Choice is Like a Biscuit Selection Box

When my clients go to see an obstetrician they are often expecting a figurative offer of a cuppa and a biccie. A good host proffers the whole selection box, because to assume your guest likes only digestives is a bit presumptuous.

But it rarely goes that way. What they more often get is no intelligent tea drinking and the perfunctory waving of a custard cream under their nose; the cream often appearing to sweeten the less-than-ideal, compromise scenario that the doctor says is now necessary.

Some of my clients will like the look of the custard cream and take it, happy with their lot. Others will really not like the idea of this biscuit, however sweet and delicious the cream inside is made to appear, and will say nothing and walk away feeling anxious and upset.

Others will want to know the benefits and the potential risks or pitfalls of eating this biscuit. This can be a hard conversation because it’s often pretty difficult to talk about an individual situation when all we have is statistics about the general biscuit-eating population.

And some will say, “I don’t like custard creams. I don’t think they are good for me and I hate the taste of them. I decline your kind offer of a custard cream. What else have you got in that box?” And then something magical sometimes happens: the doctor opens the box and reveals the bourbons, the chocolate chip cookies and even sometimes those posh ones wrapped in shiny foil.

Intelligent Tea Drinking. Artwork by Hayley Shing

Choice is a funny old thing, isn’t it? Until I became a doula I never imagined it could mean, “Have this one kind of biscuit or have no biscuit at all”. As a student of the English language I was always under the impression that it meant:

an act of choosing between two or more possibilities.
“the choice between good and evil”
Of course, sometimes in healthcare the situation is pretty dire and the choices are narrowed. But usually maternity care is a little more nuanced; as we attempt to fashion care to the preferences and needs of the pregnant person.

Sometimes the word choice means:

‘the best’, ‘the most delicious’

It seems to me that we are rarely providing the choicest menu to families using maternity services. To offer all the biscuits isn’t expensive or revolutionary. It’s usually as simple as:

“So current guidelines are to offer you induction. Here are the possible pros and cons of the induction biscuit. You could also choose to be regularly monitored until you go into labour. Here are the possible pros and cons of that biscuit. Or you could just go home and await labour and only come back if you’re concerned and feel you need our help”.

You see, I hate pink wafers. Which of the options in the paragraph above that I consider to be a pink wafer is my business and my business alone. It doesn’t matter which option the doctor thinks is the one with really thick chocolate covered in shiny foil, if I disagree and think it’s a pink wafer. We all see biscuits differently.

And most importantly, I may never know there are other biscuits if the doctor keeps the lid on the box and hides it behind their back. Biscuits are important. Parents deserve the whole selection box. Because if they aren’t shown it, I can tell you, after they leave the doctor’s office, the air is sometimes blue with another kind of choice word.

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