We were met by a very uncooperative midwife who was neither welcoming or helpful. She was antagonistic from the start and was categorial about the "water birth policy" that said the bath could not be used for labour. We were not wanting a water birth but just the possibility of using the bath later in the labout if it would help the woman who was having a very sharp, short labour with a lot of pain. The water pressure is so low in the unit that it was going to take a very long time for the bath to fill and I felt we had to get started early.
The supervisor who was then called in was extemely agitated and uncoperative. She did not introduce herself, was unnecessarily rude and was unwilling to talk to me rationally. I asked about the policy about using water in labour and was told that it was not written down. She said that she "had worked in the UK" and knew about using water but was not willing to let it happen on this particular night. She also made it very clear that the staff had not had any training and until this happened, no-one was to use the bath in any way.
My main concern in all this was the effect it was having on the woman. Her rights were being restricted, she was being limited in what she should choose to do. If this option was indeed not to be offered, why was this not communciated in advance to this woman on her labour ward tour, or through her obstetrician? The poor communication skills demonstrated by the staff were appalling. I tried to be as low key as possible because I knew that the woman could probably hear what was going on even though she was in the next room. A woman in labour is excessively sensitive to her surroundings, as I am sure you will appreciate. I kept thinking, if this is happening to me and to this private client of a very supportive obstetrician, how does the average, unsupoprted woman fare? This private client was always going to have her obstetrician in attendance as he was in the building with three other labouring women at the time and he was unconcerned about her labouring in water (or even a waterbirth is it came to that) so why were the staff so uptight? The fear thing has everyone running scared and it is the women who must suffer from a lack of preparedness and poor public relations by the staff!
Yes, this has been discussed in a public forum and I make no apologies for this. There is a "right to know" that I think must be respected and if that means discussing that RPA needs to get its house in order, then so be it. The facilities are a big improvement on the old unit and I can imagine the struggle that may have gone on behind the scenes to make sure that PRA moved with the times. I applaud the midwives who have worked hard on this, but suggest that they could have easily seen the potential for public reaction (and mine, on this occasion) when this situation arose.
As a conusmer advocate (and member of ACMI) I will not "fall into line" to protect midwives if I think they could be doing better. Women are the centre of the story and in this case, it was the woman I was with whom I was most concerned about - that is my job as hopefully effective advocate.
Some of the staff at RPA are in urgent need of a crash course in woman centred care, good communication and self help mneasures for easing pain that does not involve drugs or technology. I am not suggesting that PRA is alone in this - in fact I am becoming increasing distressed by the falling levels of skills in Australian midwives that I feel is occurring in most units. I am trying to do something about this - by offering woprkshops for midwives and encouraging managers to look at better models of midwifery care. Not talking about it will not solve these problems -
action is needed. The midwives who are competent and caring have nothing to be concerend about - they know they are being "with woman". When are we going to do something about all thes rest?
I am hopeful that a meeting can be arranged with the managers and key staff at RPA and myself to talk this through. I am sure that this would be beneficial and would lead to some productive outcomes.
Andrea
At 04:42 PM 17/01/2003, Hannah Dahlen wrote:
Response to criticisms re-use of water during labour/birth at RPA We need to respond to the criticism that has been levelled against the midwives working in the RPA Delivery Ward regarding the use of water for labour/ birth. We are disappointed that the criticisms made were so public and so one sided. As a profession midwifery comes in for a lot of criticism and brow beating but to have it come from our ownı so to speak, without the full story being told is disappointing to us all and distressing to the individuals who were referred to in a derogatory manner. It is a pity one incident has been used to tarnish the entire organisation.KGV only moved over to the new building at RPA at the end of November and has now been renamed RPA Women and Babies. Christmas fell shortly after the move and it is a time when things often grind to a halt. The move has not been easy. As with most change people are still adjusting. The relationship between the Delivery Ward and Birth Centre has always been excellent and we are very proud of this. We are supportive of each other and respectful so it is distressing to read false reports on a public chat line about a us and themı attitude when this has never existed and we will not tolerate it existing in the future. We wish to clarify what happened re the case publicly discussed on ozmidwifery. Firstly, we have a Use of bath in labour policyı that has been developed over the past year. It provides women with the option to have a water birth in the Delivery Ward if they so choose and it remains a safe option. We have fought long and hard to remove the distinction that water in labour and birth can only be obtained in the Birth Centre by developing a policy to facilitate its use in Delivery Ward. It is a pity that no one though to congratulate the midwives on successfully getting this policy through as it is a pretty rare thing for water birth to be allowed in a delivery ward especially in a Level Six Unit. Despite what has been said, not only have we been thrilled about the prospect of baths in every delivery room but we have prepared for this with a policy and workshops on water birth. Despite all the planning in the world what could not have been predicted was the plugs would have no attachments so could not be easily removed if needed, the cleaning of the baths policy would change and new solutions and equipment would need to be purchased, and the water dopplers ordered months ago would be held up. A Use of water/bath in labour workbook for midwivesı has now been developed to help with the final stages of preparing the midwives to care for women in water during labour and birth. Safety of the woman and the baby is paramount as is the safety of the staff. Those who work in the system as many of us do will know that if anything goes wrong with a birth in water, at home or in a birth centre the finger of blame is quick to fall regardless of the facts. It is essential we donıt allow wonderful options such as labour/birth in water to be removed forever because we do not follow basic safety guidelines. Whether this is philosophically right or wrong, it is the real worldı and there are those of us who battle everyday to make changes in this real worldı. We owe women and their families the best care. We also owe our profession support and guidance when they are venturing into new territory. Please let us start working together and not creating a them and usı within our own profession when this attitude does not need to exist. Women will be able to use the baths for labour and birth very shortly in the RPA Delivery Ward and midwives will be able to support this option safely and confidently. Surely they should be congratulated on this great move forwards and not condemned? Regards Hannah Dahlen (Clinical Midwifery Consultant, CSAHS) Helen Dowling (NUM Birth Centre RPA) Alexis Upton (NUM Delivery Ward RPA) Kate Griew (Clinical Midwifery Educator Delivery Ward RPA) -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
----- Andrea Robertson Birth International * ACE Graphics * Associates in Childbirth Education e-mail: [EMAIL PROTECTED] web: www.birthinternational.com -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
