Controversial Pregnancy & Birth Documentary

[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.