What's birth like in Australia?

[onthefly]

In principle, women have the right to autonomy over their bodies and informed consent. In practice however, some 'carers' do not respect this. The law is on their side - they can always play the 'it was medically necessary' line and in truth, few parents question this treatment in any case. Not just doing things without informed consent, but telling mothers they 'have' to be induced/have VEs/cannulas/etc, etc - it's pretty common really.

You have to do lots of research in your options & care providers. The surest way to be sure, is to actually build a relationship with them - so continuity with a known carer. Even if you go private and get to know your OB, you probably won't have the option to get to know your midwife (even *if* you can do 'shared care', you may not be caseloaded to a particular midwife and will have to labour with whoever happens to be there at the time).

[Three Graces]

I think there's variation b/w hospitals, however, if you educate yourself (on which hospitals will support your wishes), and have a great support team (i.e, partner, a doula or a private midwife) in hospital - you probably stand the best chance of having the type of birth you want (of course, not counting any real emergency).

I went public with my first son, went overdue, was induced and ended up having a c/s. I tried for a VBAC (public again in Melb). I had to fight some of the Dr's who thought an 18 month gap wasn't long enough b/w kids to try VBAC. We had a doula with us second time around which was fantastic. She could advocate for my wishes when I couldn't talk and was a great support to both myself and my husband. I think the staff can sometimes pressure the partners into making decisions that you may not want.
They couldn't induce me and I went overdue. They broke my waters to see if I could get into labour and gave a strict timeframe (looking back, doomed to fail with the stress I was feeling). Another c/s.

Third time around, it's hard to find many public hospitals or private obs who support VBA2C. There are some, but I've had to do my research and I'm switching providers at 16 weeks to private. A great Dr who I'd met public also works private and I really trust her. Birthing centres which are more pro-active/calmbirth/no intervention, but won't take you on if you've had a caesar or are 'high risk' for other reasons. Some hospitals have birthing pools, however their policies differ on whether these are to be used for labour and/or birth and not sure if they're keen on VBAC'ers using them. I'm asking for cordless monitoring this time around to at least use the shower. Will have a birth plan with my wishes and will again ask that we be given time to consider any intervention suggested. They were pretty good about this with my previous two experiences.

[Sweeties]

This is all great stuff. NaeNae, in many ways I'd be keen to birth back home in Australia if we had a family home there - as it is my family all live in studios or tiny two-bedders with flatmates - so we'd have to rent! And by god accommodation prices in Australia is the stuff of heart attacks.

If I had to birth in Australia it would likely have to be in the public system as we no longer have private health insurance.

Having said that, it sounds pretty darn good in the Aussie public system - a darn sight better than here where in the public system you get:
*Automatic AROM - literally close to 100% rate
*No mobility once in the birthing ward
*Automatic episiotomy - literally close to 100% rate
*Most likely forceps delivery
*In a birthing ward where you are separated from other birthing mums by curtains around your beds.
*The cost of a vaginal birth is about $70 total for the top tier of treatment and about $10 for the lowest tier. The cost of a c-section in the highest tier is about $300!

It isn't much better in the private system. Honestly. Every birthing mother has to have an obgyn and there are no true midwives. Active birthing is still something of the future. Mothers are told to lie on their backs and not move in case the EFM doesn't work. Some obgyns have 70% c-sect rates, some obgyns have 95% episiotomy and AROM rates. The rates and stories are horrific. So many women too have no idea that their birth wasn't best practice and believe that they're never able to birth vaginally. In the group I volunteer with, we are coming across many examples of birth trauma. Two weeks ago, I know of about 6 women who had unhappy/traumatic births and not necessarily because there were complications. One mum was told to hurry up or they'd need to induce as the obgyn had a dinner appointment that night!

I could go on and on and on and on...............

So mainly, I'm asking these questions as I really want to know how can things be better here. I feel that if we can train midwives here in TRUE midwifery that would be a start. If they would allow women to be active and mobile in labour, that would make a HUGE difference. Hopefully the group I volunteer with will get a forum with the obstetrics society here to put forward some suggestions for improvement. Diplomacy and 'saving face' will be necessary though!

[HotI]

BB women or not they STILL have the right to know what is being done and STILL have the option to say no.

It does happen that medics play god and don't consider the womans right of choice ... as I said in my quoted part of the post, I was referring to my particular hospital. They do not do things without consent unless a woman is unconcious or unable to make that call herself.

And women everyday say no in hospitals in Australia and are then threatened, held down, assaulted, raped and maimed.

I am glad that you have not experienced things done to you without your consent. I would have had trouble believing that these things happen today in Australia if i had not experienced it myself. Other women have had favourable experiences at the hospital that i birthed my DD, mine was not.

[Novella]

I have gone through a midwifery group practice in a public hospital and have had a fantastic experience with both DD's and Im seeing the same midwife this time around too

I had premature rupture of membranes at around 36 weeks with both DD's and was technically change over to obstetric care, however both times I saw a Dr for about 5 minutes in total and had my midwife with me through out. Even though I had PROM with DD1 without labour I was able to go home on OAB ang given a chance to establish labour naturally which it did. With DD2 labour started when my waters broke. As I was preterm the hospital policy was to use fetal monitoring but I was able to use it wirelessly. I delined antibiotics with DD2 and my decision was respected. With DD I did have a registrar ask me to stop walking so much as the monitor wasn't working well when I was doing laps of the ward but my midwife stepped in and suggested we monitor a couple of contractions while I was standing still, everything was fine so I continued my walking.

I could have had a water birth if I was at term. I could not deliver in the birth centre due to being only 36 weeks however there was a shower, fit ball, mat, bean bag, heat packs and my midwife got some clary sage oil to help progress labour when it slowed down. As the model of care I had chosen is based upon a more natural view off childbirth analgesia wasn't offered but I knew if I requested it it would be available.

I also liked the pre and post natal care I had. The midwife visited me at home or I went to her in a local community centre prior to the birth which was great when I was pregnant with DD2 as no long drives to the hospital or huge waiting lines. The post natal care was fantastic. I think I had visits the 4 times the first week with DD2 (we went home the day after she was born) then weekly for a few weeks which is much more frequently than the regular maternity care follow up

I honestly think in Australia it depends on your carer as to whether they listen to your needs and seek permission for interventions, they all 'should' legally and ethically but that doesn't always happen. I think wherever you are getting a chance to learn about your caregiver and their practices and building a trusting relationship is the most important thing. I cant imagine going through birth woth a complete stranger caring for me

I hope you get the birth you want

[onthefly]

Wow Sweeties. As much as I can complain about the lack of choice here, we certainly seem to have a lot better than over there!
All the best with your advocacy work. You probably need a two-pronged approach: working to change attitudes & approaches on the medical side, but also supporting parents to demand better care.
Good luck!

[trishalishous]

Sweetie, sadly those stats dont surprise me at all, thats why many women choose to birth at home, rather than hospital.
I had one cousin (no kids) ask why I wasnt booked for a csection, since it was 'easier'. He nearly fainted when told I birthed a 10 pounder with no pain relief, and am VBing next time too (if all goes to plan)
My relatives are lucky to have had private healthcare, and great support to stay at home until the last minute. Many women I met homebirthed as a way of life, hospital was for risky pregnancies.

[Sweeties]

It's such an uphill climb here... and every time we seem to go up... something happens to bring things down again. Sometimes it just gets so hard suggesting, encouraging, persuading, sometimes fighting. We're doing lots to try and educate families (demand) and as for hospitals (supply), if we could just ask them to fork out a bit of money to equip hospitals with gym mats, birth balls, even just to allow the use of a shower - some very few items in our massive wishlist - and allow mums to use them, I reckon there'd be a calculable improvement in vaginal birth rates. Getting a whole systematic overhaul - apart from a shift in perspective - seems impossible at the moment!