HW 41 - Independent Research

Aspect: OB/GYN’s

A) Grady, Denise. New Guidelines Seek to Reduce Repeat Caesareans. New York Times, New York Times, 21 July 2010.

In this article the author mentions that vaginal birth is better for the baby but due to c-sections that are being given that are not for medical reasons the rates of c-sections have definitely increased. This remains because after a patient has given birth through a c-section the doctor believes that it’s a risk to then have a vaginal birth. Statistics have proven that this is in fact not true. This relates to the movie “On the Business of Being Born,” which provides different scenarios where doctors make excuses to use c-sections because it is much shorter than a vaginal birth which can take hours, even days. Doctors don’t want to spend too much time on one patient so they speed up the process as much as possible. This in a sense does represent the fear of litigation placed on doctors because in the book “Born in the USA” by Wagner Marsden, he mentioned that OB/GYN feel as if they must compete with midwives so they just erase them from the competition by making false statements about their practices.

Marsden, Wagner. What Every Midwife Should Know About ACOG and VBAC: Critique of ACOG Practice Bulletin No. 5. “Vaginal Birth after Previous Cesarean Section.” Midwifery Today, July 1999.
In this article Wagner Marsden is bringing up some of the effects ACOG may have on patients and even the influence on OB/GYN. ACOG (American Congress of Obstetricians and Gynecologist) is an organization consisting of professionals who are interested in promoting the well being of the patient and the product they want to get approved. The article also mentions that there is a contradiction with that statement because they care more about the well being of the doctor before the well being of the patient. This also relates to “Born in the USA” by Wagner Marsden because the book gave different scenarios where the doctor was trying to test a new drug on a patient that had not been approved by the FDA. They didn’t care about placing the mother or child at risk; they only cared about testing the reliability of the drug and when asked about this one doctor replied that they will never know a drug is safe until they themselves prove it’s harmful. OB/GYN may feel pressured y this group called ACOG to follow their practice a certain way because it is not accepted for patients to file suit against a doctor because usually we believe that the doctor is always right.

Cantulpe, John, Fear of Malpractice Litigation. Media Health Leaders, 10 September 2010.

In this article the author is expressing some of the fears doctors face as a result of the fear of litigation or malpractice. Usually doctors do want to generally help people and do their jobs so they go into their job (handling a birth) fearful because they plan for something to go wrong. This reminds me of “The Business of Being Born” because the way midwives approach birth and the way OB/GYN’s approach birth is very different. A midwife is taught to approach birth as a ore natural process because birth is something your body does. An OB/GYN is taught to view birth as a mistake they must prevent before the mother harms the child with her body so they have to get the child out. This relates to the fear of litigation because doctors don’t want to have a lawsuit so instead if thinking about what’s best for the mother sometimes they only think about which way is best for themselves.

Brodesser-Akner, Taffy. Who Controls Childbirth-expectant moms or dads? MSNBC, 13 July 2010.

A woman wrote this article about her personal experience with birth and the way she was treated by her OB/GYN. She didn’t feel that her wishes were being respected as much as the doctors and she was the one giving birth. Despite her wishes the doctor gave her a c-section because after being given all those drugs she didn’t have the energy to give birth. The doctor began by breaking her water with a hook then giving her a c-section. This relates to “The Business of Being Born” because if the patient protested the doctor would threaten to give her a c-section, or vacuum the baby out if she didn’t push hard enough. This is wrong because doctors don’t really care about the patient they care about themselves and getting the baby out as soon as possible.

Hartocollis, Anemona. Doctors’ group fights a bill that would put fewer restrictions on midwives. The New York Times, 17 June 2010.

This article is about someone that is pushing for more independence for midwives. Some doctors agree that it’s best to have a written agreement because let’s say that a midwife took her patient to the hospital and she started bleeding uncontrollably it would be best to have a written agreement with a doctor that would help the midwife. This article relates to “Born in the USA” by Wagner Marsden because the books said that OB/GYN’s are in constant competition but I don’t feel like all doctors are that way this article provides a good example of OB/GYN who are trying to do the right thing.

B) For this project I am thinking about writing a paper about the training of OB/GYN and maybe using some historical evidence to support that the practice has changed a lot but there are still some similarities in their view of birth. I could use some of this research to support some of the factors OB/GYN’s have against them such as ACOG which doctors necessarily might not follow and how the fear of litigation causes them to practice medicine in a particular way. I can find new evidence about the rates of c-sections, episiotomies and other practices that have been used for pregnancy and birth.