Monday, February 11, 2008

Barking dogs

Navelgazing Midwife has posted a thought provoking piece, The Gray, Grey Messenger. It starts off as a response to Gloria Lemay's inane comments about hemorrhage (which I addressed in Idiocy from Gloria Lemay) and ends up considering the appropriate response to risk. NGM has this to say about doctors and nurses:
... [W]ouldn’t most of us do something if we knew someone was going to get hurt? The thought of a baby suffering certainly makes most/all of us ache to our core.

Doctors and nurses share that same inner turmoil we all do when thinking about a baby about to be hurt or damaged. They just look at things from a different vantage point.

I think about my dogs that bark at anyone that comes near the house. It drives me crazy when they both get to yapping, but I also know they are trying to protect me from danger. That there isn’t any danger doesn’t faze them because all they know is, "Someone’s coming close that doesn’t belong here. DANGER!" and they bark. I would never consider teaching/punishing/training them to not bark because the one in a million times they do bark, it will be to warn me of someone who doesn’t belong here.

Doctors, too, are barking dogs, warning, warning and warning of dangers. Most of the time, they are heralding nothing but potential dangers, especially if nothing changes to shift the concerns. But, because of their instinct/experience/training, they do recognize and are ready to defend the baby and mother against severe trouble and turmoil.

Do we really want doctors to stop barking altogether? (I try and keep my dogs from barking inside, instead sending them outside to bark.) Perhaps we can encourage them to use their indoor voices when the mom/energy needs to change positions instead of screeching so loudly we cover our ears.

And then, the question becomes: Who is the translator? Who really knows if there is danger or not? I know many believe a mom will intuit something amiss, but I have been around enough births where the woman was the least aware of what was going on. Do we take a vote from everyone present? Do we ask for a second or third opinion? (I am reminded of people with severe illnesses who traverse from doctor to doctor, looking for the response they desire, it not mattering that they really are sick; they just want to hear that they aren’t.) Do we ask for more time? Who is holding the hourglass? (The baby?)
At one level, this is not a very flattering comparison. Doctors are like dogs who lack the ability to tell the difference between the unknown and true danger. I don't think that was what Navelgazing Midwife was trying to convey, though. What came through for me was this:

There is real danger in childbirth.
Doctors are trying to protect babies and women from real danger.
Doctors do this because they don't want babies and women to get hurt.

Navelgazing Midwife, in describing her frustrations, captures the frustrations of doctors and nurses as well. It is very disppointing to do everything in your power to protect a baby and a mother from harm and then find out that not only does the mother not appreciate your hard work and heartfelt effort, she actually resents it and considers it unnecessary.


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