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Interesting article. I also thought that encouraging cesarean sections was something obstetricians did often to avoid the time spent waiting for delivery. Howev

Interesting article. I also thought that encouraging cesarean sections was something obstetricians did often to avoid the time spent waiting for delivery. However, in my training I witnessed quite the opposite. My resident and attending physicians were very cautious with going forward with cesarean sections, and would do whatever they could to continue with vaginal delivery when the mother wanted that, and also encouraged patients that wanted cesarean to consider vaginal delivery. Obviously this is one hospital, but it did help me not be as cynical of the profession, and will probably help serve as a reminder to do what's best for my future patients.

learc83 8y ago
Did you find that obstetricians encouraged inducing labor as a way to avoid spending time waiting for deliver?
- epmaybe 8y ago
  Yes and no. I can only speak for this one hospital, but most of the time we would only induce if there was indication for doing so (twins is one example that comes to mind) or if the mother truly wanted induction. I don't recall specifically encouraging for reducing time, though the residents would joke about wanting to do so instead of waiting. I wonder if this is more common at teaching hospitals, so that attendings can hand off the waiting to the residents in training.
e40 8y ago
With the birth of my son, we switched obgyn's because she basically told us it was pretty certain we'd have a c section, because she didn't have time to wait. We switched doctors and it was the first question we asked when interviewing prospective doctors. This was in 2000.
- lostlogin 8y ago
  I had no idea that interviewing doctors for delivering your child was a thing. Do they charge for it? Is it common?
  - toomuchtodo 8y ago
    My wife interviewed several OB practices in the Chicago area before settling on one for delivering both of our children. In her group of friends, it was common. There was a small charge at each as an initial consultation.
  - e40 8y ago
    We had a Doula, and she recommended that we ask a bunch of questions on our initial visit. It wasn't a separate interview. We knew we'd move on to the next on the list, should we not like some of the answers (the c section one was the primary issue).
wild_preference 8y ago
Your initial suspicion is alive here in Mexico where you need to rent your own obstetrician and install them at a private clinic facility while you wait for baby.
lellotope 8y ago
With the birth of our daughter, we had a different, and more complicated experience. Pre-delivery there was no pressure to do a c-section. None at all. My wife definitely did not want one. At the time of delivery, though, there was very much pressure to do a c-section. Although the admitting resident didn't seem to pressure my wife, care was quickly transferred (because of shift reasons) to other physicians (resident and attending) who did. The way this manifested, though, was sort of subtle. For example, my wife had a procedure done to speed up the delivery; however, as we found out later, we were definitely not sufficiently informed of the consequences of the procedure, one of which was increased likelihood of a c-section. They tried to talk my wife into a c-section, and then when she declined, they tried to talk her into other procedures that would speed up the delivery, and would omit mention of the fact that they were associated with increased likelihood of c-section. Overall, even if c-sections weren't being explicitly mentioned, they were kind of relied on or assumed, for time and convenience reasons. The discussion was sort of like "Oh you don't want a c-section? Ok, then how about X to speed things up? Oh--I forgot to mention that now we probably have to do a c-section? Oops!" It came across as manipulative to me. My wife did not have a c-section, but this was probably only because the nurses there (who were phenomenal) were actively arguing with the physicians to not do one, and to wait. We weren't really in the hospital that long either.
- wizzard 8y ago
  This is a well-known phenomenon called the cascade of intervention: http://www.childbirthconnection.org/maternity-care/cascade-of-intervention/ http://www.childbirthconnection.org/maternity-care/cascade-o...

learc83 8y ago

Did you find that obstetricians encouraged inducing labor as a way to avoid spending time waiting for deliver?

epmaybe 8y ago
Yes and no. I can only speak for this one hospital, but most of the time we would only induce if there was indication for doing so (twins is one example that comes to mind) or if the mother truly wanted induction. I don't recall specifically encouraging for reducing time, though the residents would joke about wanting to do so instead of waiting. I wonder if this is more common at teaching hospitals, so that attendings can hand off the waiting to the residents in training.

e40 8y ago

With the birth of my son, we switched obgyn's because she basically told us it was pretty certain we'd have a c section, because she didn't have time to wait. We switched doctors and it was the first question we asked when interviewing prospective doctors. This was in 2000.

lostlogin 8y ago
I had no idea that interviewing doctors for delivering your child was a thing. Do they charge for it? Is it common?
- toomuchtodo 8y ago
  My wife interviewed several OB practices in the Chicago area before settling on one for delivering both of our children. In her group of friends, it was common. There was a small charge at each as an initial consultation.
- e40 8y ago
  We had a Doula, and she recommended that we ask a bunch of questions on our initial visit. It wasn't a separate interview. We knew we'd move on to the next on the list, should we not like some of the answers (the c section one was the primary issue).

wild_preference 8y ago

Your initial suspicion is alive here in Mexico where you need to rent your own obstetrician and install them at a private clinic facility while you wait for baby.

lellotope 8y ago

With the birth of our daughter, we had a different, and more complicated experience. Pre-delivery there was no pressure to do a c-section. None at all. My wife definitely did not want one. At the time of delivery, though, there was very much pressure to do a c-section. Although the admitting resident didn't seem to pressure my wife, care was quickly transferred (because of shift reasons) to other physicians (resident and attending) who did. The way this manifested, though, was sort of subtle. For example, my wife had a procedure done to speed up the delivery; however, as we found out later, we were definitely not sufficiently informed of the consequences of the procedure, one of which was increased likelihood of a c-section. They tried to talk my wife into a c-section, and then when she declined, they tried to talk her into other procedures that would speed up the delivery, and would omit mention of the fact that they were associated with increased likelihood of c-section. Overall, even if c-sections weren't being explicitly mentioned, they were kind of relied on or assumed, for time and convenience reasons. The discussion was sort of like "Oh you don't want a c-section? Ok, then how about X to speed things up? Oh--I forgot to mention that now we probably have to do a c-section? Oops!" It came across as manipulative to me. My wife did not have a c-section, but this was probably only because the nurses there (who were phenomenal) were actively arguing with the physicians to not do one, and to wait. We weren't really in the hospital that long either.

wizzard 8y ago
This is a well-known phenomenon called the cascade of intervention: http://www.childbirthconnection.org/maternity-care/cascade-of-intervention/ http://www.childbirthconnection.org/maternity-care/cascade-o...