Defensive Medicine Series at The Unnecesarean

In case you haven’t heard, The Unnecesarean recently ran a series of guest posts on the topic of Defensive Medicine. It is well worth a trip over to check out the posts. Start here at the beginning with Jill’s post Defending Ourselves Against Defensive Medicine and work your way through.

However, if you have time to read only one article of the series, might I suggest reading the brilliant Barbara Katz Rothman’s Who is defending whom from what? Katz Rothman links defensive medicine to socioeconomic class and access (or lack thereof) to money and healthcare. All of this, of course, is tied up together with our current medical culture that privileges some decisions and outcomes and medical heroism and others as, well, sue-able offenses. Add to that the complicated lens of risk, and we’re in a fine pickle now.

Just a taste:

In the United States especially —where each child is born into great and unending poverty unless lucky enough to be born to a parent willing and able to pull it out, where basic needs go unmet, where medical care for children with disabilities can wipe a family out financially, where medical bills are the leading cause of bankruptcy — a needy child inevitably necessitates a search for deep pockets.  If I had a child who used a wheelchair, I’d want the best possible chair, and probably a sports-use chair besides; the best household adaptations money could buy; every imaginable object and service that would make that kid’s life better.  And if I had to sue my mother to get it, why sue I would.


In a better kind of insurance system, people would be insured for need – if you have a very expensive kid, one who needs wheelchairs and ramps, expensive surgeries, long-term nursing care, or all of those, then those needs would be met.  That is how universal health care coverage works in most of the world.  But we have not got that kind of system, so instead, individuals have to sue.  Private companies insure practitioners, and patients with unmet needs can sue practitioners who in some way failed them.

What is Labor?

Labor is much more than the physical process by which women give birth and by which babies are born, awesome as those experiences are in and of themselves. Labor is also the transformational opening of a woman’s entire being. Women who give birth unhindered are open to the elemental forces of nature that bring the baby forth. Heart, mind, spirit, emotions and sexual self, as well as the woman’s physical body, open to allow another life to begin an independent existence on this planet. Thus, labor is a spiritual experience of enormous importance to both the woman and her baby. While women experience various life-changing events during pregnancy. the experience of giving birth is so significant that most women in old age continue to remember their birth experiences as though they happened yesterday. This makes the totality of the birth experience one of the most pivotal in a woman’s life.

Barbara Katz Rothman as quoted in Anne Frye’s Holistic Midwifery.

Birth is

Birth is, I learned and I can say with clarity now, about women. That’s what the midwives taught me, and that’s what my own experiences have shown me. Birth is not about babies. Babies get born. But women give birth. Giving birth is awesome. Babies are miracles, and cute besides, but birth is an Event. It is Something. It is a life-shaking, developmental moment that makes you who you are, that teaches you who you are. Sometimes people say they want to become midwives because they just love babies. Wrong. Midwives who actually go through with it, the women and a few men who go through all the training, the learning, the growth and change and fear and power of becoming midwives, do it because they love women. They are in awe of the power of the birthing woman.

Barbara Katz Rothman, Laboring On