A couple of weeks ago I did the second half of the UCSF study I mentioned in July, the one about choices in genetic testing. It was a quick phone interview where they asked me a bunch of true/false questions about different chromosomal abnormalities to test what I’d learned, a bunch of values questions (“My culture tells me that life won’t give me anything I can’t handle,” etc.), and then some questions about whether I thought I had made the right choices. On those, I told them it was probably a little too soon to tell, since we won’t know for sure whether our tests accurately described the baby’s health until it’s born.
At the end of it, the woman asked me if I wanted to participate in another study, this one about “delivery choices.” I thought about it for a while, but decided sure, why not.
Yesterday I did the first third of that study, and it was totally different. They start out asking you whether you’re aiming for a vaginal birth or a caesarian section and give you a set of scenarios to work through based on your choice. (A little like a choose-your-own-adventure, in a way.) Since I chose vaginal birth, they had me weigh a variety of vaginal birth scenarios (ranging from one intervention — pitocin — and no other complications to a cascade of interventions ending with the baby on a respirator and me unpredictably pooping myself for years to come) against a pie chart that had x percent chance of vaginal birth with no problems and y percent chance of caesarian. If you picked the pie chart, which started out at 100% vaginal birth with no problems, then the pie chart split 50/50. If you then picked the intervention scenario on the other side, your chances of a c-section went down slightly. Click on the pie chart and it goes back up. You could have gone back and forth all day. It was frustrating.
Although the study wasn’t attempting to imply that choosing the one made the other outcome change, it had the effect of implying that, and it was really uncomfortable. They were testing how committed you are to your delivery method of choice, but putting some pretty artificial boundaries on things. I complained about a few things, one being that the study put “women who want an intervention-free vaginal birth” and “women who want a vaginal birth at all costs, even with complications” in the same category, and I consider them totally separate categories.
I also asked why it was telling me some of the risks/bad outcomes of the interventions, but none of the risks on the c-section side. She said they do that if women choose c-section as their preference.
Anyhow, then it got worse. Box 1 had the same list of various scenarios, from pitocin-only to baby-on-a-respirator, while Box 2 had the dreamy natural-birth (and yet still in a hospital) outcome. Only this time, you started out on both sides with a life expectancy of 81 years, and each time you clicked on your preferred outcome, your lifespan would shorten. Um. I asked whether this implied that choosing that outcome would result in your life being shorter, and she said no, it was meant to test how much of your life you’d give up in order to have the ideal outcome. (She said they tried it with money, but poorer women complained that it was biased against them. Devin asked whether you could have chosen a number of kicks in the shins or something instead.)
The problem with this one for me, aside from the hypotheticals, is that having a child makes me acutely aware of the desire to be alive for them as long as possible — in part because I know what it’s like to lose one of your parents when they and you are still pretty young. So in my case it basically forced me into saying, OK, maybe I’d rather have a c-section than miss 10 years of my child’s life, but I don’t think that really says anything about my feelings about surgery as a method of delivery.
In other words, I’m probably not the ideal candidate for this study because I have a terrible time with hypotheticals. I asked the interviewer if she’d seen “Blade Runner.” She hadn’t. Sigh.
I really hope the outcome of this study is rather different from the input … I am interested in seeing what they do with the data.
At any rate, the interview closed with a series of questions about my decision-making, how informed I am, whose opinions have influenced me the most in terms of delivery methods, and a few other things (they always seem to want to know whether you’ve been depressed or thinking of harming yourself — I wonder if they’ll correlate that to the data, or just throw responses from those women out). They’ll do a follow-up by phone 8-10 weeks after I have the baby, and then another in-person interview 6-8 months later in person. I can’t wait. :-/
– Beth
