It has been puzzling me for the longest time. Yes, I know I probably do know some of the answers, but you know when something keeps going around and around in your head? Well this is on permanent rotation.
Mums to be (parents to be) fighting with Health Care Professionals (HCPs). Why is it necessary?
An example. One of my ladies (who will eventually blog her journey and I'm hoping to persuade her to pop it here as well) went into hospital for the birth of her first child. For her and her partner, it was a simple decision. The hospital would be the safest place for this baby because they had never had one before and just wanted to be sure that everything turned out okay before, possibly, thinking about homebirth for any subsequent children.
So, they enter hospital. They decide that the HCPs know what they are doing and they trust them completely. There will be no rocking of THIS boat. Labour moved fairly quickly, but whenever she wanted to move, change positions or simply listen to her body, she was made to feel stupid and uninformed. Then they were left alone for what felt like hours. She begged the midwife to check, despite having been checked recently, because she could feel the baby gearing up for entrance. Long story short… the midwife and the doctor were unhappy with the baby's position and so she was wheeled into theatre and the baby was pushed back UP the birth canal and she was given a caesarean. Both my lady and her partner were completely traumatised by the whole experience and horrified at the way that they had been treated.
Fast forward a couple of years, and they were getting ready to welcome their second child. Enter me! They spoke to several lovely doulas and I was the one privileged to support them. They spoke at length about their fear, about the lack of listening and the sense of abandonment. A labouring woman needs a sense of privacy and security when she is birthing her baby and they felt that they would only get this at home. And so the battle began. They were refusing to go into hospital for the birth of this baby despite the many many conversations about the risk of uterine rupture. Eventually my lady told them that she understood the risks and didn't need them reiterated every time she spoke to someone or had a check up.
She spoke to the Head of Midwifery and the Head of the Homebirth team. It was agreed that she would be supported at home, but they had strict protocols. My lady listened to them and said that the ones that were supported by medical reasoning and evidence based research were the ones that she would happily follow. Don't get me wrong, both my lady and her partner were prepared to go into hospital should it be deemed medically necessary. She had been offered the opportunity to make use of the birthing centre, but she felt that that would not help her feel safe, rather she might feel pressure to transfer over to the labour ward. Finally it seemed that everyone was happy with the decisions made.
The day before her baby finally made an entrance she was told that the senior consultant had been furious to discover that she would be birthing at home. The midwife was told to tell her that she HAD to go in to meet with him to 'discuss the risks properly'. They then proceeded to take her blood pressure. It was high! So, they disregarded that reading and after 20 minutes, when they reiterated their support of her decision, the midwives took it again. Back to normal.
In the two weeks prior to the baby's birth I had received texts and calls that suggested the baby might be getting ready to be born, but nothing happened. I remember thinking, one evening, that I ought to get an early night. I wound things down slowly at home and just before I headed up to bed my phone rang. She was in early labour. She'd called the midwives and wasn't sure what they needed to do as the hospital had told them to come in because they'd seen some blood. Their midwife called them back and explained to dad that it was a show and that all was well, she would see them shortly. Within an hour I was on my way to their home. I arrived to find grandma on toddler duty, two midwives, my lady on all fours and dad beaming. Things were moving quickly, but the two midwives were glorious. They left her to it and waited peacefully. My lady would lean back into her partner as the urge to push intensified and rock forward with me as the surges faded. I remember re-arranging lamps so the the midwives could see and using my mobile phone as a torch. One of the midwives popped a mirror on the floor. Dad couldn't find a small one, so mum (as she explained afterwards) was able to watch her baby enter the world. It was all the encouragement that she needed. Less than an hour after I arrived she was holding her second child. The placenta came easily after she went to sit on the toilet. The checks were carried out and the midwives tidied away their things and left.
My point? Ah yes, there is one somewhere in this mind of mine. Why is it not possible to lay out the risks, accept that the parents have understood them and listen to their reasonings for why they choose to birth the way that they do? Why is it not possible to support without the scare tactics. Why do we move prophylactically?
I'm sure there will be those that say, 'well she was lucky this time', but was she really so lucky the first time, when she was in a 'safe hospital environment'? Her experience begs to differ.
I received this message from my lady a couple of days later:
"…just in case I didn't make this clear in my tired state - I thought the birth was amazing & one of if not the most positive experiences of my life so thank you."