Whatever Happened to Choice?

How often have I heard the words, "I really want a water birth (or insert birth method here), but my doctor won't allow (or my insurance won't cover) it." If I had money for every time, I'd be sitting in Cancun right now, downing Margeritas, supplied by a really good looking Cabana boy. No, really, I would.

Then, there are the responses I get from the question, "Why don't you change doctors?" If I had money for each time I've heard, "But he's a good doctor..." I'd never have to come back. Ever...

We are told to ask questions, we are told to pay attention to the answers, yet we never seem to know what to do with the information we get. We are never told that, if you don't get the answers you want, walk out and find another doctor. If the episiotomy rate is too high, we ask not to be cut during delivery, then act like victims if our wishes aren't heeded. Instead, we should say, "Sorry, your methods don't meet my needs, so I'm leaving now." If we did that, doctors would probably change, insurance companies would change, our lives would change, because they can't make money off of us if we don't use their services, can they.

Ultimately, we are consumers of services. If we take our money elsewhere, what we ask for will be offered more freely because they have no choice. We, as women, are reluctant to use the power we do have to affect change. Why do we buy what's offered instead of what we want? Isn't it an insult for doctors to expect us to just put up with what they want to give us, and not walk out the door?


There are many forms of insulting women. Doctors do it all the time. One that I see most frequently, is that doctors limit women's choices, depending on what would be easiest or best for them, and telling women that it's for their own good. A doctor that tells a woman that, she can't have a water birth because she's "high risk," is basically telling the woman that she's not capable of deciding what's best for herself. When a doctor tells a woman that she has to have an IV port put in at the beginning of labor because "something might go wrong" is telling the women in her care that she's way smarter than they are, and that they can't judge for themselves how they want to have their baby. In my opinion, they're also insisting on the port to cover their own ass. in case they don't see the signs of distress early enough.

I'm not saying that no intervention is best in every situation. I am not saying that precautions should not be used to safeguard the life of the mother and child. If you have a risk factor, such as gestational diabetes or high blood pressure, such precautions are beneficial. However, if there are no risk factors, routine use of interventions such as an IV port, episiotomy, or medications for pain or labor progression shouldn't be used. At the very least, under these conditions, the laboring mother's wishes should prevail over medical convenience.

We, as women, need to demand choice. We need to make it clear that we, not the doctors or our partners, are in charge of our bodies. We need to start advocating for ourselves, in advance of the birth, for what we want. We need to ask questions, demand adequate answers, and act decisively on the answers we get. We also must be wise, and take medical advise, not just when that advise agrees with what we want, but when the situation dictates.

As women, we have choices that we don't follow through on. If we don't like a doctor, we tend to stay because we don't want to hurt their feelings. We accept what's offered instead of changing. We are not victims of the medical profession, we are consumers of services that can gain change and choices by walking out on those that don't provide what we want.