Reply to Why did you pick a midwife over a doctor?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I was low-risk, aside from being in my mid-30s, and wanted to minimize unnecessary interventions.  I went with a hospital-based midwife practice that was integrated within a larger OB-GYN practice.  I ended up having some level of intervention with all three L&Ds (epidurals for two, NICU ped present at delivery for the third), and it was handled seamlessly.  I went to an MFM practice for scans; when I developed complications late in my third pregnancy, the midwives transferred me to the OBs as needed.

I was fortunate that I had skilled medical professionals (CNMs) attending my births; included in their medical training is knowing when they needed to transfer care and/or involve a different provider.  That also meant they were with me for most of my labors and all of the deliveries, which isn't typically the case when an OB is attending.

[b]21:17 - can you stop patronizing women, please?  Your "caution" is pretty thinly disguised.[/b][/quote]

I went with a practice much like described above and ended up with a c-section by the OBs.  The c-section wasn't because I chose a nice smile over a real medical professional [b]because I'm a dumb laydee.[/b]  It's because that's the way my birth went, and the [i]trained medical professionals[/i] with decent human skills that I chose [i]also[/i] had the medical knowledge and skill to handle my care correctly.  
[/quote]

DP - there are stupid people everywhere of both sexes.   21:17 is speaking to women because it is women who are choosing who provides their care, not because they think women are dumb.  [/quote]

DP, but come on.  That post was dripping with condescension.  Do women really need to be reminded about not confusing personality with clinical acumen?  Really?[/quote]

Well, let’s see - just on this thread alone, the reasons given for choosing midwives include the doctor made me wait too long, he talked down to me, it felt like an assembly line, wanted someone loving.   [b]All legitimate reasons for choosing someone, and I completely respect that, but not a whole lot to do with clinical acumen.[/b]  Pregnancy is a vulnerable time.  We all want to be protected and nurtured but sometimes the person who can best protect our health and well being isn’t the person who can provide the nurturing.  There’s nothing wrong with a reminder that there are times when these roles should be separated.  [/quote]

Another PP alluded to this, but the bolded is bullpuckey.  We KNOW that health outcomes are impacted by interactions, and particularly for women of color (see that damning series by ProPublica on maternal mortality outcomes for more).  Providers who *listen* to their patients and *trust* them ARE providing better care!  You honestly think a condescending physician is providing good care?  Shame on you.  [/quote]

Where do *you* get off comparing the health effects of systematic racism to the minor inconvenience of waiting too long for an appointment?  Because that is what we are talking about here.  The studies correlating maternal experience to outcomes are not talking about waiting room waits or rude doctors.  No one here has said or even suggested that they picked a midwife because they felt that their race was affecting the medical care they received with an OB.  If you can’t see the difference between built in systematic racism in healthcare and a doctor with poor bedside manner, I don’t know what to tell you.

Signed, a Woman of Color tired of others presuming to know what’s best for me [/quote]

16:13 again.  By the way, I’ll be sure to tell my Head of Department OB, who has some of the worst beside manner that I’ve ever seen, what terrible care he provided me when he saved my life.   After all, I can’t honestly think that a condescending physician can possibly provide good medical care.  I’ll be sure to pick the nice one next time over the better qualified one since some lady on the internet told me so. [/quote]

Do what you want, but don’t presume to speak for me or anyone else.  Where did I say I was talking about wait times?  You picked something I didn’t even mention to make your point.  Inasmuch as rudeness relates to things like not *listening* to patients, yeah, it does affect the quality of their care.  How many times did Serena Williams have to insist that she had a PE postpartum before she got a provider to listen to her?  But, right, that doesn’t matter.

My point was that things like patient-provider interactions DO matter for the quality of care.  Systemic racism is one of the most extreme examples of how interactions matter.  I didn’t say those interactions are the only part of it, but you also can’t discount them.  Stop trivializing women’s experiences just because they don’t comport with your own.[/quote]

Nice deflection.  You sought to shame me for my opinions (those are your literal words “shame on you”) and you brought up racism when there was literally no one on this thread discussing racism.  When your attempt to shame is addressed and you are told that I don’t need to be saved by you, you insist that I’m presuming to speak for you.  I have no interest in speaking for you or for anyone other than those who have experienced what I have.  Our voice matters and no amount of shaming from you will change that. [/quote]

You keep arguing that we can separate how patients are treated from the quality of their care, but the studies on this topic suggest otherwise.  I was calling out you presenting your opinion as fact, when, really, it’s your opinion.  Yeah, I do think telling women that how they are treated by their providers doesn’t matter for their health outcomes is shameful.  You assumed that I was presuming to speak for you; no, I was pointing out the complex relationship between patient-provider relationships and healthcare quality.  The voices that aren’t being heard—in part because their providers aren’t *listening to them*—matter, too.

This article is somewhat lengthy, but I think lays the framework well for why patient-centered healthcare (the kind many women describe experiencing more often with midwives than physicians) matters for quality of care: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.0888[/quote]

You need to go back and read my post more carefully because you keep shifting your argument to fit your narrative. You make a lot of assumptions in every post to support your attacks on me.  I never said listening is not important to patient care.  You seem to believe that being talked down to = doctor failing to listen and that is not my point.  It is also not my point that how a woman is treated never has any impact to outcomes.  My argument is that inconveniences like long waits and office environment are not the markers of bad patient care, which, up until you responded was what we were discussing.

Your opinion - and yes, it is an opinion - that a condescending doctor cannot deliver good patient care is just an opinion, just as you assert my thoughts are opinions.  But medical professionals need to exercise their judgment as well.  A doctor, who is perceived as condescending because she does not agree with a woman’s specific demand on their medical care (refusing a medical necessary c-section is one) is not a bad doctor and is not a bad doctor who isn’t listening to her patient.  Are there bad doctors out there?  Of course, but bedside manner (i.e.  the ability to convey information in a tone you perceive as desirable) is not the sole indicator of one.

You are free to make your own choices.  I respect your choices but you seem incapable of respecting mine.  Telling me that I should be ashamed and then bringing race into it?  I don’t need your respect but I will not be called “shameful” for voicing a thought that you disagree with.   [/quote]

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