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[quote=Anonymous]Provide the risks and benefits of each mode of delivery to patients, paying particular attention to the long term, chronic injuries sustained in vaginal delivery: high risk of prolapse, higher risk of UI, provide accurate stats re: OASI rate for first time vaginal deliveries (about 8%, not small), discuss levator avulsions and how they occur in anywhere from 1 in 5 to 1 in 3 first-time vaginal deliveries and can’t be surgically repaired. Discuss the importance of the pelvic floor being able to give way/move aside in vaginal delivery, rather than being strong. Recognize that older, fit mothers are actually at very high risk of muscle tearing in first time deliveries— be honest with your patient population, so they can make informed choices on how they’d like to deliver. Discuss interventions (vacuum and forceps) in advance.

Truly, I’ve never felt more let down by anyone in the world than the OBs who handled my pregnancy and delivery. I understand you all are busy, but how you choose to respond to patients can change the trajectory of their entire life. Realize you have that power, wield it carefully, and if you don’t know the answer to their questions, just say “I don’t know” instead of making up an answer. They will trust you because you are in a position of trust. I did, and it haunts me every day. [/quote]

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