I've been going back through the Masters Rebozo course again in preparation for finishing it, and listening to a certain part of the amazing Gena Garcia-Kirby's call with Dr Wagner really hit the nail on the head about the American Maternity Care System's (and to a lesser but rapidly growing degree in the Australian Maternity Care system) rising induction and cesarean rates - it's not just about the money, or even mostly about the money, that doctor's are paid that's contributing to high induction and cesarean rates outside of true risk factors that make it necessary (for the record ACOG, RANZCOG and the World Health Organisation DON'T consider a "large baby" to be a reason for an early induction or cesarean even though this is commonly given as a reason to women supporting early induction and elective cesarean) and informed maternal choice, it's mainly the lifestyle factors of the care providers that is causing increases in the numbers of inductions and cesareans with no medical reason behind them.
Birth does not run on a planned timetable, it's unique to each individual and every single birth is completely different, and that is why doctor's can prefer to be able to schedule inductions and cesareans so that it's on a known timetable and they can continue to live their own lifestyles in their own time outside of those scheduled times instead of being on call at all hours (which is what their job is supposed to include) to attend births that don't occur precisely between 9am and 9pm on week days only.
Most doctor's want to be able to go home for dinner, most don't want to be called out of bed multiple times a night to attend a birth, most would like to be able to socialise and do the things they enjoy without always being on call for a dozen or more women who have a due date within the next 1-2 weeks.
Just like the rest of us they want to be able to spend time with their families and friends on the weekends, or to go away overnight.
We might wonder why they got into this profession if they don't want to be on call so much, if they want to be able to do the things that they enjoy when they want to.
The truth is that they are human, just like the rest of us. They felt called to enter that particular profession, they decided that it was the right profession for them, but they may not have realised just HOW MUCH TIME IT WOULD TAKE FROM THEIR LIVES. And even if they did realise, they may not have fully known or expected just how much it would have affected them.
So they try to make it easier on themselves, at the potential expense of the health of the mothers and babies under their care.
They may be scared of the unknown that could go wrong in a birth that isn't scheduled, so they schedule birth because they are more comfortable with the complications that they know and expect, without that unknown hanging over their heads.
They may genuinely have a personal preference for one type of birth over another, just as an author has a distinct writing style that works for them, and act accordingly as a result.
Not every Doctor is like this, just as not every midwife practices women-centered care, just as not every pregnancy or birth goes the way we expect it to go (am I permitted to call these Doctor's who aren't like that the Magical Unicorns of the Obstetric System?), but the vast majority are like that, because of how they have been trained, because of the fear that has been pushed onto them, because they have been told and exposed to mostly the worst case scenarios and not enough of the best case/positive scenarios or true physiological births to balance out the negatives.
Maybe, just maybe, if they were exposed to more physiological births, more positive outcomes, less interventionist training, less fear, less damaged women, they might become better, might WANT to be there overnight with a client, might feel OK with throwing out that ineffective, outdated, non-evidence based timetable that has been placed on normal childbirth.
And maybe, just maybe, birthing people in general would end up having better birth experiences as a result.
Birth does not run on a planned timetable, it's unique to each individual and every single birth is completely different, and that is why doctor's can prefer to be able to schedule inductions and cesareans so that it's on a known timetable and they can continue to live their own lifestyles in their own time outside of those scheduled times instead of being on call at all hours (which is what their job is supposed to include) to attend births that don't occur precisely between 9am and 9pm on week days only.
Most doctor's want to be able to go home for dinner, most don't want to be called out of bed multiple times a night to attend a birth, most would like to be able to socialise and do the things they enjoy without always being on call for a dozen or more women who have a due date within the next 1-2 weeks.
Just like the rest of us they want to be able to spend time with their families and friends on the weekends, or to go away overnight.
We might wonder why they got into this profession if they don't want to be on call so much, if they want to be able to do the things that they enjoy when they want to.
The truth is that they are human, just like the rest of us. They felt called to enter that particular profession, they decided that it was the right profession for them, but they may not have realised just HOW MUCH TIME IT WOULD TAKE FROM THEIR LIVES. And even if they did realise, they may not have fully known or expected just how much it would have affected them.
So they try to make it easier on themselves, at the potential expense of the health of the mothers and babies under their care.
They may be scared of the unknown that could go wrong in a birth that isn't scheduled, so they schedule birth because they are more comfortable with the complications that they know and expect, without that unknown hanging over their heads.
They may genuinely have a personal preference for one type of birth over another, just as an author has a distinct writing style that works for them, and act accordingly as a result.
Not every Doctor is like this, just as not every midwife practices women-centered care, just as not every pregnancy or birth goes the way we expect it to go (am I permitted to call these Doctor's who aren't like that the Magical Unicorns of the Obstetric System?), but the vast majority are like that, because of how they have been trained, because of the fear that has been pushed onto them, because they have been told and exposed to mostly the worst case scenarios and not enough of the best case/positive scenarios or true physiological births to balance out the negatives.
Maybe, just maybe, if they were exposed to more physiological births, more positive outcomes, less interventionist training, less fear, less damaged women, they might become better, might WANT to be there overnight with a client, might feel OK with throwing out that ineffective, outdated, non-evidence based timetable that has been placed on normal childbirth.
And maybe, just maybe, birthing people in general would end up having better birth experiences as a result.
~ ~ ~ ~ ~ ~
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