Thursday, July 14, 2016

That Moment When A Doctor Says He Won’t Refer To Your Childbirth Classes

A childbirth educator receives a phone call from a local physician.  He proceeds to tell her that he no longer will be referring his patients to her childbirth classes (or doula service).  His reasoning is that her clients ask too many questions.  They know the risks and benefits of multiple procedures (such as induction) and often refuse certain procedures (not inappropriate refusals).  This is bothersome to him and keeps him from practicing medicine the way he desires.

Some who read this blog post will say that I am making up the scenario.  Well, unfortunately, I am not.  This event really happened in 2016.

At first glance, this scenario might truly make this childbirth educator/doula question her practice.  She may feel that she is doing something wrong.  She may feel guilty.

But why?

Clearly, the physician in this scenario played all of his cards in one turn.  What did he really say?

He said:

He will no longer refer any of his obstetric patients for childbirth educator or doula care.

It makes the physician uncomfortable that patients who attend this educator’s classes or become her doula clients are exceptionally educated either before or during their time with her.  Yes, patients can learn on their own via books, friends, family, or the internet.  The patients also have a brain that can reason.  If a procedure sounds as if it could interfere with natural hormonal orchestration of childbirth, which can also stimulate hormones essential to bonding and mothering.

Because of this knowledge of evidence-based information, this physician feels threatened and anger.

When they question or appropriately refuse (such as in the case of induction for convenience rather than clinical reason), again, the physician feels threatened and angry.

The fact that patients have evidence-based information and ask questions indicates that the physician is expected to practice according to the evidence.  This may be contrary to the way he has been practicing: the way he was taught or the way he wants to practice, as the latter meets his personal needs.  His needs.

Since the physician is concerned about his own needs being met, the needs of his patients are of no concern to him as long as the outcome of the birth experience is not medical tragic.  What the woman wants and what may actually be best for a truly positive birth outcome is of no interest to this physician.

What is the takeaway from this for the childbirth educator?

  • The quality of education that this person provides is evidence-based, and empowers her clients.
  • Her clients are empowered to own the information.
  • Her clients are acting like consumers and are asking for practices changes that are in alignment with the evidence. 
  • Even though the physician does not refer to her, there are numerous other ways to market the childbirth education classes or doula services. 
  • Clients who want to attend these classes or have these services have the right to change care provider.
  • It is their birth.
  • It is their birth.
  • It is their birth.

This educator/doula should not give up.  She is obviously doing her job very effectively.  Initially there might be some hurt, but after careful consideration, she will find that it is all about the physician and not her.

Additionally, this is one reason why we must, as childbirth educators and doulas, have in our skill set arsenal a strong understanding of marketing and social media.  We may not be able to depend on others to refer clients to us.  We have to let expectant parents know that we are out there!  We must let them know that there is information to be learned, techniques to be mastered and options to be exercised.

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