Follow The Stir

Your OBGYN's Personal Beliefs Could Ruin Your Birth

by Christie Haskell on September 23, 2011 at 9:00 AM

Not everyone who leans toward natural birth practices started there -- many have had bad experiences in hospitals or have been close to women who have. Sometimes it's women who read incredible amounts of literature on pregnancy long before peeing on the stick. It's not just patchouli-wearing, long-haired, barefoot hippies. It's law students, businesswomen, head of your PTA -- anyone. Especially with homebirth on the rise, it's safe to assume it's no longer just a fringe group of "weirdos."

Yet, many people still get accused of being conspiracy theorists, of thinking they "know better than doctors" and blown off like crazy freaks. Well guess what? It seems that many OBGYNs are letting their personal leanings interfere with their practice.

According to a new study, we aren't crazy when we point out that many common practices and recommendations aren't evidence-based -- less than a third of the American College of Obstetricians and Gynecologists recommendations are based on "gold-standard" scientific experiments.

According to Professor of Medicine, Dr. Andrew D. Auerbach, "more than two thirds" of recommendations are based on anecdotal evidence or even just expert opinions, which are wrought with personal biases. While opinion can be helpful where we don't know things, it doesn't always translate into what's best for the patients.

In the new study, Dr. Jason D. Wright of Columbia University in New York and colleagues went through 717 practice recommendations from ACOG, the nation's leading group of ob-gyns.

They found 30 percent of those were based on top-notch evidence, so-called randomized controlled trials. About 38 percent came from observational studies, whose value is limited, and 32 percent were purely expert opinion.

That's kind of scary to me, honestly. But it helps explain where quotes like these come from: "Twins are ready sooner because they grow faster than a singleton" and "In my experience, all Hispanic babies need formula."

I hate to say "I told you so," but seriously, when someone tells you that what your OB told you isn't sound, don't blow it off. When someone says, "Doctors don't know everything" or "I'd get a new doctor," most people aren't just trying to be self-righteous, arrogant assholes. Doctors CAN BE WRONG, and according to this study, they aren't using nearly as good of science as even I -- as a decently skeptical person -- believed they were. YOU are your best advocate. Do real research, ask around, ask people who disagree with you for sources of their claims, and find out yourself.

The study also noted that it's very important to go through literature and remove financial conflicts of interest from the office, and to make sure that panels for guideline review represent all stakeholders -- doctors and the patients alike. So yes, when we talk about offices having fingers in pies that hurt you as a patient, we're telling the truth.

When we have the Surgeon General, past and current, the Institute of Medicine, the World Health Organization, and the March of Dimes, to name a few, all saying that our hospitals and doctors are a huge part of the problem causing abysmal breastfeeding rates and premature birth and infant mortality, and then a study like this shows the good majority of our information isn't even based on good science ... well ... those home-birthers may not be sounding quite so crazy after all?

Are you surprised to find how little of the practices were using sound science?

 

Image via Daquella manera/Flickr

Filed Under: delivery, homebirth, labor & delivery, pregnancy health, tests & procedures, doctor visits, natural parenting

Comments

68
  • Momma...
    --

    MommaGreenhalge

    September 23, 2011 at 9:39 AM

    !!!! Thank you!  One of my biggest pet peeves is when people accuse me of, "Trying to say I know more than doctors."  I didn't go to school for this.  But I have a vested interest in my health and the health of my babies, and I have spent the better part of the last five years researching and learning everything I can get my hands on about healthy birth and raising healthy kids.  So when a doctor tells me something I KNOW is wrong (like I 'need' to be induced because the ultrasound says my baby is ten pounds at 38 weeks) I'm going to call them on it.  We hire doctors to give us expert recommendations based on evidence and good research.  That's their job.  It is then the right and responsibility of the patient to research their recommendations and figure out what to do with it.  When we give doctors carte blanche authority over our bodies and our babies, we are handing over the most precious rights we have to someone who may or may not have our best interests in mind.  Why would you trust someone that much with something so irreplaceable?


  • miche...
    --

    micheledo

    September 23, 2011 at 9:40 AM

    No, I am not surprised, but I would have been several years ago.  I always wanted to have my children naturally (no drugs).  But I ended up being induced with my first because my water broke.  It was HORRIBLE.  I thought it was a good thing I was in the hospital.  Then number 2, and number 3 - all induced and with epidurals (NEVER will I get induced without one, the pain for me is beyond anything I ever imagined).  All this time I was reading, but when number 4 came along I was absolutely determined not to be induced.  I didn't go to the hospital until I felt like pushing.  EASIEST (relatively speaking) birth I have had!!!!  It was great.  Now, after another year of research and study I am staying out of the hospital and hired a midwife to have #5 at home.  I find it ironic that I am now one of 'those crazy home birthers!"


  • Liz
    -- Nonmember comment from

    Liz

    September 23, 2011 at 9:56 AM
    OMG! Doctors are human beings too?! This is the most absurd thing I have heard all day! They have professional opinions, STRICTLY based on their experience?! You mean when scientific studies have not been conducted on certain topics, they go off of their own medical opinion?! This is OUTRAGEOUS!
  • Liz
    -- Nonmember comment from

    Liz

    September 23, 2011 at 9:56 AM
    Okay seriously, give birth however you want, I don't care. But if you use a doctor, do research and find a doctor you like, or don't complain when your doctor doesn't share your views. Doctors do what they do for a reason, because if something does go wrong, they don't want you suing them, so they follow a specific protocol. Being an advocate for yourself doesn't have to include being anti-doctor. Taking a doctors advice and self advocacy are NOT mutually exclusive.
  • kerij...
    --

    kerijeanbean

    September 23, 2011 at 10:00 AM

    It does amaze me how wrong doctors can be, not just OB/GYN's, but all doctors.  I have never heard that twins, or any multiples come early because they grow faster.  Then again I have never had twins, but that just sounds dumb.  I can't tell you how many people I have told to go find a new doctor if they are not happy with their current one.  Ultimately you have to be comfortable with the person caring for you.  


  • blh
    -- Nonmember comment from

    blh

    September 23, 2011 at 10:15 AM
    I've heard that about twins alot....idk if its tue but it makes alot of sense considering twins like never come at forty weeks...they run out of room in there.
  • Teres...
    -- Facebook comment from

    Teresa Kennedy

    September 23, 2011 at 10:24 AM

    I'm not at all surprised, after being stuck on bedrest with my first and not allowed sunlight or visits > 20 min. with my friends and family (no matter how relaxing and welcome) because they'd be "too stimulating" and being discouraged from performing "kangaroo care" and forced to feed my baby on a schedule because "that's what's best" during my son's stay. One advantage of being sicker for pregnancy #2 was a transfer to a hospital where they're striving for best practices and evidence-based medicine. Now on pregnancy #3 and shooting for un- or minimally-medicated VBAC!


  • Momma...
    --

    Momma2blessed

    September 23, 2011 at 10:32 AM
    Not surprised cause I have seen it for myself going through a few OBs and Peds finding the right one for us. They get in a habit of doing things a certain way for years and aren't necessarily up on the latest research and info on all things!

    Just cause the doctor says so is not a good a safe moto to live by. I was almost a victim of a serious medical mistakes on more than one occasion. YOU are your best patient advocate by being informed, asking questions and listening to your gut when something doesn't seem right or logical!
  • ibebr...
    --

    ibebreezy

    September 23, 2011 at 10:43 AM

    not suprised at all


  • Daynaof3
    --

    Daynaof3

    September 23, 2011 at 10:49 AM
    Surprised? Not even a little.
1-10 of 68 comments

To leave a comment, log in as a CafeMom member:

Log In

OR, use our non-member comment form: