady I am friends with want a VBAC and has been lied to by her OB from day 1. Told her No, then Yes and is now saying No again. Why? The first No was b/c hospital does not do them, Which is another lie. Then Yes to keep her from leaving and going somewhere else, and they even told her she could go to 41.5 weeks. The third No via scheduling a RCS is b/c they just don’t believe she will go into labor by 3 days past her EDD. All of this comes at 37 weeks.

    It is just so nuts.

  4. avatar
    ness
    January 25th, 2010 at 10:41 | #4

    With my first pregnancy, I was guilty of 1,2,3,4,5, and 10!!!

    10 days overdue, with NO problems, baby looked great but was quite happy in utero.

    They convinced me to come in for an induction because I was “waaaaay overdue”. And then of course, came the necessary IV and the food/water ban, etc. Eventually, the epidural came, too. 14 hours later my daughter was born with no complications for either of us.

    With my fourth daughter, I was much more informed and had a homebirth. (Even though my 2nd and 3rd were also uncomplicated and less interventive because I had learned from my past mistakes, I was tired of fighting the system for a normal birth and really couldn’t do that again. I just needed someone to believe in me.)

    I was 2.5 weeks overdue! I learned then that the medical community did not show me all of my options for encouraging labor. I did the expected midwife cocktail and lots of raspberry tea and primrose oil, but it didn’t work. What worked? Waiting! :)

    I didn’t need to epidural either. (I had natural births in the hospital, but they were hard. I had no doula, had never even heard of a doula, and we managed the best we could. Did I mention it was hard?) One word: waterbirth! Wow, what amazing pain medication water can be!

    Well, that’s just two examples. I am sure I could go on. But actually, I am pretty grateful for my first birth. Not only did I learn a lot about me and birth and labor, but I learned that it could have been much worse. I know so many women who are coerced into inductions at 39 weeks and my doctor didn’t even mention it until 41.5 weeks. I labored overnight with no impatience from my OB so he could go home. Yes, he was really hoping my kid would be born by 7 am (and she was born at 7:03) but I really believe that he wanted to be there to witness her birth. He just didn’t get it and that’s a hard problem to fix. I feel sad for him, frankly.

  5. January 25th, 2010 at 11:33 | #5

    Hmm. I guess perhaps this falls under Number 2–which perhaps could be amended to be “thinking medical care providers should actually care slightly about their patients.”

    Here’s my anecdote (it isn’t a cheerful one): I went to the doctor’s office concerned about spotting/cramping during my third pregnancy, early in my second trimester. She sent me downstairs for an ultrasound. The woman doing it did not say a single word until I said, “not good news, huh?” She responded with, “no, not good news,” handed me a box of tissues and walked out of the room. That was IT! And, then I got a bill for $700. $500 for the ultrasound and $200 for the “care” of the tech conducting it.

    I don’t expect compassion when I go to the doctor and that is wrong.

  6. January 25th, 2010 at 11:34 | #6

    @Molly
    P.S. and our insurance did not cover said “care” either, so I had to pay $700 to surmise for myself that my baby was dead :(

  7. avatar
    Augusta
    January 25th, 2010 at 15:10 | #7

    My sister’s second birth was full of stuff like this. She was about 10 days past her due date and the doctors convinced her to come in for induction. She decided she would rather wait until morning so she could be well rested. They wanted her to have Cytotec to begin the induction process. (I know I don’t have to explain here why Cytotec should NOT be used for labor induction) That evening, her water broke and she wanted to wait until contractions started. The medical staff hassled her EVERY.STEP.OF.THE.WAY. Her water was broken, and they would not begin a Cytotec induction since they said it was a contraindication. The chief resident ended up coming in and trying to talk my sister into getting Pitocin (at about 11 PM, after she’d been up all day and was tired). When they failed to covince her, the physician overseeing the residents came in to try and talk her into it. We’re talking about a 130 pound pregnant woman sitting in her hospital bed with three doctors and a nurse standing around her bed telling her she SHOULD do this. Nope. She declined again. They were NOT happy about that.

    In the morning, my sister still had not begun contractions, but she HAD been able to get some rest, so she agreed to try Pitocin. She wanted the lowest possible dose. They told her their protocol was to up the Pitocin every 15 minutes. She would not consent to upping the Pitocin at that rate, but she agreed to play it by ear. After about an hour of Pitocin, she still wasn’t contracting, so she agreed to the next level. Things continued like this until she was contracting regularly and feeling like she was in active labor (this was her second birth). She requested for the Pitocin to be turned off. That, of course, turned into another medical conference with several physicians coming in to explain to her why her wishes should not be respected. They told her that she would not be able to have labor on her own without the Pitocin at this point. The head physician told her “The longer the baby stays in, the less likely it is to come out on its own.” (HUH?) They gist of what she wanted was summed up in my mother’s pleas to the doctors, “Just let the baby come on its own!” They looked at her like she had two heads when she said this. Finally, they reluctantly conceded and her labor progressed (with no Pitocin beyond that point) normally.

    When she was getting near to pushing (by her own account), she warned the nurses she was getting close. They did not check her, and they did not believe her. She started pushing with no nursing staff in the room. When the nurse came in a few minutes later, my sister was crowning. Panic ensued and I ended up helping the doctor don his gown. My sister pushed her 9 lb. 4 oz. baby out with no tearing….until the doctor vigorously yanked the baby upward when his body was coming out. That is when she acquired a 2nd degree tear.

    After that, she was told that her baby must have a NICU stay because his breathing rate seemed a little high. They were concerned about infections since her water had been broken overnight. More major hassle. Of course my nephew ended up being totally fine, but only after spending 5 days in the NICU and racking up a hospital bill of over $40,000.

    It was such a battle just to have a minimally intervened labor in the face of absolutely NO medical indications that anything was amiss. Why should women in labor have to FIGHT for their rights to be respected and given the ability to have a normal labor unless there is a necessity for intervention?

  8. avatar
    Melanie
    January 25th, 2010 at 19:02 | #8

    Another common mistake: Thinking that the pain of natural childbirth is so much worse than undergoing (and recovering from) a caesarean.
    Another common mistake: Thinking that you need a obstetric surgeon to deliver your baby.
    Another common mistake: Listening to, and accepting education from, people who have only seen difficult and medicalised births. Get independant education from someone without a vested interest in your birth outcome.

  9. avatar
    Lisa Primack
    January 25th, 2010 at 20:28 | #9

    The first intervention in birth that a healthy woman takes is when she walks out the front door of her home in labor.

    From that first intervention all others will follow.

    -Michael Rosenthal OB/Gyn

  10. avatar
    Lisa Primack
    January 25th, 2010 at 20:29 | #10

    There is a secret in our culture –
    it’s not that birth is painful.
    It’s that women are strong.
    -Laura Stavoe Harm

  11. January 25th, 2010 at 21:09 | #11

    I pulled out my birth summary to make sure I got the spirit of this right, but the details have been modified. Otherwise this is exactly what happened.

    This is when I was working as a volunteer doula and was paged in to a birth by the nurse. When I arrived I found out that the mom was in her mid-30s, had two children with her boyfriend, and was about to give birth to her third. However, she had told all her friends and family, including her boyfriend, not to accompany her to the hospital. She had a test done partway through her pregnancy showing that her baby was at high risk for a genetic syndrome and would probably not survive long after birth, if at all. She wanted to deal with her baby’s passing alone. She had spent the last months of her pregnancy grieving, fighting with her boyfriend and very depressed.

    Just after I arrived, the nurse came in the room to tell her that she had the test results rechecked and they were, in fact, NEGATIVE for this genetic problem. Her baby was born completely healthy, but mom had a lot of mental work to do during and after the birth to adjust to that idea. She called her boyfriend and he did make it in time for the birth, at least. The birth was an odd mix of happy and sad: happy of course for the healthy baby, but also grieving all those unnecessary months of grief.

    That her screening test results were never rechecked or followed up on, that she was never given a diagnostic test, seems hard to believe. Looking back, I almost can’t believe it; I just now wondered if she had stopped attending prenatal care, and had just showed up at the hospital in labor – but according to my notes it was an induction, so she must have been getting enough PNC to be scheduled for one. My only explanation is that she was attending an overburdened public clinic system and I don’t think she was assertive enough to question what the test said or what the next steps should be. So either her test was never followed up appropriately, or it was followed up and she was never told…both of which are awful.

    This birth stands out very clearly in my mind; it sprang to mind as soon as I read what you were looking for. Mistake 3, although I hesitate, for disenfranchised women, to call it a mistake; the system is failing them as much as, or worse than, everyone else, and they are so poorly equipped with the resources to fight it.

  12. January 25th, 2010 at 23:28 | #12

    Maternity care mistake 4A: Following your request to be told about intervention risks and alternatives, not finding out about timing of said procedures or if waiting/no action is an option.
    Many times families assume that because a provider recommends a course of action that it must be followed or a decision made immediately.

  13. January 25th, 2010 at 23:34 | #13

    Maternity care mistake 1A: Not being or bringing an advocate for yourself (like a birth doula) and your baby and assuming your plans will be followed. Even mothers who specifically decline procedures such as administration of vaccines find their newborns are given the injections anyway by well intentioned/busy nurses who follow hospital orders.
    Remember: Your Body, Your Baby, Your Birth!

  14. January 25th, 2010 at 23:41 | #14

    Maternity Care Mistake 11: Forgetting that as a patient you have the right to refuse or accept any drug, procedure, test or treatment and that at any point you have the right to have your choice honored, change your mind, or ask for further information. Finding your voice in labor is essential!

  15. January 25th, 2010 at 23:59 | #15

    Maternity Care Mistake 12: Assuming that medical standard of care is the best alternative, reflects current scientific evidence, and that procedures aren’t unnecessary or even harmful to you or your baby. Just some examples include early cord clamping, episiotomy, Hepatitis B vaccine, and restriction of food during labor. You need to become educated about your choices, the right to refuse or delay standards of care, and have an advocate continually reminding your care team or your desires.

  16. January 26th, 2010 at 01:24 | #16

    A top three, of the top of my head:

    1. If you want anything other than the standard cascade of interventions with a good possibility of a cesarean, take something OTHER than the hospital-sponsored childbirth classes.

    2. Don’t think that asking your doctor something as general and vague as “Do you support natural birth?” is going to give you any real information. There are, of course, many questions you can ask that will reveal his or her true philosophy on birth (a.k.a. labor management), but it’s going to take specific questions , and at least a few of them. (Though, I must say, asking “How do you feel about doulas?” is very loaded, in a good way, from the patient’s perspective, and can be quite revealing in itself.)

    2.5 Same goes for just handing your doctor a birth plan, especially if it’s one you printed off the internet with boxes that you check off.

    3. Don’t think that somewhere in the middle of the third trimester is the time to START asking the questions in #2 of any care provider.

  17. avatar
    Veronica
    January 26th, 2010 at 10:16 | #17

    Some of us who teach in hospitals DO A GOOD JOB.
    Please don’t assume that all hospital classes are bad. While I do hear about a lot of bad classes (30 couples? REALLY?), I think with a little investigation, it’s possible to figure out if the hospital classes will be positive or do more harm than good.
    Hint: If you hear the phrase “how to give birth at x hospital” or “be a good patient at y hospital” comes up…RUN!

  18. January 26th, 2010 at 15:16 | #18

    Example of mistake #’s 1, 2, 4 & 5!!

    http://www.cnn.com/2009/HEALTH/12/17/birth.plan.tips/

    I was shocked when I first read this story and it perfectly illustrates several of the mistakes from Trisha’s book (which I look forward to reading!).

    On another note, I love your comment, Dou-la-a, about asking the vague question of “do you support natural childbirth.” I am also a doula and childbirth educator and the first thing out of my mouth when I hear this is “okay, great, so how many natural births did you support this year?” That’s where you find out the real answer to that question! Families must understand that full disclosure is not typically offered up freely. You must ask the right questions, not settling for the easy answer, and ask those key questions EARLY! It irks me how so many times providers will delay a patient’s questions about birth until 35 weeks +, in which case the patient feels stuck between a rock and a hard place when they find out that their care provider isn’t as friendly toward their birth choices as they had assumed and feel trapped and freaked out at the idea of looking for a new care provider.

    Ok, stepping of the soap box now. :)

  19. January 26th, 2010 at 15:21 | #19

    Jennifer Simons :
    Maternity care mistake 4A: Following your request to be told about intervention risks and alternatives, not finding out about timing of said procedures or if waiting/no action is an option.
    Many times families assume that because a provider recommends a course of action that it must be followed or a decision made immediately.

    Amen! Families need to use B.R.A.N.D. or some other quick acronym that reminds them to ask…

    B – Benefits? What are they?
    R – Risks? What are they?
    A – Alternatives? What are they?
    N – Do Nothing, what if we choose to do nothing?
    D – Discuss and decide, without the staff/doctor staring right at you.

  20. January 26th, 2010 at 15:30 | #20

    Molly :
    @Molly
    P.S. and our insurance did not cover said “care” either, so I had to pay $700 to surmise for myself that my baby was dead

    This is truly terrible, Molly, I’m so sorry this happened to you. I hope you filed a complaint with the hospital against the technician.

  21. January 26th, 2010 at 19:11 | #21

    I would add a mistake for expecting couples:

    Assuming that you and your doctor share the same philosophy of birth.

    In the classes I teach, I stress very early on (and often!)that if their care provider doesn’t share the same perspective on birth as they do, or if the CP has a high intervention rate, that they should switch to someone whose philosophy they share more in common. Many couples think that they will be the one natural birth exception for their highly interventive practice, but chances are they won’t be the exception or if they are they’ll have to fight tooth and nail to BE the exception, and who needs high pressure negotiations on top of LABOR?

  22. avatar
    Lisa
    January 26th, 2010 at 23:45 | #22

    #7 Spending time in a Hospital unless it is absolutely necessary
    After switching OB’s twice, I finally hired a home birth midwife when I was 30 weeks pregnant. I had feared the pain and suffering associated with childbirth my entire life, so I had little confidence that I would actually have a home birth. Up until a few months earlier, I was planning a traditional epidural-birth. But in all my reading and experiences at prenatal visits, I had come to fear our hospital’s dysfunctional spiral of interventions and coercion even more than I feared natural childbirth. So, I thought I would at least give myself the option to stay home, knowing that the hospital was just a short drive away.

    Much to my surprise, my son’s birth was really quite peaceful and lovely. My labor progressed quickly and relatively painlessly in the comfort of my own home. I didn’t even believe I was having true labor until I was already 6 cm dilated and 90% effaced. Three hours later, my midwife wanted to check me again and I told her I didn’t think I had progressed because it had been so manageable. She checked and I was 10cm dilated and 100% effaced! I only gave two nudges and my 8lb baby entered the world.

    I couldn’t believe that I had actually considered never having children because of the “pain” of childbirth! What a cultural fallacy! There is just no way to quantify the difference it makes to be at home while laboring and birthing a baby. For low risk pregnancies, studies show that it is at least as safe if not safer than a hospital birth for the mother and baby. A woman’s home is also her comfort zone. I know without a doubt that it made a world of difference for me, and I’m sure it has the same effect on other women. At a hospital, a couple is lucky if they are able to fight to get a natural birth, but that is not conducive to birthing. A woman is not in a frame of mind to be fighting – she just needs to be relaxing and allowing her body to do what it needs to do.

    This experience has made me question everything I once believed about health care and Western medicine. I’m still grappling with my realization and wondering what (if any) aspects of our health system can be trusted. For instance, vaccines…

  23. avatar
    Naomi
    January 27th, 2010 at 02:17 | #23

    The number one mistake women make in maternity care: Believing that a hospital that follows ACOG “Standard of care” is basing its policies on evidence-based medicine.

  24. January 27th, 2010 at 02:28 | #24

    Not changing care providers when it becomes apparent that he/she does not share your philosophy of birth (or does not support normal birth, VBAC, or whatever). Thinking that it is too late to change providers.

  25. avatar
    Naomi
    January 27th, 2010 at 02:41 | #25

    I have a little anecdote about Mistake # 7.

    When I was pregnant with my daughter, I had all kinds of trouble with getting the midwives/OB team at the hospital to acknowledge my *actual* due date (because I’d been charting and knew the conception date window, which was more than a week after the “LMP” guidelines said). Because they thought I was “over due” They threw a hissy fit and demanded that I get the NST and AFI done. I thought (wrongly, of course) that it wouldn’t hurt much, and I agreed to go. I liked seeing the baby on the ultrasound, anyhow.

    Unfortunately, the second time I went in for the AFI, I got an incompetent tech who measured my fluid levels wrong. I requested a second opinion, but the supervising OB came in first, to “confirm” the measurement that the tech had gotten. He made the EXACT SAME MISTAKE the tech did: they both only checked 3/4 of my belly, and that 3/4 was the part the baby was taking up. After a ridiculous amount of argument, bullying, and belittling on the part of the OB, he agreed to “let” another ultrasound tech come in and re-do the measurement. The new tech did the measurement correctly, and came up with a number THREE TIMES HIGHER than the other two. I am sure that’s because she measured the fluid in my ENTIRE belly. The OB came back in, and dithered, hemmed, and hawed, and tried to tell me that it was the SECOND ultrasound tech who was wrong, and I NEEDED to get an induction RIGHT NOW OR MY BABY WOULD DIE. Based on the results of the test, and the results of the NST, I declined, since I knew going in that the AFI alone is a VERY BAD INDICATOR of whether induction is necessary. More bullying, threats, and nonsense on the part of the OB. I stood my ground, but I later paid the price.
    Unbeknown to me, The OB wrote a *really* nasty note into my chart, saying that I was unreasonable, questioned the expertise of the practitioner, denied the results of the test CONFIRMED IN REAL TIME by the OB, and had been informed that without immediate induction, fetal demise was “inescapable” and STILL I refused the induction. Having been warned of imminent stillbirth, he washed his hands of me.

    Keep in mind, this guy wasn’t even my doctor, ok? I didn’t find out about this little gem in my record until, five days later, I showed up to the hospital in labor. I was only 3 CM, so I wanted to wait to get checked in, and, before they checked my chart, they let me walk around for a while at the hospital. The next time I went to get checked, though, they’d read my chart. And they didn’t want me going ANYWHERE. They checked me in, (I was active duty so I didn’t have a choice), and I spent the next thirty hours being harassed and stressed out, because I wanted to let things progress naturally and all I was doing was fighting the doctors (not a good recipe for a nice, easy, short labor) In the end, I ended up being ORDERED to accept pitocin, and then later, I was physically held down in the bed by five nurses until I agreed to sign the consent form for the c/s that I didn’t want, and didn’t need.
    The baby came out with apgars of 9 and 10, thankfully.
    They tried to justify it by saying that the baby’s heart rate was “dangerously low”, but the darn monitor wouldn’t even stay on b/c the baby kept kicking it and it slid off every three seconds. They tried to prove her o2 levels were low, but those came out on the high end of normal, as well.
    Later, the supervising OB admitted to me that the major reason they treated me like that was because of that entry the jerk of an OB wrote in my chart.

  26. January 27th, 2010 at 09:33 | #26

    Mistake #10: Thinking it’s enough to talk to your doctor about your wishes during labor and birth.

    As an L&D nurse as well as midwifery student, I’ve got three words for you: nurses, nurses, nurses! The doctor will probably only be there for under an hour, while it’s the nurses who are with you day and night. Getting them on your side is the key to having the kind of birth you want. If that’s a natural childbirth, I also strongly recommend saying on check-in, “I’d like a nurse that’s supportive of natural childbirth.” There are those of us who fight over those patients, but if you don’t ask, you’re just as likely to be assigned to someone who’s going to push an epidural. Not only do nurses know what the options are in their facilities (telemetry monitoring, tub time, etc) they can also run valuable interference with the physician on call (who, surprise surprise, may not be yours).

    Mistake #12: a) Thinking it’s too late to change care providers, OR, b)Forgetting that your care provider works for YOU. If you’re seeing red flags in your care, whether that’s at 16 or 36 weeks, look into your options for transferring care. Yes, it may be annoying and a lot of legwork, but it could end up being the single best choice you make about your pregnancy and birth. If a) fails, remember b). This doctor is working for you– not the other way around. Just like you shouldn’t accept rude or erroneous service from a waiter (“I didn’t order grilled cheese,”) the same should go for a doctor (“I said I didn’t want an episiotomy”). If all else fails, give written feedback to both the hospital administration (who are required to collect data on patient satisfaction and sometimes risk losing federal funding over it) naming the doctor by name, and consider doing the same to the physician’s practice, if you’re comfortable doing so. (And by the same token… if you do have a nurse who moved heaven and earth to get you the birth you wanted…it doesn’t hurt to ask if there are procedures in place for recognizing her too. Hearing it meant the world to you may give her the motivation to do it again the next time she’s at the end of a rough 12-hour shift.)

  27. avatar
    Emily
    January 27th, 2010 at 18:59 | #27

    Mistake #5 was mine.

    Planned homebirth turned hospital c-section for preterm breech.

    The nurses couldn’t get ANY contractions on the monitor and so – despite my voicing there was progression and a need to push – they refused to check me and told my midwife’s backup OB that I WAS NOT having contractions (found this out after the fact).

    I ended up fully dilated, partially birthed footling breech vaginally, then knocked out with general anesthesia for an emergency c-section in which the baby was badly bruised when pushed and pulled back through my cervix.

    Lesson learned: When in doubt, CALL AND SPEAK TO THE DR YOURSELF!!!!

  28. January 28th, 2010 at 21:44 | #28

    Emily :
    Mistake #5 was mine.
    Planned homebirth turned hospital c-section for preterm breech.
    The nurses couldn’t get ANY contractions on the monitor and so – despite my voicing there was progression and a need to push – they refused to check me and told my midwife’s backup OB that I WAS NOT having contractions (found this out after the fact).
    I ended up fully dilated, partially birthed footling breech vaginally, then knocked out with general anesthesia for an emergency c-section in which the baby was badly bruised when pushed and pulled back through my cervix.
    Lesson learned: When in doubt, CALL AND SPEAK TO THE DR YOURSELF!!!!

    Emily, your experience is proof positive that there is a serious lack in the medical training of our care providers today!!!

  29. January 30th, 2010 at 18:04 | #29

    This kind of encapsulates a lot of the mistakes listed, but it seems like so many people I know just blindly trust anything their doctor tells them. I guess it’s because of a “Well, he’s the expert” mentality. For example, my friend had a c-section for her first pregnancy, and now she whole-heartedly believes that she MUST schedule c-sections for every future pregnancy, without ever questioning it. That kind of blind trust doesn’t seem to be present in any other industry.

  30. avatar
    Sarah
    February 3rd, 2010 at 12:02 | #30

    Here’s are two suggestions for Maternity Care mistakes.

    Assuming that every doctor would make the same decision in your circumstance.

    As a doula I’ve worked with clients who have been told by their doctors “It’s not my policy on this intervention, it’s every doctors policy.” This is never true. Sometimes we end up stuck in the system whether we like it or not. If you find yourself in this situation, ask for a second opinion, or bring in research to prove that there are other safe ways of doing things. When that isn’t possible, you can say no.

    Thinking that an obstetrician is a child birth expert.

    A midwife is a childbirth expert. An obstetrician is an expert at medically solving “worst case scenarios”. If you are not in a “worst case scenario” then why not hire the appropriate expert, a midwife.

  31. avatar
    Leah
    February 3rd, 2010 at 15:49 | #31

    I made the mistake of going to an OB with my first pregnancy thinking that while I wanted a midwife, with the first one I’d pull out all the stops and be “extra safe” then for later ones I’d go to a midwife. Well, luckily I didn’t end up with a c-section, but I did end up with a major tear because of the epidural/coached pushing combo. With my next baby I had a midwife and ended up with no tearing at all even though he was 10#6 (vs. 9#1 for the first one) so around 1.5 lbs more. But no one was yelling at me to push and I could feel what I was doing.

    These books sound awesome by the way!

  32. avatar
    Jennifer
    February 3rd, 2010 at 15:51 | #32

    @Katie Yep, my #1 for a book on mistakes women make about their births is thinking that the doctor will actually be present for your labor (or that he has been present for any other woman’s labor either). The reason obstetrics calls it a “delivery,” is because the only part of the process the doctor is required to be present for is the baby’s emergence from the mother’s body.

  33. avatar
    Alicia Kaye
    February 3rd, 2010 at 17:17 | #33

    When I was pregnant with my first I was having a fairly uneventful pregnancy. I hit my 21 week mark and started feeling extremely crampy. On the second day I went to the hospital to make sure everything was ok with my son. My husband was deployed so I went into the hospital to see the OB by myself. The nurse told me the doctor wasn’t available so she was going to admit me because I was having contractions and I was dialated to about a 1. I was terrified. Everything was going so good and now they were admitting me. They hooked me up to the machines and an IV. The nurse came in 2 hours later and said “this would all be over with soon.” I asked what she was talking about and she says while drawing something into a syringe, “oh, your having a miscarriage. We’re just going to give you some pitocin to get the labor going and in a couple of hours you’ll expel the fetus and then you’ll be able to go home. Probably the same day!” She said it so chipper, like I should be excited that I would be able to go home the sae day as losing my baby. I asked her if the baby looked like he was in distress and she said no but there wasn’t anything the doctor wanted to do. I pulled out the IV and got up off the bed and told her I was leaving. She said I couldn’t do that because I would end up miscarrying at home and it would be dangerous. I asked why I hadn’t seen the doctor yet and she said he didn’t need to see me because this was routie and he had more important cases to take care of right. So not only was I not important enough to be seen-even while supposedly having a miscarriage-but this was just routine. I told her I was signing out AMA and IF I miscarried I would come back. I couldn’t grasp forcing a baby out of my body who didn’t have any medical need to be forcced out. I left, switched to a midwife and had a home birth at 42weeks and 4 days. The midwife I called told me to lay down have some water and make sure the thick Virgnia heat wasn’t dehydrating me. I stayed at 1cm until the last week I was pregnant. I went in shortly after my son was born and showed the staff and him my healthy beautiful baby that they were ready to kill and walked out. So sad that they considered what the were going to do to me routine. How many others had they done this to? I listened tomy intuition instead of blindly losing my child to a doctor who wouldn’t even check me himself because I wasn’t a priority and a nurse who was just following orders.

  34. avatar
    Cristina
    February 3rd, 2010 at 17:26 | #34

    Another mistake: thinking you can go it alone.
    Especially as a birthing mother. When plans change, it’s good to have someone, or several someones, that can help advocate for you. We all forget how susceptible we can be to “suggestions” when we’re in the hospital, for what ever reason. Having another person there can help with everything from asking for explanations to making sure you’re not given the wrong meds

  35. avatar
    Alicia Kaye
    February 3rd, 2010 at 17:33 | #35

    I’m posting a couple of stories seperately so the posts aren’t so long-too late:)
    With my second everyone said I was so big, I was all baby at 142lbs and 5’4″. I had hired a midwife who was over an hour away or more if there was traffic! The hospital was only five minutes away from me so at 42 weeks I was having some pretty consistent contractions and didn’t want to have her if it wasn’t really time. I had a friend drive me over to the hospital to the L&D to be checked. As soon as we walked into the office the nurse standing at the desk proclaimed there was no way I was having that baby vaginaly and asked if I was having a csection. I said no that I was just there to be checked because I was having contractions. She laughed at me and said very sarcastically-’sure, I’ll see you after surgery!’ The PA on call walked into the room and I explained my midwife was far away and I wanted to be checked before calling her. He walked back out and said he was going to call the OB on duty. I was hooked up to all the monitors and asked to change into a gown. I refused and said I was fine in the long skirt and shirt I was wearing. The CNA was surprised and said I HAD to change because if they had to take me upstairs to labor and delivery I would have to be in a gown. I told her I wouldn’t be going up there and she left the room. The PA came in and looked at the tape then hurredly walked back out. Ten minutes later he said the OB was going to prep me for a csection because I was having contractions, dilated to a 5 and was not going to birth the baby vaginally because she was too big. I laughed and got up and walked out. 4 days later I went into labor for real and called the midwife and 15 minutes after she got here my 9lb. 4oz. baby girl came into the world with no tearing and very little warning! They don’t have your best interest in mind. They simply want the easiest route for them.

  36. avatar
    Allison
    February 3rd, 2010 at 21:09 | #36

    I was a sheeple who failed to confirm my diagnosis. With my second child I was scared into a c-section with talk of macrosomia and shoulder dystocia. If I had only done my research, I would have learned that 3500 c-sections are necessary to prevent ONE case of shoulder dystocia!! Such a ridiculous reason for a c-section, I am still kicking myself over not looking into it and seeking a second opinion. Yes, my son was large at 10 lb 4 oz, but big babies run in my family and I birthed my 1st child, an 8 lb 10 oz baby, with only 15 minutes of pushing!! I should have walked out and fired that OB the second she started talking about him being “too big”. Patients really do need to educate themselves–they are their own best advocate!

  37. February 5th, 2010 at 09:58 | #37

    I want to thank all of you for your thoughtful, honest, and often utterly heartbreaking comments. You have confirmed to me that a pregnancy and birth version of this book is badly needed.

    Using Random.org, I randomly selected a winner from the eligible comments, and the winner was Jennifer Simons. Thanks to all of you for your participation. I’ll leave this post open for additional comments if others want to weigh in or continue the conversation.

  38. avatar
    Carina Searight
    February 9th, 2010 at 16:14 | #38

    I think #1 needs to be ammended so that it’s clear that they are not about putting their patient OR patient’s baby 1st.

    It was expressly implied by Dr.’s in all 3 of my pregnancies that natural birthing was selfish, because it wasn’t best for my baby! What a load of lies I was fed! I’m so glad that even though I caved into many of their requests with my first, I was educated enough not to do so with my 2nd! I’m being pressured with my 3rd but feel out of options because my husband want’s me to deliver in a hospital this time. :(

  39. avatar
    Karen
    February 23rd, 2010 at 10:39 | #39

    I just want to add that women who have had previous miscarriages and are now pregnant again are scared into having the most medicalized pregnancy and birth possible. I have a cousin who miscarried 4 babies before 8 weeks, and with the 5th pregnancy she had the works – every test known to man, weekly ultrasounds, etc. They railroaded her into an induction @ 38 weeks (“You’ve already lost so many babies, don’t you just want to get this one out where he will be safe?”) Of course the induction failed, and she ended up with a c-section and a 4 lb baby in the NICU. And her OB doesn’t do VBAC, and she doesn’t want to switch providers, so she has already had one repeat cesarean and will likely have more. Whether her care providers really think they have done the right thing with her, or are simply preying on her natural fears, I don’t know.

    As mothers we are so driven to do what is best for our babies, that sometimes we think that difficulty conceiving = difficulty continuing a pregnancy = difficulty giving birth. But that simply isn’t true.

    And one more thing about my cousin – and this is something that we all know already. She doesn’t want to hear about her choices. She trusts her provider, she knows that he is going to do the right thing for her, so she doesn’t want to hear about other options. I have a friend who is suffering from some pretty common pregnancy discomforts, things easily taken care of. But her OB only prescribed medicine, and she doesn’t want to know anything about pelvic tilts or birth balls. It’s frustrating, to know a better way that would help women have a more favorable outcome, but they don’t want to hear about it. And in the end, these women are also getting the birth they wanted. I just don’t understand why anyone WOULD want it. :(

  1. January 25th, 2010 at 21:23 | #1