Would it be unreasonable to request no students during labour at teaching hospital?

[mazzystartled]

DC3 is due imminently. To my surprise I am being totally supported and encouraged to have a VBA2C, on a midwife-led unit.

One of the things that I think will help me is if I can have the greatest degree of privacy possible, so I was thinking about requesting not to have students attending, but am I being unreasonable?

I know that if intervention is required or I am transferred to the obs-led part there will inevitably be more people around, and I definitely not want any student doctors forming an audience. But how about student midwives?

My DS2 was delivered by a student midwife (under supervision). She had to do a certain number of deliveries to qualify/get to the next level or something, and my DS was the magic number!

She was wonderful, really supportive, and it gives me a nice warm fuzzy feeling to think we helped her qualify.

I had a student midwife present, and she was great. It was lovely to have someone there for extra support and she wasn't in any way intrusive.

I suppose it depends on the student, but in my experience I would have no problem with one being present during my labour.

I can see that one student midwife who was committed to the project could be an asset...though a friend of mine had one who sat in the corner looking appalled and queasy throughout.

This isn't my first labour - EMCS at the fully dilated/pushing/stuck stage with DS, so I know I that I find more people about irritating. I will mull over the one student midwife idea - am guessing I can always ask her to leave. After 2 c/s (and without CFM) the obs monitoring is pretty crucial. Oh it's a dilemma.

of course not,you need to feel happy and not compromised.students do need learning experiences and hands on practice and in general most mums do consent to student present.i declined students being present

piscesmoon, for every private person like the OP, there is luckily a drama queen like me, who would have liked the WHOLE HOSPITAL to down tools and come and witness my SUFFERING. Although I should have mentioned this on my birth plan as nobody was there at all- probably all very dull to them. So IMO one way and another the training happens.

I have had two births with students present. TBH they were delightful in both cases and were very gentle with their examinations. They were also very excited by the birth, it was lovely to have them there.

However if OP doesn't want one (or more) then I think it is reasonable to put it in her birth plan.

My sister is a doctor and brother is a med student - I know from them how frustrating it is when people refuse to let them learn. I understand the desire for privacy, but if no one lets students attend their births, how can we expect to have the benefit of their professional skills and knowledge? The midwife/doctor who delivers your baby will only know what they are doing because other mothers who went before you have let them sit in.

yes but student learning is secondary to pts wishes,and as med students must learn to respect,listen to,and adhere to pt wishes.at end of day it someone's birth experience not viewing platform at the zoo.thats why the the training offer range of experience over a period of time- to fit in adequate observation and participation.in a busy teaching environment a student will see adequate without mums feeling compelled to fulfil their learning experiences

I am with the YANBUs. Giving birth is one of the most intensely personal experiences you can undergo. Really sorry if I only choose to do it in front of a minimum of people, but it is one of the few times in life where you can be as selfish as you like and it's your prerogative! Seems from this thread there are plenty of people who'd be happy with student observers so don't beat yourself up about it.

Just coming back to this - Abbie81, I totally understand that students have to learn somewhere. As I said, I gave birth to all 3 of my DCs in a teaching hospital, and had student mws present at my second two births (both VBAC) and allowed them to do VEs (I am shameless).

However, I am a medical scientist myself, and not that bothered by these things. The OP is having a VBA2C - if she needs to specify no students to give herself the best chance of achieving her VBAC, then that's what she needs to do.

I am interested to note that everyone seems to assume that student MWs will be female - one of the student mws I saw was an enormous American chap (think American-football playing sort, and you'll get the picture ). He was luvverly

Something tells me that the average person who gets to the clinical stages of training to be a doctor or a midwife is probably unlikely to construe seeing childbirth as the "viewing platform at the zoo".

Obviously it is a matter for the individual woman who she has present when she gives birth. I personally would prefer not to have a student there, but would not refuse if asked to do so, because the point remains that they have to learn, and we all expect to benefit from their skills. If everyone refused to have students there, no one would know how to deliver babies. Those of you who would refuse to have a student are lucky that others who went before you have agreed to it so that you can have the benefit of medical staff who know what they are doing!

addie81 i think I still disagree with you quite strongly, sorry.

i think women forcing themselves to do what feels wrong to them in labour is what has led to stuff like the supine position being considered the 'right' one, women not getting the pain relief they'd like, or getting too much when they didn't really want to, or remaining silent when they'd rather scream, all that stuff.

There are IMO quite a lot of women who either don't care about others watching them, or actually like an audience (I feel myself less weird in this respect since reading about a South American culture (sorry, can't remember which one) where it was usual for the whole community to spend the labour with the woman, often making noise along with her). Maybe MWs and doctors could try to do some more pre-consenting to find women who don't think they will mind having a student/multiple students, before going into labour? Their notes could even be a different colour... then supervisors could start off by asking those women, giving them a head start in finding births to observe/take part in.

If you don't want to have a student at the birth of your child, don't. Your siblings' complaints about the annoyingness and contrariness of patients are really the last thing you need to have in your head during labour.

I also wonder whether some mothers would be reluctant to let people into the delivery room, but would be fine with a discreet camera relaying the birth to another room? I would have preferred real people present, and would imagine that most would, but labour is so different for everyone that I can't be sure. Doesn't help with hands on stuff, but at least for observation.

Camera?? No way, choosy!! I didn't mind the students being in the room, even doing a couple of VEs but I would most definitely not want to risk there being a filmic (is that a word??) record of how I looked whilst giving birth, as I am confident that I was Not At My Best

Poledra, I so agree with you, I would be deeply embarrassed to have my inarticulate pleadings recorded for posterity (though tbh I was thinking more of a CCTV type arrangement rather than a permanent recording). the thing is, that women feel a range of things about this. Allie81 seemed to be saying that even though she didn't like the idea of having people there, she felt she should. I wish I'd had more people there tbh. You weren't worried by students being present. Maybe, just maybe, there are women out there who don't want people but wouldn't mind a camera. That's all i was saying.

The son of my consultant surgeon (who was a doctor!) observed my ElCS. The consultant didn't mention it till after, but I spotted him because he was clearly hanging around like a spare part! If I'd known in advance I'd have given him the camera!

They should really ask you on the day if it's okay for a student to be present. I know I was asked, and when we offer clinical placements, we need to seek consent before beginning a session.

I agree with Addie. No one WANTS to have total strangers watching them give birth, but some of us have to take one for the team or there won't be any new doctors or midwives! If you have your baby in a big teaching hospital as I am going to, then I really think the possibility of having a student there comes with the territory. When I am in labour I anticipate having way more important things to worry about than whether there is a med student in the room or not.

Choosy - I think it is sufficiently important to facilitate medical students learning to have them at the birth even if I wouldn't otherwise choose to have a crowd there. Believe me - there is no question of me being forced to do things I am not comfortable with - I am quite capable of asserting myself. Thanks for the support emmakate - I thought I was on my own!

ps - it is interesting that almost everyone who has posted below has had a positive experience of med students or trainee midwives being there.

If something goes wrong, its not the fault of the medical student!!

I don't think you have to refuse a student. They have to ask you if you would like one.

I had a student midwife at my first homebirth and it was a real blessing. I then actively volunteered to be fair game to students.

I've always had the attitude that students need as much experience as possible, and I haven't found students to be invasive at all.

I agree with choosy; there are enough people around who are happy to have students (myself included) to balance out those like OP who are not so comfortable with the idea. And I didn't do it with a star-struck "for the good of my fellow women" attitude, I did it because it doesn't really bother me. And frankly I don't give a damn whether a medical/miwifery student is "frustrated" or not. Because, guess what? It's not about them, it's about the labouring woman and her choices. And I agree with choosys point about women being put under pressure to agree to stuff has led to a lot of negative things like being supine in labour etc, and all those other points.

Shaz10, I would have had forty fits and reported him to the GMC.

I am going to keep an open mind about maybe ONE student midwife.

But I think "taking one for the team" in this context, is frankly bolleaux.

I'm thinking about Michel Odent's research etc that indicates that private, quiet and unobserved labours tend to be quicker and easier.

And if it all goes tits up and I end up with an instrumental delivery or another emergency CS it will probably be upsetting enough without a load of extra people watching.

BTW I have been happy to have students practice on me in antenatal testing, and eg when I had a minor eye op etc. But I think, for me at least birth is different.

With you mazzy - there's a strong argument that the reason so many births go tits up in hospital is because being allowing women to be observed by strangers disrupts the normal hormonal cascade of labour.

Can't imagine anything worse than having some 22 year old public schoolboy student doctor in the room with me while I shit myself and cry. Have much kinder feelings towards student midwives though.