Monday, 1 May 2017

Why the Words "Low" and "High" Should Not be Used by Your Doctor

 Ina May's Guide to Childbirth
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It often happens like this. At a routine doctor's visit you're told . . .
  • your heart rate . . .
  • your baby's heart rate . . .
  • the amniotic fluid . . .  
  • the baby's weight . . . 
  • your blood pressure . . .
is too low / too high so we need to do . . .
  • an induction.
  • an (emergency) C-section.
  • more tests. 
More often than not it's accompanies by fear and guilt techniques such as if you don't do this your baby could have serious long-term problems or even death. This is absolutely horrible and bullies parents into making decisions when they have not received complete informed consent. When you're told this by your doctor, you blindly do what they tell you. Granted there are situations that do merit immediate care. However, usually things are normal. 

Another example
Let's step away from doctors and get a different perspective. Imagine you want to find out the weather forecast for the next week and all that you can see is the date and "hot" or "cold". That's it. No temperatures. That's not very helpful, is it?

That's precisely what doctors are doing when they tell you your numbers or your baby's numbers are "low" or "high". They're not giving you the complete picture, so how exactly can you make an informed decision when you're missing the vital information?

Here's what you need to do
Always, always, ask for numbers. "Low" and "high" are subjective. Numbers are concrete and objective. Only then, can you make an informed decision. Let's look at two different situations. You need two numbers:
  • what the normal range is
  • what your number is.
Situation A
You go in for a routine visit and are told your X is low. You ask for numbers and are told that the normal range is 100-120 and you are at 98. You're 2 numbers away from being within the normal range. You now know the complete picture and can decide what to do. That might be to follow the doctor's advice, ask for re-testing, check and see what can cause low numbers and try to fix it and then re-test. 2 numbers isn't that drastic and remember that there is room for error in all tests.

Situation B
You go in for a routine visit and are told your X is low. You ask for numbers and are told that the normal range is 100-120 and you are at 50. Now this situation is very different than Situation A. Here you are 50 numbers away from being within the normal range. Knowing this you will probably make a very different decision that what you would make in Situation A.

Conclusion
Doctors do tend to have your best interests and the baby's best interest in mind. However, there are also many other things that come into play.
  • They're following hospital policies.
  • They actively manage births instead of using expectant management.
  • They want to go home because it's Friday / they have plans the next day.
  • They're afraid of being sued.
The bottom line is that it's ultimately up to you to get the complete picture and make a decision based on concrete, objective numbers not abstract, subjective adjectives.

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