To be concerned at the number of people on MN second guessing doctors?

[Wolfgirrl]

Every day I read a new thread where the poster is canvassing opinion on whether to reject medical advice.

The most common seem to be wanting to refuse a caesarean/induction and not wanting to top up fail to thrive babies with formula.

I totally agree that everyone has the right to refuse medical treatment etc, but when it relates to a baby you're not just putting yourself at risk. It just seems selfish to me? Interested to hear other's opinions.

I dunno. I know two people in the same family (5 years apart), who were both told by the same gp that their pain was psychosomatic and wouldn't investigate or treat. The first time, it was a stomach ulcer - it burned right through and required lots of surgery. The second time was her mum: also turned out to be a large stomach ulcer... happily, as it was the same GP as before, they demanded a different one and a new opinion and were swiftly treated for their very definitely existing medical problem.

I've also got a friend who was dismissed by her GP for months, also told psychosomatic. It wasn't, it was a rare condition causing hemorrhaging in her lungs. She was told this despite coughing up huge amounts of red blood, enough to soak a pillow. She was in hospital for over a month after collapsing in the street on the way to work as she couldn't get a sick note.

Another friend who had swabs left in after major surgery. No one believed her something was very wrong. She was treated incredibly badly and given a payout in the end and a huge apology.

My own mother had a Dr start to cut out a chunk of her arm after a confusion about whether she'd had a local anaesthetic or not. The fucker finished doing it, because 'your methadone is pain relief anyway'. Err, NO! He should have been struck off imo, but my mum has a pathological hatred of making complaints, so didn't, other than to him.

So no. No great faith in medical staff. Some certainly, but not unquestioning. Perhaps the NHS is better in your area?

I refused an induction at 41 weeks. Except I wasn't 41 weeks as they had my dates wrong. They agreed they had my dates wrong but refused to change it because of 'policy'.

Consultant told my DH that "he wouldn't allow his wife to make that decision". I would have agreed to a section if they felt DS was in danger but they didn't think it was urgent enough for a section. So I refused an induction.

DS arrived at 42 weeks (their dates) at 5lbs 15oz so hardly overcooked!

I actually think there is too much support for breastfeeding

That's an interesting comment from OP

I'd expect it from a formula manufacturer

Uk breastfeeding stats look at both exclusive and any breastfeeding rates, so that is a bit of a myth. We have poor rates either way. Initiation is similar, continuation is poor. And generally mothers feel unhappy about it, which is what I'm more bothered by tbh.

The kind of "too much support" people complain about is generally pressure or promotion rather than support. Support helps you to make informed choices, considering the fact that feeding decisions are complex and not made in a vacuum, doesn't just keep explaining that one option is best while not actually helping it to happen!

@jamieleecurtains

I know it sounds troll-y but I really do. Women have never had so many sources of help as they do now - midwives, health visitors, breastfeeding peer support workers, lactation consultants, breastfeeding groups, La Leche League, the Breastfeeding Foundation, websites such as Kellymom (and thousands more), books, forum websites such as MN and others, youtube tutorials...

Okay you can turn around and say 'well it didnt work for me for x or y reason' but obviously not everyone will have success, or exactly what they want exactly when they need it. But there are many sources of information.

Personally I think it is all a bit too much, a bit too pressurised.

But that's by the by - my question wasn't about GPs. And in most cases I agree you know your own body best. I'm just surprised that pregnant women or mums will put their own judgement before that of the professionals, I will always choose the smallest risk to the baby even if the difference is tiny. I just assumed most people would think like that but obviously not.

The professionals you speak of failed to spot a complication with my last pregnancy causing my son to die before birth at 42 weeks. I don’t hold them in contempt but had I listened to my instinct my son would have turned 1yo last month.

My twins were born 2.5 years ago and again, the professionals failed to notice they were failing to thrive in womb, but those same professionals saved their lives and they are healthy and thriving.

Everybody can miss something or dismiss it. Six years ago I lost a good friend to breast cancer, she had already fought it off once... her doctor convinced her the symptoms she was experiencing were psychosomatic (anxiety induced)... by the time she sought a second opinion she was already terminal.

I am happy to see people asking for collective advice (on non-urgent issues, in those cases I think ‘the fuck are you doing here - call a professional ).

You would have to have lived on a desert island for the last few years to have missed the fact that obstetrics is ruled as much by culture as it is by evidence.

As pp mentioned - a case in point is the relentless pushing of VB even when the mother prefers CS and is planning a small family. The evidence shows the risk profiles are similar in magnitude though different in detail (actually a first CS is a bit safer for first baby, though raises risks for any subsequent children). So why the pushing of VB other than for cultural reasons/prejudice/PR for the hospital?

In that scenario I absolutely understand why women don’t take the Obstetrician’s recommendations, given they appear often to be driven with the hospital’s CS stats in mind, rather than for the benefit or choice of the mother.

Similarly, the pushing of induction at 41 weeks. Yes the stats show increase risk of stillbirth, and personally I wouldn’t risk going over. But I absolutely understand those who point out the absolute risk is still very small. Also, to push induction with all its risks over a CS seems odd and culturally, rather than evidentially driven.

Like pp’s I agree doctors are human and make mistakes. And may make a difference decision based on risk than the patient. The patient is the only one who can weigh up all the risks in the context of their own life.

I think this is ridiculous BTW and probably the most likely reason why the UK has such a massive drop off of breastfeeding after the first few days/weeks.

Funnily enough, I found it was my Swedish friends and relatives who were a lot more relaxed about giving the occasional bottle, whereas English friends and some health care staff seemed to think that the first bottle would more or less spell the end of breastfeeding.

Risks of induction include higher likelihood of assisted delivery or of emergency c-section, both with their own risks/side effects. Low heart rate for baby, increased bleeding after delivery, infections,

It can lead to a longer, more painful, more traumatic birth for the mother and baby, and traumatic births can lead to PPD, poor bonding with baby etc. It’s a lot more nuance than the 1% risk of stillbirth that increases past 41 weeks.

Also a baby which hasn’t naturally sent it’s mother into labour isn’t ready. When a baby’s lungs are fully developed, it released a hormone which trigger labour. Babies who’ve been induced have more risk of needing intensive care as they aren’t always ready to be born.

I'm no expert in obstetrics but it seems like they recommend induction at the slightest thing these days. I know a lot of people who ended up being induced and some with hideous birth experiences for what seemed like very low risk situations. Are the doctors getting more risk averse?

When I was pregnant I found the attitude of some of the groups I was part of (non medical) were hugely irresponsible.

Antenatal class leaders attitude was basically, refuse all intervention, it will ruin your birth experience. (I’d rather have my baby alive than some bizarre notion of a “birth experience” thanks)

Support group for a condition I developed in pregnancy’s approach was, don’t listen to the specialist midwife for your condition, she doesn’t REALLY know what she’s talking about, do what WE tell you instead (a group of unqualified volunteers who’s only experience was that they’d had the same condition in pregnancy) to be fair they had some good advice but I hated the attitude that the medical professionals must be wrong, ironically it was the specialist midwife that sent me in their direction!

It’s just an extension of the whole “your bubba your rulez Hun” thing.

I think they are more risk averse but I think of that as a good thing.

And let's face it whatever method, birth has its risk and can be pretty horrendous!

I agree @Skigal86

I feel women sometimes make choices based on their 'experience' but justify it by wheeling out facts they found on the internet.

It just seems irresponsible.

Your bubba your rulez hun

I think you're spot on with that.

Thanks for starting this thread OP, it's interesting reading the responses, I didn't realise there was so much mistrust for medical professionals

I think they need to let the patient weigh up the different risks for themselves. My own induction was appropriate given the situation but some seem more like its done for the doctors benefit because they don't want even a 1% risk.

In any case there are clearly a lot of trust issues between the women and the HCPs responsible for their care.

The rush to recommend top ups seems like they just want a quick fix over what's right in the long term. Also given that it's the NHS that give the heavy handed no formula message in the first place it's no wonder some mums are confused as to why they are then so quick to recommend it.

I was constantly told I would have to be induced during pregnancy due to having a baby measuring slightly larger (on track for 9lbs full term). This is a contradiction to NICE guidelines as I had other wise (at that point) a normal pregnancy, and there is no evidence that big baby means difficult delivery just as many little babies get stuck. I was so scared of induction because of the horror stories you read.

I actually did end up being induced at 38 weeks as I swelled like a balloon. My birth was wonderful, no instrumental delivery and no lasting damage. Also my baby was not big in the slightest, she was under 7lbs and the dr said she would have been unlikely to get to 9lbs even if I went overdue.

I was so put off by induction but when the risk to me and her got scary i was more than happy to take their lead!

I think occassionally women so badly want their ideal birth plan that they tune out to other advice. I have a friend who was determined not to be induced (even at almost 42 weeks she was resisting strongly). Tragically her baby was stillborn at 42+1 ...

Having said that, as others have said, doctors don't know everything and get things wrong. A few months ago I saw a staggeringly incompetent neurosurgeon last year who wasn't sure how to interpret my MRI scan and suggested I come back in a week for a CT. I was very unhappy and had to fight to be admitted to hospital that night...and had life-saving brain surgery a few hours later!

Also I don't think 9lbs is a big baby but they kept telling me it was!

I think your own gut instinct needs to be taken into account too though

My newborn baby was in hospital last week, they said he had Bronchiolitis. I wasn't convinced. They discharged him and 2 days later he had got so bad, he was in PICU with sepsis. We are still in hospital now and I know my initial gut feeling was right.

I had the opposite, I should have had intervention earlier when I was giving birth, by the time I was blue lighted to hospital (I was at a standalone birthing centre) is was touch and go whether either both of us or one of us would survive. Thankfully we did, at the debrief the midwife said they had a lot of complaints from women about interventions, so she didn't know whether she should call for assistance . I would rather have been offered it and had the chance to decide knowing the benefits and the risks to be honest.

You said yourself that you assume everyone would make the same choices about risk - doctors assume that too, but it's just not true.

In my first pregnancy, I wasnt concerned about risk to myself, I chose the options with lowest risk to the baby. Now that I have a child and am pregnant with my second, I am less tolerant of risk to myself because that is in itself a risk to my first child. Some women will be more able to accept the risk of birth injury, eg severe tears which impact on quality of life but don't impact fertility vs others who can't cope with the idea of birth injury, but can cope with the idea of a hysterectomy in the extreme risk scenario of a c section.

Obstetricians also see a far higher than representative proportion of extreme scenarios. They are not well placed to judge risk, even though (and because) they are the experts. You can hear this in how they talk - "risk of stillbirth is doubled" pushes women to a different decision than "risk of stillbirth is increased from 0.25% to 0.5%".

I'm just surprised that pregnant women or mums will put their own judgement before that of the professionals

I used to think like this. Until I started doing a job that brought me into contact with medical professionals.

I don't trust doctors where I am. My experiences have been harrowing.

Nurse mixed up all patients prescriptions on ward.
Doctor gave me clean bill of health (whilst pregnant) but I still had a raging infection.
A call out doctor told me to stop being lazy and walk around to get rid of the pain (shortly after discovered to be from an enormous abscess inside c-section wound)
Midwife & hospital & doctor gave me a clean bill of health but it was wrong because first person made a mistake and no one checked it until months later, DS and I are very lucky to be here (sadly his older brother isn't)
Doctor woke up a woman on ward, told her that she has extreme preeclampsia and has to have emergency delivery....it was the wrong woman
I was advised formula top ups on ward, it made BF difficult but not impossible, midwife even said at the time it was to get us out of hospital sooner.
I've been ignored when asking for pain relief during minor procedures, there were incisions made...
I could go on. Doctors are not infallible, and in some instances I now second guess/ask for a second opinion.

I think it’s important to question advice, diagnosis, treatment because some doctors are poor diagnosticians. They are also under pain of death (being struck off) for not following precise guidelines even if that is to the detriment of their patients . Treatment can be based on old and increasingly ill-founded science (urinary tract infections being one in particular) and can result in years of suffering and invasive and unbeneficial procedures, inappropriate drugs and advice.

I’m 60 and nearly died and lost my baby due to failure to manage high blood pressure. My DMs throat cancer was missed , the wrong surgery for her carried out and she died years later in a dreadful state. My DD lost a baby at 32 weeks - systemic failure in processing a critical blood test delayed her treatment for over 2 weeks.

Doctors can give dreadful advice, guidelines can be inflexible with catastrophic results. In some situations we must question and hold doctors accountable as to what they are proposing and on what basis.

When it comes to giving birth listening to medical advice nearly killed me with my DC. Antenatal, birthing and postnatal care is woefully bad the world over, tonnes of evidence shows that consistently in the U.K. alone:

1. Women aren't listened to or believed about their pain and instincts
2. Women are pressured to make a speedier recovery than is necessary
3. Pain relief is withheld both for labouring women and women recovering from a c-section
4. It's not uncommon for women to be shouted at when in excruciating pain
5. Postnatal Care, including breastfeeding advice and comfort on the postnatal wards, is completely lacking - how many threads do we see about a vulnerable woman who's just given birth and a great big snoring beast of a man is watching sports at 2am next to her because he's the other woman's husband and gets to stay. Midwives don't tell visitors to STFU. They do not put mothers first.

When the NHS proves it can treat pregnant women and new mothers adequately then I think it's fair to say they should be listened to. Until then, we rely heavily on our instincts to make sure we don't end up dead, traumatised or in tremendous pain