Mamas on Bedrest: Is Your Provider “Thinking” Like a Man Or a Woman?

January 9th, 2012

Men and women think differently.

Well that’s no news flash! Yet I have been thinking a lot about the differences in thought patterns since writing the last post and considering how the differences in thought, speech and behavior will affect how men and women provide health care, in particular, prenatal and peripartum care.

The more I consider the war waging between OB’s and midwives, the more I am inclined to ask,

Is the obstetrical approach truly “Misogenistic” as some midwives accuse, or is it more a function of how men think versus how women think?

I think cases can be made for both, but having been trained in a very “male” model of health care delivery (the Duke University Physician Assistant Program), I firmly believe that this more masculine/left brained model is more a function of mental organization as opposed to deliberate cruelty.

Millions of dollars and countless hours have spent trying to determine just why men and women think differently. In my hunt for answers, a short surf of the internet yielded a very interesting website by Renato Sabbatini, PhD, a neurophysiologists in Brazil who has done considerable research on the subject. Dr. Sabbatini, citing studies by numerous researchers on the subject presents many anatomical reasons as well as evoutionary reasons for differences in the ways that men and women think. Anatomically, (and I’m grossly generalizing here, do read the citation for more precise characterizations of the differences) the left brain in men (the side of the brain linkied to independence, dominance, spatial and mathematical skills, rank-related aggression), is larger than in women. Conversely, the right brain in women (human relations, recognizing emotional overtones in others and in language, emotional and artistic expressiveness, esthetic appreciation, verbal language and carrying out detailed and pre-planned tasks) is larger than in men. Additionally, the corpus callosum, the think band of neurons that runs between the two sides of the brain is thicker and more developed in females than in males. What does this mean? It means that women are more adept at sending messages back and forth across the brain than me. In simple terms, we multi-task while men focus on one or two tasks at a time.

A simple illustration: Send your husband to the grocery store with a list. He’ll most likely come home with exactly what is on that list and little if anything else. But when you go to the grocery store, you’ll get what’s on your list, but if there is a sale on some item you use a lot, you’ll likely pick up a few. Likewise, if you have forgotten an item and see it on the shelf, something will trigger your memory and you will remember that you’re running low and pick the item up. Is one mode of shopping better than the other? Not really, just different. (Sabbatini and his colleagues note that if roles are reversed, then habits and behaviors often reverse. So if your husband does most of the grocery shopping, he may be more likely to spot necessary not on the shopping list before you do!)

Sabbatini also cited some evolutionary reasons for these differences.

“In ancient times, each sex had a very defined role that helped ensure the survival of the species. Cave men hunted. Cave women gathered food near the home and cared for the children. Brain areas may have been sharpened to enable each sex to carry out their jobs”.

As a mama on bed rest reading this, you may be thinking, “Well that doesn’t help me. I’m worried, I have no one to help me care for my children at home and I may end up losing my job over this. ” All this is entirely true, but your OB (especially if male) isn’t even thinking about these “ancillary” issues. The practice of obstetrics trains physicians to “ensure as healthy a pregnancy as possible so that a healthy, live baby results.” The motivation behind this is, “By any means necessary. ” Steroids making you sick, suck it up, and you’ll get your baby. Preterm labor, go on bed rest. You can rehab your body later and get another job after you clear bankruptcy.

Now I have made this seem callous, cut and dry, but the “life factors” that come into play when a pregnancy has complications are not mentioned or intended to be treated by physicians. (Interesting to note that most of these issues are handled by hospital social workers. How many of them are male??) That’s not what physicians are taught in medical school nor are they trained to consider these issues. To that end, don’t be surprised when your female OB is as cut and dried as her male counterparts. Medical School is a tough road to trod and while there are many women in obstetrics, the rule of thumb is “If you want to make it with ‘the boys’ you have to play by their rules.” Many women physicians go on to develop more caring “feminine” practices, but a large majority continue in their “produce, produce, produce or perish” mode of operation.

How do we blend the two approaches? How can we utilize the scientific, “management” model of obstetrics when needed while maintaining a softer, more collaborative and fully encompassing approach at the same time?

It’s called working together and we’ll discuss how this can be done in our next post.

What are your thoughts on the male and female brain approaches to pregnancy care? Share your comments below. You can also follow and discuss with us on Twitter (@mamasonbedrest) or on our Facebook Page. To keep up with this feed, be sure to sign up for our RSS feed in the upper right hand corner of this page.

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