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August 22, 2017

Advocating for Women’s Rights in Birth is not “dangerous”

There was a discussion today that led to the comment that I was “dangerous”…why?

Yes. I Have An Agenda.

That’s why.

Because even when faced with others who firmly believe that they are doing the best they can, I still choose to advocate for women.

ACOG’s ethics statement offers us the idea that obstetricians are supposed to give women informed decision making and not force them, not coerce them, but let them actively participate in their care.

And yet, when a mother wants support for her birth, a trial of labor, even, we are supposed to believe that fears of malpractice within those facilities, or biased policies are supposed to trump her right to at least try to have a healthy labor and birth.  Ethically, we are supposed to be bound to do no harm and yet, that premise has died a swift death in the face of a pretense for evidence-based care. Evidence-based care doesn’t mean there has to be specific evidence that every case will be perfect or that every case will be without risk. It means that we also have an ethical liability to not do procedures on women without evidence that it’s the best practice. We keep missing this part of the puzzle because it doesn’t fit our protocols. It can’t be fit within the parameters of a malpractice insurance document. It requires NOT acting unless there is a NEED to act. It requires prevention pf risk through being patient and awaiting a reason to act. And ultimately, it requires asking for permission to act from the woman herself, not telling her what she HAS to do, how NO providers will do it, and telling her that she should simply lie down for another surgery because it’s too risky to her providers.

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