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Making Your Family’s Medical Decisions: Social and Emotional Costs

By Lauren McClain

When I was planning my first home birth, I realized that if–heaven forbid–the worst happened, people would blame me. Anything bad that occurs at a home birth is assumed to be a factor of its unconventional location.

If the same outcome occurred at a hospital I knew people would pity and comfort me. After all, I would have followed the standard path—what most people consider to be ‘the right choice’ and the safest choice. In choosing a home birth, I made a socially risky decision.

If you have a hospital birth that goes all wrong, no one blames you for what the doctors did to cause or exacerbate your problems. There is risk at a hospital, too. But there is not social risk. We do not punish each other for choosing the well-trodden path.

Let’s say your toddler has an ear infection. You take her to the doctor who recommends antibiotics. You learn about viral ear infections and antibiotic resistance and decide to see how her body fights it on her own. If your child gets over it in a few days, it’s billed socially (and probably by your doctor) as happenstance. If she gets sicker, people think, “What’s wrong with you!? You’re taking risks and making your child suffer!”

Imagine your toddler gets better with antibiotics but then gets another ear infection, and then another, and so on until she’s miserable, taking mega-strength antibiotics and having surgery. To the people and professionals around you, this is just how children are sometimes, and they will say, “You did the right thing.”

The right thing is what everyone wants you to do. The right thing is the most socially normal thing. In medicine, the right thing is to do what you are told.

Let’s say you have a preemie and want to hold her, even though the hospital’s standard of care is for her to stay in an incubator. You did some research and feel strongly that it’s better for her if you hold her. You know other hospitals do it, but you’re strongly discouraged from holding your baby.

If you decide to hold your baby and the outcome is positive, you are considered lucky…happenstance. If the outcome is negative, you are considered stupid and selfish, a bad parent. Even if the outcome can’t be directly tied to your skin-to-skin time, it will always be assumed that the bad thing happened because you took the path less traveled by. This is the challenge of making your own medical decisions.

You know what I love? Not being responsible if something goes wrong. I don’t want anyone looking at me, especially myself. I don’t want to reflect on my choices and feel regret. Who does?

Making unpopular or unusual medical choices is risky. Often it’s more socially risky than medically risky. I understand wanting to off-load the responsibility. At some point, in life and during labor, we just need someone to take care of us. These people have studied and practiced their field for years, so we let them make the decisions for us. We trust.

There’s nothing wrong with that. That’s what they’re here for. But it really underscores the importance of having a provider that you trust, doesn’t it? I tell my birth classes that the best thing they can do for their birth is to have a doctor or midwife that they deeply trust. They have professional knowledge and at some point, you’re going to want things to just be taken care of.

Back when I chose my home birth midwife for a VBAC, I chose her in part because if that woman told me I needed to go to the hospital or have a cesarean, I would believe her. I’d have no regrets and no problem going.

I would love to find an OB, a family doctor or a pediatrician that I felt this way about. I’d pay double.

I don’t know much about most medical fields, but if they are anything like the field of obstetrics, they deserve to be second guessed. There’s risk in falling into mainstream care. Any good doctor will tell you to get a second opinion.

It would be nice if I didn’t have to know anything and just let professionals take on the responsibility for my family’s care. If something goes poorly, it’s not my fault! But it’s even nicer to have choices and involvement in my own and my children’s medical care. I’ll take the responsibility.

Here’s why: No matter what happens, no matter the outcome, I have to take it home. The doctor or midwife or scientist may feel heavy or sad about it for a while, but it won’t last, and they can’t help me cope.

It’s my body, my children, my stewardship, my life. I, personally, will live out the consequences every day.

After talking to professionals and doing my own research, only I have all the information necessary to make the best choice. This doesn’t mean I will, of course, but it’s a risk I am willing to take.

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Lauren is a childbirth educator (Birth Boot Camp) and the author of the Breech Baby Handbook. She owns Better Birth Graphics, a shop full of practical, intuitive birth media for professionals. Her work has been published in Mothering, Holistic Parenting Magazine, Birth Issues, True Birth, Mama Birth, and elsewhere. She lives in Maryland with her family of five.