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?

withorwithoutyou I wasn't suggesting that you valued your perenium over your DD's life and I am sorry if that is the impression, I was interested in whether the issue of consent was borne out of anger at not having been asked to consent or whether it was related to your wish not to have the procedures carried out at all.

I am genuinely saddened that you had such a horrific experience and FWIW I do have some comprehension as to how you must have felt, having had a manual extraction of placenta after the delivery of DS2. I suspect the key difference was that that was managed with the utmost respect to me as a patient.

Nancy, sorry, I see now that's not what you meant.

I apologise, I'm touchy on that subject as I've been asked before if I'd have preferred that my DD died than have the birth experience I did. Obviously that's not what you were asking and I understand your question now.

"surely the reason most people have a birth partner is so that they can make a decision based upon what you have stated you want rather than to make decisions for you!?"

AND

"If she had specifically said before hand that her husband could consent for her then fine. Personally, it is horrifying that my partner could consent for me and i'm not the only one on the thread to feel that way."

NO NO NO NO NO NO NO!!!!!

In the UK NO-ONE can consent on behalf on behalf of the patient. Doesn't matter if patient has said that's OK, that they are their husband/civil partner/mum. That notion is just plain incorrect.

Some changes came in with the Mental Capacity Act (2005 I think, don't quote me)

here

I find it really concerning that people think that others can give consent on their behalf.

Thank you LittleSilver, I am glad that technically at least, husbands are not allowed to consent to stuff for women generally and in labour.

Not just husbands, ANYONE, unless, like I said you have appointed a helath care proxy which involves ++paperwork and solicitors and I believe is generally used in progressive illnesses IIRC.

littlesilver, this is what I was trying to get at. A birth partner is not there to make decisions for you but to support you in your choices.

If you're lucky she hisses bitterly

BrightLight, consent is an ongoin process and something you can withdraw at any time.

The midwife who delivered ds left the NHS shortly afterwards. She told me about shouting at the gaggle of midwives who were rolling their eyes at birth plans and saying 'well that's not going to happen'.

Women are up against many things. But I find that really upsetting. We have to rely on midwives (and drs) - there is no choice there. It's seven kinds of shite if some of them behave like bastards, and we have no way of knowing who will and who won't and what to do about it anyway.

UnePrune,

I agree, it's the complete lack of security, of now knowing who we can trust and getting the luck of the draw which is so frightening.

When I was going through the process of getting my ELCS for my 2nd pregnancy I spoke to the very understanding and competent senior m/w at the hospital. She went through my previous birth with me and basically said if I wanted to go for a natural birth we could write a birth plan together and so that we could make sure that nothing would happen that I didn't want to happen.

I declined, on the grounds that although I knew she had my best interests at heart I simply could not trust that whoever I got on the day would listen to what I wanted and go with what we had agreed. She tried to say that that wouldn't happen but it was healfhearted, she knew that there was no way of ensuring I was listened to.

I find that very sad.

exactly, the midwife you discuss your birthplan with isn't always the one on duty when you actually give birth.

I have only read about half the thread but I just wanted to say thank you to AhickeyfromKenickie for her post early on in this thread.

I think you have described what a lot of women go through very well. I know my sister had experiences very similar to yours. There is just no excuse for this sort of treatment.

Big hug.

This is a subject very close to my heart; I have suffered with PTSD for 2 years after my horrific birth experience.

Over the course of a few months I wrote down what happened to me. I won't put it all on here (pages and pages worth!) but here is a small section, just to make some people see that this treatment DOES HAPPEN:

...They decided to take a blood sample from the baby's head to determine her level of distress. I was told there was going to be an internal exam. I was not told how different this one would be from the 1000 I had had since I'd been there.

The bottom of the bed was taken away and my feet put into stirrups. I was exposed to everyone in the room, which had suddenly filled with 5 or 6 people. I hated that so many people were standing at the end of the bed, many seemingly doing nothing to assist. All of them just staring at me. And not at my face.

The consultant came in. He did not look at me. He did not say hello or introduce himself. He did not tell me what was happening. He immediately sat at the end of the bed and barked at the midwife to bring him the equipment he needed.

All of a sudden I felt an instrument being inserted into me, hard. To my horror, I had had no warning.

A hook was placed into the first instrument, and the blood was taken. At this point a nurse, spectating, told me that my baby had lots of hair! Just how much of me could they see?! The consultant, having done his job, muttered something to the midwife and left.

I was physically shaking, really hard. Someone asked me if I was cold. "No" I replied.
I was terrified. Terrified there was something wrong with my baby, and so upset that we had hurt her before she was even born. I was humiliated, disgusted, ashamed. In my whole life not nearly as many people had seen me intimately as they just had in the last 10 minutes. No dignity, no respect, just a piece of meat. A job to be done.

I do not believe that the consultant meant to "hurt" me in the way that he did. If questioned, no doubt he would say that he was just doing his job. But the WAY in which this procedure was carried out has left me feeling like this.

He did not acknowledge me.
I was meat, an organ.
Things were put inside of me without my consent or awareness.
I had no control, I was powerless.
I was left feeling humiliated, violated, brutalised.
I did not stop shaking for a long time afterwards.

If only I had been recognised as a human being, considered, consulted, I don't think I would have felt this way. The experience would have been traumatic, yes, because of concern about my baby. Not because I was so out of control over MY body.

To this day, thinking about this procedure always brings me flashbacks of when I was raped.

It's long winded, sorry. There are SO many other incidents during this time which I don't want to bore you with. (This post is long enough!) To cut a very very long story short, I almost died during an emergency C-Sec in the end. The post-natal care was so unbelievably poor, it led me to have severe PND too.

So in conclusion, to me, this issue is MASSIVE. And something needs to be done.

larrygrylls - I really really don't want to come across as agressive but it is going to be difficult as your posts on this thread have seriously annoyed me.

If you don't think maternity care/childbirth is a feminist issue then why would you come and debate it on this thread?

You also don't seem to have much of an issue with the current state of maternity care in this country (although the fact that you paid for independent midwives suggests otherwise).

You have said:

I really do not think it is fair on the medical profession to make the claim that childbirth is a feminist issue.

Naturally, childbirth will always be a women's issue (or at least until such time as men give birth, or all babies are incubated in artificial wombs). However, to say it is a "feminist" issue in 2010, implying that there is some patriarchal anti woman agenda is an insult both to my mother's generation (see my previous post) and men, who actually, genuinely, take an interest in getting the best for their partners and unborn babies (who they will co-parent for the next 18 years.

I am sorry I disagree - childbirth is one of the most important feminist issues!

This is the way that I see it: in order to have children women have to give birth to them - for men to have children they don't have to give birth to them.

There are things which effect women's lives adversely as a consequence of childbirth - PTSD/episiotomy/fanjo "issues"/incontinence -etc etc.

Different feminists (liberal/radical) will have their own theories as to why things are not better for women wrt to childbirth both in this country and in other countries. Personally to me it's not about blaming "men" in particular but I would argue that the following would help:

-giving a "voice" to women to express their experiences/problems etc and for these to be taken very seriously by the medical profession

-ensuring government and NHS bodies such as PCTs etc have a much higher proportion of women in positions of power.

One definition of feminism is "an attitude favoring the movement to eliminate political, social, and professional discrimination against women."

Originally the medical profession was dominated by men - this may be part of the problem - indeed there is lots of evidence relating to the "medicalisation" of birth by male doctors wresting power from female midwives.

For me it's not so much about blame just looking at how we can improve things for women.

You mentioned testicular cancer etc - irrelevant to this discussion IMO.

Also "It is also the case that there are horrendous cases in every area of medicine, not just childbirth."

see this re "what's wrong with saying things happen to men too

Also you say that men are interested in birth/their partner's births - yep I totally agree - this doesn't mean that we can't look at childbirth/preganancy from a woman's point of view.

I found this a little bit abrupt:

"AHickey: "birth in stirrups not uncommon in 2010"...evidence please?"

Where's your evidence that it is not uncommon?

"I think I explained the genuinely patriarchal nature of the health service in my mother's generation (no female doctors, no informed consent, no pain relief except gas and air) relative to that of today (high proportion of female doctors, informed consent as a guiding principle, choice of pain relief, birth plan guiding the whole process)." - thanks for that - how bloody condecending - do you not think most of us have discussed childbirth with our own mothers?!?

As for this:

"MsRisotto, You really annoy me. You are on a parenting site on a childbirth thread when you are neither a parent nor even sure if you intend to become one! I find that bizarre."

What a horrible attitude.

MsRisotto I can totally understand you being here and I'm sure that the vast majority of posters can.

Let's make this a thread where people can post their experiences of childbirth and be listened to.

I absolutely agree that all too often the standard of maternity care is woeful. When my DS was born the midwife was more interested in filling out forms rather than paying attention to what I or, more importantly, my labouring partner was saying. It was awful. Things didn't improve much when she got up to the ward, either.

The second time round with DD it was a lot better as we had a midwife who was involved, attentive and most importantly there.

I've spent a fair amount of time in A&E and orthopedic wards as a result of crashing motorbikes. It's a long-held belief among bikers that they often get poorly treated in hospitals and there is some justification for that view. But despite being some unpleasant experiences myself, I've never been treated anywhere near as inconsiderately as many women are when they're in labour or afterwards. I don't understand it.

snorbs good question:

"I've never been treated anywhere near as inconsiderately as many women are when they're in labour or afterwards. I don't understand it."

I wonder it it is because coming into hospital for any other reason is for an "unnatural" problem/issue - i.e. after a motorbike accident you assume patient is shocked/injured/in pain but for birth it is possible to have a very easy birth (in some circs for lucky women and more likely to happen in stress free environments).

Therefore for some reason the woman is not listened to because there is a possibility that she is "over-egging".

larry, episiotomy is an unecessary medical procedure except in rare cases.

A mark of a good midwife is the pride she takes in enabling the woman to deliver the baby perinium intact (in midwife speak the woman delivers the baby; in hospital often the doctor believes he is the one delivering the baby )

It has been down to feminist midwives to uncover the array of misogynistic and unecessary procedures the hospitals have meted out onto women over the years: enema, pubes shaved, don't crouch, on your back, stirrups and episiotomy.
Absolutely barbaric..

SOme medical journals reccomend that the doctor gives an episiotomy before the woman begins to push....
But during the pushing process the perinium stretched gradually and slowly lets the baby come out, gently.

Doctors are often too impatient and they cut.
In countries where episiotomy is rife, women experience third degree tears more frequently. IN other words epis create problems. Imagine a piece of paper: you pull it and it doesn't rip. Cut a slice in it then pull it and it will rip fairly easily.

Because episiotomy is a slice it takes a long time to teal. Natural tears heal much quicker because they are jagged.

Huge HUGE feminist issue. LArry, you have no business saying it isn't.

I'm glad Larry brought up testicular cancer, because an entirely different debate is how the medical establishment infantilises women with compulsory smear tests (which are very unreliable and results can be unclear if the woman happens to have had sex or a period)and procedures for cervical cancer but apparently men are allowed to take matters into their own hands. I think the rates of testicular and cervical cancer are pretty similar but women are taught to fear cervical cancer.