Wednesday, December 23, 2009

Cardiology & Birth Analogy

I'm sorting through my large stacks of books containing pages I've marked with quotes/ideas I'd like to share via various blogs. The pile has become very overwhelming and I've decided I need to pare it down...decide what to post about and what to put back on my shelf. Some time ago, I shared a birth analogy from the book Mother's Intention about health clubs needing to be staffed with cardiologists (just in case one of the patrons had a heart problem while exercising).

Later in the book, the author employs another helpful analogy, again using cardiology as an example to make a point about inappropriately applied maternity care interventions:

What if...

You went to the doctor complaining of chest pain...not bad pain, but bothersome. To rule out a heart problem, the caregiver listens to your heart. He scowls, then excuses himself to make a phone call. He comes back in and tells you that you need to be admitted to the hospital for a test that requires the use of a drug. The drug has a low risk of serious complications, which is why you must be in the hospital, but he feels confident in taking that risk.

You go, and within minutes of having the drug administered, you have a heart attack. You are rushed into emergency open-heart surgery. Complications arise, but they are dealt with. You nearly bleed to death, but with a blood replacement you recover.

The repair doesn't go well, which may mean you will need further surgery later...maybe even a heart transplant. You definitely will need to change your previously active lifestyle.

Later, you discover the call your care provider places wasn't to a specialist, but an HMO lawyer who advised him not to let you walk out the door, just in case the routine examination missed a serious problem. You also learn there were less dangerous ways to determine if there could be a minor problem.

It turns out, you really did have a minor case of heartburn. All you have been through was unavoidable, but "As long as everyone's ok now...that's all that matters"...right?

A comment like that, to a mother who has suffered unnecessarily, when she would have--or could have had--the result of a live, healthy baby without such sacrifice, disregards her feelings of loss.

Parents should be expecting more!

In another book waiting in my pile (Open Season), I was amused to see a quote marked in which OBGYN care is referred to as "gynogadgetry."

And in another book, The Doula Guide to Birth, I marked another quote that feels very relevant to the others above: [a March 2006 study in the American Journal of Obstetrics & Gynecology] "reviewed all fifty-five of ACOG's current practice bulletins, calling these articles 'perhaps the most influential publications for clinicians involved with obstetric and gynecological care.' The study concluded that 'among the 438 recommendations made by ACOG, less than one third [23 percent] are based on good and consistent scientific evidence.'"

Enough said.

CfM Blogger

1 comment:

Tiffany said...

Yes, I have learned (very early in my midwifery program) to take anything ACOG says with a grain of salt. But they do rate the evidence for each statement they make so gotta give credit there :p

Great analogy!