As I looked at my screen to check which patient was next, seeing her name made me smile.
The patient was a delight. I had delivered her first baby two years ago, an adorable baby girl with curly blond hair and rolls on her thighs. The patient pushed like a champ, but despite her efforts, her 10 pound bundle of joy entered this world through a low transverse abdominal incision.
She was newly pregnant with baby number #2.
A perfect flutter of a heart beat was seen on the ultrasound, and all was good.
“Doc, do you think I should try for a VBAC (vaginal birth after c-section) or have a planned c-section this time?” she inquired, as we finished up with the usual questions.
I carefully reviewed the risks and benefits of each, encouraging her to weigh which option would be best for her.
As I finished, I noticed she was pursing her lips in anticipation of a question that she could barely contain.
“But Doc,” she asked smugly, like a jeopardy contestant who knew they had the right answer, "What would you do if it were YOU?"
The favorite question. I smiled and leaned back on my rolly stool.
“Nope.” I said as I shook my head back and forth with a smile, "I don’t answer that one.”
Somewhere there has to be a Readers Digest Article, ‘Top Ten Questions to Ask Your Doctor’ and this is probably #1, based on the number of times that I have heard it.
Initially, when I started practicing and my newly board certified brain was bursting with memorized textbook knowledge and randomized controlled trials, I would fall for this trick. I would rattle off my personal opinion on such matters. Because obviously, I knew best.
No, I personally wouldn’t VBAC, but sure, you go right ahead.
It didn’t take me long in practice to realize that every women is unique. I was biasing these women with my personal opinion on issues that really, I had no business discussing.
I am not saying I don’t give advice. Of course I do, I am a doctor. I give my best medical recommendation in all situations. However, I do not give patients my honest, personal opinion of what I would do in their specific situation, because I am not them. And I am not in their situation.
In obstetrics there are multiple situations when women really need to decide for themselves:
VBAC vs. C-section
Natural vs. epidural
Circumcision vs. no circumcision
These are just a few of the very personal decisions that women need to make for themselves. Options that should NOT be decided by their moms, NOT by their friends and definitely NOT by me.
Is this a question you answer?