Can we talk?
I recently watched clips from a show called “The Doctors” where four physicians discuss health-related current events. Ricki Lake, talk show host and co-author of Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience, was a guest panelist. The topic was home birth. The show’s OB/GYN, Dr. Lisa Masterson, MD, works at Los Angeles’ Cedars-Sinai Medical Center and trained at USC Medical Center. Hey, that’s where I went to nursing school. She says she’s seen thousands of births. Me, too! Dr. Masterson and I started out on the same page. Things took a turn rather quickly.
Ricki Lake advocates for a woman's right to choose home birth as a safe birthing option. Dr. Masterson says the best and safest place is at a hospital. During their debate Ricki tried to supply statistics and anecdotes about how increased infant mortality rates aren’t due to home births. Dr. Masterson wouldn’t let Ricki finish a sentence before interrupting with statements like, “Every minute a woman dies in labor. We know from working in other countries that if we don’t follow labor properly you’ll have fistulas. There are reasons why we do interventions.”
When Ricki interjected that medical malpractice is partly driving interventions, Dr. Masterson cut her off again saying “that’s why doctors will be ever-cautious.” Dr. Masterson said she wishes “no one ever had to think of Cesarean section rates because the best C-section rate is . . . what is medically required.”
Dr. Travis Stork, an ER doctor and panel moderator mentioned well-informed women he knew who’d had safe, beautiful home births. Dr. Masterson cut him off, too, saying, “You take a risk with your baby if you want , but doctors, we’re not going to go there.”
Dr. Masterson said, “We always want to empower women. Hospitals have really gone to an extent to give that to women.” She said since today’s labor suites look better than some women’s bedrooms and you don’t have to have an epidural, there’s no reason to have your baby at home.
Finally, after her interrupting got out of hand, Dr. Stork stepped in, acknowledged Dr. Masterson’s passion and dedication and gave Ricki the floor. Dr. Masterson held a tight-lipped smile while Rikki stated that some women feel having a hospital birth is a risk due to unnecessary Cesarean sections. She wondered why, with all our technology and interventions, infant mortality statistics are going up. Dr. Stork and the rest of us want to know too.
Here’s where Dr. Masterson and I agree: Medical malpractice makes doctors ever-cautious. C-sections should be done only when medically necessary. Here’s where we disagree: Fear of lawsuit makes doctors do interventions that aren’t always medically required. They just can’t risk doing anything else. That wasn’t exactly Dr. Masterson’s point.
I was annoyed with Dr. Masterson for two reasons:
1) Interrupting is bullying. It says, “I’m more important than you and what you have to say doesn’t deserve to be said.”
2) Hospitals don’t “give” women empowerment by decorating a labor room. Empowerment is something women own themselves but give away far too easily when vulnerable and frightened.
This debate isn’t about emergencies in other countries. It’s about what we do in American births. It’s about listening to each other and letting our collective experiences be heard. Women should be able to talk about home birth without having their voices overridden and being accused of recklessness.
All of us who work in hospitals know about real emergencies. We also know that a lot of what goes down is risk management. Let’s get real here. Less than 1% of American babies are born at home. They aren’t responsible for most infant or maternal deaths. Those happen primarily in hospitals. Are home births responsible for some deaths? Yes. Some babies shouldn’t be born at home. But, OB/GYNs dominate 99% of the birth industry. World health experts agree that our 31% c-section rate is way too high. It doesn’t represent only medically necessary C-sections. Maybe they have room to listen to what the other 1% has to say. We need a health care reform. That’s empowerment.
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