Saturday, September 12, 2009

The First Step

ACOG has taken a commendable first step in releasing the results of their survey this week: the changes OBs have been making to their practices due to fear of litigation are harming their patients.
"By publicizing the widely known fact that defensive medicine is aggressive and harmful to women seeking maternity care, ACOG has taken a profound step in openly admitting and sharing data that women’s options are being severely restricted and iatrogenic injuries are occurring on a large scale due to physician fears."
And you know what? I applaud them, as have some other birthing advocates in their response to the news. A common response is "It's a start," and "At least it's a first step." I agree, and would add that admitting you have a problem is the hardest part.

I look forward to the rest of their recovery, especially the "examining past errors with the help of a sponsor", "making amends for these errors", "learning to live a new life with a new code of behavior" and "helping others that suffer from the same addictions or compulsions". And I definitely know a few OBs who could benefit from the Serenity Prayer now and again.

Keep coming back. It works if you work it.


  1. Hee hee. The first step to solving a problem is admitting that you have a problem, right?

    Hi, my name is Bill and I'm a compulsive c-sectioner.

  2. I think that's great - but wonder (because I'm that friend) if the high rate of litigation against doctors for problems that would also occur in non-assisted births is also being addressed. The medical world will not stop over-medicalizing (in all areas, not just birth) until we can admit that sometimes births aren't perfect and babies don't always come out whole and hearty even under the best of circumstances. And while birth advocates and birthnerds (to use your word) are likely to acknowledge this, it's the people who listen to talk-show hate mongers who are looking for someone to blame and a quick infusion of cash who drive the force behind malpractice and fear-delivered medicine. And sadly - there are many more of them than there are of you. Of "us" even since I do not consider myself on a different "side" just sitting on the pragmatic wall of malpractice where I have one hand on my tort law handbook as a clinic manager.

    Having said that - the overmedicalization of healthcare in general does not always lead to better results. Somehow it is not surprising to note, however, that in the land of supersize patients equate "more" with "better" and therefore sue less often when more has been done.

    Oh wait... I have a great idea. What if healthcare weren't market based? *gasp*.

  3. "Oh wait... I have a great idea. What if healthcare weren't market based? *gasp*."

    Funny you should mention it - this is the focus of Dr. Marsden Wagner's book "Born in the USA", a read I think you'd likely appreciate a whole lot. Litigation is absolutely, positively a huge part of the maternity care crisis, there is no doubt about it. And despite how I'm sure I sometimes come off, I actually am NOT unsympathetic to the dilemma.

    It's funny how I used to argue about tort reform with my dad (who's a doctor, for anyone out there reading along) from a COMPLETELY different viewpoint, and now I definitely do see it as vital.

    Or, like you said, take the market out of the picture, period. Seriously, give Wagner's book a look-see. He's a perinatologist and the former director of Maternal Health for the WHO. It even got through to my dad, a bit.