Thursday, March 8, 2012

The More Things Change, The More They Remain The Same

I am absolutely shaky with rage at this moment. A very quiet rage, but rage nonetheless.

Lily just called me, crying. "What's wrong?" I asked her, my mind racing to every sort of horrible reason for her to be so upset.
And then she told me, haltingly through tears, that the pediatric practice which she takes Owen to just informed her that they are no longer taking home-birth or birth center babies.

She had called them to ask what she needed to do to make sure that this coming-baby could be examined for a newborn check as soon after birth as possible. And that's when they told her. So here she is, about to give birth, without a pediatrician. And of course I'm sure she can find a doctor who will take her but the main doctor she has taken Owen to in that practice was HER pediatrician! And now she has to scramble and change and it's just one more thing and she's upset and I'm upset.

I called the office manager myself. She informed me that yes, this is a new policy and reflects the doctors' beliefs that babies should be born in the hospital where "everything is covered."
"What exactly does that mean?" I asked the woman.
"I am not sure," she said. She was defensive and I do understand that she did not make the policy although as the office manager, I think she should know the answers to these questions. I told her that I did not understand such a policy- that there is no scientific or medical evidence to support it.

I asked her to have the doctor in the practice with whom I have mainly had a relationship with for almost thirty years to call me. This is a man for whom I have had the greatest respect as a doctor and as a human. He has always treated me with respect as a mother and as a nurse and I have always felt that he gave my children excellent and sensitive care. When I was pregnant with Lily, I went to him and explained my situation- that I was having a home birth- and he said then that although he did not approve, he respected my choice and that was that.

So I am interested to hear this doctor's explanation. The office manager told Lily that they had had some problems with some babies from the local birth center and this may be true. However, I am QUITE certain that they have had to deal with problems caused by things which have happened at the hospital, too, no matter how well things are "covered" there.

This whole thing just completely enrages me. It has been proven over and over and over again that the way we deliver babies here in the US is not the safest or best way to deliver babies. Our infant and maternal mortality rates are abysmal for an industrialized nation and yet, we just keep throwing more and more unproven technology at the problem and haven't yet seemed to figure out that this may BE the problem.

I've been fighting this battle for thirty-six years now. When I had my first baby, a planned home birth was considered next thing to infanticide. And yet, the hospitals were still at the stage where only the most lenient doctors allowed even husbands in the delivery room. Where babies were separated from mothers for up to 24 hours after birth. Where women were routinely shaved, given enemas and tied down for delivery. And if you dared to question THAT status quo, you were looked upon as a complete and utter nutcase.

And here we are now and oh yes, you can have people with you when the baby is born. You are not shaved or given an enema or tied down. Your baby can stay with you after delivery. BUT, Caesarian rates are so high that as a mother delivering today, your chances of dying during a delivery are higher than they were in the 1950's! Babies are regularly induced at 38 weeks for reasons I don't even begin to understand and if you DARE go past your due date by a week, you WILL be induced. And inductions lead to more interventions and more interventions lead to C-sections and why IS it that babies are being induced? Do we not think that humans can give birth to normal sized babies any more?

Oh. I am just so angry. And I am angry for Lily and I am angry for women in general who are once again being told by THE MALE DOMINATED ESTABLISHMENT that they don't know what's best for them or their children. And it also enrages me that women have NOT taken control of this situation. That we have allowed the doctors and (and this may be the bottom line cause of all the problems) the insurance companies to tell us how we should give birth to our babies. WE are the ones who have allowed childbirth to be taken away from US and given a medical procedure in its place.
Yes. God. We NEED hospitals and doctors if something goes wrong. But if nothing DOES go wrong, if birth is managed with skill and patience and respect for the process, if an educated and trained midwife is the person doing that, mothers and babies will all be better off and the doctors and the hospitals can do what they do best which is to take care of people who have actual medical problems.

I could go on for days here, seething and simmering until I explode.

I won't. I am waiting for that call but I have also told Lily that she needs to find a different pediatrician. One who respects women who choose to have their babies in the way they deem to be safest and best. As much as I respect that doctor, as long as our relationship goes back, I do want Lily to have to suffer the indignity of going to a practice where her choices are not respected. Where the science is not sound, the medical practice not sensitive to the realities of life. Even if they made an exception for her because of her long history there, I don't think she would be comfortable with them any more and if there is not trust and respect between doctor and patient, then another doctor must be found.

Which makes me so sad. I have loved going to Owen's check-ups with him and his mama. It has been a joy to have the same doctor who examined Lily after her birth and did all of her well-baby check-ups and who took care of her when she had her childhood illnesses, do the same for my grandson. To chitter and chat with that doctor, to talk about his children and grandchildren, to laugh about how quickly the time goes, about what complete fools we grandparents are. To have that relationship with him. That trusting, confident, easy relationship. To feel that my grandson's health care was in good hands. To know that Lily felt the same way.

Well, la-di-dah and let it go.

But I want to talk to him first. I want to ask him how a practice can make such a blanket policy and I want to know why it was made. To hear his explanation. And to let him know as a mother, as a parent, as a home-birth advocate, my point of view on the subject. He deserves to hear that, just as I deserve to hear what he has to say.


  1. The Broken America. It makes me rage too.

    love to you and Lily,

  2. Yes! Full support! (for you of course)

  3. It takes an angry woman to get things done. Apparently the male establishment only listens to us when we unite and show our rage.

  4. I hope you can talk some sense into him and get he to change his mind. Or at least find out that, insurance wise, his hands are tied. Maybe it's about his liability insurance....

    Very upsetting for Lily, especially at this time. Way to pull the rug out from under an expectant mom.

    Can't wait to hear the resolution on this...

  5. So sorry that such an unsettling thing happened to Lily and to you at this late stage.

    I hope you get to have that conversation with this pediatrician. But I also hope that Lily is able to find a new doctor for her babies that supports and encourages her way of mothering. That would be the best way to let these fuddies know that women are becoming more enlightened and taking back the control over our bodies and our babies.
    But I understand too, that at this late date - that will be no small task. Good, good luck to Lily !!!

  6. Very nice..

  7. So very strange.

    Well... he loses business. Lily loses peace of mind... he's not the right doctor for her or her kids, though, I'm afraid.

    I'm so grateful we haven't needed doctors that much since I had kids. What I have seen of them has unfortunately not settled my fears about them either, and I genuinely wish I could say differently.

    But my heart goes out to Lily, this is a terrible time to be judged or let down. I hope she finds someone lovely and is glad she made the move in the end.

  8. That is absolute bullshit. Now I'm mad. How can doctors say they won't care for specific children? Isn't it their DUTY to care for children? Oh I'm pissed.

  9. I totally understand your position about this. I'd be angry too. In fact, I am angry and very concerned that this may become a trend and I believe it is likely being pushed by insurance companies...

    However, I have never liked the majority of physicians in that group and have felt so much more at ease and even HAPPY with where we are now... and wished we'd done it sooner even. They rock.

    Good luck. I hope the info helps Lily to decide. It's good to have choices. PUN intended.

  10. I agree 100% with every word here. There have been doctors offices that have put up signs stating that no doulas will be allowed at patient births. Hmm hmmm, because doulas empower the parents to ask questions. Obviously this doctor or doctor group decided they dont get enuf business from the families that are using midwives. FL allows homebirths and for its midwives to get paid by ins companies. GA does not. You have not mentioned Lily's midwife--surely she has recommendations for going forward. That is how for my hb baby here in GA I knew what doc (who would not admit it on the street) backed up my hb midwife (again in GA they do not license the hb midwives). So I had a doc to go to for the "well check up".
    It is going to be OK because Lily's baby will be perfect and she will find a much better office to spend her money. AND she should let the folks at Publix' HR dept know. I am assuming that is where she and Hubs' have their insurance. Publix does not use the insurance co. to pay claims. Publix is self insured and pays its own claims and only uses the ins company to process the claims and provide the doctor network.
    It reminds me of docs who may fire customers due to their belief in low vaccinations or no vaccinations. Or heck, dentists that force along too many xrays cuz they pay well. Or MRIs. I could go on and on, but Lily will now become a strong advocate for herself and learn that SHE and her hubs are the customer and customers decide where and when they will spend their money.
    That doc is so shitty and this reminds me why I am lucky enough to take mine to the CVS Minute Clinic if they have an ear ache or need a sports physical.
    Oh I am pissed too! Tell him he sold out and has lost much respect.

  11. That's some bull! Yeah, I said it. And I'm a doctor, too.

    I'm sorry Lily had to go through that.

  12. In my rant above I failed to explain better when I mentioned about her employer being self insured. her employer should love that as a benefit user, Lily and her hubs choose hb (legal in FL) because it costs Publix SO much less money than all those other stats you know about. Self Insured companies like Publix love it when employees and dependents make smart, money-saving choices to be healthy. So here is a practice that discourages the choice of a low-cost way for Publix to pay for a birth claim (i.e. $2,500 vs $12,000 for a normal birth, or excuse me a c-section birth at twice that). It may be a drop in the bucket but it is worth it for Publix and the network to know that this practice is encouraging only higher priced births.

  13. Madame King- Just fuck all of us that don't accept the status quo. Just fuck us all.

    NOLA- Thanks, sugar.

    Angie- Or at least our not-backing-down spirits. But women just don't even care to educate themselves for the most part anymore. Ask ten women on the street and I'll bet eight of them at least say they'd go right for the hospital birth and the epidural and whatever the doctor says. It's what we deserve if we don't educate ourselves.

    Taradharma- Well, the office manager did say that the doctors believe that babies should be born in the hospital. Now as to why- she couldn't say. Or wouldn't say.

    liv- Still waiting for that doctor to call. Mmmmm....
    Lily will figure it out. She is smart and she is responsible. I just wish she didn't have to do this NOW.

    Saranya- If that is a real comment, thank you.

    Jo- I think in Owen's entire life he's only been to the doctor twice for anything other than well-baby checks and one was for a cold and one was when he sucked that seed up his nose. Or whatever it was. But if a child DOES get sick, you need and want a doctor you trust.

    Jill- Yeah. Real ethical, right?

    Ms. Fleur- Thanks for the recommendation. I'm sure Lily will find the right doctor for her and maybe it will be yours.

    Michele R- Publix does NOT cover Lily's birth. She's paying the midwife out of pocket. Which sucks. But yes, Diana does have recommendations for homebirth friendly midwives. Believe me- Florida is NOT that midwife friendly, no matter what the law says. Especially if they are homebirth midwives.

    Gradydoctor- Well, I think it's bullshit. I keep thinking of you and how you find a way to relate and communicate with your patients regardless of their circumstances and beliefs and I can't help but compare this situation and this practice is not coming out well in the comparison. I find it to be, quite frankly, unethical.

  14. Insurance Liability, Period

    That's all people are anymore, is a line on an actuary table.

    Talk to the doctor. He should hear every single thing you have to say regardless of the outcome of his policy. And yes, Lily should just find another doctor. He should hear that too.

    And what happened to the word, "midwife"? How did "doula" show up? I have some opinions on how that word alone has effected the practice, but...I won't tell them to you now.

  15. Ugh, Mary. I'm so sorry. I was given hell because I wanted a midwife, and refused induction and was overdue and would have desperately wanted to have my baby at home, not in that hospital room where the nurse yelled at me for breastfeeding 'wrong' and shoved a bottle in my baby's mouth.

    I'm sending all sorts of good xi your and Lily's way.

  16. Infuriating!

    Bless you for taking it up with the doctor. He clearly needs to get an earful about this.

  17. Magnum- I think you're right. Yep. I do. Anyway, a "doula" is not a midwife as you probably know. She's sort of the mother's support during birth. I think a lot of hospitals don't like them because they are advocates for the mother when she is, let us say, compromised, by being in labor. I'd love to hear what you have to say about them. Don't worry- I'll speak honestly to the doctor. Should he ever call.

    Sara- See- we all have our stories and yet, what do we do? We have our babies, we go on, we let it go. It is the way of it. And meanwhile, very little changes. I'm not saying YOU should change things- I'm just saying that we women KNOW we are not being treated right and we let them get away with it. Probably because we're too damn tired after the baby's born!

    Amna- Agreed. I'm just waiting...

  18. I'm sorry that Lily is going through this. She needs peace of mind and not having her mind fucked with. I don't know shit about birthing humans. I just hope that all will go well for Lily and her baby. It makes me a bit fearful to think about the whole birthing thing.

  19. Yes, i'm on your side on this.

    It may be the doc's malpractice insurance is squawking about it; those companies are just as bad as the health insurance companies in this stuff.

  20. Perhaps he`s been blamed for things that happened outside his control - sued - and now his malpractice insurance is sky-high...but I doubt he would tell you that - doctor/patient confidentiality and all that. Finding a new doctor is the best bet. When he loses a good chunk of his clientele he may relent - but too late.

    The world just sucks.

  21. And here it is again, the war against women in this country. because we are just too stupid, because we are barely better than children ourselves, a man, any man, must makes these decisions for us. And we let them! that's what I don't get.

  22. I guess I assumed that since hb is legal in FL then her claim would be covered even if out of network. well shame on Publix. Guess they would rather pay for $10,000 or $12,000 for a normal birth than the $2,500 or so. BTW I still filed my claim and some of it got paid anyway.
    It makes me want to ask the doc...what if a patient who is 9 yrs old shows up? Do they friggin ask if he was born in a freaking hospital?
    You guys should contact DONA or CAPPA or La Leche or other "crunchy" organizations about this pediatrician not seeing children who were not born in the hospital and that doc sure would hear from plenty.
    I wonder who at the hospital is threatening his admitting privileges.

  23. I guess I assumed that since hb is legal in FL then her claim would be covered even if out of network. well shame on Publix. Guess they would rather pay for $10,000 or $12,000 for a normal birth than the $2,500 or so. BTW I still filed my claim and some of it got paid anyway.
    It makes me want to ask the doc...what if a patient who is 9 yrs old shows up? Do they friggin ask if he was born in a freaking hospital?
    You guys should contact DONA or CAPPA or La Leche or other "crunchy" organizations about this pediatrician not seeing children who were not born in the hospital and that doc sure would hear from plenty.
    I wonder who at the hospital is threatening his admitting privileges.

  24. There will be a rational explanation that will no doubt include a defensive response to the possibility of 'things going wrong' and of doctors being held responsible, I expect. It's tragic that so much defensiveness goes on in life such that people cannot do their jobs, the ones that come naturally like giving birth, with assistance, but not hindrance.

  25. Yes, I was going to say, I'm sure this is COMPLETELY motivated by insurance issues.

  26. long before there were doctors, hospitals and insurance companies, there were women having babies. that in itself should tell us all we need to know about which type of birth is 'better'. if it ain't broke, don't fix it.


  27. Syd- Well, even a marine biologist could tell you that when a system has been designed to work after tens of thousands of years, it's pretty ridiculous to try and fuck with it to the degree that we here in the states do. Check out infant mortality rates per country for a quick education on how well all this technology is working for us. Very enlightening! And very, very sad.

    messymimi- Oh you can bet that dollars are involved here somewhere.

    Michele R- It's his whole practice. And I just discovered that his practice isn't the only one. The office manager said something about how they would, of course, take the child as a patient later. I asked her again- what does that mean? She had no idea. So what? You have a baby at home, some other doctor pronounces he or she perfect and THEN they'll accept the baby as a patient? I don't get it.
    And if the doctor would call, maybe I'd find out. I am not holding my breath.

    Elisabeth- You're exactly right, I am sure.

    Jo- Yep.

    Mrs. A- Well, it's broke now. Believe me.

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  30. I had a baby who was a successful C-section deliver, in a local hospital on an emergency basis, because I had been in labor for 23 hours and he refused to budge from his shoulder breech position. He was premature, as well. That was successful birth number one, after two miscarriages. I had completed lamaze classes and planned to have a natural childbirth, but it didn't work out that way.

    I had a second baby who was stillborn at 5-1/2 months. This baby died in utero and not as a result of any delivery problem. This experience occurred in a hospital setting with a chemical inducement, and we we were allowed to grieve and spend time with our child after the delivery.

    I had a third baby after less than an hour (from door to delivery floor) where our baby beat the surgical team to the delivery room. This was beautiful live child #2.

    I don't feel like less of a woman or any more of a mother with any of these deliveries. (The C-section delivery for me was the easiest from which to recuperate, but it might be because I hadn't yet been diagnosed with lupus, which brings its own set of problems to the delivery room).

    I was allowed to choose whether I went to a hospital, a surgical suite, or a labor and delivery birthing room.

    My pediatrician stayed with me all three times.

    My childbirth coach was there the second and third times.

    My OB/GYN listened to my husband and me every time, and we listened to him, too.

    Why is it rare that doctors won't listen to patients, or that patients stand for not being heard?

    I don't necessarily see this as a male-female issue, as over 50% of the graduates from medical school are now NOT MALE.

  31. WE need to get in there and be the power. The senators, the congress people, the doctors, the hospital administrators. WE need to be on the inside, running the show, making the rules, the laws, the loans, and the babies. There are just too many paternalistic father-knows-best men. All you good men out there, throw in with the women in power.

  32. We've long gone to a pediatrician out here in California who is utterly open-minded and tolerant. He does not accept any insurance, so we've paid out of pocket all these years and gotten minimal reimbursement from our insurance company. I know that this is impossible for most and I have been, perhaps, financially stupid to have done this, but given the amount of bullshit we have to put up with with insurance companies for Sophie, we make it worth. I say fuck the insurance companies. I am so sorry that you're having to go through this. Just so sorry.

  33. you're right, it is so wrong that we have to do the same things over and over and over. to fight the same battles that somehow weren't won 30 and 40 years ago when we thought they were. enraging.


Tell me, sweeties. Tell me what you think.