Maternity care

[lucyintheskywithdinos]

My first thread here, been lurking for ages though.

I have been thinking about the way the medical professions treat women, particularly in regard to pregnancy and birth. This was sparked by one woman's comment at the natural birth support group I help out at. Her exact words were that she felt 'as though I wasn't human, I was thinking for God's sake, will someone just explain what you're doing down there'. While she was thinking this 'they' had actually performed an episiostomy with her husband's consent and delivered her baby by forceps.

I have expereinced a similar thing myself, DD1 was rushed away for recussitation my DP went with her, noone thought to tell me what was going on. I thought she'd died.

It seems to be quite a common thing amongst women I've supported (I'm a BFC), is it common in general? As a newbie feminist is it a feminist issue? And what can be done about it within hospitals?

Yes, resuscitation is done after the premature baby is born, so not really relevant to whether a fetus inside a woman's uterus has rights, and whether they trump the woman's basic human rights, like the right to refuse medical procedures done to her own body...

That's a whole other debate, of course, probably more relevant to abortion law than childbirth practices, so I don't want to derail too much here.

I can't really comment on that tabouleh, but it was far less 'brutal' - I know that in an emergency situation, which some (but fewer, year on year), cesareans are speed is of the essence just as in a forceps or ventouse vaginal delivery. But it was a much calmer experience for me, my partner and the baby. The differences in how he responded to his birth compared with his older siblings (same hospital throughout and just a year between two births), was marked. He seemed far calmer and more alert.

And I truly treasure seeing him 'be born', it was a magical moment, seeing him go from aquatic animal to land-dweller.

I am not sure whether I had a bad birth experience per say (so I may have appeared on larry's survey as being satisfied). However a lot of the experiences that are being talked about here resonate.

I don't know (seriously!) whether I had an episiotomy. I don't know what degree tears I had. I am sure that they were on my notes but I didn't find it because I didn't realise the implications that may have later on and because it was too close after the birth to be raking through it all. Plus my DS was taken into SCBU 36 hrs after birth with hypoglycaemia so I was a bit preoccupied with that. The only part of the notes that stuck was the fact that they put that I asked for an epidural which wasn't strictly true. They offered it and I accepted (with love!). I don't know why they couldn't just put it as it happened. They seemed very ready to put everything else as it happened (19:30 - got up and moved around; 19:37 - lay on bed etc etc!)

I had a forceps delivery which was presented as "we have to do this". I really didn't want a cs (the only part of the whole birth experience I was 100% sure of) and I thought forceps would have negated this so took the lesser of 2 evils. I was also under the impression that if they told you they were going to do a cs then you had no choice in the matter (oh, the naivety!)

As a result I had an extremely painful coxyx which was dismissed by nurses/midwives/GP as part of the process or even "Are you sure? You shouldn't have that!" Yes I am sure and no shit sherlock! So looking back I did feel my experiences were diminished/dismissed by the medical staff involved. I am not going to even start with the treatment I received while DS was in SCBU from the consultant. The rest of the staff there were great but do all consultants have god-syndromes?

I recently visited a friend who lives in Holland who are very anti-intervention in birth and promote home-birth. On the face of it this sounds positive and good. However on probing a little deeper their whole attitude is that birth isn't a big deal, most women go through with it and get on with it and push. As a result my friend had her 3rd child in hospital but she had to push hard for that (no pun intended!) as she had to with getting 9 mnths off after the birth (the standard was 3 mnths). Overall, the needs and wants of women seemed to be dismissed for the "party line". It appears that what is promoted as good is really just a way to control women so that they have the birth that is deemed correct by the health authority there.

I didn't request a natural caesarian because I decided I didn't want to, but I did produce a birth plan for both my planned ones; things like finding the sex of the baby ourselves, skin-to-skin as far as possible and holding my babies whilst I was stitched. I also had a blanket that I'd slept with which smelled of me for them to be wrapped in for the times when I couldn't be holding them.

I couldn't agree more with Sprogger who has summed it all beautifully for me:

"At home, the focus was on me and the process I was undergoing to give birth. In hospital, it felt like it was all about the care team (which was quite dysfunctional in terms of teamwork) and their processes, with me as the poor, messy, irrational patient. THAT, in my opinion, is what makes childbirth a feminist issue. It's not about men being mean to women, it's about the inability of traditional hospital structures and systems to accommodate really positive birth methods. The community midwife unit is a "feminist" service (in the sense of being a reimagined, woman-centric birth service), while the hospital one is traditional even though efforts have been made to respect the patient."

I think birthing in hospital feels like being in a factory, you can be moved from room to room, have a series of different doctors and midwives and have to compete against a clock. It was not about how I felt but about how I was made to fit into their protocol. We are not the centre of our experience which is very odd.

Just to add my experiences. I have 2 DDs and their births were very different.

I always knew I wanted to have a home birth with my first, as I was so worried about not having any control over it if I was in hospital. Luckily my midwives were very supportive. However, at one antenatal appointment, after a very stressful day my blood pressure was slightly raised. I have been monitored for high bp in the past and the conclusion was that I have white coat syndrome! The midwife sent me to hospital to be monitored and I had no high bp readings in hospital, or any abnormal blood or urine checks. It did however get written all over my notes that I had high bp.

I was told I was still 'allowed' to have a hb but that I would be monitored closely.

I went into labour and the midwives came to my home and I had reached 10 cm and was ready to go. Based on my notes wrongly saying I had high bp the midwives insisted on taking it every 5 minutes, which I found very stressful. The contractions were so close together at this point that they had to take my bp during them, when surely it will be raised?!

It was decided that I 'had' to go to hospital, so I was taken in by ambulance.

As before, my bp was taken in hospital and judged to be normal. By the time I got to hospital (after waiting around for the ambulance etc) I was told that the baby was not in distress, but that I had been in 2nd stage for far too long so I would 'have' to have forceps. Before I was given the epidural the dr decided he wanted to know which way the baby was facing, so used his arm to reach the baby. This was by far the most painful aspect of the birth. I thought that if I removed consent and told him to stop he would, however I was simply told to use the gas and air. I tried kicking him to stop him, but the midwife simply held my legs.

My baby was born with forceps and as such came out looking very bruised.

I was then transfered to the postnatal ward, despite asking to go home. I had a catheter put in due to the epidural given for forceps, but was promised this would be removed as soon as I could feel my legs to go to the toilet myself. However the postnatal midwives kept refusing to take this out, without giving me any reason why it had to stay in.

I gave birth at 6am, so asked to be 'allowed' to go home that evening, as if I had given birth later in the day I would have ended up staying in hospital for a shorter overall time but this was also refused.

I was told to take paracetemol that I declined as I wasn't in pain as 'we like you to take it regulary' Why?

I finally managed to get to sleep that evening to be woken up to be offered a cup of tea by a hca. I'm not sure why she thought I needed a cup of tea more than my sleep.

The following day I was told I 'had' to wait for the dr to see my dd before I could come home. My dh arrived to take me home and we were told there was a delay and we would have to wait. Dh was then made to leave as it wasn't visiting hours, leaving me alone, sobbing, looking after a newborn.

The whole experience was horrific. It left me with a real fear of hospitals and when I needed a routine op 9 months later I insisted on being treated at a bupa hospital via choose and book. Here I was treated like a human being.

You might ask why I didnt insist on being heard, but as a first time mum I felt very vulnerable and wasn't sure what to expect.

My second birth was amazing. Again my bp was raised in late pregnancy so the hospital advised twice weekly monitoring and said I had to go into the antenatal ward for this, which I refused. So my community midwife came out twice a week and took it in my own home and found that it was normal.

When I went into labour I was lucky enough to have this same midwife come to see me, who knew that despite my notes my bp was fine. This meant that my bp was not taken at all (no time!) and I managed to have my 10lb dd at home (with no stitches needed).

As I was in my own home I felt able to tell the midwives what to do to help me, rather than be dictated to.

I think that the problems with my first birth were that I had seen so many different midwives so no one knew me personally and were all relying on my notes which made the situation sound far worse than they were.

Once I got into hospital it was the middle of the night, so I was seen by junior staff who simply wanted the easy option of getting the baby out with little thought to me.

I was left feeling very inadequate after my first birth. I felt like less of a woman, that I had 'failed' in someway because I hadn't pushed her out myself. Fortunately my second birth has helped to heal those thoughts, but the fact remains that I didn't have to be left feeling that way.

Sorry for the long post, but it's the first time I have really been able to talk about what happened to me and it felt good to get it out! Dh doesn't understand as 'we got a healthy baby at the end'.

Jesus lilmiss, this:
"so used his arm to reach the baby. This was by far the most painful aspect of the birth. I thought that if I removed consent and told him to stop he would, however I was simply told to use the gas and air. I tried kicking him to stop him, but the midwife simply held my legs." Is distressing to READ let alone experiencing it. You poor thing!

lilmrschatty - I really relate to your time in hospital. I was actually quite glad of a couple of extra days in hospital after the birth but this stretched to 2 wks once DS was out SCBU and we were on the transitional ward. I never thought I was going to get out of there. And no-one would tell me how I could. The phraseology was all "have to", "let you", "allow you". Basically I got told I couldn't leave while DS was feeding from a cup and if his blood sugar dipped below a certain amount then we would have to wait another 24hrs. Oh how I would do things differently given my time again. I was very grateful to the hospital for all the work they did when DS had his hypoglycaemic fit. That was fantastic! But the post-natal care was all do's and don'ts.
"You might ask why I didnt insist on being heard, but as a first time mum I felt very vulnerable and wasn't sure what to expect." - Absolutely spot on!

msrisotto, I was horrified to read that too.

If nothing else, you'd think they might have some awareness that some women might be rape/abuse survivors, and that even those who aren't would find such a thing distressing.

That's kind of what I meant about treating the pregnant woman as though she's not really a person, just an inconvenient obstacle getting in the way, between them and the baby.

"Beachcomber - you are probably giving me an education in modern day feminism and what it is about, which I am finding genuinely interesting. But I really don't feel like any of the decisions in my life have been influenced by the patriarchal society (matter for another thread maybe)."

Ali, that no doubt would make for an interesting thread - I'm amazed that you have escaped the influence of such a pervasive and insidious system of social organisation in your decision making.

I've been a radfem for going on 20 years now and I know there are plenty of things I do which are influenced by patriarchy.

Glad you are finding things interesting.

"but that this is another case where womens' opinions about what is done to their bodies is being ignored."

But IMO it is not just about what is done to your body. Whether you agree with me or not about whether your baby is a baby or not and whose rights are more important the medical team has an obligation to deliver a healthy baby, if they can.

TBH I don't actually believe that half of you would put your baby at risk, which is why all your children are alive.

I think a medical team has many complex, intertwining and possible contradictory obligations.

One of them is to aid the woman to deliver a healthy baby.

Another is to respect the woman and treat her with respect, care and dignity.

Difficult things can happen in birth but nobody needs to feel humiliated or degraded or violated in order for a healthy baby to be born.

Of course none of us would risk our babies for the sake of pain or ideals about birth but most of us could have had a better birth experience without having to risk our babies. Indeed many of the things women want in birth are because they know they are better for their babies (no early cord cutting, limited chemical pain relief, avoiding instrumental delivery). Mostly women just want to feel listened to and not have their childbirth be 'taken over' by insensitive medical teams.

Tortoise's birth story earlier was a fantastic example of a difficult birth with interventions required for the safety of her baby that she sees in a positive light because they were clearly unavoidable and she was treated with respect and kindness throughout.

I wouldn't put my baby at risk BUT it's still very important to me that I am asked for consent before any procedure is done to me. Of course the huge majority of women will want the best for their babies, often regardless of the cost to themselves, but it's still important to have consent. Saying 'yes' is meaningless unless there was a possibility that you could have said 'no'.

As another example, if I was ill with a life-threatening disease and needed surgery to cure me, there's no question over whether I would want it, absolutely I would. But the surgeon would still have to obtain my consent before proceeding, they can't just get a nurse to forcibly hold me down on a bed and just start cutting me without asking. If they did, and then said afterwards 'what are you complaining about, at least you're alive and healthy' - well, yes, I'd be glad to be alive, but that wouldn't make what they did OK. And if, for any reason, I had wanted to refuse the treatment, they would be obliged to accept that, though it might seem a terrible decision and an awful waste of life to them. I don't see why it should be different if I happened to be pregnant.

Someone asked earlier about the example of a woman who refused C-section and had a stillborn child - was she right to do so? I would say that no she did not make the right decision, but it was rightly her decision to make, right or wrong, and her consequences to live with. Women are not helpless children who should be protected from decision-making in case they choose badly, we have the same right to choose what happens to our own bodies as anyone else, and the same responsibility for the consequences.

Actually that sounds very harsh, presumably she did not expect or want that outcome and a stillbirth is a terrible loss. But in childbirth it can be very difficult to predict how things will go, and what the best course of action is, and even qualified health professionals make the wrong call sometimes.

Link please about being "obliged to resuscitate". I don't believe that's correct at all.

V. interesting thread.

Bumperlicious, if you are still there, I feel your points so much - it is maddening that the pregnancy seemingly disqualifies you from having any treatment for anything at all. It seems to me that GPs behave like unstrategic, scattergun pharmacists with "normal" patients - "don't know what's causing it, doesn't necessarily matter, here are some drugs that often work on your symptoms, come back in 2 weeks if they didn't and we'll try different ones". For very good reasons they don't want to throw drugs into pregant women in the same casual way, but what this means is that if you go to the doctor with something non-life-threatening, (s)he will probably just shrug and say, "oh well, you're pregnant". It is not as if the rest of your life stops because you are pregnant so it doesn't matter if you can't walk, breathe properly, etc etc.

However, piriton is a very, very sleepy-making anti-histamine which is available over the counter and often prescribed to pregnant women who are deemed to need it for severe allergies. If you ask the pharmacist for it, for any coincidental allergies you may happen to have, it might have a beneficial side effect.

Beachcomber, the interesting thing is that I don't actually even see it as a difficult birth, because it was such a fantastic, empowering, vital experience.

And yet, yes, "objectively"* it was difficult. I had gestational diabetes. My waters broke more than five days before my daughter was delivered. I had back to back labour for the first day or two, meaning I was vomiting with every contraction. Labour kept stalling, because I was exhausted. I went through the more extreme part of labour, and transition, in the middle of the night, in complete silence because I didn't want to wake my husband (who was green with fatigue after three days!). The midwife didn't believe me when I told her I was through transition, because I was "too coherent" and I had to wait for a doctor to arrive, which took another hour. I needed an episiotomy. My daughter needed resusitating. The medical staff were so involved in that that, quite seriously, it was at least an hour after she was born before anyone told me what sex she was.

But, because I was kept informed, and every single physical intervention was done after a conversation and some thinking time and my active permission (there's a rape analogy here - I was expected to say, positively, "yes" as opposed to just an absence of "no" being taken as consent. The default assumption was not consent) I felt like it was an easy, uncomplicated birth.

One of the (many) reasons I am eager for a second child is because I am eager to experience birth again. I can't tell you how positive that was. I mean, I keep telling you, but I don't feel that I'm saying it loud enough. Birth can be awesome, incredible, fun, astounding. And where medically possible, which is almost always, it should be.

*I'm thinking I might start a thread about objectivity and the idea that because it has a dictionary definition does not in fact mean that it is always, or even often, possible to define what is the objective way of looking at something. If third wave feminism has done nothing else for me, it has at least made me question the power structures that assume that objectivity and subjectivity are an easily identifiable duality. But that's a subject for another time. Objectivity: a feminist issue.

Larry.
Your function in this debate has been to prove that this most. definitely. is. a feminist issue.
Thanks!

Tortoise, your birth story is amazing.

ITA with what you say here "Birth can be awesome, incredible, fun, astounding. And where medically possible, which is almost always, it should be."

It is fantastic that you are looking forward to giving birth again when, if your birth had been handled differently, you could have been put off the whole experience entirely.

My sister had a difficult time with her first baby (in a large maternity unit) and got the 'stop being silly, pull yourself together and get on with it' treatment. She was made to feel inadequate and incapable of giving birth without help. She was very afraid for her second time and questioned her ability as a woman to bring her child into the world. She saw a fantastic midwife who went through her notes with her and did a great job of restoring her confidence and laying her fears to rest.

For the birth of her second child she chose to travel quite far to a small midwife led unit where she was assured they would be as hands off as possible and where again they boosted her confidence.

Her second birth was straightforward and natural - she didn't need to push, have pain relief or any intervention.

She really felt that the second birth 'laid to rest' the trauma of the first and was a very healing and empowering process for her.

Whilst of course every birth different (the first time in particular), we are sure that she could have had a much much more positive experience the first time round if her emotional needs had been cared for better with regards to consent and so on.

It shouldn't be the luck of the draw when it comes to birth - every birth should be as positive as possible whether intervention is required or not.

Your story is inspiring - wishing you a wonderful experience when you get the chance to do it again!

Forgot to say,

"Objectivity: a feminist issue" - would make for a very interesting thread.

The whole issue of consent is a biggie too.

This is my first post here so please go easy on me! I've just read the entire thread and found it fascinating (thanks very much for the link AvrilHeytch).
My ds (first baby) was born 10 months ago and I found it incredibly scary and traumatic. I never considered it to be a feminist issue before because the things that were done to me were done by women. I had a fast labour and was not believed, they kept telling me to call back later until dh took the phone from me and told them we were coming in anyway. When I got there I was already pushing, the mw panicked because my bump was small and made me lay on my back attached to a monitor. She ran out and got a (female) dr, leaving me terrified and pushing. They spoke over me, performed vaginal examinations without asking and at one point even laughed at me because I was crying! They told me my baby was in distress and gave me an episiotomy and delivered ds by ventouse. One of them (I'm not sure which) cut the cord and put ds on my tummy. I felt so happy and grateful to them both for delivering him safely. 3 weeks later I had a survey through my door asking about my birth experience and I stated that I was very happy with the care I received because I honestly believed that I owed ds' life to them.

Several months later I went to a debrief because I still felt utterly traumatised by what had happened. I felt that I was a failure as a woman because I had been unable to push my ds out myself. At the debrief I found out that ds had not been in distress at all, his heartrate had dropped slightly only once and could maybe have been resolved by letting me get up onto my knees which is what I wanted but had not been allowed to do. Other issues which bothered me are the fact that I was so obviously going through transition while a mw was telling me on the phone that I wasn't in labour yet. After the birth there were no beds on the ward so we were discharged home. I had 1 mw visit where I complained that my stitches hurt but was not examined at any time. A bf support worker visited, then a care assistant, neither of whom are qualified to examine mothers. In total I asked 3 times for my stitches to be checked and they refused. Eventually I took them out myself as they were so painful.

If I received that survey now my response would be very different! Interestingly at the hospital where I gave birth the chief exec and head of midwifery are both men!

Has this thread died?

Thanks AvrilHeytch it was strangely cathartic typing that out! I've decided to make a complaint, I think I'll feel better knowing the people involved are aware of how it felt to be on the receiving end of that treatment.

That link is its horrifying to realise how little compassion some caregivers have towards vulnerable people in their care!

Marjee so sorry to hear of your experience.

It is helpful as you say to write/talk about these things. Women sharing their experiences and listening to each other is comforting. We shouldn't need comfort though because these things shouldn't happen.

Welcome to the feminist section.

I think this thread may have dropped off a lot of people's 'threads I'm on' that's why it has gone quiet.