I consider myself an educated woman. Two degrees and post graduate studies would certainly indicate such however it is only since the birth of my first child that I came to realise how difficult it is for a medical lay person to obtain information that truely allows them to make an informed choice.
My first birth was the classic cascade of intervention leading to a csec and I was led down that path by my obstetrician. It wasn't until some months after the birth and a lot of reading, that I discovered there were many many aspects of the decisions made by myself that were far from informed. On almost every aspect related to my "care" my obstetrician presented me with advice and information that could only lead me to conclude and agree that his advice for the recommended intervention was right. I later found there were a whole range of risks and options that I was not told about and on one piece of intervention he actually out and out lied to me.
I can only presume that he thought he was doing the right thing, but I also get the feeling that often we, the woman, are only told what our carer wants us to hear. Whilst we may think we are informed at the time it is not until we get our noses into some good medical research papers and text books that we discover how much wider the risks and options are.
This in itself presents a couple of problems. The first being time, and what do you teach women? There is obviously a lot to learn or obstetric and midwifery training wouldn't take so long. Some of the concepts I have read about I have had to bounce of my husband (a radiographer) to fully grasp what is being discussed and its implications, indicating that those with a lesser education than I may have even more difficulty in grasping some of the risks or benefits of different ideas related to labour management.
I am very pro informing the woman. I think one of the best ways this could be done would be to have a series of little brochures that talk in simplified terms that most women could understand what the causes, treatments and consequences of the myriad of birth related problems and procedures are, eg.
Understanding Fetal Distress
1. What is fetal distress 2. Some examples of what can cause it 3. How is it diagnosed - intermittent, continuous, fetal scalp monitoring, fetal ph testing, fetal stimulation test - pros and cons of these (maybe referring to another brochure for the monitoring)
3. Alleviating fetal distress by - changing positions, oxygen, turning of interventions (oxytocin, epidurals etc), operative delivery (referring to another brochure), csec (referring to another brochure) - pros and cons of these.
As you can see even a simple approach can prove complex - there would be a lot of different brochures - and unfortunately most women will take the "it will never happen to me" approach, and being in labour is probably not the best time to be reading a document - although having such information available would mean that at least the support person would be aware if the woman had been given all the options.
I don't know that there is a solution to this. Whilst early birth education may be useful there will always be the problem of information retention as women wait for longer and longer after finishing school to have their babies. The only way I can see to help women is to make the information as widely available as possible, it is then up to them if they choose to absorb the facts or if they choose to rely on other people for the information - which of course carries the risk I encountered during my first delivery of being told what they want you to hear.
Debby Miller
Chat with friends online, try MSN Messenger: Click Here
-- This mailing list is sponsored by ACE Graphics. Visit
