[Music] [Applause]
it was in October 1983 it was a late
it was in October 1983 it was a late evening like today and I was Sinti with
evening like today and I was Sinti with
evening like today and I was Sinti with my grandmother on her sofa the TV had
my grandmother on her sofa the TV had
my grandmother on her sofa the TV had nothing interesting to watch but we had
nothing interesting to watch but we had
nothing interesting to watch but we had a very interesting discussion she asked
a very interesting discussion she asked
a very interesting discussion she asked me what I wanted to do when I grow up
me what I wanted to do when I grow up
me what I wanted to do when I grow up and I said I want to deliver babies that
and I said I want to deliver babies that
and I said I want to deliver babies that triggered her to share his story with me
triggered her to share his story with me
triggered her to share his story with me that I didn’t know I knew she had seven
that I didn’t know I knew she had seven
that I didn’t know I knew she had seven children but I didn’t know she lost
children but I didn’t know she lost
children but I didn’t know she lost three at birth back then there was no
three at birth back then there was no
three at birth back then there was no doctor
doctor
doctor she had no option she delivered babies
she had no option she delivered babies
she had no option she delivered babies in her house and some others in the
in her house and some others in the
in her house and some others in the fields while working there was only one
fields while working there was only one
fields while working there was only one woman acting up as a midwife her only
woman acting up as a midwife her only
woman acting up as a midwife her only experience was the fact that she has
experience was the fact that she has
experience was the fact that she has done this before he was scary but there
done this before he was scary but there
done this before he was scary but there was no option so this is me I serve
was no option so this is me I serve
was no option so this is me I serve women’s health and I serve in gynecology
women’s health and I serve in gynecology
women’s health and I serve in gynecology fertility and obstetrics I see women
fertility and obstetrics I see women
fertility and obstetrics I see women every day and nowadays women have got
every day and nowadays women have got
every day and nowadays women have got the option to choose which hospital to
the option to choose which hospital to
the option to choose which hospital to go to they’ve got the option which
go to they’ve got the option which
go to they’ve got the option which doctor they choose they’ve got the
doctor they choose they’ve got the
doctor they choose they’ve got the option to demand to be listened and to
option to demand to be listened and to
option to demand to be listened and to demand explanations let’s see some
demand explanations let’s see some
demand explanations let’s see some examples endometriosis I won’t bother
examples endometriosis I won’t bother
examples endometriosis I won’t bother you with the medical details only to
you with the medical details only to
you with the medical details only to tell you that amongst yourself women one
tell you that amongst yourself women one
tell you that amongst yourself women one in ten has got endometriosis
endometriosis can cause no symptoms or
endometriosis can cause no symptoms or pain and infertility and what do you do
pain and infertility and what do you do
pain and infertility and what do you do you run around you shop opinions from
you run around you shop opinions from
you run around you shop opinions from doctors you go on the internet you go on
doctors you go on the internet you go on
doctors you go on the internet you go on Facebook you go everywhere because
Facebook you go everywhere because
Facebook you go everywhere because you’re starving to understand what it is
you’re starving to understand what it is
you’re starving to understand what it is but what do you deserve you deserve us
but what do you deserve you deserve us
but what do you deserve you deserve us to sit down and talk to you in a
to sit down and talk to you in a
to sit down and talk to you in a language you will understand to tell you
language you will understand to tell you
language you will understand to tell you what it is to tell you what
what it is to tell you what
what it is to tell you what investigation steps you have to follow
investigation steps you have to follow
investigation steps you have to follow to give you the options of treatment do
to give you the options of treatment do
to give you the options of treatment do you need treatment and if yes what
you need treatment and if yes what
you need treatment and if yes what treatment medicine surgery and even
treatment medicine surgery and even
treatment medicine surgery and even surgery what are the risks what is a
surgery what are the risks what is a
surgery what are the risks what is a cost we need to listen to you we need to
cost we need to listen to you we need to
cost we need to listen to you we need to explain to you
explain to you
explain to you it’s too much information though you
it’s too much information though you
it’s too much information though you cannot make up your mind you need to
cannot make up your mind you need to
cannot make up your mind you need to just get out go back home read your
just get out go back home read your
just get out go back home read your information again reflect what you heard
information again reflect what you heard
information again reflect what you heard and come back in your own time to
and come back in your own time to
and come back in your own time to discuss what you want to do tell us your
discuss what you want to do tell us your
discuss what you want to do tell us your choice
choice
choice that’s called informed choice let’s see
that’s called informed choice let’s see
that’s called informed choice let’s see another example fertility a huge topic
another example fertility a huge topic
another example fertility a huge topic in my everyday practice a lot of
in my everyday practice a lot of
in my everyday practice a lot of infertile couples nowadays it might be
infertile couples nowadays it might be
infertile couples nowadays it might be your first time going through a
your first time going through a
your first time going through a treatment it might be your tenth time
treatment it might be your tenth time
treatment it might be your tenth time going through treatment you still
going through treatment you still
going through treatment you still frustrated anxious upset you might be
frustrated anxious upset you might be
frustrated anxious upset you might be depressed we’re here for you demand
depressed we’re here for you demand
depressed we’re here for you demand explanations from us you want to know
explanations from us you want to know
explanations from us you want to know why you can’t get pregnant we might find
why you can’t get pregnant we might find
why you can’t get pregnant we might find the reason why not but we’re here to
the reason why not but we’re here to
the reason why not but we’re here to tell you again the investigations you
tell you again the investigations you
tell you again the investigations you need to go through your treatment
need to go through your treatment
need to go through your treatment options you might be treatment 1 2 or 3
options you might be treatment 1 2 or 3
options you might be treatment 1 2 or 3 let’s compare them let’s see what the
let’s compare them let’s see what the
let’s compare them let’s see what the prodigal said let’s see what the
prodigal said let’s see what the
prodigal said let’s see what the experience say what is the cost in every
experience say what is the cost in every
experience say what is the cost in every treatment what are the risks what are
treatment what are the risks what are
treatment what are the risks what are the side effects what is the success
the side effects what is the success
the side effects what is the success rate and what is a cost you might need
rate and what is a cost you might need
rate and what is a cost you might need to see a psychologist we work as a team
to see a psychologist we work as a team
to see a psychologist we work as a team and you are part of our team we need to
and you are part of our team we need to
and you are part of our team we need to explain to you your options and we need
explain to you your options and we need
explain to you your options and we need to come to an agreement we might use
to come to an agreement we might use
to come to an agreement we might use your own ex and if that doesn’t work
your own ex and if that doesn’t work
your own ex and if that doesn’t work you’ve got the option of donor X and if
you’ve got the option of donor X and if
you’ve got the option of donor X and if there’s a problem with a sperm there’s
there’s a problem with a sperm there’s
there’s a problem with a sperm there’s an option with a donor sperm we might
an option with a donor sperm we might
an option with a donor sperm we might use your own uterus and if we can’t do
use your own uterus and if we can’t do
use your own uterus and if we can’t do that we might use somebody else’s you
that we might use somebody else’s you
that we might use somebody else’s you too is what we call surrogacy you should
too is what we call surrogacy you should
too is what we call surrogacy you should know you’ve got the option of
know you’ve got the option of
know you’ve got the option of adopting as well and what if you’re a
adopting as well and what if you’re a
adopting as well and what if you’re a single woman or the same-sex couple of
single woman or the same-sex couple of
single woman or the same-sex couple of course you’ve got the option to have a
course you’ve got the option to have a
course you’ve got the option to have a baby and if your country doesn’t let you
baby and if your country doesn’t let you
baby and if your country doesn’t let you just get out go to different country get
just get out go to different country get
just get out go to different country get pregnant come back or don’t bother
pregnant come back or don’t bother
pregnant come back or don’t bother coming back can you delay your fertility
coming back can you delay your fertility
coming back can you delay your fertility of course you can what if you’ve got
of course you can what if you’ve got
of course you can what if you’ve got breast cancer you have to go through
breast cancer you have to go through
breast cancer you have to go through chemotherapy chemotherapy probably will
chemotherapy chemotherapy probably will
chemotherapy chemotherapy probably will kill your eggs yes you have got the
kill your eggs yes you have got the
kill your eggs yes you have got the option of freezing your eggs before you
option of freezing your eggs before you
option of freezing your eggs before you go to the treatment what if you choose
go to the treatment what if you choose
go to the treatment what if you choose career over family and you’re
career over family and you’re
career over family and you’re approaching at the age of 40 where
approaching at the age of 40 where
approaching at the age of 40 where fertility declines yes you have called
fertility declines yes you have called
fertility declines yes you have called the option of freezing your eggs
the option of freezing your eggs
the option of freezing your eggs likewise if you haven’t found them mr.
likewise if you haven’t found them mr.
likewise if you haven’t found them mr. perfect yet freeze direct you might come
perfect yet freeze direct you might come
perfect yet freeze direct you might come later
okay so now you’re pregnant
okay so now you’re pregnant congratulations with or without
congratulations with or without
congratulations with or without fertility treatment you are pregnant
fertility treatment you are pregnant
fertility treatment you are pregnant it’s a long journey 9 months in the
it’s a long journey 9 months in the
it’s a long journey 9 months in the first three months you’re anxious you’re
first three months you’re anxious you’re
first three months you’re anxious you’re worried how am I going to miscarries my
worried how am I going to miscarries my
worried how am I going to miscarries my baby going to be okay then you’ve got
baby going to be okay then you’ve got
baby going to be okay then you’ve got five months after that where you collect
five months after that where you collect
five months after that where you collect information again you read on the
information again you read on the
information again you read on the internet you read in the books you go to
internet you read in the books you go to
internet you read in the books you go to classes you speak to your doctor your
classes you speak to your doctor your
classes you speak to your doctor your midwives so everything is beautiful
midwives so everything is beautiful
midwives so everything is beautiful you’re dreaming your labor you’re
you’re dreaming your labor you’re
you’re dreaming your labor you’re dreaming your baby you spend money
dreaming your baby you spend money
dreaming your baby you spend money towards the end there is the last month
towards the end there is the last month
towards the end there is the last month where you become heavier you might be
where you become heavier you might be
where you become heavier you might be bored a little bit but at the same time
bored a little bit but at the same time
bored a little bit but at the same time you’re anxious because you’re going to
you’re anxious because you’re going to
you’re anxious because you’re going to give birth but at the same time you’re
give birth but at the same time you’re
give birth but at the same time you’re excited what do we do here
excited what do we do here
excited what do we do here again all this information is coming
again all this information is coming
again all this information is coming into place we need to discuss and
into place we need to discuss and
into place we need to discuss and nowadays you’ve caught the option of a
nowadays you’ve caught the option of a
nowadays you’ve caught the option of a birth plan a birth plan is an agreement
birth plan a birth plan is an agreement
birth plan a birth plan is an agreement between you and us we have to go through
between you and us we have to go through
between you and us we have to go through what you know and tell you what we know
what you know and tell you what we know
what you know and tell you what we know and then negotiate how your labor has to
and then negotiate how your labor has to
and then negotiate how your labor has to be now we can’t do this negotiation in
be now we can’t do this negotiation in
be now we can’t do this negotiation in labor board is too difficult you’re in
labor board is too difficult you’re in
labor board is too difficult you’re in pain or you might be too tired but you
pain or you might be too tired but you
pain or you might be too tired but you have to do this with us many many weeks
have to do this with us many many weeks
have to do this with us many many weeks beforehand
beforehand
beforehand say 34 weeks we sit down and we discuss
say 34 weeks we sit down and we discuss
say 34 weeks we sit down and we discuss all the possible scenarios what you want
all the possible scenarios what you want
all the possible scenarios what you want might not necessarily happen because
might not necessarily happen because
might not necessarily happen because labor is unpredictable you cannot fix
labor is unpredictable you cannot fix
labor is unpredictable you cannot fix labor if your friend had a water birth
labor if your friend had a water birth
labor if your friend had a water birth it doesn’t mean you can have it but what
it doesn’t mean you can have it but what
it doesn’t mean you can have it but what we can do discuss your options let’s go
we can do discuss your options let’s go
we can do discuss your options let’s go through different scenarios if this
through different scenarios if this
through different scenarios if this happen we’re going to do this if this
happen we’re going to do this if this
happen we’re going to do this if this happen going to do that through this we
happen going to do that through this we
happen going to do that through this we develop trust and when the time comes
develop trust and when the time comes
develop trust and when the time comes whatever happens it happens and the end
whatever happens it happens and the end
whatever happens it happens and the end of the day you’re having a baby if
of the day you’re having a baby if
of the day you’re having a baby if that’s your target a baby and the money
that’s your target a baby and the money
that’s your target a baby and the money to be home safe it doesn’t matter it
to be home safe it doesn’t matter it
to be home safe it doesn’t matter it doesn’t matter how it happens this
doesn’t matter how it happens this
doesn’t matter how it happens this beautiful lady up there came to see me
beautiful lady up there came to see me
beautiful lady up there came to see me at 34 weeks with a birth plan ten pages
at 34 weeks with a birth plan ten pages
at 34 weeks with a birth plan ten pages it was fixed to have a water birth guess
it was fixed to have a water birth guess
it was fixed to have a water birth guess will happen at the end she had a
will happen at the end she had a
will happen at the end she had a cesarean section but you know what she
cesarean section but you know what she
cesarean section but you know what she was very happy only because that was
was very happy only because that was
was very happy only because that was part of the discussion we did before so
part of the discussion we did before so
part of the discussion we did before so she was prepared for it and we cannot
she was prepared for it and we cannot
she was prepared for it and we cannot control labor again it’s about all the
control labor again it’s about all the
control labor again it’s about all the information that is shared between us
information that is shared between us
information that is shared between us the discussion we do and the agreement
the discussion we do and the agreement
the discussion we do and the agreement we have these two fellows came in my
we have these two fellows came in my
we have these two fellows came in my office one day in the outside window
office one day in the outside window
office one day in the outside window clearly they didn’t come to us for
clearly they didn’t come to us for
clearly they didn’t come to us for fertility health
fertility health
fertility health likewise not to discuss my options there
likewise not to discuss my options there
likewise not to discuss my options there no humans they don’t need options
no humans they don’t need options
no humans they don’t need options they’re free and they’re happy so we’re
they’re free and they’re happy so we’re
they’re free and they’re happy so we’re in October 2016 a late evening like back
in October 2016 a late evening like back
in October 2016 a late evening like back in my grandmother story back then there
in my grandmother story back then there
in my grandmother story back then there was no option with now it’s about time –
was no option with now it’s about time –
was no option with now it’s about time – now we’ve got options it’s about time to
now we’ve got options it’s about time to
now we’ve got options it’s about time to give up this gift that is called options
give up this gift that is called options
give up this gift that is called options and it’s about time medicine speaks to
and it’s about time medicine speaks to
and it’s about time medicine speaks to patients is happening in many countries
patients is happening in many countries
patients is happening in many countries but not in all and it should happen to
but not in all and it should happen to
but not in all and it should happen to all let me explain to you what I call
all let me explain to you what I call
all let me explain to you what I call the modern doctor we’re human beings and
the modern doctor we’re human beings and
the modern doctor we’re human beings and we do mistakes – but we owe to share
we do mistakes – but we owe to share
we do mistakes – but we owe to share with you our knowledge in the language
with you our knowledge in the language
with you our knowledge in the language you will understand we have to share
you will understand we have to share
you will understand we have to share with you medicine in a way you will
with you medicine in a way you will
with you medicine in a way you will understand so when we discuss options
understand so when we discuss options
understand so when we discuss options one or two or three pros and cons you
one or two or three pros and cons you
one or two or three pros and cons you understand what’s happening and you make
understand what’s happening and you make
understand what’s happening and you make an informed choice for which you’re also
an informed choice for which you’re also
an informed choice for which you’re also responsible we listen to each other we
responsible we listen to each other we
responsible we listen to each other we discuss we need to understand each other
discuss we need to understand each other
discuss we need to understand each other we challenge each other we may agree or
we challenge each other we may agree or
we challenge each other we may agree or we might agree that we disagree and then
we might agree that we disagree and then
we might agree that we disagree and then you move on and find another doctor this
you move on and find another doctor this
you move on and find another doctor this is my vision I wish that although
is my vision I wish that although
is my vision I wish that although medicine develops and knowledge changes
medicine develops and knowledge changes
medicine develops and knowledge changes doctor-patient relationship remains we
doctor-patient relationship remains we
doctor-patient relationship remains we are both humans that need to understand
are both humans that need to understand
are both humans that need to understand each other and it’s about time to do
each other and it’s about time to do
each other and it’s about time to do this and consider it thank you
this and consider it thank you
this and consider it thank you [Applause]
”
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