Empowered Patient or Entitled Patient?
Posted by realityrounds on December 17, 2009
In my past life I was a journalism major, and I know about the power of an article’s title to suck a reader in, and maybe, sway their judgment about a subject before they ever read the article. Case in point: CNN just ran an interesting article in their “Empowered Patient” section. The article addresses the case of Joy Szabo who had one previous C-Section and would like to have a VBAC for her fourth child. Her obstetrician informed her that she would not be able to have a VBAC due to hospital policy and liability concerns. So, Joy packed up and moved to Phoenix Arizona three weeks before her due date to have a VBAC, which she did very successfully. Yeah Joy! You are a fellow VBAC sister.
The title of the CNN article is this: Mom fights, gets the delivery she wants. Does anyone else see anything wrong with this title? To me, it sways the reader, especially the lay reader, to believe the mom is being selfish and entitled to get something (a delivery) that she “wants.” What if the title was this: Mom fights, and avoids getting sliced open against her will. Do you think readers, especially lay readers, would view the article in a different way? I wonder.
Obviously it is not just a title that will sway a readers opinion. Personal experience means all and everything to a single person. If someone had a tragic VBAC experience, that is all that matters and all that anyone needs to know. This is proven over and over again in the comment thread to the CNN story. Anecdotal stories can be very heart wrenching and moving, but public health policy certainly should not be swayed by anecdotes alone.
If you dare, read the over 450 (and climbing) comments included in this thread. I refuse to get sucked in to comment, especially when the comments are filled with people who do not know what the hell they are talking about. (I have also been reading an article about Michelle Duggar who just delivered a 25 weeker, on People magazine’s website. The comment section on that thread is also filled with dunder heads who do not know what the they are talking about, like mom blaming. But anyway, that is for another post. ). It can be frustrating reading what some in the general public believe about women, and women’s and infant health care.
From this article in a very main stream media outlet, it seems from many of the comments that Ms. Szabo acted more like an entitled patient and not an empowered one.
Thoughts?
RR
MelissaRose said
Dangit, you dared me, and now two hours later I’ve made about 15 comments, each one getting more indignant, and I’m only through about the first 200.
Something is wrong…on the internet.
Long time lurker, first time commenter, by the way. I heart your blog.
marfmom said
I see how you took that from the article’s title, although I got a diff. feel. I took that this woman was empowered enough to fight for what she felt was best for her body & baby. What’s sad is that she had to go to such lengths. Certainly a VBAC isn’t always safe, but how often is one choice the best for EVERYONE? Hospitals should be instructing their doctors to have open-dialogue w/ their patients to ascertain the best decision for the individual, not creating blanket policies.
Erin said
I agree with you, I didn’t take the title negatively. Instead, I thought that this woman was brave and empowered.
darlene said
I read a few of the comments yesterday, and what really hit me was that the obstetric community has really snowed the public. People really believe that surgery is always, always safer. People really believe that doctors are always, always looking out for their best interest and have no vested interest. And women really believe that their bodies just don’t quite work properly, or are builty incorrectly, or are incapable of birth.
And while I knew that before, somehow this story has truly driven it home for me, and makes me just so, so sad.
Jill said
Me too.
Sometimes I think I am jaded to ignorance, but every now and then something hits hard enough to crack the facade. This is one of those times.
Kathy said
I haven’t read any comments — hearing *about* some of them is enough! You’re right about the “power of persuasion”, and although I took the title in an “empowered” way (knowing the story already, plus the stats behind the story, etc.), I know many people just don’t have the knowledge base to do the same, even if they wanted to… and many don’t want to. That said, there is another thing to keep in mind — space constraints — the editor may require a “short and sweet” title, trying to get the most said in the least space, and as correct as your alternative title is, it likely wouldn’t have fit within the allowable space. Of course, that *shouldn’t* be as big a deal in an online article, but I bet there are still some constraints that would require all titles be less than X characters long.
How ’bout, “Mom fights, avoids unnecessary C-section”? — But in a way, that doesn’t sound as “powerful” as “I get what I want”… but at least, it doesn’t sound as selfish that way. Hmmm… :-/
Michelle Potter said
I would have said “Mom fights back, escapes forced cesarean.” That’s only one character longer than their headline, and very powerful.
Crystal said
I have followed this story closely from the onset, and have read about 80% of the 450+ comments on CNN. There is a lot of ignorance in 2/3 of the comments, but in 1/3 there are the facts in support of the SAFETY of VBAC compared to Repeat C-Section. *Big Thanks* to the community of women who read this blog, who are out there telling the facts!
Joy Szabo had already had 2 vaginal births, 1 of which was VBAC, and she just had her 2nd VBAC. It horrifies me that people would STILL think that “once a Cesarean always a Cesarean” should apply as an across-the-board rule for all women.
I think the whole controversy goes back to the Abortion Issue in many ways. There is a struggle for the control of a woman’s body, and so instead of decisions being made by an informed female patient, in consultation with her care providers, there is a push to place all decisions into the hands of “higher authorities” (Hospitals, Doctors, Men, Judges, Politicians, and Public-Opinion). Very Dangerous way to move! What’s next? We women like Michelle Dugar (5 Cesareans and counting) be forcibly sterilized, since 19 pregnancies and multiple cesareans may be deemed “too dangerous” for both Mom and Baby?
Michelle Potter said
I think you may be right that the abortion issue is part of the problem, but there are also a lot of people who are pro-life (like me), whose convictions on both issues spring from the same source. As a Christian, I feel it’s my sacred duty to protect my child before, during, and after birth, and therefore I have an obligation to fight against doctors who endanger my child with unnecessary interventions. (I know that pro-choicers also feel a duty to protect their children. This is not a judgment, just an explanation of how I feel.) When I argue for evidence-based care in pregnancy and birth, I am often aware of how I ironic I sound saying that women be allowed to make their own health care decisions, but at the same time I am saddened that our society is ok with a woman choosing abortion, but not VBAC. (Even if you don’t agree that abortion kills a baby, if you ivew it from my perspective for a second, you can see why this seems absolutely crazy to me. And yes, I can see the other side, too.)
Amy Romano said
Great post, RR. I had another reaction to the title. Certainly Joy didn’t “want” to travel hundreds of miles away from her family and provider, nor any of the other upheaval that came along with her ultimately getting a safe vaginal birth. In some ways the title seemed to give a false sense that in this system if you are empowered enough and stand up for yourself, you can actualize informed choice and autonomy. But that ain’t necessarily so…
realityrounds said
Amy,
Your are right. Joy really did NOT get the birth she “wanted”. Who the hell wants to drive hundreds of miles away to have a VBAC? I need to thank my lucky stars I only had to drive three miles away, with no drama, to attain a VBAC. Sheesh.
Knitted in the Womb said
EXACTLY Amy, I wrote a blog post that said essentially that(a href=”http://knittedinthewomb.com/wp/2009/12/18/was-joy-szabos-birth-a-victory/” title=”Was Joy Szabo’s Birth a Victory?”>, and took a lot of heat for it. LOL.
Kristen said
YES. I was so enraged by many of the comments on the article that I hadn’t even bothered to notice how problematic the title was.
In fact, this reminds me of one of the ways in which women who have birth plans, want to avoid unnecessary birth interventions, plan a VBAC instead of a repeat cesarean, etc. are sometimes stereotyped: as women who have some exaggerated sense of *entitlement* instead of women who are *empowered*. (Not saying that women who don’t have birth plans, plan RCS, etc. aren’t or cannot be empowered, of course…)
scout234 said
Did you see this link at the bottom of the article: “What doctors don’t tell you about c-sections.”
http://www.cnn.com/2009/HEALTH/11/11/caesarean.section.risks/index.html#cnnSTCText
I am irritated that an article that is supposed to get women to question whether a c-section is necessary ends with a story about a necessary, life-saving c-section and a quote from said mom. No one has a problem with life-saving c-sections. Why not a quote from a mom who had a c-section because of failure to progress even thought both mom and baby were doing fine?
Jessica said
I think a good title would have been “Mom fights for vaginal delivery, baby born healthy and safely!”
realityrounds said
Yes, that does sound less judgmental!
MomTFH said
There is only one thing that bugs me more than the way many media outlets handle medical stories, particularly those regarding pregnancy and birth, and that’s the comment sections on those crappy stories.
realityrounds said
Yep,
My blog started out as an outlet to analyze how media portrays medicine and nursing, etc. Little did I know how ignorant the media, and the consumers of media can be. I am sorry I read those comments on the CNN story.
Jill--Unnecesarean said
Oh, that’s right! It started as a place to call Code Bullshit on mainstream media stories. Getting to hear about how your cat ate your daughter’s umbilical cord stump was just a sweet, sweet bonus.
Rachel said
I read through a bunch of the comments before my head started to hurt and I decided to do happier things. As someone currently aiming for a VBAC (with a supportive provider with a good track record but with whom I disagree on some aspects of my care), it drives me nuts that there is a perception that women want to VBAC to “experience birth.” That makes us sound idealistic and entitled–like the language comparing home birth to a “spa experience.” While is definitely true that women also VBAC to reclaim their power to birth, we also VBAC because it is safer for us and that baby, and doesn’t restrict our future reproductive choices the way RCS. But that’s never the story. I think Joy’s story has been empowering to a lot of us–she has always been clear and direct in why a VBAC was a good option (including caring for her other kids) and was willing to withstand the media scrutiny.
Michelle Potter said
I can never understand this thinking. Imagine if you went into the doctor for a routine checkup, he noticed your throat looked a little red, and based on redness alone asked when you’d like to schedule a tonsillectomy. When you objected, he insisted, implying that you were being reckless, ignorant, and selfish, and ought to leave important medical decisions like that up to the professionals. If all else failed, he’d get a court order and force you into surgery. Can you imagine? Who would say that a patient in that position was foolishly refusing surgery because she wanted a better tonsil experience?
The fight for VBACs is not about *getting* a vaginal birth, it’s about *escaping* forced unnecessary surgery.
1nonblog said
well said!
pinky said
I am not going to go look at CNN. I am not going to go look! Crap….Now I am going to go look…I know I shouldn’t.
Michelle Potter said
It’s very sad when a woman loses her baby, whether it occurs during a VBAC, a c-section, or any other time. When I hear of such a story, my heart always goes out to the family. But there is a reason that we don’t base important decisions on anecdotes. If we did, and we heard of one woman who had a VBAC and lost her baby, we’d conclude that VBACs were always dangerous. If we heard of Joy Szabo, who has had two successful VBACs, we’d conclude that VBACs were always safe. And what about my experience — three successful VBACs followed by one VBAC-turned-necessary-cesarean? Maybe VBACs *were* completely safe until my fifth baby was born, and then they suddenly became dangerous. Yep, he changed everything for all women everywhere. (I always thought he was special.) And what about all those anecdotal stories of babies who were injured or died due to problems caused by the c-section?
This is why we have scientific studies and research, and data. And the data says that for most women, most of the time, the safety and benefits of VBAC clearly outweigh those of routine repeat cesarean.
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RehabRN said
It just makes you wonder why childbirth is such a crazy topic. It happens all the time…the media just has a need to spin it into something completely different.
C-sections are not easy. All these media losers telling people how great they are and how you recover faster are so full of it. I hurt for at least a year. No one told me that. I don’t know how my mother made it through three of them.
This is just a spotlight on one birth issue. I really don’t think most people can handle (or don’t want to handle) rational discussion of any of them.
It’s too bad in most OB offices, you don’t get to talk much to the nurses. It would probably change many perceptions out there.
Ciarin said
Hmm….sucks she had to go so far to get a VBAC. Thank god there are providers out there still doing VBACs, cuz we all know that’s going against the current grain in obstetrics :p I haven’t heard where she went…perhaps a hat-tip would be welcome.
I stopped reading comments on news articles cuz the sheer idiocy of many was causing me to have an eye tic…had to xanax myself out of it! JK, have never had xanax.
kr said
I have mixed feelings about this story. On the one hand, if a doctor/hospital tells me, “We feel that what you’re asking is too unsafe for us to do,” I would feel that they are unprepared. I don’t want to be the first breech vaginal birth my OB delivers, or the first VBAC, or the first anything really. If a hospital thinks they’re understaffed, or don’t have enough anesthetists on call to do what I want to do, or whatever other failings, I’m inclined to believe them. I don’t think they secretly have a knowledgeable, abundant staff with a system set in place to deal with uterine rupture hiding in the next room, giggling evilly.
On the other hand, it’s a shame that there wasn’t the resources for her to give birth closer to home. It would be nice if her hospital close to home had *made* a system to keep VBAC safe (hired the extra anesthesiologist), or if the liability could be controlled so they wouldn’t be scared out of it. I’m inclined to believe it’s more the liability, but that’s more a systemic problem than a hospital administrator/doctor one, and if they don’t want to risk all of their money on me, that’s their prerogative. I don’t see why I should ask someone to risk going bankrupt to give me the medical care I want–I think I should get the medical care I want without having to ask that.
I guess what I’m saying is, I wish the world were different, but I think she did the right thing by going to a different hospital. This was really ramble-y, so I hope it makes sense.
hillary13 said
grrrrrr…tell me about horrible birth commenting. It actually frightens me to see how uneducated ppl are about birth.
Anyways, I read the title as a good ‘ole, “hoorah go you girl!”, but I see your point. I like to dissect language and see what is sometimes hiding behind a seemingly good statement.
I would say that your observations go deeper than just this title and actually that *is* the energy of the state of VBAC’s. You have to find a practitioner who will *let you* and then you are so happy to get to *try* for one.
Women don’t realize that she cannot be forced to have surgery and I’m under the impression that a hospital also cannot refuse a patient in need. However, who the hell wants to be the woman laboring in those hostile conditions. blech.