During the years of my private practice, all kinds of women came through my doors. Plenty of women knew from the start that they wanted a midwife. But I congratulated the women who transferred care mid pregnancy or later when they realized they weren’t going to get the birth they wanted. They overcame the fear of offending their doctor and brought their pregnancy elsewhere. That they overcame anything is of course an assumption I’m making. Some women didn’t give a thought to what their doctor might think. Most, though, had some degree of discomfort that they may be hurting their doctor’s feelings.
Some were surprised, perhaps with mixed feelings, that their provider didn’t even notice or care. For some of them, though, their fear was justified-like one woman getting an angry phone call and the Dead Baby speech from an obstetrician who refused to accept that she had actually left his care.
Today I came across this headline: “Fear of Being Labeled “Difficult” May Keep Patients from Participating in Shared Decision Making”. It’s from the website of the Informed Medical Decision Foundation, who states, “We believe that the only way to ensure high quality medical decisions are being made is for a fully informed patient to participate in a shared decision making process with their health care provider.”
I read the article with increasing incredulity, and something in my head broke in the last paragraph: “Most physicians are probably not aware that patients are concerned about asserting their preferences in a medical consultation,” says Dominick (Frosch, lead author of the study). “Our study suggests that health care providers need to be explicit with patients that their opinion matters and that it’s okay to disagree, otherwise the treatment that is prescribed may not be one the patient is willing to adhere to.”
What dream world does this guy live in?
Take this fear and add female social conditioning to it. You know, the female conditioning of not making a fuss and being a good girl.
Add to THAT the natural conservatism we have towards our babies. A health care provider can make a pregnant woman do anything by saying her baby may be in danger.
“Our study suggests that health care providers need to be explicit with patients that their opinion matters and that it’s okay to disagree.”
What if it isn’t?
Dr. Dominick Frosch, I’d like you to meet the physicians of Aspen Women’s Health Center in Provo, Utah:
These health care providers explicitly state that their client’s opinion DOESN’T matter and it’s SO not ok to disagree that they can go to another provider if they do.
I commend them for their honesty.
Fear doesn’t come from nowhere. This particular fear is a solidly rational one for pregnant women.