Sunday, January 6, 2008

Dr. Grant's Gift to Women

I ended up at NYU hospital a few months ago after we had to transport a mama (possible placenta separation which turned out to be fine once we got there... still, better safe than sorry).
She was totally committed to continuing laboring as home birth-like as possible, so we had sort of set up shop in the L&D room. We had our oils and birth ball out and my co-partera was doing some EFT. The nurses were surprisingly great and everything was moving along as smoothly as possible (of course mama was still hooked up to all sorts of machines), when this guy walks in.

He walks past everyone in the room and comes up to mama mid contraction and says with a huge grin on his face "Hi, I am Dr. Grant and I am the Director of Obstetric Anesthesia here. Tell me something, do you find labor painful?"

Mama breathes through her contraction and then looks up at him and nods.
Dr. Grant then begins to push the epidural like a high class drug dealer. I have never seen such a hard sell. "Look, you wouldn't have an appendectomy without anesthesia would you? Why would you suffer like this? My wife had an epidural from the first pain she felt and we have three wonderful children, all c- sections, all healthy!"

After his long winded pitch and still no candy takers, Dr. Grant pulls out the big guns.
"Look" he says "have you read my book? You never heard of it? It's called Enjoy Your Labor!"
He moves quickly out of the room and returns with two signed copies of a shiny book with the image of a pregnant belly with sunglasses balanced on the front; no doubt intended to conjure up feelings of lazing on the beach with a margarita.

The proselytizing did not stop.
It was as if Dr. Grant believed he had found Gods gift to women and it was his duty to spread the word. To share the gift. It had similar feeling to those moments when well intended born agains have tried to save my soul. After several unsuccessful attempts, Dr. Grant shook his head and stated that some women just feel they need to be a martyr and left the room.

At some point, I opened the book.
Here are a few choice excerpts found on his website:



A sure way for women to expericence painless childbirth


I did not read much more. Only to the point when he says that he believes the C-section rate should be higher than one in three because it is so safe.

I have read plenty of natural birth advocacy books, and believe me, I know many are every bit as slanted towards the positives of the midwifery model of care as this book is slanted towards complete interventionist and technocratic model- however, this book just infuriates me.
It is an abuse of power and obstetrics to be so medically one sided and opinionated. It is his job to inform the patient of the risks and benefits of the procedure, not sell it like a used car.

Dr Grant, who are you to decide what importance the labor process may or may not have on a woman's experience of transition into motherhood.
And honestly, comparing childbirth to an appendicitis? What? An appendicitis is an emergency surgery. Nobody is suggesting women go into c-sections without anesthesia. But the correlation between natural childbirth and men having an organ cut out of them is beyond ludicrous.
Stating that women will be able to push more effectively with an epidural because they will have better control? Excuse me, when is total numbness a better source of control than being able to move and feel your own legs? And Dr. Grant, the medical evidence on this one is not on your side. Most studies show that women with epidurals take significantly longer to push their babies out, often leading to increased fetal distress, forceps, episiotiomy and c-sections. There is no evidence that suggests epidurals help the pushing process in any way. You just can't find it.

And lastly, on his website under 'book reviews' you have a bunch of moms exclaiming the wonders of their epidurals:

"A must for all mothers-to-be! Enjoy Your Labor dispels the myths that are all too common. Finally, the straight scoop from the best source. Thanks to Enjoy Your Labor, I was able to make an educated decision regarding anesthesia and to finally rest easy knowing I could advocate for my own pain relief." - Katie Cullen, mom, San Diego, California

I have to question using phrases like 'able to advocate for my pain relief'. Since when did women have to advocate for the right to be made numb in a labor room? It seems we haven't come so far from the Twilight Sleep era after all.

5 comments:

Rebekah said...

I thought about this encounter a number of times since first reading this post (I found you via the Dr. Amy homebirth blog), trying to imagine what I would have wanted to say to this guy if he'd popped into MY labor room peddling his book and pain relief philosophy. I still have no words.

I have really enjoyed reading your blog.

Question said...

There really are no words. Its an interesting issue of control/paternalism vs actually practical and good medicine. I think it's that Dr. Grant wanted to feel good himself, not actually help anyone else? I know he has a lot of takers at NYU, so we must have been the rare case and that must have thrown him off his game a little.
(Side note, I have nothing against epidurals, just something against medical professionals with an agenda.)

Baby Keeper said...

"Dr Grant, who are you to decide what importance the labor process may or may not have on a woman's experience of transition into motherhood."

Who is Dr. Grant or anyone -- like 98% of doctors, nurses, midwives, and parents -- to decide what importance the labor process does NOT have on the BABY'S transition into life?

THE BABY will live with the choices, actions (interventions, drugs), and environment of labor and birth. There is no time in human development from the moment of conception -- and before, even -- through labor, birth, early infancy, and beyond that the human is not interfacing, interacting with, and being impacted by the environment.

It's time we all started to ask what is the safest passage, treatment, and care of the fetus-becoming-newborn.

Nice blog.

BabyKeeper
www.safebabyresolution.blogspot.com
www.hospitalbirthdebate.blogspot.com
www.babykeeper.blogspot.com

Judit said...

Rachel, I hope you won't be offended that I'm not appropriately scandalized -- but my image of that guy, his misdirected zeal -- it was downright comical for me. I hope the mom will eventually get a good laugh out of that episode too!

Reminds me of my favorite anesthesiologist story is when my friend, her hubby, and I as her doula were hanging out in triage right after she was admitted. She had labored very well at home, and she got there so calm and happy and relaxed, the nurses doubted she was in labor. Until her midwife found her to be a good 8 cm. We had just stopped clapping and cheering when the anesthesiologist came in to offer his services. My friend's reaction: she burst out laughing, and the whole room joined in while the doc stood there with a confused look on his face until mom graciously thanked him and sent him on his way.

Question said...

I am glad you aren't scandalized! Personally I was only annoyed with his presence in the room- but I found the book to be inappropriate. It makes claims that are stated with authority, and yet in opinion, not really his to claim, or flat our factually wrong. He has such an agenda towards epidural that he completely forgoes the oath he made when he became a doctor to give fair and unbiased medical information.

Basically my feeling is: If you have an agenda, leave it out of the hospital room. Sell your book on the street or the internet, but don't let it detract from giving good medical care. Calling a woman a martyr while she is in labor is clearly an example of a doctor allowing his agenda to get in the way of actually caring for a woman.