Hi Carolyn, Gail and others,
I can't agree with you enough Carolyn. Having just completed (yes!!) my
BMid degree after attending homebirths for 23 years without a degree, I
agree with everything that you have written - in particular the need to
work with the doctors not against them, talk to your colleagues, don't
just turn off or walk away.
We as a society have participated in all that has been set up - the
heirarchies, the 'powerful' few, the fear that has permeated and changed
women's respect and understanding of birth.
And it will only be through quiet, respectful but definite changes -
mainly working with and truly understanding the nature of birth and the
role that we as midwives can and do play, that anything at all will change.
Through my clinical placements over the past two years I have seen many
absolutely horrific situations in hospitals and I honestly can't
remember one where it wasn't in my eyes due to the management - be it
the dominance, the belittling of the woman, the panic from care
providers, lots of practices that are not evidence-based and should be
changed yesterday, poor practice and often simply the lack of
understanding of normal labour by the care providers causing
haemorrhages, depressed babies , separation, interference...
And so at fifty years old I enter a new faze in my life - not totally
sure where or how but it will certainly be building bridges, informing
people - families and practitioners alike - of safe and effective
practice, agitating for change and then more change. As a mother of four
homeborn beautiful kids I feel now like a warrior/lioness ready to move
into a new era and will be challenging all those shitty old practices
and attitudes as I go.
*/ Never doubt that a small group of
thoughtful, committed people can change/*
*/the world. Indeed, it is the only thing that ever has./*/ /
/Margaret Mead (1901-1978)/ *//*
Happy New Year to all of you,
Sue
Dear Gail,
Firstly, your instincts are spot on.
This is a very distressing story. It is not a coincidence that these
women's labours stalled following his VE's, that is absolutely to be
expected and is the result of a mindless disruption of the women's
optimal state of neurophyiological functioning. Taylorism, that is an
industrial, efficiency management model, has no place in the dynamic
fluid process of birth, sadly it has become merged into the 'health'
care system with this sort of unconscious abuse becoming more common.
'Discussions' with the doctors at that stage will do nothing except
breed resistence and further intervention; in mindless individuals it
can even result in payback situations where intervention will be done
just because you are the midwife. The right to rule is still endemic
in the maternity services.
the first thing to understand is that these people really believe they
are doing the right thing.
the second thing to understand is that they are taught all about the
abnormalities of birth, they have absolutely no idea about normal
physiology as applied to birth (gross generalisation, I know)
the third thing is that they are terrified of birth
the fourth thing is that they are taught throughout medical school
that they are the boss of everything and the government and health
departments agree and structure everything (I know, there are
exceptions) to reinforce that idea
the fifth and probably MOST important thing is that they do get taught
about 'patient' autonomy and the need for consent.
So, here is where it gets interesting and where our opportunity lies.
It is vitally important that you use every moment with birthing women
to help them understand the situation, without making it combatative
and engendering a siege mentality and ask them what they want to have
happen, how they would like things to go, so they can say what they
want - be left alone, checked in another hour a few more hours, more
time, a bath, move freely, have the baby listened to by doppler in the
shower/bath etc if women have the information that can help them with
the deeply damaging throw away lines that get trotted out like
'stillbirth' 'brain damage' etc, then women can say what they want and
we as midwives can support them in that and remember to DOCUMENT what
women want. To do things against rational people's will is abuse. To
argue about medical intervention with midwives is a nuisance and an
affront to power beliefs.
Getting strategic is important. Learning tactical support of birthing
women is a midwifery art form and a very challenging one. It is
crucial that you avoid blame, judgement and criticism as these
emotional states are damaging for everyone and lead to despair. It is
useful to come from the point of view that they mean well but are
ignorant about birth physiology and are taught to look for problems.
Neuroscience and quantum physics teaches us we find what we are
looking for. That also means we make it up if it is not there.
Our job is to work with women and their processes, to give women
information to make their own decisions and to help them actualise
their decisions and to help doctors know what women want. :-) makes
it so simple really. Simple does not, however, mean easy.
Every time you find yourself with a pregnant and/or birthing woman ask
questions of yourself like 'how can I best inform her of her
options?' ' how can I best explain the process of birth so she knows
what to expect?' 'how can I support her with what she wants?' ' how
can I best let her know how well she is doing so that she can feel
secure in asking for more time if she needs it?' " how can I best let
her know her rights so she feels powerful and in control of her
process?' some women, no matter what doors you open, will succumb to
medical pressue. That is just the way it is and all we can do is
support her through her experience with love, compassion and kindness.
One last thing, make friends with that doctor. It is not 'sucking up'
it is working with integrity. Everyone wants to do a good job.
Approach that person, say you feel uncomfortable about the interaction
- open dialogue. We need to be friends with each other. Focus on
creating a healthy workplace. Over time, you may have more influence
as trust deepens between you. We need to focus on the long term with
our doctor midwife relationships. Remember that he is scared of birth
and wants to control it - the women get in the way of that and get
caught in the melee. He is doing the best he can with what he knows.
Doctors are not enemies, they are, in the main, ignorant about normal
birthing physiology. Power dynamics, history and politics have put
them where they don't belong. We as midwives have to work with that
reality to the best of our ability. Birthing women, when they have
accurate information, can call the tune. However, if someone is doing
something that is not medically 'right', then it is important to put
in a formal complaint and have the matter seen to.
Hope this helps, warmly, Carolyn
----- Original Message ----- From: "Gail McKenzie"
<[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Friday, December 29, 2006 11:04 AM
Subject: [ozmidwifery] What happened with this birth?
It's been so interesting for me to read about this birth and Andrea's
woman's experience too. I am a newly qualified student midwife
currently working in birth suite doing my rotations. I have come
across both these types of births and each time I instinctively knew
the mother & baby only needed to reorientate their head-space.
Unfortunately, hospital protocol & "time" would not allow for it. I
even had a "discussion" with the doctor about giving more time as the
labours were going so beautifully until then (coincidentally, both
stalled when VE performed by him???????)
Outcome was 1 enemy for me & 2 very unhappy women getting C/S. If it
wasn't for websites like this one the next 12 months would be the
longest, most unhappiest of my life. You are all keeping me sane &
knowing that my instincts are not wrong. Thank you, ladies.
Gail xxxxxxxxxxxxxxxxxxxxx
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