"All that is necessary for the triumph of evil is for good men to do nothing" Edmund Burke, 18th century Philospher.

"A long habit of not thinking a thing wrong gives it a superficial appearance of it being right." Thomas Paine

"The welfare of humanity is always the alibi of tyrants." Albert Camus

"Choice is the essence of ethics: if there were no choice there would be no ethics, no good, no evil; good and evil have meaning only insofar as man is free to choose." Margaret Thatcher, March 14, 1977

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” ― Upton Sinclair

Explaining the Cause

I am a practicing obstetrician who is a strong supporter of patients rights to informed consent and refusal. I believe a patient has the right to choose her own path given true and not skewed informed consent. Following that tenet, just as a woman should be able to choose to have an elective c/section she should be able to choose not to have one, as well. The American system of hospital based obstetric practice has been eroding those choices for women for quite some time. Due to concerns of economics, expediency and fears of litigation women are being coerced to make choices that may not be in their best interest.

I have had a long relationship collaborating with midwives and find the midwifery model of care to be evidenced based and successful. I was well trained at Cedars-Sinai Medical Center in the mid 80's to perform breech deliveries, twin deliveries, operative vaginal deliveries and VBACs, and despite evidence supporting their continued value, hospitals are "banning" these options. Organized medicine is also doing its best to restrict the availability of access to midwives.

Home birthing is not for everyone but informed choice is. Medical ethics dictates that doctors have a responsibility and a fiduciary duty to their patients to provide true, not skewed, informed consent and to respect patient autonomy in decision making. Countries with the best outcomes in birthing have collaboration between doctors and midwives. This is not what has been happening in the hospitals of America. Its time for a change and the return of common sense.

The midwifery model of care supports pregnancy as a normal function of the female body and gives a legitimate and reasonable alternative to the over-medicalized model of birth that dominates our culture. Through this blog I hope to do my part to illuminate what is wrong with our maternity care system and what is right with it. I do not expect all to agree and that is OK. We must all understand that given honest data it is not always reasonable to expect two people to come to the same conclusion. Our differences should be respected.

Sunday, August 30, 2009

Supportive Organization Brings up Important Issue

Received this e-mail today. Points out another rarely mentioned consequence of lack of true informed consent. I was unaware of the extent of this problem and want to thank Jennifer Zimmerman for her good work. Check out her link in the supporters column.

Hello, I am from the non-profit organization Solace for Mothers: Healing After Traumatic Childbirth (http://www.solaceformothers.org/). I am very interested in your case because we have identified a lack of informed consent and the ability to refuse care as a major risk factor in developing traumatic stress (or PTSD) symptoms after childbirth. Women are unable to get a lawyer if their legal rights to informed consent and refusal were violated and caused them PTSD. Lawyers simply will not take these cases, which means that providers are free to trample over women's rights with no punishment for their illegal actions. Having a lack of true informed consent is leading to more and more women suffering from postpartum PTSD, which is often misdiagnosed and treated as postpartum depression. Our organization will soon launch a letter writing campaign to Lynn Rosenthal, the newly appointed Presidential Advisor on Violence Against Women (an office within the Department of Justice). We intend to inform her of the violence that is happening against women in maternity care, and the effect it has on these women. If you would like to add your voice to this campaign, I will inform you of when we begin.

Jennifer Zimmerman
Project Coordinator
Solace for Mothers, Inc.

1 comment:

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