Dismissal from OBGYN

[Anonymous]

I agree that if the match between patient and provider is not a good one, it is best that they part ways.

I'm probably one of the posters you are referring to. I haven't wanted drugs for my births, or cesareans (though of course understand that they are sometimes lifesaving). And I have wanted whatever type of monitoring gives the best information with the least interference and least chance of a 'false alarm' (which most research suggests is intermittent monitoring). I don't blast doctors or nurses or tell anyone how to do their job. But I do find providers who share my beliefs about birth and whose practices are in line with what I want.

Anonymous wrote:I read a lot of posts on this board- and feel sorry for some of the doctors and nurses who get blasted on here because it seems that a lot portion of the posters are experts on birthing. No drugs. No c-sections. No monitoring. Etc... If I was told in my profession everyday how to do my job by 'google MDs' it would get old.

Sorry you were 'let go,' but it sounds like it was best for all involved.

[Anonymous]

It's actually not unethical to dismiss a patient from one's practice. As long as you let the patient know in writing, give them 30 days notice, and assist them in finding another caregiver, you are not prohibited from doing this. I am a doctor and we have done that with certain patients in our practice (not for "asking questions" as the OP claims; for things like obvious narcotic drug-seeking behavior or abusive treatment of staff). However, if the doctor did not follow those procedures, you can accuse her of abandonment, which is unethical.
So, you can go ahead and report the doc to the AMA, but I don't think you're going to get much support from them for your argument.

[Anonymous]

I actually know someone who had to have a VBAC. Her doctor advised against it but she wanted to try the natural experience. Unfortunatley her uterus ruptured and the baby died. It has been over 9 months and she still to this day blames herself because if she just had another C-section she knows she would be holding her beautiful baby girl. It is fine to have preferences but the doctors have their medical expertise and are there for a reason. I know there are feelings that doctors push C-sections to hurry up the delivery but I think that those doctors are not the norm. Find a doctor with similar beliefs but don't be too quick to dismiss a professionals opinion because it doesn't fit with your desires. In the end, all that matters is that you have a healthy baby. Who really cares if the birthing plan varried from your original plan?

[Anonymous]

I am really sorry for your friend's experience, that is really sad and awful. But it sounds though like you are blaming your friend for her loss and assuming she made an unsafe choice, when in fact the choice to attempt a VBAC is supported by a lot of medical evidence (including a recent NIH consensus report), and in many cases is a safe and healthy option. It is always awful when there is a tragic outcome, but that doesn't mean the mother made a reckless choice or that VBAC in general is unsafe, both of which you seem to be suggesting.

Also, while of course everyone's main priority is a healthy baby, many women do also care about their birth experiences. There are plenty of us out there who have had either really good or really bad birth experiences that have greatly affected how we feel about ourselves and our babies. To tell someone they should not be upset about their birth experience and should just be happy to have a healthy baby is insulting to women who have had a traumatic experience giving birth. While they might be thrilled to have a healthy baby, they might have personal trauma resulting from the birth, and those feelings are valid.

Anonymous wrote:I actually know someone who had to have a VBAC. Her doctor advised against it but she wanted to try the natural experience. Unfortunatley her uterus ruptured and the baby died. It has been over 9 months and she still to this day blames herself because if she just had another C-section she knows she would be holding her beautiful baby girl. It is fine to have preferences but the doctors have their medical expertise and are there for a reason. I know there are feelings that doctors push C-sections to hurry up the delivery but I think that those doctors are not the norm. Find a doctor with similar beliefs but don't be too quick to dismiss a professionals opinion because it doesn't fit with your desires. In the end, all that matters is that you have a healthy baby. Who really cares if the birthing plan varried from your original plan?

[Anonymous]

I agree with 9:41. What a tragic outcome. I'm certain if the mother truly believed her child would be in danger, she would have elected for a c-section. I hope she can find peace; she made the best decision she could with the information she had at the time.

[Anonymous]

I think what the last two posters are missing is that the prior poster said that the doctor advised against the VBAC. Clearly there was some risk there more so than the regular risk. The person decided not to listen to the doctor's advice. The poster didn't say she blamed her friend but that her friend blamed herself. I think the point of the post was that everyone has an ideal birth experience in their head but if things change it given circumstance know before the labor or during labor, you should be able to trust your doctor to make the right decision/suggestion regarding the care. If you don't have that relationship, change doctors.

[Anonymous]

"It's actually not unethical to dismiss a patient from one's practice. As long as you let the patient know in writing, give them 30 days notice, and assist them in finding another caregiver, you are not prohibited from doing this. I am a doctor and we have done that with certain patients in our practice (not for "asking questions" as the OP claims; for things like obvious narcotic drug-seeking behavior or abusive treatment of staff). However, if the doctor did not follow those procedures, you can accuse her of abandonment, which is unethical.
So, you can go ahead and report the doc to the AMA, but I don't think you're going to get much support from them for your argument."

The abandonment procedures are in place to deal with situations like physical threats to the staff or doctor or drug seeking as the PP identified. Many doctors do not feel it is ethical to expand these reasons and reporting the doctor to the AMA could do some good depending on who is reviewing the case. Its a very controversial practice in situations where there are few doctors supporting a community/area or patients with mental health issues like dementia in the elderly. These patients can be the most difficult to manage but are often the most vulnerable.

The abandonment procedures really are not in place to weed out patients who ask lots of questions or make it difficult to stay withing the 2 minute clinical visit clock the practice needs to maintain to see more patients. It certainly is not meant as punishment mechanism or a way to stop patients from questioning procedures or asking for advice on alternate courses of action. A patient asking questions is connected with a patient providing informed consent. A doctor's role is to not only prescribe medical therapies and advice but fully explain it and obtain the patient's consent. This is a cornerstone of medical ethics and one that does get overlooked by some doctors.

[Anonymous]

Anonymous wrote:I think what the last two posters are missing is that the prior poster said that the doctor advised against the VBAC. Clearly there was some risk there more so than the regular risk. The person decided not to listen to the doctor's advice. The poster didn't say she blamed her friend but that her friend blamed herself. I think the point of the post was that everyone has an ideal birth experience in their head but if things change it given circumstance know before the labor or during labor, you should be able to trust your doctor to make the right decision/suggestion regarding the care. If you don't have that relationship, change doctors.

[Anonymous]

I'm from a family of doctors, and from these posts, I can see why none of them went into OB/GYN. What a bunch of freaking high maintenance whiners!!! And I say this as someone with two children who also had high risk pre-pregnancy issues. Listen, you only have OP's CHARACTERIZATION of her interaction with her doctor. Maybe the doctor was high-handed and dimissive, but maybe OP was the type of PITA patient who turns around and sues for the slightest thing. Doctors have to practice protective medicine. I'm a lawyer, and I can tell you that there are some types of clients who I just won't take -- too much agita. and by the way, OP, I recommend that you don't post the name of the doctor on this board. You could wind up with some real legal problems.

[Anonymous]

old thread, but apparently people are still fired up. this is precisely the reason women who have an interest in participating in their birth experience, rather than just being along for the OB's surgical ride, should find midwives. at each and every appointment (including the "boring" ones in the middle of the 2nd trimester, e.g., at 24 weeks when there's nothing but a quick measurement and doppler to do), my midwife will entertain any question or concern i have. while the OP is long since done with her birth (having posted originally in jan 2009), i do encourage women to explore non-OB options. the midwifery standard of care is far more appealing to those women who are educated about child-birth (definitely the minority here in DC where women seem to prefer inductions and C-sections -- but for the minority out there, you have many wonderful choices if you do your research).

[Anonymous]

I wish I could go to a midwife. I can't find any in my area who handle VBACs (had a c-section with my first for failure to progress) and I also have high BP which makes me "high risk" so no midwife will take me.

[Anonymous]

Anonymous wrote:I am really sorry for your friend's experience, that is really sad and awful. But it sounds though like you are blaming your friend for her loss and assuming she made an unsafe choice, when in fact the choice to attempt a VBAC is supported by a lot of medical evidence (including a recent NIH consensus report), and in many cases is a safe and healthy option. It is always awful when there is a tragic outcome, but that doesn't mean the mother made a reckless choice or that VBAC in general is unsafe, both of which you seem to be suggesting.

Also, while of course everyone's main priority is a healthy baby, many women do also care about their birth experiences. There are plenty of us out there who have had either really good or really bad birth experiences that have greatly affected how we feel about ourselves and our babies. To tell someone they should not be upset about their birth experience and should just be happy to have a healthy baby is insulting to women who have had a traumatic experience giving birth. While they might be thrilled to have a healthy baby, they might have personal trauma resulting from the birth, and those feelings are valid.

Anonymous wrote:I actually know someone who had to have a VBAC. Her doctor advised against it but she wanted to try the natural experience. Unfortunatley her uterus ruptured and the baby died. It has been over 9 months and she still to this day blames herself because if she just had another C-section she knows she would be holding her beautiful baby girl. It is fine to have preferences but the doctors have their medical expertise and are there for a reason. I know there are feelings that doctors push C-sections to hurry up the delivery but I think that those doctors are not the norm. Find a doctor with similar beliefs but don't be too quick to dismiss a professionals opinion because it doesn't fit with your desires. In the end, all that matters is that you have a healthy baby. Who really cares if the birthing plan varried from your original plan?

You have got to be kidding me. A "birth experience" is successful if you leave the hospital or birthing center healthy with a healthy baby in your arms. That's it. Simple as that. To think there are some women who feel badly about themselves or their BABIES because of the BIRTH is just inconceivable to me. I think it's safe to say everyone cares about their birth experience. But I think the sane logical people put that in the context of what's best for their babies, not the dreamed up Hollywood version of what a birth should be.

And the PP who talked about her friend's tragic situation didn't sound like she was judging or blaming her friend. It sounded like her friend was blaming herself. And that feeling is certainly valid if she went against medical advice and ended up losing a baby. So heartbreaking to have to live with that for the rest of your life.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am really sorry for your friend's experience, that is really sad and awful. But it sounds though like you are blaming your friend for her loss and assuming she made an unsafe choice, when in fact the choice to attempt a VBAC is supported by a lot of medical evidence (including a recent NIH consensus report), and in many cases is a safe and healthy option. It is always awful when there is a tragic outcome, but that doesn't mean the mother made a reckless choice or that VBAC in general is unsafe, both of which you seem to be suggesting.

Also, while of course everyone's main priority is a healthy baby, many women do also care about their birth experiences. There are plenty of us out there who have had either really good or really bad birth experiences that have greatly affected how we feel about ourselves and our babies. To tell someone they should not be upset about their birth experience and should just be happy to have a healthy baby is insulting to women who have had a traumatic experience giving birth. While they might be thrilled to have a healthy baby, they might have personal trauma resulting from the birth, and those feelings are valid.

[
You have got to be kidding me. A "birth experience" is successful if you leave the hospital or birthing center healthy with a healthy baby in your arms. That's it. Simple as that. To think there are some women who feel badly about themselves or their BABIES because of the BIRTH is just inconceivable to me. I think it's safe to say everyone cares about their birth experience. But I think the sane logical people put that in the context of what's best for their babies, not the dreamed up Hollywood version of what a birth should be.

And the PP who talked about her friend's tragic situation didn't sound like she was judging or blaming her friend. It sounded like her friend was blaming herself. And that feeling is certainly valid if she went against medical advice and ended up losing a baby. So heartbreaking to have to live with that for the rest of your life.

Well that is your opinion, you have every right to feel that way but that does not mean that it is a universal truth. I think the multitude of women you are seeking out midwives, using hypobirthing or choose home birth demonstrates that there are lots of people for who its not "that simple". There are some people who view labor and child birth as a natural occurence and not an illness. When I go to the hospital to have a baby, I do not want to be treated like I am there to remove a brain tumor.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am really sorry for your friend's experience, that is really sad and awful. But it sounds though like you are blaming your friend for her loss and assuming she made an unsafe choice, when in fact the choice to attempt a VBAC is supported by a lot of medical evidence (including a recent NIH consensus report), and in many cases is a safe and healthy option. It is always awful when there is a tragic outcome, but that doesn't mean the mother made a reckless choice or that VBAC in general is unsafe, both of which you seem to be suggesting.

Also, while of course everyone's main priority is a healthy baby, many women do also care about their birth experiences. There are plenty of us out there who have had either really good or really bad birth experiences that have greatly affected how we feel about ourselves and our babies. To tell someone they should not be upset about their birth experience and should just be happy to have a healthy baby is insulting to women who have had a traumatic experience giving birth. While they might be thrilled to have a healthy baby, they might have personal trauma resulting from the birth, and those feelings are valid.

[
You have got to be kidding me. A "birth experience" is successful if you leave the hospital or birthing center healthy with a healthy baby in your arms. That's it. Simple as that. To think there are some women who feel badly about themselves or their BABIES because of the BIRTH is just inconceivable to me. I think it's safe to say everyone cares about their birth experience. But I think the sane logical people put that in the context of what's best for their babies, not the dreamed up Hollywood version of what a birth should be.

And the PP who talked about her friend's tragic situation didn't sound like she was judging or blaming her friend. It sounded like her friend was blaming herself. And that feeling is certainly valid if she went against medical advice and ended up losing a baby. So heartbreaking to have to live with that for the rest of your life.

Well that is your opinion, you have every right to feel that way but that does not mean that it is a universal truth. I think the multitude of women you are seeking out midwives, using hypobirthing or choose home birth demonstrates that there are lots of people for who its not "that simple". There are some people who view labor and child birth as a natural occurence and not an illness. When I go to the hospital to have a baby, I do not want to be treated like I am there to remove a brain tumor.

I am not sure it's not a universal truth. Tell me how a birth can be a traumatic failure if you and your baby leave healthy? Maybe I'm just missing something major. It's great to prepare for childbirth and it's great to have an idea of how you'd like it to go, but in no way should that obscure what is medically safe or necessary for you or your baby. It doesn't matter if you get to follow your birth plan to a T if something terrible happens to you or your baby. I am all for low/no intervention births - my last one was completely drug free - and I, like most people, of course know it's a natural occurrence and not an illness. Good Lord. But if you go to a HOSPITAL to have a baby, you should keep in mind that it's...a hospital. And in my 2 hospital births I was never treated like I was there for a brain tumor...

[Anonymous]

I'm completely with 15:35 and cannot understand the like of 9:41. The entire phrase "birth experience" is a bizarre concept to me - it's not a tropical vacation, or a 3D movie, it's childbirth. Ideal outcome = healthy baby, healthy mom, and the rest is just details. Nowhere else in the world can I imagine women being so obsessed with their "birth experience".

Tired argument that childbirth is a natural occurence and not an illness. Yeah, duh, who doesn't know that? Have you been prescribed antibiotics to cure you of your pregnancy? Has anyone suggested that you really need to be careful not to transmit this pregnancy to anyone else?

Not to point out the obvious, but illness is also a natural occurrence, as is a brain tumor, so work on your analogies a bit.