I was listening recently to an episode of Fresh Air on NPR in which the show's host, Terry Gross, interviewed journalist Elisabeth Rosenthal on the high price of healthcare, and in which the two women spent quite a lot of time discussing US childbirth costs.
A few weeks back I blogged about Ms. Rosenthal’s New York Times piece, "American Way of Birth, Costliest in the World," and told my own story about how I haggled for healthcare with my second pregnancy. In this week’s Fresh Air interview, Rosenthal mentioned that “more medicine” doesn’t necessarily equal “better medicine” and in fact, excess medical intervention often leads to “worse medicine.” That’s a really hard concept for many American mothers to wrap their heads around, but here’s an example of what that looks like:
Lisa went to her six-month prenatal appointment feeling just fine. Her baby was moving well and her vital signs were normal. She was healthy, happy, and feeling good about her pregnancy. That is, until her doctor said, “Let’s just do a quick ultrasound and make sure your baby’s in the right position.”
Not knowing any better, and because Lisa always liked taking a peek at her baby, she agreed to the procedure and hiked up her shirt. Her doctor squirted on the ultrasound jelly and said, “Just what I thought. Your baby is in an awkward sideways position. He’s going to have to turn head down pretty soon if we’re going to let you have a vaginal delivery. Otherwise, he might get stuck that way and I won’t be surprised if we have to do a C-section.”
And just like that, Lisa’s happy, healthy pregnancy turned on a dime. All of a sudden, Lisa thought she had a pregnancy complication and her attitude about everything changed. She went from feeling good about her pregnancy to feeling worried that there was something wrong with her baby lying sideways in what we call a transverse position. She’d been committed to having a vaginal birth, but in the blink of an eye her doctor planted the seed that she might need a C-section. She went from feeling empowered to giving her doctor all the control. In fact, using that word “let” as in “if we’re going to let you have a vaginal delivery” implies that she’ll be lucky if he gives her permission to have a normal, vaginal birth.