I think many of us are used to going along with whatever our doctor recommends, without pausing to probe more deeply. Obviously, if your health care provider is advocating that you do something, he or she thinks that the benefits outweigh the risks.
But that’s not his or her call to make.
While a treatment may have reduced the chance of a certain problem by, say, 25 percent in studies involving tens of thousands of patients, that’s not the same thing as predicting what your personal risk of going on to develop that problem is in the first place.
Then there’s the fact that you and your doctor (or any other individual, for that matter), can look at the same set of facts and yet come to very different conclusions about what is most acceptable.
Take menopausal hormone therapy for relieving symptoms such as hot flashes, night sweats, and the sleep disruption they can cause. In the largest-ever study on the subject, over a five year period, taking estrogen and progesterone was linked with eight more cases of cancer per 100,000 women versus not taking hormones.
As the doctor I interviewed recently on this subject said, one woman will look at that statistic and say, ‘that’s nothing’, particularly if the medication has substantially improved her symptoms, and quality of life. For another woman, even such a small apparent increase in risk is absolutely unacceptable. In other words, there’s no one-size-fits-all answer.
(And that’s assuming that your doctor or other health care provider actually lays out the potential risks and benefits of a particular medication, test, or other intervention in that detail. Based on my own experience, often, that doesn’t happen.)
The same goes for choices around pregnancy and birth. Your care provider is an expert advisor, but ultimately, it’s your body. And once your baby arrives, you’re responsible for decisions around his or her health, too.
Yet, particularly if you’re expecting for the first time, you may not even know that you have the right to opt out of certain common tests and procedures.
You can also read about the study that gave me the idea to write this story here.
My heartfelt thanks to the interviewees who so kindly shared their time, stories and expertise:
- Emily Boros-Rausch of Moncton, NB.
- Molly Hope of Moncton, NB.
- Andrea Landry, who lives in Poundmaker Cree Nation, SK. (Check out the piece she wrote about her birth experience here.)
- Dr. Vanessa Poliquin, an assistant professor in the Department of Obstetrics and Gynaecology at the University of Manitoba.
- Dr. Kathrin Stoll, senior research associate with the Birth Place Lab, at the University of British Columbia’s Faculty of Medicine/Midwifery.
- Vicki Van Wagner, associate professor of midwifery at X University* in Toronto.
- Dr. Saraswathi Vedam, professor and principal investigator at The Birth Place Lab, in the University of British Columbia’s Faculty of Medicine/Midwifery.
- Kathi Wilson, assistant professor in the Midwifery Education Program, in the Department of Obstetrics and Gynaecology, at McMaster University in Hamilton, ON. (Full disclosure: Kathi is one of my favourite people and attended my third birth (my second at home) as a student midwife.
* The name of this Toronto university is being changed, over concerns that, ‘the man the institution is named for and his links to residential schools‘.