Saturday, 30 March 2013

What's the alternative?

We all like choice don't we?  We like to be able to weigh up our options and decide the one(s) that work best for us.  Sometimes, when we choose, we make a decision that we didn't want to make because we weren't in full possession of the facts.  It is important that the decisions that we make are made with informed consent.

Last Monday I went on a march to help save independent midwifery.  I marched with a group of doulas, midwives, independent midwives, parents and children.  Why did I march?  Well that's simple.  I believe in choice.  I think that it would be a shame if we were to lose independent midwifery because of insurance being linked to midwifery.

I don't just believe in independent midwifery.  I believe in  midwifery full stop.  Midwife means to be with woman.  What independent midwifery gives is the opportunity for the mother to know the midwife who will be with her when she births her baby.  I don't know a single NHS midwife that doesn't wish for this too.  There are some lucky places in the UK where women can meet and know their midwife, but not everywhere.  This saddens me.  Surely this should be the national norm?

This, of course, is the point where people start talking about the risks of birth.  There are risks in everything and I think that when we are able to make decisions based on fact rather than scaremongering, that can only be a good thing.  More and more women are being labelled high risk.  Pregnant with twins? High risk.  Higher than average BMI? High risk.  Over 35? High risk.  Baby is breech? High risk.  How much higher are the risks?  What are the actual risks?  Even borderline women are being denied choices.  One of my ladies was borderline diabetic.  She was denied use of the birthing centre.  When we went in to the labour ward, the midwife wanted to know why we were there.  She couldn't see the issue.  There will be many good reasons, but each case deserves to be looked at on its own merit.  One of my favourite homebirth teams has been disbanded.  Now women wanting a homebirth have less opportunity to get to know their midwife.  Another homebirth team that I have been worked with has been reorganised and one of the midwives seconded off.  It wasn't her choice.  That same team operates with less midwives.  I cannot see how this helps women have choice in childbirth.  We read in the papers about the lack of midwives, but there are midwives qualifying who cannot get work.  None of this helps the birthing mother.

What can we do to protect women's choices?  How can we support a maternity system that seems to be being eroded?  There are so many questions in my mind.

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