When I first read it, I read it as "we will participate in a Birth Contract...", then I reread it and saw the NOT.

Yes, it is completely misogynistic, I'm assuming a "birth conract" is a type of agreement between the woman and doctors/midwives on how she wants to give birth?

I understand them.

Sometimes clients in my line of work bring people along who thing they know something, but they don´t. But they don´t know that they know. So you have to explain everything twice. It is anoying.

Doulas do not require any training. So the doctor may have to deal with someone as described above. They may have to argue with someone about a medical procedure, decide if they are allowed to act if she says no and so on. This may danger child and women.

Bradley method means no drugs or surgery if not nescessary. So what if something goes wrong and you have to decide right now what to do? If it is against the contract the doctor might want to have a lawyer next to him to decide if he can do what she/he thinks is best for the women and the child or if he upholds the contract and tries something less save.

They only care about unborn babies and not of the mother's well-being. After a baby is born, society turns its face away from the baby and the mother.

Typical.

Unbelievable. This is such an infuriating thing to wake up to.

I've seen the studies showing that doulah are good to have in the case of an uncomplicated pregnancy, but are there any studies about what happens in a high-risk pregnancy or if complications occur?

I don't find this offensive at all. They are protecting themselves from malpractice suits and being visibly upfront about their policies. If a woman does not like their policies then she can find a doctor or midwife that follows the procedures she prefers. I don't like much of the policies and procedures of today's obstetrics, but I would never expect my doctor to go against his/her expertise. There are many patients out there that refuse to follow doctor's recommendations and then are quick to sue and it takes a long time for a doctor to transfer a patient to another healthcare professional.

But nobody is saying "no interventions if it's an emergency", all of the natural/home birth literature I've read has been "no interventions unless it's an emergency". They're basically saying "we're going to give you an epidural, induce your labor, give you an epistomy, artificially break your water, and quite possibly give you an unnecessary C-section, and you can't do a damn thing about it." There's no real evidence that hyper-medicalized birth improves outcomes for mother and baby. But, medicine isn't always based on evidence. It's based on covering your ass.

First off, I'm not familiar with obstetric practices at all (i.e. policies, ethical issues, etc.).

Could you elaborate on how refusing to perform a procedure and offering to transfer a patient equals the "forbidding" and "isolating" you're referring to?

Also, how does not treating a woman equal insisting on access to her vagina? I get the impression these doctors don't even want to see let alone have access to the vaginae of the women in question.

This is absurd. But, I'm glad they're upfront about it, as that means plenty of women simply won't go there. Good - take your births elsewhere, to hospitals/birth centers/etc that deserve the business.

Not that I know for certain but is not Utah like this yank heretic mormon cult zone or something similar?

But should not yanks tolerate even this type of thing. Isn't this kind of like the point of their multiculturalism, that everyone can have the freedom for their own way of doing things in life. No matter matter how stupid and harmful they are. This is the core of american society: Total valueless ignorance! Because real tolerance does not mean blind acceptance of every bizarrity such as this, as if morality did not exist. For the yank it does not, as we know.

My initial reaction is similar to when I see businesses with "no guns allowed" signs on their door. While I disagree with their conclusions, I appreciate them giving me the information I need to take my business elsewhere. At least I won't waste my time interviewing any of your doctors.

I think a lot of you are missing the point. A doctor or other facility has every right to tell their patients that they will not allow a doula, or a particular procedure (although the part about not agreeing to a birthing contract is inane).

It's the wording of the sign that is the problem. I guess maybe some women prefer the Doctor-centered model of health care but I don't.

Are men giving birth at this facility?

I know you are trying to make a little joke, but men can give birth if they are transgender.

My initial reaction is similar to when I see businesses with “no guns allowed” signs on their door.

I don't know where you live, but here in Texas any business which sells alcohol (including convenience stores, grocery stores, and restaurants) are required by law to post that sign.

This is a good illustration of the variation in maternity practice between the USA and the UK. I'm not so sure I agree that it's misogynistic, which implies that doctors in this obstetric firm hate women, but rather that it is paternalist. It implies that these obstetricians always will dictate the management of the mother antenatally in labour, regardless of her opinion.

Such a sign would be unheard of in the United Kingdom, where the involvement of the mother is paramount in her antenatal care.

I fully appreciate that all I can do as a doctor is to provide my patients with the best information they can to make a decision, and that all competent persons have the right to refuse any form of medical treatment. Sure, if I find out that the Bradley Technique is not something I'd agree with, I think it was my responsibility to ensure the patient knew the reasons why I disagreed with it, but I would never refuse them care.

In my opinion, the persistence of the paternalistic attitude of the obstetric practice illustrated in this post serves only to push women who merely want a say in their care towards refusal of obstetric intervention where it is desperately needed. Not all women will have a normal and natural birth, which is partly why the maternal and perinatal mortality in developing nations is so high. Pregnant women need to be fully informed of the choices available and the reasoning behind the management options being put to them.

They're saying they care about the health and welfare of the unborn child, not about the health and welfare of the woman.

Yes, and another thing, let us not pretend that yanks care of children, either.

Guess what is the only country in the whole wide world that has not ratified UNs Child Rights Pact? - UNITED STATES OF AMERICA trash yankeeland. Yanks really hate children, apparently.

I find it puzzling, if these yanks would not want to be deemed as such subhumanoids, why do they act in such subhuman way? I truly must wonder.

I just see it as self-defense against lawsuits.

Too bad the Unconstitutional State-seizure of the medical system will not address that issue... driving more doctors out of business and stressing the ones who remain even more.

I am speechless at how horrid this is. But I agree with the original poster - this attitude is actually nothing new.

In thinking this over I'm so thankful for my own births and the assistance I had (p.s. it was only ASSISTANCE, as my body did the work). I was in a much better place than this office.

I don't think this is anti-woman at all. It's just a practice stating up front what they are willing to work with and what they aren't willing to work with. You've got nine months to decide if that works for you.

One of the best pieces of advice I got was from a friend who is an L&D nurse who said, 'don't get induced, get the epidural and don't do a birth plan as it will fly out the window as soon as you go into labor.' Is she misogynistic? No, she just works helping women everyday and her advice is based on experience. And it was the best advice I got, despite a rather natural birth leaning class I ended up taking.

I came across this on a completely different website and someone chimed in from Provo and said this doctor is, yes, old school, but very skilled and can perform both breech and forceps deliveries, both skills on the wane in favor of c-sections, SO, if the goal is reducing those, this would be your doctor, but if it's adherence to more of an ideology, then, yes, seek service elsewhere.

Feel like Iris Marion Young’s “Pregnant Embodiment: Subjectivity and Alienation” offers a valuable, complementary reading to the sign addressed in this post. The chapter attends to pregnant subjects’ “alienating encounter” with the institutions and practices of medicine: “Medicine’s self-identification as the curing profession encourages others as well as the woman to think of her pregnancy as a condition that deviates from normal health. The control over the knowledge about the pregnancy and birth process that the physician has through instruments, moreover, devalues the privileged relation she has to the fetus and her pregnant body” (p. 47 in the book On Female Body Experience: “Throwing Like a Girl” and Other Essays).

Geez, oh Pete. You femenazis will jusmp at the chance to point out every single time the word WOMAN is omitted in anything! I can't believe you're all actually getting all up in arms about this dumb sign! So it says "patient" instead of 'woman' and you blow your victim horn for everyone to hear! The physicians at this office have EVERY RIGHT to refuse to deliver your baby if they think your birth choices may negatively impact your or your baby's health! So you go in there and say, "Hi. I want minimal prenatal care. I want zero inducement, zero drugs, no epiz, basically no help at all. But I want you to be my doctor." Why in the heck would a doctor want to put their name and reputation and time into dealing with what could be a potentially frustrating or tragic situation?! my advice- EarthMamas- don't get any prenatal care and go have your baby in a bathtub or a field or wherever feels nice to you and shut up about being discriminated against. You're only bringing it on yourselves. These docs said it very plainly in the sign- if you want an unassisted home birth with a doula, then go somewhere else, we don't do that here. They aren't pigs or jerks. They're actually smart. Would you have been happier if the sign said "In order to better serve the wonderful WOMEN at our office, we will no longer be using sterile equipment, any medications, doppler heart machines, ultrasounds, prenatal vitamins, and every WOMAN will leave this office with a cd of earth music for meditation during your home birth, which we will personally oversee at your house. We will give no medical assistance whatsoever, only sit back and watch everything unfold and listen to you dribble on about your connection to the earth and your tingly feelings about carrying a baby and any other emotion you feel you want to talk about. We'll also take full responsibility for any outcome that may arise so that the WOMAN will not have to bear any responsibilty for her choices. Have a nice day."???????

If you don't like it, stop the name calling and go home!

point taken

I don't think that "informed consent" is being used correctly here. The doctors (and you're assuming that they're all male) are required to inform the patients only about the "medical" procedures that they are offering. Have you ever tried getting "holistic" care from any specialist? You can ask and ask, but they tend not to offer suggestions beyond their specific fields.

I can also understand how some doctors would prefer not to work in the delivery room with people who lack formal medical training. I thought that doulahs helped after the baby was born.

The only problem I have is that the woman's preference should be discussed early in obstetrical care; the sign is a crude way of communicating this.

The sign has a typo. It should be "patients'".

OB/GYNs pay the highest (by far) malpractice insurance premiums. When things do not go as the mother planned, she sues. When the doctor must take extraordinary steps to save the mother and/or child, and those actions fall outside of the birth contract; people sue. These doctors are literally covering their bums. While I think it is a sad statement that women have less options, I understand the need to curb malpractice claims as they drive up the cost of care and clinic operation. The best way to circumvent these issues, in my opinion, is not to disallow certain practices, but to have a pre-delivery counseling session that involves birthing options and signing of an informed consent and any necessary waivers to cover the physicians if problems ensue.

The medical system is full of paternalism. There are plenty of people who willing place complete faith in their doctor. Medicine is complicated. You kind of have to put you trust in the expert. But that trust should be limited.

You have to recognize that doctors are human; they make mistakes, and not everything they do is in your best interests. Take c-sections for example. For the doctor, it's quick and easy birth. For the woman, it's fraught with complications - there's always a risk when you cut someone open, and the recovery takes much longer. I'm not saying that c-sections shouldn't be done, merely that they are done when they are not needed.

Doctors are seeing a lot of patients. They're not thinking about your comfort or your emotional needs when your giving birth, even though a situation of high stress can promote complications and difficulties in the birthing process.

An overburdened medical system is resulting in assembly line medicine - treat them like patients, not people, and get them out as soon as possible. If the doctors could put you on a conveyor belt, attach you to machines that would do the job for them, and merely sit behind a window and press buttons, you bet they would.

The result of assembly line medicine is the dehumanization of the patient. Patient has illness. Treat the illness. Send the patient home.

This formula, already problematic, is still more problematic when you take something like pregnancy which is not an illness at all. Pregnancy can come with complications that do require a doctor's presence, but the doctor is not the one giving birth. The pregnant woman is the one who is doing the work. The focus should be ensuring that her working conditions are optimal, not the doctor's. For example, it doesn't make sense for a woman to give birth on her back, because then she's working against gravity, but being on her back gives the doctor better access, so that's the norm.

If I accept (and, having breifly reviewed the easily available research, I accept it without prejudice) that the medical evidence is overwhelmingly supportive of these things, then it's pretty clear: This facility has a questionable philosophy and should not be used by anyone for any reason.

They have chosen to take a philosophical position on healthcare that is contradicted by facts about patient welfare. They "Care about the quality of patients' deliveries" and are "Concerned about the welfare" of teh babbys. They obviously don't want to "Improve the quality of patients' deliveries." or "Maximize the welfare" of the as yet unborn child; they want to control it and provide mediocore care.

I can't fault them morally for that. I fully support the right of doctors to control their practice and what services they are willing to provide, for any reason. However, people have a right to choose doctors who perform the procedures they want. In this case, choose another doctor.

If all of the doctors that you can find refuse the same procedure, then you do not have the right to have a doctor perform that procedure. Their right to control their actions is the controlling factor. Conversely, you have the right to refuse any medical care, including lifesaving care, based on your right to control your own actions.

A few small exceptions are left for such things as discrimination and mentally unsound patients, and the law varies from morality in places, but the Aspen Women’s Center seems to have gotten something right: "We will not provide these services, and this is how you get somewhere that will." Ideally, they should say so in a less "If you ask about this, we will give you to evil, mean strangers who use questioned practices." manner. Or, you know, catch up with current medical research. Because I seriously doubt that there is a real philosophical objection to the practices listed.

When I first read this post I went "Fuck, don't tell me this place is turning all NATURAL BIRTH OR ELSE like Hoyden About Town with its shaming of any woman who doesn't have a dangerous natural birth. So I'm glad to see that Laurelhed is responsible and that there is only one blogger in the Universe that natural birth obsessed and stupid.

I am late to the party, but I could never choose a care provider that lacks basic knowledge of evidence based care. While I do not use the Bradley method, their rate of vaginal birth seems excellent, and to be commended. And the overwhelming evidence on the presence of a doula? Just having one sit in the room lowers the incidence of intervention. So, when I read this sign, I take it to mean "we will manage your birth, and are not interested in ways to help you have the safest birth possible. We would rather just do an emergency section than encourage a birthing mother to have her baby naturally or vaginally." This practice ignores the facts, for whatever misguided reason.

This really really disturbs me. Doctors should not have this kind of control over patients, it's like the Anti-Hippocratic society from the horror film Anatomy.