Saturday, May 31, 2008

On Midwives

Doctors can be quite useful, but when they are not necessary it may be best to not have them. Last week when my son was born an incredible nurse midwife was beside my wife from the moment she arrived at in her room until almost an hour after our son was born. As a doctor myself I have been in hundreds of deliveries and I have never seen a delivery so calm or a physician so comforting.

There are times when a doctor is needed. In a life-threatening illness a doctor may be the best person to have, but we doctors are trained to act boldly, to fix, to intervene. When there is discomfort but little danger a physician's presence can often disrupt, dismay, and even bring a danger of its own. I think of all the times people bring their sufferings to the ER with minor illnesses such as colds. My training says "It could be a cold or it could be something more dangerous. I need to poke, prod, X-ray, and draw blood just to be sure." The doctor must constantly disturb the patient in order to look for death or disability hiding behind their suffering.

That is what I loved about the midwife. She saw the suffering of birth as part of a natural process. I know she was alert for problems, but unlike a doctor her primary goal was comfort and support. She had a doctor in the hospital on back-up if their were any problems. She didn't have to focus on death. She recognized the suffering as part of a beautiful unveiling of life. In many ways I was jealous of the midwife. I became a doctor due to a rather vague desire to "help people" but often I find my job is more fighting illness than really bringing comfort to people's lives. Comforting people is a side job in medicine, the real responsibility is to find, fight, and manage diseases. I realized watching the midwife that I wish had the ability to stop worrying about disease and focus exclusively on caring.


roadrunner201 said...

Yeay, Johnathan! Great blog today! Although, as a doctor saying these things, I think you might be in the minority. You have a very clear picture of the benefits of a midwife. I think that all OBs should have to spend some time watching midwife assisted births.

Lisa (Franceschini) Roerdink

roadrunner201 said...

You are a wise man in your profession! I think that you are probably in the minority in your thinking as far as doctors go, but I think you are right on target.