Wow. I wasn’t expecting such a wealth of wonderful comments made in regards to my previous post about doulas. I do really appreciate the discussion, but I also have to acknowledge that I’m really not the right person to criticize the state of hospital birth, because I don’t participate in that model. I do hope change will come for women who want or need medical support for birth, some day. In the meantime, I’ll just get on with my own reality, in which my body possesses all the power and knowledge required to give birth perfectly, without mediation, medication, coaching, assistance, all that jazz.
One of the issues that was brought up by a couple of readers though, is the issue of money. I did admit, in my response to one of the comments, that, perhaps only semi-consciously, I have shied away from voicing my opinions on money and health care in the past…It’s not a popular opinion. But here goes. (Keep in mind I live in Canada, and Canada is the extent of my healthcare experience.) It seems to me that our entire system is built on a conflict of interest. The more procedures someone is exposed to, the more money flows into the system. Each time a woman is sent in for an ultrasound or a “stress test”, during pregnancy, the technicians and doctors and nurses get paid. Each time a c-section is “performed”, someone gets a fatter cheque.
I actually believe that probably the majority of ailments and procedures and doctor visits that people engage in are unnecessary and/or frivolous. We are, as a culture, bored, self-absorbed, hypochondriacal, and entitled (me too, everyone, me too). If we all took more personal responsibility for our health (making healthy preventative lifestyle choices), and accessed the emergency department primarily only in instances of acute trauma, everyone would benefit. Feeling sick? Have a bath, eat an orange and go have a nap. You’ll be fine.
So to me, the general absence of personal responsibility from the general population, combined with a system that *rewards* doctors and nurses (in effect) when people are sick, perpetuating a cycle of testing and testing and more over-testing, PLUS the fact that doctors typically over-test in order to cover their asses for insurance reasons if someone does in fact die, (which people tend to do, once in a while)…creates the current bloody mess that is our healthcare system. In an overly-simplistic nutshell.
I really do understand that our healthcare conundrums are not simple. And I am *not* trying to make anyone feel guilty about their personal situation. We are all doing the best we can. Again, not everyone has the time, or the inclination, or the ability, to fully research health issues, or pregnancy & birth, in order to truly understand the evidence, or to make an informed decision, or to comprehend deeply where the system falls short. Sadly, so much ancient healing wisdom has been lost. Advertising plays a large part in this, too. (As an example, off the top of my head, I can’t understand why any woman would visit a doctor and then pay $20 at the pharmacy to deal with a yeast infection, when she could stay home and pop a piece of garlic and a dollop of yogurt in her yoni and be done with it… Wait a minute. I DO understand why. It’s because capitalism has taught us helplessness and that our own bodies are disgusting…and on and on it goes). So yes. None of this is simple.
But seeing as the Canadian government and Canadians are constantly whining about our healthcare system, why couldn’t we just take a look at the way billing is carried out? Hey management: couldn’t we just pay doctors and nurses an amount, no matter how many patients they see, no matter how many procedures are done, so that they would have an incentive to deal sincerely in prevention and to treat *people* rather than symptoms? Craziness.
The problems surrounding money and healthcare are most tragically in the fore when it comes to birth. I absolutely don’t believe that *ANY* individual healthcare workers are out to hurt mothers or babies. It’s the system, man. These are the fundamentals of our system. A woman whose birth process is induced at 39 weeks, tends to end up stumbling through that whole cycle of interventions that leads to a c-section. She and her baby have just moved a heck of a lot of money around. It kind of makes me sick. Not women! The system man, the system.
Speaking of money, I applied to be an Amazon “affiliate” as a bit of a lark, and was kind of shocked when Bauhauswife was accepted. I have thought lots about this, and talked to all my peeps, and every single person I spoke with has unequivocally urged me to set up my little “Books we’re reading” list like all the other Mommy bloggers. I have actually been wanting for some time, to do some book reviews, but haven’t quite been sure how to link to amazon without “advertising”. So silly. Join them, Yo, join them.
I’m also going to be adding some ad buttons to my sidebar, to promote my own work as an artist as well as some of my other projects. (I assume that considering how opinionated and difficult I clearly am, I don’t have the same sponsorship cachet as other parenting bloggers who seem to focus more on loveliness and a joyful aesthetic. Thats ok.) I have thought a lot about this, but I suppose I have come to agree with those who point out that, when one works as a writer, or in any other capacity, it’s nice to be paid somehow. So…Let me know what you think! Are you disgusted ? It’s fine. I understand. I do promise, however, to be utterly honest and transparent. By the way, please please please support independent artists and makers this season! We need you: your money, your appreciation. But most of all, you need us.
Talk soon,
Yo
PS: In other news, Horus DID remain fully clothed during his Karate class, for which I am grateful. More nuggets of fabulousness like this on our facebook page. Mothering is one gem after another.
Enjoyed my early morning read, as I always do. I was unsure of something though, in my experience no nurses get paid additional money regardless of how many tests are given. Is there a specific example of this or are you saying it in a broader sense. I find in healthcare, there is actually the feeling that every test is costing the system money and they have to be careful to not order tests considered “unnecessary”. Doctors get paid more per visit but not more for say, ordering an mri.
I am glad Horus kept his clothes on for his class, although a naked karate kid would be cute too 🙂
You’re absolutely right, Ebony. Nurses, individually, don’t get paid additional money. But every time testing or further testing is done *someone* gets paid more, or paid again–the nurse in the next department, the radiologists. And then in order to be given the results of whatever test was done, the patient often has to make another appointment with their family doctor, who then gets paid. Again. All the gatekeeping and repetition…You’re right, there is that rhetoric of procedures “costing the system money”, but there also seems to me to be no internal incentive to actually lower the rates of [often] unnecessary testing. MRI’s are a good example. Why so many MRIs? On one hand, I think doctors do feel the need to protect themselves by offering testing that may not actually provide any real benefit, but of course, patients also fight for diagnostics like MRIs, I think probably because we have been led to believe that this will somehow give us some measure of security or protection. We have been led to believe that there is a much higher degree of knowing than I think there really is. And I do genuinely believe that we have invested SO much money in the infrastructure involved in setting up MRI labs and ultrasound labs….I’m sure you have heard me go on about ultrasound in pregnancy. I just cannot wrap my head around the fact that almost *every* woman receives several ultrasounds during her pregnancy. There IS potential risk (that she is often totally unaware of, because doctors simply don’t talk about this), which has been documented by science, and there is little to no evidence that repeated ultrasounds as a standard procedure has any effect on outcomes. But what would happen to obstetrical care as it is now, if doctors and nurses *actually* acted only according to REAL evidence-based practice? Gosh. The system would collapse. It’s simply not designed for what’s best for mothers and babies. Rar.