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?

I think lots of things need to be change , simple things such as the common statement " So and so was TAKEN in / KEPT in, ALLOWED home,, LET OUT the other day ,Docter says i HAVE to , WONT LET ME , the kids HAVE to have their vaccinations ect ".

I hear this a lot and it makes me groan. Small children hear this and think what ? The other issue i think is that children are taught their bodys are not their own , how many parents make their children give out kisses to relatives they hardly know ?

Somebody earlier on said how theres this idea that when your pregnant / labouring your expected to lose your dignity. You are, and its not on , and i think as a woman im meant to not mind whipping my shirt off. Ive presented at the docters with a chest infection and been told to " pop my top off " by a male gp. ( Umm no, id rather you put the stethescope down my shirt thanks, i deliberateley wore a loose one.) Worse ive heard similar when taking my teen dd,s, its completeley unnecessary.

When i was pregnant ( i was very young ) i attended the hospital for a check up where i was given a VE ( why ?) by a male docter. During this very long VE he made inapropriate comments and asked if it was my first time , did i enjoy it ect. It was horrible. I never told anyone, and id never had a ve before.

That delivery consisted off intrusive unnecessary procedures being done ( waters broken, catheterised ect ) , i suspect this was all done to demonstrate to a student midwife. I wasnt asked at any point . I had a retained placenta and it was removed manually with no pain releif, ( guess who by ) and it was utterley horrific, i was truly traumatised afterwards, but expected to get over it as " we women have to tolerate these things ."

Unless your mum, or someone in your life is on the ball with these things, youve really no idea. Id like to see young women educated about rights during pregnancy ect ,id like to see the nhs held more accountable, they provide a service , we pay for it. Id like to see criminal charges brought for the medical staff who butcher us unnecessarily and without our permission.

Think about this, if a stranger penetrated me without my permission, its serious assault , if they inserted anything into me, cut me ect , its serious assault , yet some strangers DID do those things to me , only it doesnt count because he was wearing a docters coat and her a nurses uniform, and it seems that when i entered that hospital i left any rights over my own body at home.

No one bats an eye , id like to see it persued as a criminal charge.

I think that of course it's a feminist issue in that it has to do with women & there are so many different experiences / opinions / strong feelings etc: enough to make it an issue for feminist discussion.

Other than that. I too had a forceps delivery plus episiotomy. I accept that consent is not always clearly asked for / given (I am certainly not disputing the experiences of all those who say this). However, I believe this is often done because of things being rushed & women being slightly 'out of it'. At least in my case- when I was taken to theatre & given the 'strong' epidural, and then episiotomy & forceps, I was asked for consent (that's what my DP has said) but I really don't remember this as I was so out of it! I vaguely remember saying 'might a c-section be better than forceps' and someone said to me 'no it's much nicer to get the baby out yourself' .

I never felt during that whole thing that I 'got the baby out myself' as it was a horrible experience despite the wonderful behaviour of the medical professionals.

Sometimes we want someone to blame for a situation that's in itself awful & no-one really is to blame, it's just a bad situation. It's then easy to say 'oh it's the medical professionals' fault, this should not have happened'. But sometimes it's no-one's fault :(.

I accept that other times things may be done in a patronising, dehumanising way for women. In my case, what was dehumanising was the whole theatre/forceps/strong epidural thing, not the medical professionals who were lovely.

As I said, I'm not disputing the experience of other people. I'm just throwing a further idea into the mix.

How are men allowed 'to take matters into their own hands', sakura?
If you mean in that they are allowed to monitor themselves, surely this is because of the, ahem, relative ease of self-checking!

OMG dignified It's not to late to report it you know. he's prob still practising and getting his name from notes would be a simple matter to report to GMC.

Sakura, smears are NOT compulsory.

When I was 19 I saw a gynae for irregualr periods (had pcos). Saw OK female sho/reg, and she called in a consultant. He was awful, spoke really aggressively to me "WHY are you worried about your fertility?" (Er, because I'm not menstruating???) and then asked me to turn over and face the wall. I though he was just going to examine me, but he found a polyp (was in the uterus but descended through the os into my vagina)and proceeded to get a pair of forceps and pull it out. No local. Nothing. I screamed and burst into tears. I was inconsolable. I felt so violated. I was sobbing for the rest of the day.

Incidentally that prob recurred, saw female GP who arranged for me to have it removed under GA as routine.

Jesus LittleSilver, what a bastard G.P.

I'm not sure I really want to entice Larry back to this thread but I just spat tea out at this and wanted to comment;

"However, these days, I really do not think it is fair on the medical profession to make the claim that childbirth is a feminist issue. Firstly, let's rewind the clock to my mother's experiences in 1964-1966, when childbirth really WAS a feminist issue (she was one of the first NCT clients). She firstly had an ectopic pregnancy which burst. When she went into hospital, internally haemorrhaging, she was told she was a hysterical woman and to take two aspirin and go home. It was only when my father threatened to sue the hospital that the consultant was dragged from the golf course to operate on her. She was five minutes from death by exsanguination. Her two natural births were in stirrups, discouraged from moving at all, with an arrogant consultant looking in from time to time. Things really have got a LOT better."

Ok - how about we wind back the clock a few months on MN where some posters here (notably Aitch IIRC) saved another posters life by insisting that she go back to a hospital which had told her she was not having an ectopic pregnancy when it was clear to them that she was. Ectopic pregnancy is routinely missed still, nowadays. I have a friend who had a very similar experience and only insisted with the hospital because her mum got her to.

As for birthing in stirrups, well, I live in France where it is routine in most maternity units for women to give birth in stirrups. With my first birth I was denied the right to move around and quite possibly as a consequence was badgered to have pitocin (to hurry me up even though I was labouring just fine - it appeared the doctor wanted me finished before the end of his shift!), an epidural and was threatened with forceps if I didn't 'get a move on'. The midwife afterwards told me I was lucky to not have an episiotomy because the doctor who attended had a very high rate of cutting first time mothers - my midwife persuaded him that I didn't need one (thanks!). She was right - I didn't tear at all in my perineum and was never in need of a cut by a scissor happy (male) doctor. I gave birth in stirrups despite telling the staff that I felt unable to push in that position.

For my second birth I wanted to be at home after hearing some horror stories from the women in the maternity unit. I prepared for this with a midwife who treated me totally differently to the treatment I had had by the gynaecologist for my first baby (for some unknown reason women in France are followed by gynaecologists for their pregnancies). The midwife performed no VEs (routine every month with the doctor) and explained to me all the things she did to avoid perineum damage (like not labouring on your back à la hospital).

Anyway my second baby was slightly premature so I ended up having to go to the maternity unit and gave birth in stirrups despite having a completely natural labour with zero intervention and no pain relief (didn't want it). I insisted on having active labour even though the staff wanted me lying on my back attached to a monitor. I refused pitocin and an epidural (wasn't going to make the same mistake second time round!) and had my baby easily (I didn't have to push) and without any distress. I hardly saw the midwife during the whole of labour because she was looking after 4 other women as well. The only times I did see her was for her to offer interventions that I did not need.

And you know what larry? I am unbelievably lucky - I got away from both of my births with my fanjo and my emotions relatively intact. But it shouldn't be about luck, it should be about respect.

Interventions can safe lives and perineums - but they must be used judiciously and respectfully with the women being informed.

Any women could tell you that they could get over the trauma of an episiotmy or forceps a whole lot better as long as they had been kept informed, spoken to with respect and care and knew that what had happened to them was unavoidable (and not the result of bad or hurried medical decisions, fashion, cultural tendance or a cascade of intervention).

That is why maternity care is a feminist issue. Any women who has given birth could tell you that.

Hugs to all those who had bad experiences.

Apologoes for this being so long. What an interesting thread. I am suprised by how much,5 years after having my last child, I am haunted by the treatment I received at her birth if I think about it.

I ought to add that the birth of my first child was fantastic, even though I was induced. But I knew at the time that this was down to luck. It could have been so different had a shift change not occurred and we got the most fantastic midwife who made me and DH feel listened to and treated us like intelligent human beings.

I was lucky to still experience a low-tech birth with my second baby but I was spoken to like a child, told off for moving too much on the bed, using too much entonox, not given entonox when I was stitched up (I was then too scared to ask) stitched before I was numb,stitched on a bed with nothing covering my by then cold, bloody, naked body (I was holding my baby, and the one sheet from the bed was wrapped over the baby). I really felt dehumanised and after the midwife was gone, my husband confirmed my thoughts about the midwife had been true. I be sure to know why neither of us called the midwife on her attitude. On admittance to the hospital I was less than 2 hours off giving birth and no midwife came to check on us until after 40 minutes. I think we were just so grateful that someone eventually came (although they offerred no apology for our painful wait)and then I was in very active labour.

I was also treated poorly when I had to be hospitalised in the night following a miscarriage where I was losing too much blood and no-one believed that I was. I was humoured and given a bed since I'd been dropped there alone by ambulance but the next morning shocked the doctor doing her rounds when on standing, I lost a lot more blood. I was rushed straight to surgery for a rapid ERPOC and narrowly escaped having to have a blood transfusion.

I think the issue is a three-fold one in this country. A culture in the NHS of offering patients (male and female) little autonomy over their care and instead treating them like children. That has probably been facilitated by a long time attitude that the doctor/nurse/professional is deserving of respect and not to be questioned. And thirdly, women in receipt of maternity care are especially prone to accepting and receiving sub-human treatment because of the unpredicatble nature of each individual woman's labour and birth.

I did complain but all I recieved back were a string of excuses and justification for the sub-standard treatment we recieved rather than apologies.

Apologies for typos/poor grammar. I wrote a lot more then tried to condense it!

"Is that because you think that the loss of sexual function, loss of continence, PTSD, PND are relatively trivial matters? I can tell you that they are quite common where I live, and utterly devastating to the women concerned."

I am not trivialising these matters or saying they don't have an awful effect on people's lives. It's not what I think but I am trying to understand how the NHS works. People are still more likely to die from cancer / heart disease etc than childbirth which is why they are a higher priority.

"birth partners are there for support to suggest that if I don't want them to speak for me."

MsRisotto, I agree birth partners are there for support. That is their fundamental role. However, in the even you can't speak (I know at least two other people who found themselves in the same position as me) they are there as your spokesperson and advocate and to act in your interests. I know loads of people who were in my position (not even been able to form a word let alone a sentence) and I am pretty sure they were pleased their husbands were there.

I would like to ask you all how you define a feminist issue? Is it any issue that affects a woman regardless of cause or is it an issue where man have to show prejudice against women?

Oh good, glad smears are not compulsory .

I suppose a feminist issue is if women are being harmed in some way by something. In this case ignorance, disrespect. WOmen are dehumanized at their most vulnerable.

Ali - if you don't feel comfortable that birth is a feminist issue then you are not compelled to discuss it here.

I find your and your DH's questioning of why birth is a feminist issue to be .

But just because it seems obvious to me doesn't mean that I won't have a go at explaining it (NB I have paraphrased from my Feminism: Beginner's Guide.

Feminist methodology takes the lives of women as central. Making the lives of women the starting point for thinking about things means focusing on women's experiences to see how this challenges theory and practice - articulating and validating insight that comes from women.

I might start a thread entitled "what is a feminist issue" and capture peoples thoughts on that there...

That could be an interesting thread tabouleh.

I see maternity care as a feminist issue simply because feminism is concerned with the treatment of women in patriarchal society.

In the book "The Politics of Breastfeeding" there is some stuff on how birthing experiences changed for women as they were taken out of the hands of midwives and other women and placed in the medicalised and male dominated hospital setting.

If you come from the viewpoint that feminism is anti-men then I think you're bound to be put out. It's not anti-men though.

"birthing experiences changed for women as they were taken out of the hands of midwives and other women and placed in the medicalised and male dominated hospital setting."

I could well believe that is how it started. But I have to say that out of the few dozen medical staff I saw in and around maternity wards when my DCs were being born, only one was a man. I think he was an anaesthetist. There were more male porters than male doctors there and it was the female midwives who seemed to be in charge of what happened and when.

Snorbs, there has been an evolution of maternity care, and it is still evolving of course.

It's a fact that male doctors (they were all male until what, 90 years ago?) got right on the birth gravy train back in the days when all health care was private. It was initially a financial decision: doctors saw women, and often lay women at that, being paid for something they thought they ought to do because it's to do with the body. How very dare they, pesky women. Of course, women simply didn't have the voice then that they do now, society was different, and even though midwives did prove themselves perfectly capable of getting proper training, they have been thwarted quite a bit and remain subordinate in most cases.

That book, Birth: A History tells it from a slightly more American-centric point of view, with a good dollop of Irish birth history too, and Marjorie Tew (Safer Childbirth?) catalogues the development of doctor-centric care and has a right good go at women and midwives in particular for rolling over and accepting it - which, in the main, they did.

Things might be politically quite different where birth is concerned if there had been mobilisation to object to legislation at the appropriate time. We'll never know.

It was a female doctor who called me a "born harlot" because I spread my legs obediently when she gave me a vaginal examination and it was a female midwife who said "do you want your baby to die?!" when I demurred over being strapped down with monitors attatched during my second term pregnancy.

Doesn't mean they weren't a product of patriarchal system.

Aldrin that is just so shocking

this I found very interesting.

Yes I agree with that LG. I would add, I would like to see midwives and doctors who have zero empathy for pregnant and labouring and postnatal women to be retrained/sacked. Or required to pay for the woman's/couple's mental health care for the next ten years...