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.
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