At
some point along the way, I always talk about death..."in the best of
care, with the best of intention...death of a baby and even death of a mother is
a possibility...birth, as with every other aspect of living, is not without
risk." As I see it, what is important is that people understand the
possibilities and choose for themselves what set of risks they are willing to
live (or die) with. They after all are the ones who live most intimately with
the outcome of the birth.I also talk with parents about outcomes for my own
practice so far... promising them that while I cannot give them a guarantee of
safety, I can commit myself to working alongside them doing my absolute best to
facilitate the happiest healthiest possible birth outcome.
I
might tell them he story of the ob who ''guaranteed safety'' as long as the
woman would only come to hospital or the hospital administrator who politely
explained in a letter to a client that the reason he was insisting on her coming
to hospital was to "ensure safety". I tell them that these wonderful people
are a lot more skilled than I or perhaps have a direct line to a higher source
of information to provide such promises...I did once ask an ob where one could
get a hold of those guarantees..but he just looked at me funny and walked away.
Must be a trade secret.
Around
the 36 week mark, I will initiate a session incuding ''what if the baby arrives
before the midwife'' ''what if the baby is not breathing?" "What if the baby
dies?" This will usually generate discussion on a huge range of issues. I will
also go through situations that may arise and what may need to be done. I even
demonstrate my ''this is serious'' voice so there is no misunderstanding between
''Oh, this is something you might like to try" and ''We have a problem, this is
what we need to do!" This way, clients have a good understanding of how I would
act in a certain situation so on the (unlikely) event occuring there is already
knowlege, trust, partnership. When a woman is bleeding profusely, this is not
the time to begin conversation, weigh up pros and cons of acting upon the
problem, researching alternative treatments....
I
remember once when a woman had had a sizable bleed and went all wafty, laid
back, and said dreamily "I'm going away, I'm going away" I spoke sternly
and said "Not on my time, you're not!!'' She came back quick smart. She said
later that the feeling was really beautiful and she would have been quite happy
to drift off. I explained that apart from anything else that would have been
really bad for my reputation and not a good idea!! :)
Vicki
-----Original Message-----In a message dated 16/06/02 1:48:12 PM AUS Eastern Standard Time, [EMAIL PROTECTED] writes:
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of [EMAIL PROTECTED]
Sent: Monday, June 17, 2002 3:25 AM
To: [EMAIL PROTECTED]
Cc: [EMAIL PROTECTED]
Subject: Re: Fear of death in childbirth
Do you talk about maternal death in class ? Does everyone feel it should be dealt with routinely in classes, afterall I'm sure everyone must worry about it, so we shouldn't ignore it? How do you approach it? Do you just wait to see if someone brings it up as a question ? What are some reasurring things you say about it ? How would you present this to your classes ?
I feel this is an area I need to work on and would very much appreciate input as I formulate my thoughts ...
hug
Julie Clarke
Julie
Hi Julie and all......
talking death (maternal, fetal or infant) in class is something I always struggled with too....its a hard one particularly in large groups when it can be difficult to gauge on a more 'intimate' level just how people are feeling/responding...I've found smaller groups strangely enough worked better...but this may be just my facilitating bias...
However, irrespective of how the group is organised, I personally feel its important to discuss death, (peoples views on death are remarkably similar to their views on birth) but the HOW to initiate the discussion or if in fact we should at all and what potential is there for causing more harm than good are just some of the questions I always asked myself when I was facilitating CBE. Something I never really resolved for myself or in my work at that time....Then one day in a small group of women I was working with, we stumbled onto talking about dreams...how vivid, 'weird' and prolific dreams are in pregnancy....so we explored this for awhile...what sort of things do pregnant women dream about, what comes to them in their dreaming and how dreams make us feel.
What I did find interesting from this work was the amount of times pregnant women dreamed of dying...of their babies dying...of their babies having abnormalities etc etc.. Our 'dream talk' made for a great way to explore death associated with birth, initially from this 'fantasy' perspective, as this approach seemed to make people feel more at ease to talk about the 'fantasy' of death and dying, than the reality, but often would provide an opening, through careful exploration and guided questioning, on how people would respond to similar situations in their 'waking' lives. 'Dream talk' then became a useful approach to discussing death and dying....the trick though was to not get caught up in what people's dreams meant...I have no claim to expertise in analysing dreams...but rather to more explore women's feelings to their dreams and how they would respond to such senario's in the 'real world' - not the fantasy one of our dreams...by bringing the dream senario into the reality f! ! or exploration I found it offered a valuable approach to talking death....
Yours in birth,
Tina Pettigrew
Birthworks
Bachelor of Midwifery Student and Independent CBE
Convenor, Aust B. Mid Student Collective.
http://groups.yahoo.com/group/BMidStudentCollective
[EMAIL PROTECTED]
" As we trust the flowers to open to new life
- So we can trust birth"
Harriette Hartigan.
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