Help a future OBGYN!

msjananimsjanani Posts: 624Registered Users
Hi guys, I was just poking around on here and wanted to mention how beautiful all your kids and birth stories are!

I'm applying to medical school this spring and I think I want to be an OBGYN, so I thought I'd ask you moms:

What makes a really great OBGYN from a patient perspective to you guys? I really want to be the best I could possibly be not just from the strictly "medical" side of things but in terms of bedside manner, putting women at ease, etc.

All the best! :toothy7:
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Comments

  • jcejce Posts: 512Registered Users Curl Connoisseur
    Please treat us like we have some common sense until you learn otherwise. I realize that there are some women who haven't a clue about pregnancy or health issues, but a lot of us do. If we say we're concerned about something, take the time to talk to us. If we say we want natural labor, few interventions, etc. be supportive. If we say we don't want to take certain tests, etc., don't push it unless it really is a life threatening situation.

    The biggest complaint I have had is that most doctors seem to have a one-size fits all approach to pregnancy. I'm considered high risk just because of my age. I am relatively healthy, didn't smoke, eat fairly well, had a fairly easy first pregnancy, but all but one of the practitioners in the group I see keep questioning me about my decision to not have all sorts of testing. When I said I didn't want an amnio (for the 3rd time), the doctor started in with the risks for people my age and why I should get one, yada, yada, yada. I interrupted him to say, "But, aren't there risks with having an amnio as well?" "Well, yes, there are."

    I had done my research, knew what the risks were, and made my decision. He wasn't the first to ask me, so it should have been in my chart. If the doc would just take a few minutes to look at the chart and make the patient more involved instead of just treating them all the same, I would like that better.

    The person I like seeing best at the practice is the nurse-midwife. Her approach is just different. I don't feel like I'm just a number with her. She answers my questions, makes me feel at ease, and is very open to my input. She gives me my options, but hasn't pushed anything on me. And it's not just because she's a woman or has been pregnant herself that I feel more comfortable. The other women/mothers in the practice aren't like she is. I hope she's on call when I go into labor.
    3b/c normally, 3a/b in the winter

  • RedCatWavesRedCatWaves Posts: 31,259Registered Users Curl Connoisseur
    What makes a really great OBGYN from a patient perspective to you guys? I really want to be the best I could possibly be not just from the strictly "medical" side of things but in terms of bedside manner, putting women at ease, etc.


    A really great OB-gyn puts women first, before their own malpractice premiums. A really great OB-gyn practices evidence-based medicine, not just what the other OB-gyn's in town practice.

    Don't treat us like we're stupid. We're not. Don't withhold information from us. Don't lie to us...that'll be a tough one for you once you're in practice, because lying is deeply embedded in the OB industry.
  • geekygeeky Posts: 4,995Registered Users
    As an OBGYN you may deliver hundreds and thousands of babies so each one may be no big deal to you. But remember that for the parents this delivery is one of only a couple (possibly the first/only) so it is very important and special.
    Allow your patients the opportunity to make truly informed decisions. Give them all the info based on research and evidence and then let them make their decision. Respect that decision even if you don't necessarily agree with it, remember it's not your body or your baby.
    Don't bully, belittle, pressure or use scare tactics. Everyone wants to go home with a healthy baby bit that is not the only thing that matters. Labor and delivery are a very vulnerable time in a woman's life, probably the most vulnerable. If she is treated with respect and dignity she will remember it. If she is treated as only a medical condition or an idiot and not respected, she will feel violated.
    You go to medical school and learn about all sorts of problems and how to solve them. Great. But for the most part pregnancy, birth and labor are normal processes that work (otherwise our species would not exist today), so don't let your knowledge of pathology color your view of normal processes - let them proceed normally and step in only if there is a problem.
    To Trenell, MizKerri and geeky:
    I pray none of you ever has to live in a communist state.

    Geeky is my hero. She's the true badass. The badass who doesn't even need to be a badass. There aren't enough O's in cool to describe her.
  • iris427iris427 Posts: 6,002Registered Users
    What everyone else said.

    Learn to listen to the actual words you are saying. Don't put the blame on a patient when something goes wrong--for example, we've given you six hours and you're not dilating so I don't have a choice but to do a c-section. Or, I can't get this needle in, you have bad veins. Or you failed your glucose test. See what I mean? Try to reword those so they don't subtly put the blame on the patient. Things aren't progressing as much as we had hoped. I'm having trouble with this needle. The test results came back positive for gestational diabetes. Another thing is you don't deliver the baby. The mother does. You catch the baby.

    Remember that medical ethics and the law require you to tell a patient all the potential risks and side effects of everything you do. I have seen so many doctors and nurses not follow the ethics of informed consent and it makes me furious.

    Don't just assume that because every OB in America does X that it is scientifically proven and safe. There is no evidence that routine continuous fetal monitoring improves the outcome but nearly every hospital in America does it. OBs across the country use Cytotec to induce labor yet not one clinical trial has ever shown that to be safe.

    Don't belittle a patient just because they may have a different view of childbirth than you. For example, a doctor who tells a patient it's good she doesn't have a birth plan because the women with birth plans always seem to be the ones that end up with c-sections. Or the ones who laugh at women when they bring up natural childbirth.

    Remember that your patient is an active partner in her care, not your underling. She is paying you. And she has knowledge about her body that you will never have because she is living in it, so don't discount what she says just because she didn't go to medical school. She has the right to direct her own care, to question you and to say yes or no as she sees fit.

    Remember that childbirth is a natural bodily process, not something pathological. The more you intervene when it's not necessary, the more risk you introduce to the health of this woman and her baby. Women have been giving birth to babies in all different ways, without OBs, for all of human history--there is no one right way to have a child.

    Remember that the US has one of the worst infant mortality rates in the developed world. 41 other countries have better rates than we do. American babies are dying more than babies in 41 other countries, suggesting those deaths could be prevented. So our OB care isn't all that great in comparison. Remember that when you have a patient who wants to go natural or doesn't automatically want to do whatever you say. There's a reason many of us question the American model of maternity care and we're not just crazy. There are statistics and scientific evidence to back us up.

    Question things. Why is it that 30% of all births now in this country are by C-section? Isn't that high, even including elective cesareans? If so many babies could not be born vaginally, our species would have died out long ago. Why are there so many supposed cases of labor not progressing or babies that are too big to fit through their mother's pelvis? Again, if that were really the case, there would be no humans. Why do so many women get induced these days? Again, if that many women could not go into labor on their own--you guess it, no human species. It's so easy to just turn to technology and medicine when things don't go right, but question it before you do, because inductions and c-sections carry risk.

    Don't discount the value of things that aren't a new drug or machine. Doulas are a great tool in labor and have proven medical benefits, yet hospitals and doctors discount or even discourage them because they are people and not some shiny new technology.
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  • webjockeywebjockey Posts: 2,786Registered Users
    Don't treat husbands/male partners like sperm donors. Involve them in the process unless instructed otherwise. One of my pet peeves was that the medical folks would only look at me, or talk to me, like my husband wasn't even in the room.


    With the way things are going in the medical community, I'm too scared to give birth in a hospital. I know this is a long shot, but it would be nice if OBGYN's would do deliveries at homes.
    hello.world.
  • geminigemini Posts: 3,325Registered Users
    All women:

    We're not stupid, don't treat us as such

    Try not to have us waiting for too long, especially if we have to sit in those paper gowns in a cold office!

    Regarding pregnant women (and obviously this stems from my individual experience):

    Treat us like we know our bodies--before you ask for the last menstrual period, ask if we know when we conceived.

    Make internal exams optional and make women (esp. new moms to be) understand that they can refuse this if they need to

    Avoid intervention--don't scare people into induction if the baby's at 41 weeks. It's not necessary and the more you mess with nature, the less likely things will progress naturally.

    Don't give statistics on how inductions only slightly raise the risk of c-sections or how pitocin induced contractions aren't worse than natural ones. That's all BS.

    Don't starve us when we're at the hospital because the staff doesn't want to clean up poop/puke while we're in labor. How would you like to go two days on ice chips? Try it sometime.

    Avoid using the fetal monitors

    Let moms to be walk and move around while they are in labor, don't keep them bedridden.

    If you pump us full of fluid, state that it is normal to go home and be at pre-pregnancy weight or more and that the swelling will go down as the fluid leaves the system. Don't make me leave the house for an appointment because I didn't know this.

    Treat delivery as a natural event FIRST, not as a medical procedure.
  • Brown_Eyed_GirlBrown_Eyed_Girl Posts: 1,353Registered Users Curl Neophyte
    What everyone else said. Also,
    iris427 wrote: »
    Don't belittle a patient just because they may have a different view of childbirth than you. For example, a doctor who tells a patient it's good she doesn't have a birth plan because the women with birth plans always seem to be the ones that end up with c-sections. Or the ones who laugh at women when they bring up natural childbirth.

    This is why I left my OB/GYN for a midwife. (The OB/GYN didn't laugh at me. In fact, I never even saw her smile once.) She was condescending toward me when I asked about natural childbirth.

    I grew up seeing a family doctor with a WONDERFUL bedside manner, and that is how I measure the care I receive from others now. When he first walks in the room, he asks how I'm doing, and he doesn't mean medically, he means life in general.

    Then we get down to whatever the medical issue is. He is willing to answer any number of questions, even down to drawing a little diagram one time of heart rates to explain something to me. He is never hurried and never panics about anything. (My dad saw him for a cut cornea a long time ago, and even though we found out later the dr had never seen a cornea injured that badly, the dr never flinched or batted an eye while first examining him.)

    All that is to say, when I met my midwife, not only did I agree with her view of childbirth, but her manner was very similar to my family doctor.
  • Brown_Eyed_GirlBrown_Eyed_Girl Posts: 1,353Registered Users Curl Neophyte
    gemini wrote: »
    Treat us like we know our bodies--before you ask for the last menstrual period, ask if we know when we conceived.

    ITA. No one cared that I was charting and knew that I ovulated at 3 weeks, not 2. To me, that means my due date is a week early. It makes me wonder how many women are induced too early because they aren't really at 38 weeks.
  • cajuncurlscajuncurls Posts: 270Registered Users
    Just show up at the hospital. For all three of my daughters' births, no doctor. Just a nurse saying "Hold on until the dr. gets here."
    No. I'm not holding on. There's a head ramming against my pelvic bone and I'm letting it come out.

    Another thing - when I say "I'm fully dilated and the baby's coming out," don't say "No, honey, I just checked you and it's not time." A lot can happen in a few minutes, and believe me, we know when it's time! Who's on this bed???
    Did you do it for love? Did you do it for money? Did you do it for spite? Did you think you had to, honey?
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  • rainshowerrainshower Posts: 4,420Registered Users
    msjanani wrote: »
    Hi guys, I was just poking around on here and wanted to mention how beautiful all your kids and birth stories are!

    I'm applying to medical school this spring and I think I want to be an OBGYN, so I thought I'd ask you moms:

    What makes a really great OBGYN from a patient perspective to you guys? I really want to be the best I could possibly be not just from the strictly "medical" side of things but in terms of bedside manner, putting women at ease, etc.

    All the best! :toothy7:

    develop a reliable intuition about patients. not all patients will require the same level of interaction and feedback from you. this will be useful for you to know so that you won't come across as condescending, detached, uncaring, or uninformative to your patients.

    some of your patients won't have family support or a good relationship with their child's father. you may want to be in tuned to those women and gauge who would be receptive to you lending a shoulder, or letting them vent or share anxieties or worries. you may find that you are the only person that some of your future patients can get warmth and understanding from.

    create various birth plans for your patients' consideration so that they can feel in charge of their delivery and can have it carried out to their specifications as much as possible. you'll want to discuss birth plans during their initial consultation with you, and periodically check the status of their birth plan throughout their pregnancy so that your records and what they file with the hospital will be up to date.

    if you are one of a team of doctors, let the patients know the importance of seeing all of the doctors during the duration of their pregnancies so that no matter who is on call at the time of their delivery, they will have developed some familiarity with all the doctors to ensure a level of comfort with whoever will be delivering their babies.
    "Dogs stink too, but I like dog stink." ~ rileyb
  • wavezncurlzwavezncurlz Posts: 1,814Registered Users
    cajuncurls wrote: »
    Just show up at the hospital. For all three of my daughters' births, no doctor. Just a nurse saying "Hold on until the dr. gets here."
    No. I'm not holding on. There's a head ramming against my pelvic bone and I'm letting it come out.

    Another thing - when I say "I'm fully dilated and the baby's coming out," don't say "No, honey, I just checked you and it's not time." A lot can happen in a few minutes, and believe me, we know when it's time! Who's on this bed???



    yessss DO NOT DISMISS me!
    also I agree with all the comments about inductions and c-sections - too many are done and it cannot be the best option for all these women.
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  • msjananimsjanani Posts: 624Registered Users
    Thank you all so much for your advice and guidance. I know I'll always try to keep it in mind for the future.
    3A low/medium porosity, medium texture

    Current products:
    Stylers: HE Tousle Me Softly, Condition 3-in-1 Mousse
    Conditioners: Terax Crema, Mill Creek Botanicals Henna Conditioner
    Cleanser: DevaCurl NoPoo

    http://www.flickr.com/photos/theevolutionofcurl/
  • iris427iris427 Posts: 6,002Registered Users
    Good luck msjanani
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