Reply #153: OBs in the US do not practice

[gaia_gardener]

evidence based medicine and most are just lucky they haven't caused damage.

I was at a birth where the resident came in and broke the water without checking the baby's station. OOPS, the baby wasn't engaged. She's lucky the cord didn't prolapse. Then they gave the patient pitocin without getting consent (of any kind). We didn't even know she had it until the nurse said something about turning it off. The 3 of us turned and said "when was pitocin ordered?" She was in labor less than 6 hours total (for a first time mom) and they ordered pitocin at the 3 hour mark (about 30 minutes after they broke her water). I walked out later the residents were talking about "saving her". They didn't save her, neither she or the baby were ever in danger, her labor was normal. Yet these residents believe in the myth of birth being a major danger that they reacted by using medicine and procedures that weren't warranted.

Women are getting c-sections are ever increasing rates. I can't count the number of women that submitted to an induction (and subsequent c-section) because the doctor thought 40 weeks was long enough and any longer would be dangerous (never mind that the average gestation for a first time white mom is 41w3d). We still have doctors using cytotec to induce labor (cytotec is an ulcer drug that has a side effect of uterine contractions). Because cytotec only causes uterine contractions (and not cervical dilation) women are at an increased risk of major labor complications (including ful uterine rupture) and fetal distress.

OBs think that the only way to prevent being sued is to use all the interventions they have - never thinking about the complications of the interventions. There is a risk/benefit to every medical procedure. Sometimes the benefits far outweigh the risks and sometimes they don't. In some situation, the risks so far outweigh the benefits that they shouldn't even be considered, but in the OB field these interventions are used regardless.

A major problem is that the malpractice rates aren't related to the individual provider. A midwife in town lost her practice because she couldn't afford the malpractice insurance. She had never even so much as had a complaint made against her, nevermind been sued. The costs to the patient for her care were a fraction of the traditional OB cost and considerably safer.