I was discussing the issue of Natural Selection with one of my best friends going back a couple of weeks ago. It was a lighthearted discussion yet since then I have used it more times than I can count on two hands.
As the Caesarean rate continues to creep to 30, 40, 50%, I have had to find some understanding beyond the cop-out that woman want them. Lisa Barrett discussed this very issue in a recent post which can be read here.
My plan, in my spare time (haha), is to do some research into birth history. My reasons for wanting to do this is related to wanting to know what happened to women and babies when the common obstetric complications of today occurred including CPD (if there was/is such a thing), shoulder dystocia, postpartum haemorrhage, high head, malposition, failure to progress and breech. Many of these are interconnected and are questionable in terms of the word 'complication' when much of the problems seem to be caused by insistent intervention but this post isn't addressing this issue (I will save it for another), instead I want to make comment about the outcomes.
In the event that this happened in history, what would the outcome be with the understanding that no testing, consistent monitoring, scans etc would have been available? I am expecting to find that natural selection would have become real and these issues would have resulted in the demise of the woman, baby or both. Its shocking for some people to contemplate this when we have todays technology but for me it is natures of way of choosing the 'fittest'.
So my question is, are we fighting natures intentions and therefore messing with Natural Selection? And does this have something to do with the rising section rate for the simple reason that women who would have died during childbirth because of physiological incompatibility are now given the opportunity to have babies who in turn carry the hereditary incompatibility and so on and so forth?
This way of thinking has ethical and moral consequences and was intended only as thoughts and ideas. It is the way of species to survive but what are the long term consequences? Particularly for midwifery...
Friday, February 20, 2009
The story so far... not without frustration
Since registering, I have had the opportunity to be with a number of women, all of whom have shown strength that has driven me to follow my instincts and believe in birth. Unfortunately, as it stands at the moment, 0% of the woman I have been with have had a normal vaginal birth. I could allow myself to feel disheartened by this however its fuelled me with a fire to question everything and use my voice for the good of the women, despite the pressures of the system.
Three women I have followed through have had elective sections. I have been careful in the way I have worded this because it would be easy to say that they have 'elected' to have section. Given the fact that I was told at the beginning of each of my shifts that these women were booked for sections, I soon became aware that the option of a vaginal birth may not have even been provided as an option. Go figure...
Of the two other women that I have cared for through to the birth, one was induced shortly after her due date for a 'large baby' and the other augmented for no good reason after spontaneous onset. One more section and a forceps (which could have been a section but I fought with all costs to prevent this).
I am frustrated by the 'limits'. Why is there the need to bring about labour and birth so unnaturally? I have always been of the mind that intervention is utilised because it is there rather than because it is needed and its strikingly and blatantly clear that this is so much the case. The reason given always seems to be the same, intervention = baby in arms quicker, however what isn't discussed is the risks and likely result of surgical or instrumental birth. I wonder what women would have to say if this information was laid out in black and white and not given as medical jargon? I would like to think that some or all would have the strength to say 'no'. I will later discuss my intentions for trying to make a difference to this reality in my Honours project. Something that is very passionate to me and will be primarily focused at giving women back the power.
In all of this I have been eagerly awaiting the opportunity to work at the early antenatal end and provide the options that are obviously not being provided. Today was my first opportunity and I am ecstatic to say that even with the widespread perception that its a woman's choice to choose intervention, even though when provided with an alternative, they tend to go with the alternative. This means giving the truth and not the 'biased truth'. In a job where we strive for woman-centred care but somehow fall short the majority of the time, women can be empowered to decline "routine" screening, "recommended" stipulations and unnecessary interventions. It was a great day :).
Three women I have followed through have had elective sections. I have been careful in the way I have worded this because it would be easy to say that they have 'elected' to have section. Given the fact that I was told at the beginning of each of my shifts that these women were booked for sections, I soon became aware that the option of a vaginal birth may not have even been provided as an option. Go figure...
Of the two other women that I have cared for through to the birth, one was induced shortly after her due date for a 'large baby' and the other augmented for no good reason after spontaneous onset. One more section and a forceps (which could have been a section but I fought with all costs to prevent this).
I am frustrated by the 'limits'. Why is there the need to bring about labour and birth so unnaturally? I have always been of the mind that intervention is utilised because it is there rather than because it is needed and its strikingly and blatantly clear that this is so much the case. The reason given always seems to be the same, intervention = baby in arms quicker, however what isn't discussed is the risks and likely result of surgical or instrumental birth. I wonder what women would have to say if this information was laid out in black and white and not given as medical jargon? I would like to think that some or all would have the strength to say 'no'. I will later discuss my intentions for trying to make a difference to this reality in my Honours project. Something that is very passionate to me and will be primarily focused at giving women back the power.
In all of this I have been eagerly awaiting the opportunity to work at the early antenatal end and provide the options that are obviously not being provided. Today was my first opportunity and I am ecstatic to say that even with the widespread perception that its a woman's choice to choose intervention, even though when provided with an alternative, they tend to go with the alternative. This means giving the truth and not the 'biased truth'. In a job where we strive for woman-centred care but somehow fall short the majority of the time, women can be empowered to decline "routine" screening, "recommended" stipulations and unnecessary interventions. It was a great day :).
Where has time gone?
Typically, my intentions to get on here have been put on the backburner with work and uni taking up all of my time. So much so that even trying to spend time with my family has become a rarity. The best of it is, I am loving being a midwife and being able to give women options, one of the highest priorities and I am proud to say that I have witnessed the strength that women have to make decisions that are right for their own needs and well being if given the opportunity to do so.
I have much to write about in relation to this as well as a myriad of other things that have been brought to my attention and that I need to voice so will leave this post here and get some of it in writing.
I have much to write about in relation to this as well as a myriad of other things that have been brought to my attention and that I need to voice so will leave this post here and get some of it in writing.
Wednesday, January 14, 2009
Malaysia... An Awakening!
If anyone read my old blog (what little I posted on there!), they will know I had the opportunity to work in Malaysia as a Student Midwife. I had mentioned a few times that I had no idea what to expect... even walking down the corridor on my first day I still was oblivious to what I would experience. Amazingly my very first thought was how I was going to overcome the humidity! It was the beginning of Cultural Awareness that was for sure!
The hospital where I spent most of my time was very different to that that we have in Australia, however not in the ways I envisaged. It was beautifully landscaped and designed, particularly given that the wards were entirely separated from each other and joined only by one, long open-to-the-outdoor corridor. I think one of the most memorable aspects of working there was transferring women to the postnatal ward after they had given birth. The walk almost felt like a tribute to their ability to give birth and to the beginning of a new life.
The hospital where I spent most of my time was very different to that that we have in Australia, however not in the ways I envisaged. It was beautifully landscaped and designed, particularly given that the wards were entirely separated from each other and joined only by one, long open-to-the-outdoor corridor. I think one of the most memorable aspects of working there was transferring women to the postnatal ward after they had given birth. The walk almost felt like a tribute to their ability to give birth and to the beginning of a new life.
Labour ward was at the very end of the corridor (the picture above is of myself (left) and the other mid girls in front of the labour ward doors on the first day!) the walk to which was quite educational in that I learnt a lot of Malay by trying to guess which ward was which! The above picture captured before we had actually set foot in labour ward, the smile on my face quietly disappearing as I went beyond those doors. It was for no other reason than I was hit with a symphony of echoing fetal hearts. It was quite disheartening when much of the information that I had been given about the care in Malaysia was very basic. In this, I naively believed that basic would mean just that. Unfortunately that was not the case. I soon learned that every woman, regardless of any significant factor, were strapped down by those awful machines they call CTG's. But wait there is more... in case for some radical reason these women decide they might want mobilise, they are further restricted by intravenous lines for reasons that no one could explain. Then it became obvious that where you had a line going in, you needed something coming out... yeah, you guessed it, pretty much every woman was catheterised. Definitely a rude awakening.
Despite the obvious deflation in enthusiasm you would feel being faced with this, I remained enthusiastic about the opportunity to find out what Malaysia believed midwifery was.
Stay tuned, there are positives amongst some pretty full on and testing experiences that I will post shortly!
New Year, New Blog, The Same Ambition...
Despite the hours of study and the need to find some time for my family and I guess, myself, I have been slack as far as getting on here to discuss anything birth related. It does not mean that my passion and complete love for birth has lessened, if anything it has become even more central to my life and therefore consumes most of my time.
As the title of this post states, its a New Year... many find some mystical trust in the continuation of the last marked by a change in number, however I see it more of a continuation of my want to make a difference in this life, no matter how small. So to mark the beginning of much more than the New Year, I have begun a new blog, with the intent to regularly post how I am still fighting for the same things I in my previous blog.
The blog also marks the dropping of the infamous 'student' title and officially announces me as a MIDWIFE!! It was a long time in the happening and for some unexplainable reason the past month since gaining registration has been completely surreal and I am still dealing with the realisation that what I say and do actually has substance and I am being listened to with some deal of respect. It is to me a fulfilling and exciting prospect but at the same time, a little scary to realise the huge battle that I am going to have on my hands to bring birth back...
Throughout the entire duration of my studies, my ultimate intent was to become an Independent Midwife. It bothers me somewhat that I have chosen another path due to aspects of my life that I cannot change, however although at this point in time I cannot be where I would like to be, I know I have a hugely significant role in the position that I have accepted in the Political, Procedural and Problematic Public Sector. Much of what I have witnessed over the past 3 years has troubled me but amongst it, I have come to the realisation that nothing will change if no one is willing to fight in the thick of it. I know I am going to take some hard knocks, no harder than those that I inflict on myself but its the position that I always wanted to be in whatever I found myself doing in life. Beats having a mundane job with meaningless outcomes or no outcome at all.
My motivation is and always will be the same... the women I work with and my ambition to have them experience birth in all its beauty...
So this blog is the new chapter of my life... the fight begins :)
As the title of this post states, its a New Year... many find some mystical trust in the continuation of the last marked by a change in number, however I see it more of a continuation of my want to make a difference in this life, no matter how small. So to mark the beginning of much more than the New Year, I have begun a new blog, with the intent to regularly post how I am still fighting for the same things I in my previous blog.
The blog also marks the dropping of the infamous 'student' title and officially announces me as a MIDWIFE!! It was a long time in the happening and for some unexplainable reason the past month since gaining registration has been completely surreal and I am still dealing with the realisation that what I say and do actually has substance and I am being listened to with some deal of respect. It is to me a fulfilling and exciting prospect but at the same time, a little scary to realise the huge battle that I am going to have on my hands to bring birth back...
Throughout the entire duration of my studies, my ultimate intent was to become an Independent Midwife. It bothers me somewhat that I have chosen another path due to aspects of my life that I cannot change, however although at this point in time I cannot be where I would like to be, I know I have a hugely significant role in the position that I have accepted in the Political, Procedural and Problematic Public Sector. Much of what I have witnessed over the past 3 years has troubled me but amongst it, I have come to the realisation that nothing will change if no one is willing to fight in the thick of it. I know I am going to take some hard knocks, no harder than those that I inflict on myself but its the position that I always wanted to be in whatever I found myself doing in life. Beats having a mundane job with meaningless outcomes or no outcome at all.
My motivation is and always will be the same... the women I work with and my ambition to have them experience birth in all its beauty...
So this blog is the new chapter of my life... the fight begins :)
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