Does Your Doctor Know Squat? An Interview With “Birth Guru” Henci Goer
Why do OB/GYNs have women labor in beds when squatting is the better way to birth? More importantly, does your OB/GYN, in particular, know the researchbased facts regarding obstetrics in America? Or, is your OB/GYN perpetuating the myths that keep pregnant women from making practical, logical decisions for childbirth?
Award-winning medical writer Henci Goer, author of The Thinking Woman’s Guide to a Better Birth and Obstetric Myths Versus Research Realities, makes the case that mothers are being kept in the dark. Contributing writer Brian Wimer caught up with Goer during an East Coast tour, promoting the Mother-Friendly Childbirth Initiative.
Wimer: Why did you first begin writing about evidence-based childbirth care?
Goer: There is a gap, you may even say a chasm, between what the research establishes as safe and effective care and what conventional practice is. I essentially wrote the book that I wanted on my shelf but didn’t exist...in the same way that Consumer Reports does the research and presents it to people who want to know what car they want to buy...this car has a poor repair record, this car gives you a bumpy ride, this car explodes on impact.
Wimer: Why is there a gap?
Goer: I don’t think that many obstetricians are reading the research. At best they are reading the digest that they get in their trade magazines.
Wimer: Is it because they aren’t aware of the clinical research? Or, it is more willful than that?
Goer: The American College of Obstetricians and Gynecologists (ACOG) could play the role here in leading obstetricians to practicing evidence-based care...but they have, quite honestly, chosen not to do that.
They [ACOG] are a trade union. They are there to protect the interest of their doctors. Sometimes that overlaps with what’s best for women and babies. But, where it does not, they will follow what’s best for their members.
Wimer: Are you saying that ACOG is not always interested in what’s best for women and babies?
Goer: I just came from a conference at the Jacobs Institute of Women’s Health, in which, on a panel, I heard the very recent president of ACOG state that one of the roles of ACOG was to protect its fellows from liability. What she was saying was that where there’s a conflict in what practices ACOG should back, they back the ones that protect fellows against liability.
I proceeded to make myself unpopular by pointing out that that went against their own code of ethics which says that where there’s conflict of interest it must be resolved in what’s in the best interest of the patient.
Wimer: During his campaign, President Bush said that, due to malpractice liability, “OB/GYNs aren’t able to practice their love with women.” Is that so?
Goer: (laughs) They do tend to get sued. But, to a great extent, they’ve brought it on themselves. The subtext to the contract between [the doctor and mother] is: “If you don’t submit to all this high-tech medicine, that I think you should have, then I can’t guarantee a healthy baby.” Well, what happens when there isn’t a healthy baby?
Wimer: What do you believe are the biggest myths regarding childbirth?
Goer: One is that cesarean is safe...and that it’s superior to vaginal birth because it protects the pelvic floor. Both of those statements are demonstrably untrue. Anyone who wants to know more about that can go onto the Maternity Center Association website at www.maternitywise. org. Cesarean section is not safe. It does not protect the pelvic floor.
The second myth is that there’s no harm in inducing labor...when, in fact, inducing labor increases any number of risks over a spontaneous onset of labor...chief among them: a woman who is a first-time mother roughly doubles her odds of cesarean section if she has labor induced. Most of the reasons that are given to women such as the baby’s too big, you are past your due date, or your membranes have ruptured... are not supported by sound research or are not supported by research at all.
Wimer: But a woman still has a choice as to how she wants to birth, right?
Goer: Yes and no. Women are making choices, and they may even be happy with those choices, but they often are not making informed choices...because they are making them on the basis of no information, inadequate information, or outright misinformation.
There is what I believe to be a corruption of evidence-based care. You will see, published in very prestigious journals, studies that are incredibly flawed...flawed to the extent that it’s difficult for me to believe that nobody noticed. They are essentially propaganda, not research.
Also, women have bought into this culture as deeply as their obstetricians have. The philosophical underpinning to obstetrics is that birth is a difficult, dangerous business. Women believe this right along with their doctors.
And, there’s a more disturbing trend, where women are being coerced into agreeing to interventions. Women are so vulnerable (during childbirth). If you could convince a woman that you needed to cut off her arm to save her baby...most women would hold their arms out and say, “How high?”
Wimer: Since you first wrote your books, has the situation gotten better or worse for pregnant women?
Goer: One thing that has gotten worse is VBAC (vaginal birth after cesarean) denial. It has become acceptable to tell a woman that she has to agree to major surgery in order to get medical care. That’s actually a human-rights violation. The fact that that is commonly accepted has changed in a very fundamental way on an unconscious level how we think of the rights of women once they become pregnant.
Wimer: Last question: If you were to meet a pregnant woman and had one minute to tell her something, what would it be? (Other than: “Read my books.”)
Goer: Find out your caregiver’s cesarean rate because that’s the tip of the iceberg. If it’s an OB, it should not be more than 15%. Research consistently shows cesarean rates can safely be 15% or less. Yet, you’ll rarely find an OB who’s rate is in that range.
Think of it this way: The cesarean rate is over 25%. If you knew that your car mechanic recommended an extremely expensive repair that had the potential for damaging the engine for one out of every four cars that came in for routine maintenance...would you stay with that car mechanic?
About Henci Goer:
Read about this amazing author and her works here: www.hencigoer.com
This article appeared in Pathways to Family Wellness magazine, Issue #11.
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