• Nathan Riley, MD

Obgyno Wino Podcast Episode 64 - Shared Decision Making in Maternity Care

"Understanding that a Mother has the power to shift the Provider-patient relationship to a more balanced dynamic suddenly makes the pregnancy less fearful and anxiety-provoking. This shift does not come at the expense of usurping her Provider, but more so from intentionally making the Provider a better supportive partner in the pregnancy journey."

- Dr. B. Bootstaylor

In episode 64, Brad Bootstaylor, MD, an OB/GYN and MFM, is back on the show to talk about the unfortunate turn of events that forced him to leave his collaborative OBGYN practice in Atlanta, GA. At the hospital where Dr. B worked for 20 years and even served as chair of the Department of OBGYN, a non-clinical professional committee determined - apparently arbitrarily - not to renew Dr. B's hospital privileges, essentially forcing him out of practice. Perhaps the silver lining of these very unfortunate circumstances is that he has more freedom to explore creative avenues for changing U.S. maternity care from outside of the hospital system. Dr. B is a hero to many of us in the OBGYN community, and in conversation with him, I still have a great deal of hope that his legacy will live on through his book and his engagement directly with birthing people, the true keepers of birth.

Keys from our conversation:

  • Changing the culture of maternity care in the U.S. is not going to happen from within through the spearheading efforts of the few OBGYNs - like Dr. B and myself - who care deeply about this issue

  • Change can come through empowerment of those individuals for whom this system was intended to help: birthing people

  • At the foundation of compassionate maternity care is basic conversational skills in which a patient is given the time and space to clarify their values and fears). From there, a provider and their patient can come to terms with what they are each comfortable with on an individual basis.

  • Birthing persons need to know that they alone hold the power to change a hospital's accommodations for birth as well as the power to choose their maternity care provider.

  • Dr. B describes his 10-part questionnaire ("B" score) for determining if your care provider is a good match for you.

  • Shared decision-making is valued dearly in other disciplines...why not maternity care?

References from the show:

Dr. B can be contacted through his website or Instagram page

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