What’s an obstetrician to do?

Compare and contrast:

Mother #1

… So yes, I had preeclampsia and I needed to have my baby in the hospital just in case something went wrong.

This isn’t the part of my story that makes me angry.

The diagnosis does not make me angry.

Ok I am angry about my diagnosis, but that’s my placenta’s fault not the hospitals.

I am angry with the hospital because of the cookie cutter way in which they treated the diagnosis of preeclampsia.

Is all they saw was a woman showing signs of preeclampsia who was 38 weeks pregnant, full term in their eyes. And as far as they were concerned I needed to deliver that baby right then and there, not 2 days from then, not 12 hours from then, right then.

They could see no reason to compromise. No benefit to staying pregnant even a day longer…

They could not accept that I was not trying to put me or my baby at risk by refusing an immediate induction but that I needed ONE night to both change gears and accept what was happening mentally AND GET SOME FUCKING SLEEP so that I could come to the hospital refreshed and ready to have a baby, not so exhausted that I don’t know how I even found the energy to do what I did.

I had even signed all the leaving Against Medical Advice paperwork that they shoved in my face so I could not sue them should I start seizing in those 12 hours that I was away from the hospital. But they couldn’t let it go.

And the fuckers bullied me into that induction by calling me an hour after I left to tell me my bloodwork was changing. Had I not been so exhausted, had I not already been fighting them for 2 days, had I just been in a better place mentally I would have questions WHAT was changing and what it meant.

But I was tired of fighting and I gave in….

And that, my friends, is why I desperately tried to stay out of the hospital system while I was pregnant. Why I so desperately wanted a homebirth. Why I was so upset with the way the induction was handled.

Everyone says that once you have the baby it doesn’t matter how he came into the world because you got a healthy baby in the end.

I disagree.

Mother #2

… This pregnancy i switched from an ob practice to a midwife practice. 1st appt with them was everything i was looking for. But when i found out i had GD they act like they couldn’t let me vbac at all. One midwife the one i liked scheduled my c section for me without me and it’s on my due date. Another midwife said i can’t go past 39 weeks.

Then:

So im 36.5 weeks with GD. And my chances of vbac are slowly decreasing. Im currently on meds only at bedtime to controll my fasting numbers. They might not let me go past either 39 or 40 weeks i have to go into labor by then or its a rsc for me.

But at 39 weeks and 6 days:

My angel passed the day before i was suppose to get my c section… I was high risk with GD so im mad at the fact they didnt induce me earlier before she passed…

And, inevitably:

I’m devastated i know this could’ve been prevented.

So, natural childbirth advocates, what’s an obstetrician to do when confronted by a patient with risk factors for a serious complication? Please tell me because I and other obstetricians want to know.