My daughter was born late last year with the help of the midwives from the Community Midwifery Program, WA, and I would like to commend the excellent services offered by the program to parents and babies here in Perth. We are very fortunate to be able to access such a high-quality, state-funded program offering continuity of care in a midwifery-led, parent-centric model.
I’d like to take this opportunity to tell you a little more about our story and how we came to seek the services of the Community Midwifery Program, WA.
Having experienced two low-risk pregnancies via two contrasting models of care – our first child was born in a private hospital in Perth – I have come to appreciate what a difference the care and support women receive can make, not only during the birth, but also the entirety of the pregnancy and post-natal period.
When pregnant with my son, our first child, my husband and I decided to consult a private obstetrician, one who was recommended as being ‘pro-natural’ in his attitude to labour and birth. We thought that we were paying for continuity of care, as well as the peace of mind of having a surgeon available. We had regular checkups with our obstetrician, though we did not truly have the opportunity to get to know each other. As my due date came and passed, we were propelled into a medical induction of a perfectly healthy pregnancy.
At the outset of labour we found ourselves in argument with the obstetrician as he was very reluctant to consider our wishes – we wanted simply to delay the use of drugs in the induction. We then realised the folly of our previous thinking in regard to continuity of care as our doctor left and we were cared for by a number of different midwives whom we had never met before. The only support these midwives offered for me, even when I myself was in distress, was drugs.
The induction led to a cascade of intervention, with my son ultimately removed from me with forceps. Given that there was nothing apparently wrong with either myself or my baby prior to the induction, I feel this was an unnecessarily traumatic birth for my child. The guilt and disappointment I felt following my son’s birth remains with me still. In time I came to realise that at the heart of my disappointment was the lack of respect with which I was treated. I was only ‘allowed’ to make decisions for my pregnancy and baby grudgingly – as though the final responsibility for birthing was not mine. The midwives – constrained no doubt by being as unfamiliar to me as I was to them – watched their machines rather than me, and offered me nothing more than medical pain relief.
Following this experience, my husband and I agreed we wanted to do things differently next time, leading us to the Community Midwifery Program, WA. Having our own midwife made a world of difference. Appointments were relaxed, and most were in the comfort of my own home. I was never hurried, in fact our meetings were rarely shorter than 30 minutes. This gave us plenty of time to get to know each other – building rapport and trust – and discuss all our preferences and wishes for the upcoming birth.
An important difference was the attitude of our midwives towards the birth – principally their recognition that it was my responsibility as mother to birth my baby. This framed our relationship, so that while our midwives offered medical advice based on their training and experience, they also provided all the relevant information on the options available with the final decision left up to me.
Whereas our previous experience left us anxious about our medical caregivers and unsure whether we could trust their advice, the calm, considered care and support offered by our midwives meant we could trust them implicitly. During my labour, our midwives were able to offer the support we needed – which for us was a quiet presence in the other room, with as few interruptions as possible to check on myself and my baby.
The labour was long and very painful – we later discovered malpresentation was the reason for this. Late in the labour our midwives advised a hospital transfer due to foetal distress. We accepted this judgment and still feel no unease with the decision. In the end we did require obstetric assistance, and this was available to us through our nearby backup hospital where I birthed my daughter.
Even though I did not experience the ‘normal’ birth I longed for, the care I received throughout the pregnancy and birth meant that my daughter had the best birth experience possible. I feel quite certain that (based on our experience first time round) had I returned to the same obstetric model of care I would have certainly needed medical pain relief to cope, and I think it very likely I would have ended up with a caesarean, either due to failure to progress or foetal distress.
And yet I birthed her. And as hard as it was, I’m really glad I did.
We are very thankful to the midwives of the Community Midwifery Program, WA for the tailored care they gave us throughout the pregnancy, labour and post-natal period. I would never want to birth again without my own midwives and truly this level of continuity of care should be the gold standard in maternity care in Australia. Every woman should have access to care via a known midwife, even if they are classed as higher risk and also require obstetric care. Knowing each other and building trust means mothers and babies are safer and their needs are more likely to be met while avoiding unnecessary interventions that actually increase the risk to mother and child.
I hope that the State Government will continue to support the Community Midwifery Program, WA and its work. Sometimes in the debate about birth choices there seems to be an emphasis on survival rates, as though just being alive at the end of it is all that matters. I would think, as a first-world nation with a high standard of living, we would view low maternal and foetal mortality rates as our starting point – we should aim higher, to help mothers and babies achieve the best possible experience. I believe that supporting the sort of care model exemplified by the CMPWA is one important way we can do that.
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