Im beginning to question things my doctor says...

tiggerhammon
tiggerhammon Posts: 2,211 Member
Where to begin...? I like my doctor and have always felt like I can trust him but lately I am feeling confused by things he says.
At my ultrasound, they told me that my baby was very long for his age. At 21 weeks he was measuring 14 inches long! Aside from that, everything else measured on track. So, my due date stayed the same. So, we have known from then he is just going to be a big kid.
3 months ago I was measuring 1 week ahead of schedule, 2 months ago I was measuring 2 weeks ahead of schedule and last month I was measuring 3 weeks ahead of schedule. Today, doctor tells me I am measuring 4 weeks ahead of schedule. I asked him why the baby seems to be growing at a faster rate than normal and he tells me it is probably my diet.
He said to be careful eating white pastas, white rice, white bread, white sugar, etc and that excess amounts of these can cause the baby to gain fat at a faster rate than normal. I posted this on my wall and got some differing opinions so I googled it. Turns out the doctor is only partially correct.
What gets me though is that as of today the baby is measuring almost 17inches. How can the doctor blame it on me fattening the baby when it is obvious that the kid is just big? His length is 3-4 weeks ahead and, of course, a longer baby is going to weigh more. This is impossible to blame on diet. Regardless of what I eat, it isn't going to make the baby longer. Then, I really get thinking about it - I don't eat white rice or white bread. Yes, of course, I eat sugar but I really don't eat a lot. What else could be causing my baby to grow at a faster rate than normal? I really don't think the doctor knows.
Few more things ...
My doctor has done a really good job of scaring me and convincing me that I have high risk of repeat Csection and complications.
First, he says that I cannot be induced if I do not go into labor on my own, as this could cause uterine rupture. Well, online it says that that theory was thrown out in the 1980s because the risk of uterine rupture is so low.
Second, he tells me of how, because I have had a Csection, my risk of uterine rupture is higher and goes on to explain a uterine rupture and scares me. Well, online it says the risk of uterine rupture is not only super low, but it is actually more common in women that have not had a Csection.

Questions: Doctor says if I do not go into labor on my own by 41 weeks, they have to do a Csection. What if I say no? What if I refuse? They can't make me! ... Right?
Also, doctor says I cannot be in labor for more than 24 hours, or they have to do a Csection. Again, they can't force me, can they?
He says if I go into labor on my own, go into the hospital and then labor stops - they have to do a Csection. That is not right! This happened with my daughter and they just sent me back home to wait for it to start again.
He also says if my water breaks and contractions don't start, they have to do a Csection because they can't trigger labor and baby can't stay in there without water. I can't find any information online about this. Is there any specific time frame on how long without water the baby would be okay?

Also, along the lines of triggering labor. Doctor says he can't start my labor using pitosin because of the risks with someone who has a Csection. Online, it says that using pitosin poses no additional risks to someone that has had a Csection than to someone that hasn't.

I have to give my doctor the benefit of the doubt, with him fearing that my labor and inability to deliver with the first will be repeated with this baby. But, it doesn't mean that is for sure. I hear stories all the time on how women have a horror labor with one and then smooth the next. My doctor is so convinced that it is going to be the same as last time he is already planning a Csection.

Quick 'did you know' fact I found online (reputable website) that my doctor said exactly the opposite of: women that refuse the epidural have a lower percentage of Csection of those that get it. There is also evidence that the use of an epidural may contribute to labors failing to progress.
Failing to progress is precisely the reason I had a Csection the first time.

I would just like some other opinions...
Anyone?
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Replies

  • Nique85
    Nique85 Posts: 105 Member
    I don't know if you are apart of Facebook but they have this group that is called VBAC Community Facts. They can answer most of your questions and most of the women have experienced the same thing you are going through. Second, my doctor has told me the same thing about if I don't go by 41 weeks automatic c-section and she won't induce me with pitocin if I'm not progressed (dilated or effaced).

    From what I've read, most doctors try to scare their patients with "big baby" tactic to get them to get a c-section (that is what happened to me when I was pregnant with my daughter hence me getting the c section).

    Also, from what I have learned you can refuse a c section. In the Facebook group the women will schedule the c section , then cancel it or call in and say an "emergency" happened so they don't show up to their c section. Then they wait until they start labor on their own, but still request weekly NST's from their doctor's just to make sure the baby is safe until they go into labor.

    I have also read the same thing about the epidural which is why if I do get one I want it low as possible, because I read it can slow down labor.

    I don't know if what I am writing you is even addressing your concerns. But I am also questioning some of my doctors statements as well. I have trust issues with doctors anyway just because of what happened with my daughter's pregnancy and delivery. So I've been trying to research as much as possible. I'm starting to write my birth plan on exactly what I want from my doctor to help guide things along.
  • meggwyn
    meggwyn Posts: 226 Member
    Most of that sounds like rubbish! Let me ask my cousin to comment. She has had two VBACs, both with very large babies. With the second one, her water had been broken for well over 24 hours, but labor was stalled and she still ended up being able to go on her own. I think she even had some pitocin at one point to try to help pick things back up. Let me message her! :)
  • psmd
    psmd Posts: 764 Member
    Ob/gyn is the least scientific of all specialties. So some of what your doctor says probably has some scientific data behind it, and some that contradicts it.

    I would say the most important thing about your doctor is your comfort level with him. Is this the same doctor you had for the first pregnancy? How did that go? If you don't feel that comfortable anymore, can you get a recommendation from friends for someone they had a good experience with?
  • usernameMAMA
    usernameMAMA Posts: 681 Member
    I would seek out a second opinion. Some of what he is telling you doesn't sound right. I read an article a little while ago that said more doctors are pushing women to get C sections so it doesn't disrupt their lives (plans, vacations, having to deliver in the middle of the night). The only thing I can say is that when I had my first my water broke fully at 5am on a Thursday morning and I didn't deliver until 8:41am on Friday morning. That's 27+ hours without water and my boy was just fine when he arrived. I wouldn't be pushed into anything I didn't want to do.
  • DawnieB1977
    DawnieB1977 Posts: 4,248 Member
    We see a midwife in England, not a doctor, and when we have scans, a sonographer does it. So I've never heard anyone say anything about certain foods making a baby bigger. People just have different sized babies. I think the thing that can cause bigger babies is gestational diabetes. If you have GD here they don't let you go overdue.

    With a VBAC, they won't allow you to be induced with drugs here either because contractions are stronger and it can risk rupturing your scar. I was talking to my midwife about it (I've never had a csec, but was talking about someone I know who had an elective for her 2nd baby) and she seemed to think the risk was low. They don't do csecs readily over here, we have a much lower percentage of csecs than in the US.

    A friend of mine was aiming for a VBAC, and they allowed her to go 10 days overdue. They offered to induce her by breaking her waters, but she decided to go for a csec instead as she was worried about ending up with an emergency csec again.

    I was induced with my 2nd as she was 12 days overdue (using a pessary - prostin I think) and contractions were definitely stronger than my natural labour with my first.

    As for the epidural, I've never had one, but have also heard that it can slow down progress. I've also heard that you're more likely to tear as you can't feel properly when you're pushing.
  • HeyNikkita
    HeyNikkita Posts: 147 Member
    Okay, okay... I want to throw this out there as a licensed medical professional. I am assuming you live in the States.

    First let me say, I HOPE you get your VBAC as planned. This is best-case scenario. Your doctor is preparing you for WORST-case scenario (and from my POV, it's appropriate)...

    Your doctor is giving you as much information as possible about the worst case scenario. You have the right to be informed about all the possibilities and outcomes of whatever delivery may happen.

    You absolutely have the right to refuse any and all procedures. Again, you should be informed of the risks, benefits, and alternatives of said decision. So if you don't want a C-Section, it is your right to refuse. However, you must understand the risk you put yourself and your baby at. Uterine rupture is deadly for both parties. Period. Can you blame your doc for being overly-cautious and protecting him/herself from such a litigious society?

    About the water breaking - realistically, the baby's heart rate tells a lot about conditions in the womb.
    Some doctors get impatient, some C.Y.A., some babies truly need saving...

    Delivery is not the time to be selfish, you have another precious life hanging in the balance of your decisions.

    Try to find peer-reviewed, scholastic information and studies to guide your decisions. Not some magazine/news article or blog or WIKI that ascertains whatever the writer believes without credible sources.
    Medline Plus and National Institutes of Health are good websites.
  • dandelyon
    dandelyon Posts: 620 Member
    Seek a second opinion immediately. I just had my second vbac. A long, large baby with a four day s of ruptured membranes and erratic labor. There were some medical interventions including Pitocin and they were thoughtfully considered. No one ever said to me, you must do xyz, they said here is a option, I will leave while you and your husband discuss it. They did insist on antibiotics after a certain amount of time with the ruptured membranes, even though I had no symptoms of infection. I suspect it was because it had become clear this labor would be measured in days, not hours.

    Here is the problem with a long labor - your doctor has to stay on the floor the whole time. My midwife was basically tethered to me from Friday to Monday. She looked more tired than I did when it came time for me to push. But this is her passion :) there are lots of providers like her.

    If you have a low horizontal scar and haven't had a previous section in the last 12 mos, find a doctor who will treat you like a regular low risk patient, because that's basically what you are. I mean, I had my own doubts and insecurities going into my first vbac. I needed support encouragement, and I needed objective facts. The practice had put together a fantastic handout with risks and benefits that both repeat cs moms and vbac moms had to read, discuss, and sign. My midwife group made me visit an obgyn for an independent consult as well.

    Ps when I said big babies, we are talking 9 1/2 and 22in for my baby and 10-14, 21 1/2 inches for my toddler. I didn't even tear with the little 9 lber, He was 15 min of pushing and it was a fantastic recovery.

    Another thing to consider is your childbearing future. If you want to have more babies, then a doctor who is okay with several sections but tying to scare you about vbac definitely is not the best provider for you. Risks of c section, especially multiple c sections, are serious and should be explained to you fully.

    Check out ACOG statement on vbac. Definitely more encouraging than most doctors!
  • dandelyon
    dandelyon Posts: 620 Member
    Oh, re the risk of uterine rupture, yes it is higher in women who've had a section, that is an undisputed fact. But rupture doesn't mean death of you or the baby, it doesn't mean you can't have more children. But it does mean you'll have an emergency that you want handled by competent providers.
  • tiggerhammon
    tiggerhammon Posts: 2,211 Member
    I am assuming you live in the States.

    First let me say, I HOPE you get your VBAC as planned. This is best-case scenario. Your doctor is preparing you for WORST-case scenario (and from my POV, it's appropriate)...

    Your doctor is giving you as much information as possible about the worst case scenario. You have the right to be informed about all the possibilities and outcomes of whatever delivery may happen.

    Thank you everybody for all of your insight and opinions.
    After really thinking about it and discussing it with my husband, I think what I quoted here summarizes how I feel now.
    The doctor did give me a long scary list of worse case scenarios and he scared the crap out of me. I was definitely scared and maybe that was the doctor's intentions was to scare to scare me, maybe not.
    I am still scared. Scared enough that I don't feel comfortable switching to a midwife because I truly do want to be in the hospital, just in case. But, I think it is time I put my foot down and stand up for what I want. My husband said to tell the doctor that "I am going to give birth to this baby on my own or I am going to die trying!" and see what the doctor says then.
    While I probably won't use those exact words, this is pretty much what I am going with/how I feel. If my doctor can truly understand how important not having another Csection is to me, then I feel I can trust him to not try to make me unless it really is medically necessary.
    Statiscs say that 80% of women attempting VBAC are successful and 1% of women experience uterine rupture. Knowing the real facts, and not just hearing a horror story, help me feel better.
    I want to do everything I can to prepare my mind and body for a natural delivery and letting myself be struck with fear isn't going to help. I have got to stop being scared.
    I CAN DO THIS! lol
    I have also decided, after a lot of reading last night, that regardless of the fact that the doctor says I can't have pitosin anyways - I don't want it. Awful stuff.
    I have also decided I am opting out of an epidural (which makes me scared a little again) and I am going to get a water tub in the hospital. This is probably as close to a natural birth experience as I am going to get. I applaud all of you that dare have your babies at home, I just don't.

    And, yes, I live in Utah - where there is almost no controversy about home births and natural delivery, it is rare that women have less than 3 kids and women are respected in their right to make their own decisions on these matters. I am sure all will be fine.
  • TLCEsq
    TLCEsq Posts: 413 Member
    I also just want to comment regarding the whole ultrasound dating thing - both of my doctors maintain that the due date DOES NOT CHANGE. Babies don't always grow at a constant rate, so you might measure ahead one week and behind the next, that's what's happening to me right now but my due date is still 5/31. I did have to get an ultrasound dating when I was 5 weeks because I ovulated two weeks late and my cycle was all wonky. When I had my positive test I hadn't even missed my period yet and it made a difference.

    Regarding C Sections and all that stuff - no you don't have to do anything you don't want to do. I am high risk and I can't tell you how many comments I get when I go in for monitoring and whatnot and the nurses are asking me when my delivery is scheduled. Like EVERY SINGLE TIME. It gets very irritating and I don't take it personally but after the fifth time I start getting snarky.
  • miranda_mom
    miranda_mom Posts: 873 Member
    I don't have any experience with VBAC as I had both my children vaginally but I did want to comment on the size thing. I was diagnosed with gestational diabetes with my second pregnancy. At all the ultrasounds I had before the diagnosis they were saying his size was fine, pretty much right on target.
    Then I had a growth scan due to the GD diagnosis. Right away, they are telling me that his abdominal circumference is too big. They had me do all this additional blood sugar testing (all of which was fine). And I said wasn't it possible that he was big before I got the diagnosis? I have a medical condition related to diabetes. And they said yes but they were still concerned that he was going to be big, etc.
    I had a second growth scan at 37 weeks and they told me that now his abdominal circumference was in the normal range but his weight was too high. They were giving me percentages, not gestational ages, but we're talking above the 90th percentile.
    Luckily they were on board with seeing how things progressed and I actually went into labor on my own at 37 1/2 weeks. My son was 7 lbs. 6 oz. which I guess is big for a baby of that gestational age but he did not have a big belly or anything like they were saying. He was 21 inches long, which was longer even than my daughter who was born at 40 1/2 weeks gestation so, like you, I'm thinking the high weight was due at least in part to the high length.
    My point is that the weights that they gave me weren't even accurate. At the last growth scan they were saying 7 lbs. 11 oz. and he wasn't even that much when he was born. I've heard of women being told 9 lbs. and giving birth to 6 lb. babies - more than once.
    As for the water breaking, I believe they want to deliver within 24 hours to prevent infection.
  • DawnieB1977
    DawnieB1977 Posts: 4,248 Member
    I also know women who've had scans and been told their baby will be massive, and then given birth to a 7lbs baby on due date. They can never be totally accurate.

    Over here, if your waters break and you haven't given birth within 24 hours you get IV antibiotics, but they don't induce for 72 hours after waters breaking. Obviously it depends on individual circumstances.

    As for the induction thing, they are far more reluctant in England to do elective c-secs, yet they will not induce a VBAC with drugs, so there must be a risk somewhere.
  • Mslmesq
    Mslmesq Posts: 1,000 Member
    You may want to switch drs to a vbac friendly doc.

    My doctor also tried to give me bs scare tactics (not in relation to vbac, but to natural birth) and then said 'I'm not trying to scare you, but'. I said dead pan, 'you're not'. He looked pissed by my response. Wonder how his face looked when he found out I switched drs. :-/
  • mycrazy8splus1
    mycrazy8splus1 Posts: 1,558 Member
    Ultrasounds are like looking through murky water. They are not as accurate as doctors would like to think. With my 4th child the doctors kept telling me the baby was going to be huge and they wanted to induce me. They said my due date was wrong and wanted to move it up. I know exactly when I got pregnant because my husband was deployed all but 3 days the month I got preggo. I refused the induction and waited 3 more weeks (according to the doctors I was 43 weeks along when he was born but I say he was 40 weeks). He was 7 pounds 9 oz NOT the 9 + pounds the doctors had feared. I had my 9th baby at home and it was amazing and wonderful. Most of my hospital births were not great BUT #8 was born in a different hospital (non-military) and for a hospital birth it was very nice. My doctor was very hands off, I was able to change positions, use a birthing ball, no drugs, ect. My military births were not like that at all. You need to find a doctor and a hospital that will work with your birth plan and make you comfortable. Being stressed and uncomfortable will make your labour longer and more difficult.
  • DawnieB1977
    DawnieB1977 Posts: 4,248 Member
    Is it usual to have a doctor deliver your baby in the US? We don't see a doctor all pregnancy in England, unless we're high risk. The only doctor you see is the paediatrician who checks your baby before you get discharged from hospital. Our maternity wards are staffed by midwives and health care assistants. When you give birth, your baby is delivered by whichever midwife is on shift. Throughout pregnancy you see a community midwife at your GP surgery.

    I'm planning on having no.3 in a midwife-lead unit, which has no doctors at all, and all you have access to is gas and air and pethidine, no epidurals.
  • lisapr123
    lisapr123 Posts: 863 Member
    Is it usual to have a doctor deliver your baby in the US? We don't see a doctor all pregnancy in England, unless we're high risk. The only doctor you see is the paediatrician who checks your baby before you get discharged from hospital. Our maternity wards are staffed by midwives and health care assistants. When you give birth, your baby is delivered by whichever midwife is on shift. Throughout pregnancy you see a community midwife at your GP surgery.

    I'm planning on having no.3 in a midwife-lead unit, which has no doctors at all, and all you have access to is gas and air and pethidine, no epidurals.

    Yes, the vast majority of births are with a doctor here in the US. I know maybe 3 people that have had non-physician deliveries. We have an excessive amount of medical care here. It's pathetic.
  • seidel1325
    seidel1325 Posts: 94 Member
    Medical technology and education in the United States is a wonderful benefit, not a burden. It's one of the reasons why we are at the top of the list for low infant mortality rates.

    Having waited 17 years between babies, I can understand your frustration with the conflicting medical information out there. OB/Gyn seems to be a dynamic, fluid specialty. That being said, your doctor is a residency trained physician with lots of experience. Even if he is just staring out, he has at least 7 years of medical knowledge. I think that Nikittapolk said it best - basically, because of litigation our doctors are forced to practice "defensive medicine." This means they are generally going to promote the most conservative approach to treatment and try to talk you out of riskier situations.

    The bottom line is you always have a right to refuse care...unless you live in Texas and happen to be in a coma while pregnant (said with tongue in cheek). Just make sure you are aware of the risks to you and your baby. May your pregnancy and delivery be safe!!!
  • meggwyn
    meggwyn Posts: 226 Member
    Medical technology and education in the United States is a wonderful benefit, not a burden. It's one of the reasons why we are at the top of the list for low infant mortality rates.



    Surprisingly, we rank 34th for countries with the lowest infant mortality rates, which is shocking considering we've basically made birth a medical procedure and most women give birth in hospitals here! I would have expected us to be much higher on the list.

    http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate
  • DawnieB1977
    DawnieB1977 Posts: 4,248 Member
    Is it usual to have a doctor deliver your baby in the US? We don't see a doctor all pregnancy in England, unless we're high risk. The only doctor you see is the paediatrician who checks your baby before you get discharged from hospital. Our maternity wards are staffed by midwives and health care assistants. When you give birth, your baby is delivered by whichever midwife is on shift. Throughout pregnancy you see a community midwife at your GP surgery.

    I'm planning on having no.3 in a midwife-lead unit, which has no doctors at all, and all you have access to is gas and air and pethidine, no epidurals.

    Yes, the vast majority of births are with a doctor here in the US. I know maybe 3 people that have had non-physician deliveries. We have an excessive amount of medical care here. It's pathetic.

    Well, I guess they can charge you for it! We have free health care in England.
  • heatherz104
    heatherz104 Posts: 70 Member
    Well, I'm also trying for a VBAC and your doctor sounds like they might not be that VBAC friendly, unless you think they were truly just trying to give you all the worst case scenarios. I am in the process of switching docs at 20 weeks to find a more VBAC supportive practice. I wish you luck, try to do lots of reading on the facts and risks, and remember a repeat C section has just as many risks if not more as a VBAC:)
  • heatherz104
    heatherz104 Posts: 70 Member
    Oh and I think you could request to wait until 42 weeks instead of 41 before scheduling a repeat cs. And there's lots of natural ways to help stimulate your body going into labor once you've reached your due date. I had my first cs for failure to progress after several interventions I didn't want but I did go into labor on my own (on my due date lol) before all that happened. So I feel confident about that part. I think we have a better chance of success if we aren't put on a time schedule and aren't rushed. I'm going to try drinking red rasberry leaf tea this time when I get to my third trimester and may consider EPO. I also plan on trying to make sure I'm in good labor before going in to the hospital this time.
  • Verity1111
    Verity1111 Posts: 3,309 Member
    Wait till 42 weeks to schedule a c section or induction. Being tall is not a diet issue, it is likely a genetic "issue" in my humble opinion..
  • tiggerhammon
    tiggerhammon Posts: 2,211 Member
    Yes, I have since learned that (aside from what the doctor was insistent on) I can request to wait until 42 weeks. No longer than that though as it poses health risks.
  • jennk5309
    jennk5309 Posts: 206 Member
    Is there any way that you can switch doctors? Maybe to a female one? I have noticed that they have a tendency to listen to their patients more and are willing to discuss things, rather than having that "how dare you question me" attitude that some of the male doctors do.
  • tiggerhammon
    tiggerhammon Posts: 2,211 Member
    Unfortunately, for insurance and financial reasons, switching doctors is not an option.
  • mycrazy8splus1
    mycrazy8splus1 Posts: 1,558 Member
    when are you due? How are things going?
  • pamelak5
    pamelak5 Posts: 327 Member
    It sounds like you really don't trust your doctor...is there really no way you can switch, even if it means a further drive? Your doctor knows you and your specific situation, and what you read online can vary drastically in reliability (and it's not tailored to you). Placental abruption is no joke. 1% doesn't sound like a lot, but it is a significant risk when it can lead to a dead mom and/or dead baby.

    I would recommend reading "expecting better" by emily oster - she has a chapter on induction. You don't want to refuse, on principle, to consent to an induction in a serious situation. She explains situations that truly call for an induction, versus those that don't. People just not showing up to inductions makes me really nervous.
  • tiggerhammon
    tiggerhammon Posts: 2,211 Member
    I will be 32 weeks tomorrow.
    I cannot switch doctors. This one is already completely paid for and to switch would mean $3,100 out of my own pocket to another doctor. I just can't do it.

    I have been doing a lot of research and a lot of branching out. I cannot actually go to a midwife clinic, nor do I feel comfortable having my baby at home. I will be having my baby in the hospital and with the doctor but will be doing everything possible natural and in my own way and time.
    My aunt (licensed massage therapist but does so much more) has been helping me tone my uterus and birthing muscles. I am drinking raspberry leaf tea, taking natural supplements and using essential oils to 'prepare' my system. I am seeing my aunt once a week now and when there is 4 weeks left I will start seeing her twice a week.
    I feel so much better since I started working with her. I will continue to receive care and testsbfrom the doctor and will listen to everything he says but am continuing to research everything he tells me before just swallowing it.
    My aunt has helped me completely get rid of my sciatic nerve pain, all water retention, my aching hip pain and more. She has also helped eased my nerves a lot. I am feeling much less scared :p
  • miranda_mom
    miranda_mom Posts: 873 Member
    It sounds like you really don't trust your doctor...is there really no way you can switch, even if it means a further drive? Your doctor knows you and your specific situation, and what you read online can vary drastically in reliability (and it's not tailored to you). Placental abruption is no joke. 1% doesn't sound like a lot, but it is a significant risk when it can lead to a dead mom and/or dead baby.

    I would recommend reading "expecting better" by emily oster - she has a chapter on induction. You don't want to refuse, on principle, to consent to an induction in a serious situation. She explains situations that truly call for an induction, versus those that don't. People just not showing up to inductions makes me really nervous.

    ^^ That's a really awesome book! I read it cover to cover in like two days when I was pregnant.
  • Verity1111
    Verity1111 Posts: 3,309 Member
    Also, I forgot to say, they CAN induce labor if your water breaks.. They should NOT do it right away. There is increased risk of infection when the water breaks..if it leaks, it is not as bad of a risk for your baby, from what I know, because you will keep producing fluid until the baby is born and the placenta is delivered... The best doctors usually wait 24hrs to see if you can naturally start contractions (by walking, exercising, or other methods) before inducing them... A c-section should only happen after the other two ways have been tried and have failed. Good luck... I would switch doctors. If you can't, then try standing up to your doctor, instead.. If you need to, find proof, in books written by doctors, in a written second opinion from another obgyn, or even printed from certain websites...if the website is credible, like the one for the Mayo Clinic. Don't be rude about it, but say "Well, I read... and I prefer to have as little intervention as possible."