Controversial Pregnancy & Birth Documentary

[Lulu]

Nat, mrmoo, Tara - I am so APALLED and angry about your stories. I just don't know what to say. Except for the fact that, Nat - I swear I would hunt that nurse down and BELT her one if that she did that to me.O M G.

There is obviously good and bad eggs all over I suppose. I had on OB for my first - but only to due a heart condition. He was a kind and lovely man and did the right thing by me and my baby.

The point is - a crappy midwife with a dangerous "hero" complex is not motivated by massive amounts of money - I don't know what motivates people like that to stay in the proffession, but it can't be money...

[Aranah]

From my understanding Lulu it was about glorification by this lady's peers. The next day, I had many midwives coming in saying 'I heard his head was stuck on the perinium and Margaret got him out without a doctor'. Weird thing was, they had all heard I had pethidine which I hadn't touched, and they kept blaming that for the slow 2nd stage and also the breastfeeding problems I was having.

Margaret was very uncaring in the birth. I knew this already because my mother had had her 15 months prior with the birth of my sister and even though it was her 5th baby, it shocked her. My mother was actually told to go home by Margaret, but she insisted on staying and told her she knew it wasn't far and 30mins later when Margaret finally checked her, she was 10cm.

Margaret did a few strange things. When I first got the pushing urge, she told me I must wait for 1 hour till I could push. I don't understand this because she didn't even check if I was dilated, she just said I had to wait 1 hour. After my DS's birth, Margaret basically yanked my placenta out. It must have looked bad because my XH who wasn't the nicest caring person even was saying to her that it didn't look right that she was doing that. I had bits of placenta left in there everywhere which caused a haemorrage 7days post partum and caused a massive pelvic infection, requiring a D&C and 10 courses of antibiotics. AFter this, I caught every infection going around as my body took a good year to recover, I had several bouts of severe mastitis requiring hospitalization, my body just became immune to antibiotics so normal things weren't working.

She also wouldn't let me pursue with BFing my son in the delivery suite. I tried for 20 mins to get him attached with no help from her. She told me that most babies won't attach straigth away, and to wait for 12 hours and then try! She was trying to get me out of the birthign suite as her shift had ended half an hour prior to me giving birth, which she kept reminding me during my bonding with my son. Of course, being 19 and naive I listened to her about the BFing bit and then had a big battle ahead to get him to feed at all. I suceeded in the end, but only by my sheer will of desperately wanting to BF and alot of distress along the way.

This hospital I was in had a terrible reputation and due to my extended stay from PE, I saw many things that midwives did in the ward which were downright lazy and dangerous. One would come on for her shift, take all our charts, not too the obs all day, then return the charts at the end of the day. Me and some other girls got curious and read out charts after one of her shifts, and realized that the 4 sets of obs she was supposed to do she had just made up the numbers! THese were the numbers that the doctors reviewed every morning to decide what to do about each of us. The woman across from me baby went into distress at 33 weeks the day after this midwife was on day shift, and she had to be taken for an emergency c-section. If this had happened the day before when the babies or us weren't checked, her baby probably would have died. This is just one of many things that happened. Many of us were yelled at for using the buzzer because we weren't dying, some poor mothers were ostrasized for wanting to stay longer than one night for a rest after their baby was born, the midwives would come in in a group and would yell at them in front of everyone else in the ward.

There was obviously a real culture of that kind of practise there. I became friends years later with one retired senior midwife that had tried to do something about it and was bullied to the point of needing to leave.

I know the hospital I am going to with the birth centre is different, I've only heard good things about it, so I'm hoping this will be a healing experience.

[Julie Doula]

I think this is a good and important discussion.

It makes you think about what causes complications? And what promotes safety?

(Yael): "The only thing i question is that people often blame complications on monitoring, the situation etc. Is it at all possible that unforseen complications could arise to a women giving birth at home under a midwife??"

For myself, I feel that the majority of healthy women, who already have a track record of being responsible with the care of their own bodies and selves, are good candidates for a spontaneous, uncomplicated birth in the most (not all) cases - if their birth potential is supported and not interfered with.

I think there is a percentage of women in every culture who will need more help to have a birth that is safe for both the baby and the mother. In the majority of these cases, I think the complications can be predicted ahead of time - because of the woman's health history and the signs already showing. This is why the stats for safe homebirth are so impressive. The chances of a healthy, motivated, well-nourished, fit woman with a well-positioned baby and a healthy foetal heart, who begins labour spontaneously getting into serious complications later on in labour are pretty slim. If rare complications should occur the attentive care of these skilled homebirth midwives is likely to pick it up as soon as anyone. They take no chances when anything departs from normal. Then you have this skilled midwife escort you to hospital during your labour. Women everywhere in Australia are transporting to hospital in the middle of labour, but when you're transporting from a homebirth, at least you have your midwife right there with you, checking the foetal heart and reassuring you.

Yael: "I don't think its right to imply without intervetion EVERYONE would be having spontaneous and positive births..."
Yes I agree with you Yael, reducing intervention is not going to be the magic solution for everyone, there will always be some of us who really do need that extra help and thank God for medical science. The problem is that (IMO) that we have too many fit healthy, average women whose chances of having a spontanous birth are being disrupted by a blanket/routine application of monitoring and intervention, and that this standard care contrasts dramatically with what you see happening in birth centres and homebirths where the intervention rates are low, the complications are low and the safety rates are high.
Yael:" But I also believe that intervention leads to more interventions...."
Yes, me too. At a homebirth, the mw checks the FH every little while and just keeps an eye on everything (your behaviour, blood loss etc) to make sure that everything is ticking along normally). In the best birth centres and hospitals, the approach is similar.
Dr. Sarah Buckley talks about Undisturbed Birth - the way that a quiet, private, familiar environment promotes the release of hormones our bodies need to birth efficiently. We birth best in an environment and atmosphere similar to the one we like when we conceive - simple: wha works for sex, works for birth. For most people, the kind of place they are expected to birth their babies in is pretty different from the kind of place they would be comfortable to have sex in. (It must feel a bit like that when a man has to up and produce a sample in a hospital bathroom.)

When supporting my clients, I've seen three or more changes of staff occur during their labour. They're just about ready to crown - and oops, change of staff, here comes a new midwife to get used to - and her manner is quite different to the last one -

That can't be very nice for the mw's let alone the mothers. When mw's have more autonomy as independent practitioners in their own right, who do not have to work under the authority of doctors (as in NZ and Europe), then the MW's are able to provide continuity of care that greatly increases satisfaction for the MW's and the mothers - and increases overall safety. That's one thing I'd like to see change in Aus. Meanwhile, the doulas are the onlly service that provides this continuity all the way through pregnancy birth and the post-natal period.

Yael: "Also, lets not forget womens choices in here... We are talking about hospitals/dr taking away woemsn "privace, support, gravity and mobility"... basically her choices... there are quite a few women who are still informed, or don't want to be informed, feel safer in a hospital enviroment, and don't want a midwife. Just becuase its right for one women doesn't mean it is for another, and doesn't mean you can blame the drs for that womens choice!"

Good point. But I also think that women's "choices" are fed by fear and misinformation that is rife on the subject of birth in our society in recent decades. No, you can't blame the docs or the hospital's for women's choice, but "choices" based on poor, incomplete info and bias are not real choices. There is still a dynamic of control being kept from the woman and disempowerment going on.

Safe homebirth practice in places like NZ, Holland and Aus can't be compared with developing countries where you have things like poverty, malnutrition, abuse of women, child brides, incredibly misogynistic practices going on. A 14 year old with rickets who has already had her genitals mutilated, and who has been abandoned in the bush to either die or survive, maimed, alone, is not a comparison to an independent thinking, resourceful woman in Australia who has done the homework, done the preparation and made it her business and her choice to birth the way she feels is safer - at home, or in a birth centre. I've also seen birth in middle of the road places like Hong Kong and China and Thailand. HK was very high tech, like a conveyor belt approach, China was downright scary, I'd rather give birth in a field. (many of the western women just had their babes at home). The hosp I went to in THailand was excellent - lovely OBs with a great reputation, very pro-natural birth, C/s rate of 10%.

Have to go - but thanks everyone for contributing to an interesting and valuable discussion.

[mrmoo]

Just on a side issue as one of the gripes that comes out in all this is how much OBS charge and how greedy they are

But dont Doulas and private midwives charge a arm and a leg also ?

Wasnt i reading a thread recently where somone asked what the cost was and someone said $5000 ???

That's almost half a years worth of Parenting Payment!!!

[Liz]

If you broke down that amount into $ per hr, considering the antenatal care as well as being on call for a potentially all day labour, it's probably not an unreasonable fee at all. They likely have insurance to pay as well. I don't think it's covered by medicare tho, and I think only a few health funds cover it? That needs to change too in order for midwives to be used more.

[Inanna]

Julie Doula - I LOVE your work...

Caro: I am not sure who said that obs are greedy - I don't recall reading that. Undoubtedly they are very expensive as is private health insurance. I am a nurse and am fully aware of the HUGE insurance bills faced by obstetricians. I also would like to make a little point.

When you see an obs (trust me over the past couple of years I have seen my share!) it is a quick 10-15 minutes. When you see a professional midwife your visit extends sometimes up to an hour and sometimes more! A doctors visit for that 15 minutes costs around $120 at my obs - with during a 40 week pregnancy requiring perhaps 15 visits that's about $1800. On top of that you have the delivery costs and the insurance costs that are passed on to the client. This is now packaged as a pregnancy maintance fee or some other such wording. My obs charges $2500 for this... Then for a routine delivery the cost is another $1200 so tht takes us up to $5300. Of course the fees will vary between obs and obs and depending on where you are situated. A friend of mine was charged $4000 from a Melbourne obs for her pregnancy maintainence fee. So clearly the fees are high. The fee at my obs will depend on the risk of the delivery. A "complicated" delivery will cost more - having a condition such as GD will mean I am a "complicated delivery" and with this I was charged an extra $500.

An independent midwife will charge a set fee. What she charges will depend again on where she is situated, where you are situated etc. An independent midwife in my area charges approx. $3000 for a birth (including antenatal and postnatal care) The midwife will come to YOUR home and visit you before during and after the birth. She will bring her practice to you. She will spend at LEAST half an hour (often more) with you and talk to you about your joys and fears. She will palpate your baby, talk to your baby, listen to your baby, watch your baby grow safely... She will massage you and get to know your husband and other children. She will refer you on if a dis order rears its head. She will come when you phone her when you are in labour when you need her to. She will stay with you and support you at home or in hospital wherever your preferred birhing place is. The costs involved with this vary from midwife to midwife. However, the cost is less than an obs and the time she will give you is much more.

An obstetrician is a doctor. He treats dis order. His role is to care for women who need medical assistance. As many of the women have said in here THANK GOODNESS that we have access to them if we need them. I personally have never required a doctor for any of my births. (However I do require one now for my pregnancies due to a dis order I have.) Most often an obs will come only when birth is imminent. He/she has many more clients than an independent midwife they simply haven't the time to labour with you or to come to your home.

Someone mentioned not comparing apples with apples. We can't compare midwifery care with obstetric care as they are very different. The charges are different because the service is different. One is treating dis order and one is caring for women during a natural process.

Tara: You had a harrowing experience and I am so sorry :hugs:. There are certainly midwives out there like that, I have come across some too . I hope your next birth is all that you want it to be. Choosing a birthing centre with midwives that you can get to know and can get to know you is a wonderful way to get the birth you chooose.

Safe birth is about INFORMED choice. Not choice made from a perspective of fear and not choice made from a perspective of "it won't happen to me". We do need balance as Julie Doula has so beautifully put.

My concern is that women are very often not independently seeking out the truth. Women are fed images from the media about "what goes wrong". We get images of those over the top movie stars that are "too posh to push". We are fed fearful stories by our mothers and grandmothers who often had APALLING birth stories to tell. It was the norm in the 60's and 70's and even in the 80's to be drugged and in stirrups.
We think that we are safer in the hands of a doctor that we will get a better outcome. The stats just don't support that. Statistically you will have a better birth outcome if you are supported through pregnancy and birth by a woman known to you. Women who educate themselves about the birthing process generally care for their bodies, minds and spirits. They read and educate themselves, they connect with other women. This is what we need to have an empowered birth.
Yes, you can have that and still be under the care of an obs. But you need to make some choices. If you are laboruing under the care of an obs you can ask for what you need. I laboured with my last child under the care of an obs but I had my own midwife. I asked that the obs did not enter my birthing space unless there was a medical indicator. I found an obs who would do this. He sat outside and read the paper and ate donuts. I needed to protect my birthing space. That to me is sacred. I made it my own with oils, and candles and music and my children around me. Someone mentioned that to birth we need to replicate the conception space. This is so very true. No one wants to get jiggy with it on a stainlessteel bed. No womb feels like giving up it's baby in a sterile environment. Many new hospitals recognise this and birthing centres where there are lamps and soft furnishings. These things (meaning a homley environment) are incredibly important. OUREHEADS ARE THE MOST IMPORTANT BIRTHING ORGAN. When are head is right so are our cervix's.
Who wants to make love with strangeers watching? Not many of us. The same with birth - we need to have a connection and a relationship with those that are in our birthing space. We need to move freely. We need to vocalise. To squat to swivel to dance to cry...

African women are not the same as white Australian women - Indigenous women face third world conditions too unfortunately in this land of plenty. Women of spirit are bundled off to the stainless steel rooms to birth their babies - often these women have terrible experiences. They don't believe it is "right" to birth away from the land. We can learn an awful lot from our indigenous sisters. They know about instinct and position and about woman love and support. Yes, they need a little help sometimes too just as white australians do but they very often haven't lost their inherited "knowing" about birth.

Someone mentioned that a midwife led birth isn't for everyone. I wonder why that is? Clearly it's not if there is a medical problem. But apart from that I believe that many women don't choose a midwife because they don't really understand what a midwife can do. They have experiences in hospital where a different midwife comes on each shift and you need to get into a new rythum with her. This isn't what is should be like. Birth is a sacred event. It should not be at the whim of a shift change. Women should labour with a midwife that they know. This has been proven to have incredibly good outcomes.
We can learn much from countries such as NZ and even the UK.

We need to ask for what we want. There will always be women who want a medicalised birth. What I fear though is when women make this choice without an educated decision. This decision is often made from a perspective of fear. This troubles me greatly...

[BellyBelly]

Another perspective on the fees - they are that much because the government is not subsidising midwifery choices for birth AT ALL. In NZ you can get midwifery care through medicare. Not here! But you can get claim a podiatrist and other things like that. The govt will not give provider numbers to midwives and until enough people kick up a stink about it not much will change. Private health is pretty bad too, some will cover small amounts, some like Medibank Private not at all - so I cancelled my PHC with them. Midwives do not do as many births as an Ob would, private midwifery is not in huge demand so that 3000$ may be their gross income for the month, ex-tax etc. I am yet to meet a filthy rich midwife driving around in a BMW. Its not a job you do for the $$.

Doulas - Anything up to $900 (completely depends on the package +/- visits) in Melbourne for VERY experienced attendants. More in some states. But they serve purposes different to an Ob you cannot compare. They spend around 2 hours at a visit with you. They specifically de-brief with you for about the same time. You wont get an Ob who will sit down with you and ask you how the birth was for you and to share your feelings and talk about it over a cuppa, and help with feeding, settling, light cleaning if needed etc. I see much value in that. A doula will also spend more time with you than anyone. I spend 6 hours in pre/post natal visits and have been with a woman in labour for up to three days. Yes, two nights with no sleep. Another birth was two days and most are 1-2 days. No-one else gives you that except your partner, so we physically work for every cent. Not that we do it for money! Who would work three days straight with no sleep? A doula would LOL. And she would do it at the drop of a hat, usually arranging childcare and no matter what day and time, there is no sick leave, annual leave or super.

I also see much value in an Ob being present during times of complications which a midwife cannot help with. Watching shows like saving babies where there ae premature, sick babies, we are so lucky. But as I always say, I would not go straight to an Ear, Nose and Throat specialist every time I had a bad cold. I'd go to my GP first.

But again, this is not about choices of carer or place of birth, its having those choices in the first place, equally affordable and balanced info. As much as this doco may look unbalanced to you, if you go to a GP, they will not give you brochures on homebirth or midwives along with your private hospital recommendations. In fact some will give you a serve! Equal info for all I say.

[Inanna]

One of the reasons Caro that midwives are not covered by medicare is because our system has become so medicalised. Midwives have degrees as do nurses some have doctorates. It is not about education it is about the medicalisation of birth that midwives are not covered by medicare.

[BellyBelly]

Yep insurance has been taken away from them which is hard to understand when they offer care with great outcomes, but as a result they are not given provider numbers and hence why you cant get private care for them. They are close to getting insurance again from a mob in WA, they apparently need 200 midwifery signatories to go ahead and have something in the 190's. Must get an update.

[Inanna]

Yes Caro - midwifery led care is much less of a drain on our health budget. Mr Beattie is slowly realising this up here but we have a LONG way to go. There are some happy things on the horizon in the public system in Qld with regard to midwifery models of care.

I dont' know that it is accurate to say "a lot of babies and mothers died". The maternal and infant mortality rates were higher in hospitals and at home in our grandmothers/greatgrandmothers day. That is due to health standards, economy, education and care.

Too Posh to push I believe was first coined by POsh spice. She didn't want her scrawny little hoo haa disturbed!

Kelly - midwives in a Qld hospital here are getting closer to obtaining independent insurance - I will find out more and get back to you on that. It was last a few weeks ago that it was discussed... Things are changing. Bringing in non nurse midwives is a huge start - UQ has it's first intake this year...

[Liz]

One of the reasons Caro that midwives are not covered by medicare is because our system has become so medicalised. Midwives have degrees as do nurses some have doctorates. It is not about education it is about the medicalisation of birth that midwives are not covered by medicare.

Well, in theory we should all be happy it's not covered by medicare, coz otherwise midwifery would be medicalised!

[BellyBelly]

Yes I heard some very good things are happening in QLD

My great grandmother lost two babies due to homebirth midwives (in the UK, my family are english). One was drunk and one was dirty. Alan and I were discussing it the other day, he has an ad for a midwife role in the late 1800's I think? The description asked for midwives who were clean and sober.

I don't think they know times have changed LOL.

[Inanna]

Not too much information at all Caro - Hoohaas are one of my favourite topics !!!!
There is a lot of fear about how your vagina will be after birth and it's something that many women feel they can't ask other women about. It is a fallacy as you have discovered. My vagina and it's sexual functioning is the same as it was prior to children. Vagina's are made to let babies through. Some women can have problems after an instrumental birth requiring an episiotomy or a tear. But this doesn't make it "baggy" it can make it painful for a time... That brings us to the suture or not to suture debate and that is a whole other thread!

About the too posh to push. I want to say some women need to have a c/section for medical reasons, for psychological reasons... The too posh to push is totally about a very small and select group of women who believe to have a c/section will keep their bodies in better shape...

[BellyBelly]

To use Ina May Gaskin's hysterical example, does a horse's butt go all loose and floppy after it's pooped? The vagina is a stretchy, elastic muscle, its designed to stretch then go back to shape. Just like a horse's butt.

[hannanat]

Well, Ive had seven babies pass through, and I'm not getting any complaints

[Lucy]

Well, Ive had seven babies pass through, and I'm not getting any complaints

Ha ha, me too........

I asked DH "is it like chucking peanuts into a cathedral?" after I got back in the saddle after Lexie (3rd vaginal birth in 3 years).......to which he replied "Nope, still a perfect fit"......LOL!

On a more serious note, this discussion/debate makes really interesting reading: thanks ladies! xx

[Yael]

The vagina is a stretchy, elastic muscle, its designed to stretch then go back to shape

So, how come i have a prolapse?? I think i got a faulty woohaa

[BellyBelly]

I believe its a possible complication of the form of intervention you had Yael but I need to need to double check...

ETA:

Damage to the pelvic floor occurs particularly in long second stages of labour, rapid deliveries, forceps or vacuum deliveries, and in the delivery of large infants. Often damage that occurs during pregnancy and childbirth goes unnoticed at the time, with symptoms only becoming evident following menopause. Recent research has revealed that the pelvic muscles are avulsed from their attachment at the actual time of delivery rather than later atrophy as a result of nerve damage.