Friday, December 17, 2010

the mysteries of maternal medicine

alternative title: "The obscurity of obstetrics".

I may have been enjoined not to write much here about our personal experience with the baby doc industrial complex, at least until ours is born, but I can share other people's thoughts.  This post on BoingBoing by a guest blogger captures some of my frustrations (I'm quoting a choice bit, but read the whole post for his context)
Our child birthing class teacher: "Oh only 5% of babies are actually born on their due dates."
Me: So are half born before, half after?
Teacher: "Oh you can't know when the baby is going to come."
Me: I get it. I just want to know the statistics.
Teacher: "The baby will come when it is ready."
I asked on obstetrician.
Doctor: "The due date is just an estimate. There is no way of knowing when the baby will come."
Me: But of your patients, what fraction delivers before and what fraction deliver after the due date?
Doctor: "I try not to think of it that way."

Right.  And so it goes. 


  1. I totally agree -- is there a reason it has to be so gd mysterious? I get it, birth is a beautiful, mystical experience. But I still expect my doctor/medical professional to be as informed and informative as my ENT. Would some numbers kill us?!?

  2. re: "Would some numbers kill us?!?"

    don't forget that seven eight nine.

  3. we had a recent OB visit where the doctor reached up in there to check for cervix dilation (none yet) and then, later that day there was a colored discharge (note to sensitive readers: read a different blog!).

    We have SINCE learned that this is a normal occurrence under the circumstances, but nobody bothered to tells us this before...I imagine that in the way our medical industry actually operates (not should or could operate) that the management of patients' expectations is a big part of a successful doctor/patient relationship.

  4. This is all really awesome. I mean, how could you make that up? A man of science, a doctor, asked about a VERY simple stat that should be of critical importance to his practice... says, "I try not to think of it that way."

    What way???? That "numbers-based" way? That "experience-based" way? That "improve future chances by learning from history" way? Good gravy.

    I know that's what you meant by the "Right. And so it goes." part. Still. I felt like saying more words on the topic.

    I love doctors, they've helped me and my family a LOT over the years. But there are giant areas of competence we assume they possess... that they just don't. And really shouldn't be asked to, I guess. It's a big society, we can specialize, have the docs do the technician work and have other people study the data and see the patterns. No longer does the barber do surgery, right?

  5. @AdanA: I know what you are saying, and I appreciate's in line with what I mean by
    "the way our medical industry actually operates (not should or could operate)".

    In the States we have more or less abdicated our individual responsibility (and rights!) for managing our health care to the technicians...I think of it in terms of a market failure, as well, that there are not more options for home diagnosis (or at least home data gathering) so that when we show up at the doctor's office we could provide them with baseline data.

    Why are there not the equivalents of a McDonald's or UPS Store or 10 minute oil change place for people to go for cheap and superficial "medical" data collection?

    Blood sugar, BMI, blood pressure, bond density, MRI? (some of these may be beyond the scope of storefront testing centers, but let's go with it) - if people wanted to keep an eye on their stats, and had access to these sorts of services, "sick" trips to the doctor could be more efficient and effective. Maybe this should be a separate post...

  6. I think it's definitely worthy of a separate post. I think it's possibly a business model worth mulling, for sure. You could improve people's lives while also making some cheddar.

    Mmmm. Cheddar.