Judgements about big families

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We had an incident today at work that engendered quite alot of discussion. A mom was having her sixth c-section and seventh child. Throughout the case the anesthiesiologist was making comments to the mom about how this was plenty of kids and no one should want to have more than this, how it would be irresponsible of her to have more children (note he was not referring to the fact that she had so many c-sections and more pregnancies could be dangerous.

The nurse in the case talked to him afterwards saying she thought it was inappropriate for him to be making these judgemental statements to a patient. He responded that there was nothing wrong in giving his opinion to the patient. I asked if people thought it was okay to make judgemental statements to patients who had abortions. Everyone in the room immediately gasped no!! The opinions on the statements regarding the number of children were split about 50/50.. Why is it okay to make judgements about family size but abortion is taboo??? I personally think they both are off limits!!

I think that the current over population of this little planet warrants anyone saying STOP having so many children. You go doc!!

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Specializes in ER, NICU, NSY and some other stuff.

This is not your call, nor was it this Docs call to make for this lady.

If this is how you feel then that is a decision for you to personally make FOR YOURSELF. In addition this was the anesthesiologist not her OB or PCP who could address these issues in a more appropriate format, not on the delivery table.

What was this poor lady supposed to do? " Oh well, while you got me split open why don't you just burn my tubes." With consent and waiting periods that was not an available option.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

No it's not our call as health care professionals ever, to express judgements upon our patients regarding their chosen family sizes.

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I think that the current over population of this little planet warrants anyone saying STOP having so many children. You go doc!!

You've GOT to be KIDDING me.....:uhoh3:

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Don't health care providers pass judgement on their pts every day......"Don't do drugs"....."You are over weight"......"It should be against the law to ride a motorcycle without a helmut".etc.

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Specializes in LTC/Behavioral/ Hospice.
Don't health care providers pass judgement on their pts every day......"Don't do drugs"....."You are over weight"......"It should be against the law to ride a motorcycle without a helmut".etc.

I'm having a hard time taking you seriously because of the manner of your posts, but ok, I'll respond at least once.

Drugs are illegal for one thing, and very harmful to health for another. However, if someone came in needing help, after using the drugs, we would be obligated to treat them with dignity and respect, not rant at them while we hold their medications in hand. Being overweight is not a judgement but a fact. A healthcare worker can discuss the implications to a person's health without judgement. Riding without a helmet is against the law in many states. Where it is not against the law, it would be appropriate for a health care provider to suggest wearing one, in the appropriate setting! I think you may be missing the point that the setting in which this was said, and who said it, made this wrong. If the Ob/gyn had discussed the health pros and cons to having more babies to the mother , in his office, this would not be such a big deal.

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Specializes in Maternal - Child Health.
Don't health care providers pass judgement on their pts every day......"Don't do drugs"....."You are over weight"......"It should be against the law to ride a motorcycle without a helmut".etc.

I am answering this at my own risk, as I assume that you are baiting those of us who disagree with your stance.

There is a HUGE difference between appropriate health teaching (Using illicit drugs can be harmful to your health.) vs. passing judgement on a patient (You are a dirt bag for using drugs.)

The same holds true in this situation. Health teaching: (Having further pregnancies may be risky due to the poor condition of your uterus.) Passing judgement on a patient: (You are irresponsible for having so many children.)

Furthermore, health teaching MUST occur in an appropriate setting and be offered by an appropriate practitioner. An OB discussing further pregnancies with his/her patient prior to hospital DC is appropriate. An anesthesiologist passing judgement on an anesthetized surgical patient in the OR is clearly not appropriate.

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I was listening to a sermon on the radio the other day, and the pastor said "Where your desires are your heart will follow." It made me think of what we are teaching our kids, and how it will ultimately make them hollow inside. My husband and I are thinking of selling our house, paying off our debts and moving out into a little house in the country. No cable TV, no competing with the "Jonses"....homeschooling, the whole bit. It's hard to let go of what you think your family "needs", when probably most if it isn't necessary.

I live near the Amish community, and it amazes me every time I see these families. No cars, no fancy gadets, and the kids are out in the fields working the farms. Are they deprived? Nope, I know they have A LOT more than our kids do. Ahh, I can always dream about living the country life.

I live in an area with a lot of Amish, too, but what bothers me is the way those kids are used like field hands and put in extremely dangerous situations.

We just had yet another child killed in a farming accident; because it occured at another family member's home, the state is investigating. Both families feel

little, if any, regret. It's more or less an attitude of "Yes well, these things happen." They're upset that the state is looking into the situation and feel it's none of anyone's business what they do with their kids.

I took care of a three year old girl who was torn from her pubic area to her sternum by a piece of farm equipment. The parents couldn't even be bothered to stay with her. At least one parent could have stayed, but no...

Almost every day I see these kids in extremely dangerous situations, purely because they're being used to keep the farm going.

As far as the women, it was great fun getting 40-something women in the ED who were hemorrhaging because it was their 14th or 15th pregnancy...at some point the body just can't handle any more pregnancies. My friend in OB had one father, right after the woman delivered, ask the doctor, "When can I breed her again?" Or the ones who were in full-blown eclampsia or going into labor at 29 weeks.

So I wouldn't use the Amish as a terrific example, at least in my area. People tend to romanticize that lifestyle; let me tell you, it ain't "Witness." (A movie that was filmed, incidentally, in my county.)

In any event, it was totally inappropriate for that anesthesiologist to say that.

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
Don't health care providers pass judgement on their pts every day......"Don't do drugs"....."You are over weight"......"It should be against the law to ride a motorcycle without a helmut".etc.

No, because the circumstances leading up to the person's conditions are not factually known (i.e. did you see the person do drugs, did you see what caused them to get overweight, etc..)

As it's already been said, it's not our place to judge, nor impose our personal opinions. There's a difference between personal and professional opinions.

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I am talking about a private conversation, after the case, not discussing it "over the patient's head" Steph. A guy who did this once, likely will do it again in another case.

gee what is it w/me today? I seem to be misrepresenting myself all over the place. Sorry about that.

Did ya ever think it could be my interpretation skills are off today? ;)

Whatever . .. .I see your point and agree with you.

steph

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Regarding farming and kids . . . . all my older kids have worked on a farm. All except the 4 year old, who rides on his grandpa's lap on the tractor. My husband and I have many fond memories of one of our older boys falling asleep inside the tractor, leaning on my husband's knee. My older boys use a chain saw to fall timber for firewood for us and people we donate wood to and for my inlaws. My older boys both have truck driving licences and have driven logging trucks. My older kids have changed irrigation pipe, plowed fields, cut hay, pulled weeds in our beet fields, siphon irrigated, shot blackbirds off the wild rice fields, etc. My daughter rides a horse and has been bucked off. Farm life - I think it is a great way to grow up and doing hard physical labor teaches kids to be responsible and to be able to work hard toward a goal. I'm grateful I married into a farming family.

I'm not sure I would castigate all farm families . . .

One of my mom's friend drove down her steep driveway in a sedan and didn't see her 3 year old riding his 3-wheeled trike and ran over him and killed him. Not sure the answer is to say women who drive sedans down steep driveways are bad parents.

Accidents of all kinds are the #1 cause of death in the young children and I think drowning is up there pretty high.

Sorry - hit a nerve - farm wife here.

steph

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Specializes in Public Health, DEI.
I think that the current over population of this little planet warrants anyone saying STOP having so many children. You go doc!!

Since you are not yet an RN, I am giving you the benefit of the doubt and hoping that with your education comes some degree of enlightment as to how inappropriate was this doctor's behavior.

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