Would you give birth in a midwifery led unit?

[Smoke Jaguar]

EzAckly, Tobily! Still wondering where they put all those dead, deformed, disabled babies in NZ...It's not a very big place...

[Trillian]

But it wouldn't matter if there were enough midwives in a lot of cases because of the sheer distance some women are from a hospital, if something did happen to go wrong and further medical intervention was needed you are a minimum of 2hrs from a hospital that can do an emergency c/s. Like for my situation - I am 80km from the nearest hospital that has a functioning maternity unit. Due to that unit only being within a small district hospital women can only birth there at term (being 37-42wks - if you show up in labour earlier than that they ship you onto the next hospital up the line but naturally if there is no time for that then you birth there but there are no facilities available if baby is unwell at birth) and if an emergency c/s is needed it can be done (as are elective ones). BUT if the mother presents with twins, they cannot be birthed there - they have to go onto the next hospital, which is a larger base hospital and even then they can only handle births after 35wks gestation - anything earlier than that and you get a trip to Canberra.

Even when I had Alister last year, there was a huge dilemma when my Dr decided to leave town - he was the only anaethetist and one of two GP Obs in that town. Now if any women went there to birth and required and emergency c/s, she would have to be rushed to the Base hospital 1hr away in an ambulance - mothers and babies can die in an hr and if the situation was bad enough, that was a real possibility of happening.

I just don't think that those of you in metro areas fully appreciate the choices you do have. Even though some of you may find it hard to get into a birthing centre, you still have that choice, you have the choice of a homebirth, you have a choice of a public hospital birth, you have the choice of a private hospital birth. So compared to us, you are SPOILT for choice.

[richsaralex]

I agree mostly with whats been said so far... tho I should add that the reason midwifery care disappeared from view for a while was because their insurance premiums went through the roof!! They used to practice independently, but were forced into working in 'units' in hospitals etc so they could afford to still practice as midwives!

The other main problem though is the medical profession! They have this 'god' complex where they beleive that nobody other than a trained doctor could know what they are doing (I mean this in relation to EVERYTHING health related) If they just stopped their scare-mongering then alot of health issues could be so easily solved! There would be no need for all these drugs and sometimes even surgeries!
My midwives were very certain that alot of intervention in labour is so easily avoided through some very very simple techniques! Even just considering the power of thought - avoiding an induced labour or c-section through sorting out any emotional issues you might have about the birth of your baby! Its amazing stuff and I honestly beleive I would have ended up on a surgical table in my birth if not for my husband talking very strongly to me, and talking me round to accept that I really was capable of delivering my baby naturally.

Its incredible that there exists the number of natural therapies and techniques for any number of things, yet you will be hard pressed to find a doctor who has an open enough mind to support anything outside his/her immediate education.

Until the medical profession changes - and this wont happen until the people demand it - then of course we wont see change!! People need to educate themselves (the internet is an amazing resource & should be more utilised in making educated health decisions), make their own decisions and stand up and say "no" to the medical profession when its obvious there are other more viable alternatives.

[BellyBelly]

Has anyone seen this in the Daily Telegraph? Supposed to be in today but I cant see it online.... anyone got a copy?

[*bLuE*]

I have 5 children all of whom were birthed in a hospital environment due to circumstances out side of my control. But I would like to point out that not one doctor was present at any of my births. If I had the choice i would have had my children at a midwife run service, these women know mor3e about the mechanics of birth than all the OB's I've ever met.. I would love to see more mids out there and available to all of those who want them..

[Schmickers]

If for some reason we could not have a homebirth, then by all means our next preference would be a midwife-run service.

[Trillian]

The other main problem though is the medical profession! They have this 'god' complex where they beleive that nobody other than a trained doctor could know what they are doing (I mean this in relation to EVERYTHING health related) If they just stopped their scare-mongering then alot of health issues could be so easily solved! There would be no need for all these drugs and sometimes even surgeries!

Yes, there no doubt would be some that have this attitude, but I think the biggest reason for opposing it is self preservation - if they all went out and said "yeah sure, use midwives and have homebirths - we know that's the best standard of care" they may as well take their name off the door of their fancy rooms because they would do themselves out of a job. Over the decades Dr's have become so ingrained into the birth industry that they can't walk away from it now - careers have been built on it. So they have inadvertently put themselves in an ugly catch 22 situation, because if they sided with the midwives, then that undermines the perceived confidence of the women who would use them - like why would you use them if even they are saying that midwife led care is better? See what I mean?

[Phteven]

The other main problem though is the medical profession! They have this 'god' complex where they beleive that nobody other than a trained doctor could know what they are doing (I mean this in relation to EVERYTHING health related) If they just stopped their scare-mongering then alot of health issues could be so easily solved!

I really can't agree with such a sweeping generalisation. Yes, there are awful Drs just as there are awful midwives but I've worked for some wonderful Drs, been treated by a fab Dr who reccomended accupuncture and more time in the gym for stress related issues and recently I've befriended an ob who is finally qualifies after years of hard work. We haven't discussed birth much but one of the things that she has mentioned is how frustrated she is with patients who start asking for inductions at their 39 week appointment. She's all for midwife care for straightforward births because she's really into giving her all for the complex ones but her patients feel that since they've paid her for her expertise that she should hover around while they give birth.
TBH in the brief discussions that we've had I've come to realise how much of the stuff that we lay at obs feet is patient driven. An ob can warn a patient all they want about the side-effects of epidurals but if the patient insists that they get one then the ob would be remiss to refuse it.

[Janie]

TBH in the brief discussions that we've had I've come to realise how much of the stuff that we lay at obs feet is patient driven. An ob can warn a patient all they want about the side-effects of epidurals but if the patient insists that they get one then the ob would be remiss to refuse it.

So true Dach. I know it's not the whole problem, but it's certainly part of it. Maybe it's just who I mix with, but I have more friends who would rather labour with an epidural than not (for instance).

[BellyBelly]

Warning a woman in labour is useless though!

She needs encouragement and support, which she often doesn't have, and will look for the weakest link to get her that epidural! They also don't elaborate about how the epi can lower your blood pressure and make the baby go into distress etc which I have seen happen. Its all the 'you might get a headache, very low risk of paralysis - they focus on the big things which are very rare to make you feel better about it.

[SunnyRain]

I wish people would stop bashing doctors. There aren't any obstetricians here to defend themselves, but there are plenty of midwives and doulas getting their jibes in, it doesn't seem a fair or balanced argument.

Please remember this entire thread is based on the opinions of 1 single obstetrician and at that it was just a short quote, God knows what context it was said in.

Have you ever read a newspaper article about anyone you know? They are always, ALWAYS completely and utterly wrong about every detail, and yet we turn the page and instantly take the next thing we read as gospel.

Why are people so anti doctors, it's very strange. Do you really think someone would become an obstetrician, of all trades, if they were an evil person? These doctors help women every day deliver babies safely. Many women truly appreciate their efforts.

In defense of obstetricians who aren't here to defend themselves: They don't just sweep in and cut cords. They are busy seeing multiple patients at the same time as well as conducting private consultations in their suites. Where they find the time to actually attend a birth at all is beyond me. You should know that most specialists work 12 hour days and barely pause for lunch, only having enough time to shove down a sandwich in their rooms between consults. The reality is, they would gladly spend more personal time with individual patients if only they had that luxury. That's why those doctors in smaller country towns get a more positive review than the doctors in large cities.

[Trillian]

Kuraizia, I don't think you are catching the drift. Most of the women who've commented with supposed 'anti obstetrician' flavour to their posts have either experienced first hand the damage they can do, or have borne witness to women getting the rough end of the stick during their pregnancies and births. I myself have read on here time and time again of women who have had terribly traumatic births, due in part or entirely to their care giver, or women who have their confidence in their birthing ability undermined by Obs telling them they can't birth big babies, they can't birth overdue babies, they can't birth breech babies, they can't birth period. Now you tell me that's fair? That we are being unfair to obs? I think not. This is your first pregnancy, and by the sound of it you're seeing an ob? And I am not at all saying there is anything wrong with that at all if you are, because it is a valid mode of care for women to choose, but Obstetricians are trained to deal in birth WHEN IT GOES WRONG - they have no place in a normal pregnancy and birth. And I beg to differ on them 'not just sweeping in and cutting cords' - the majority of the time that's all they do do. And as for Dr's in rural areas - they are usually MORE overworked and busy than a Dr in a metro area because there aren't enough of them to meet the demand from women.

[Toomanytoomany]

I wish people would stop bashing doctors. There aren't any obstetricians here to defend themselves, but there are plenty of midwives and doulas getting their jibes in, it doesn't seem a fair or balanced argument.

Given that the AMA seems to dictate how the policy is formed on this issue, I think it balances the scale a little.

Have you ever read a newspaper article about anyone you know? They are always, ALWAYS completely and utterly wrong about every detail, and yet we turn the page and instantly take the next thing we read as gospel.

I'm a journalist so I'm aware of how newspapers work. Anyway, from my experience, from policy decisions, and from listening to the stories of other women, the article meshes with the reality.

Why are people so anti doctors, it's very strange. Do you really think someone would become an obstetrician, of all trades, if they were an evil person? These doctors help women every day deliver babies safely. Many women truly appreciate their efforts.

This is the biggest straw-man of these arguments. People aren't anti-doctor. Mostly, they are against unnecessarily medicalised birth which can lead to a cascade of interventions, a lack of empowerment for the birthing woman, worse outcomes for her and her baby, and a higher health bill for the country. The plea to be grateful for this kind of misguided thinking on childbirth furthers the idea that women should submit to what they're told and be grateful for it. Sorry, I'm not doing that. Or at least, I did, and then I learned better.

We get cross when pathologists overservice but people aren't accused of being anti-pathologist when they do so. It isn't denigrating the value of pathology, or the hard work pathologists do or the long hours they put in, to suggest that overservicing is not a good thing.

[Ca Plane Pour Moi]

Hmmm. Pre-DS, Yes - and I was all ready to go to one but DH was REALLY pushing the hospital all through the pregnancy. Now... no.

I'd go there over a hospital, but I'm homebirthing next time, probably freebirthing. I had the world's worst midwife in the hospital (thankfully not for the birth) and I don't want to be around someone like that for a few days next time. I want to be in my own environment and not told what to do and when to do it all the time.

[Cassius2]

Again i guess i agree with everyone here! LOL!

I wouldn't be opposed to an OB next time. I like the guy i had and the midwives he worked with...

and what would the problem be if the OB just 'swept in and cut the chord'? wouldnt that mean that they didnt interfere in the birth, and were available in case something did go wrong? In fact, i wouldnt care if i paid for the OB and they didnt turn up at all! But i would want to know the person that potentially will have me and my baby's life in their hands if the need arose.

why cant we have the best of both worlds? isn't that the REAL choice?
For me i chose my OB because i knew that he was compassionate and very able if the need arose to perform an emergency c/s with as much compassion and understanding as possible (i wanted the guy cutting me up to know the person i was, not just the next belly in line). I ALSO knew that he worked closely with Anne and Michelle (m/w's) who would provide the primary care and this last point was my main reason for going with him.

Also, i have only had one experience (thankfully positive!), and i loved the fact that he (my OB) came by the hospital every day to say hello and have a cuddle of Leila. Not all of them are just there to be the surgical specialists. some of them just have a passion for babies and decided to specialise in a field that for various reasons appealed to them.

[BellyBelly]

Clare - then they should be midwives

[briggsy's girl]

Clare - then they should be midwives

too true Kel - if those with a passion for helping a woman birth stepped away from the obstetric model of care, and more towards the midwifery model, the birthing mother would be better served. if the emphasis of only paying a respectable income to those who have studied for years was taken away, and given more to those with experience, people with a genuine passion would be more prepared to move into that field. academic learning and a big pay packet don't make you qualified to help in birthing

how many doctors, of MANY specialties (GP's included), are all about the academics, and are only doctors because they got good grades in school, not because they have a genuine passion for helping PEOPLE. i think OB's have their place in some births, no doubt about it. and for some people, the obstetric model of care is what they need - but the argument here is that we SHOULD have a choice, and for so many people, that just isn't an option - there are not enough birthing centres by far which leaves you with the option of obstetric led care in a hospital environment (and even if it's mostly midwife care, ultimately, they don't have any power - they answer to an OB), or homebirth, which for many, is just not an option

[Cassius2]

Clare - then they should be midwives

yeah, but from what i have read and heard, being a midwife here in Australia is an uphill battle to find respect and acknowledgment of experience and knowledge in what is ultimately THEIR field...only for the strong!

Briggsy's girl: academic education is not reflective of a person's ability to relate to people. Also, most doctors are not academic. academic is a term that implies that they have gone on to further study and have dedicated themselves to a particular field through the completion of PhD (trust me, requiring loadsss of passion!). in the case of OBs they have gone to university to get a degree. that's it. MOST dont have a PhD, because, like you said, they don't give two hoots about what they are doing.

The state of care in rural areas is abysmal. i can only talk from a QLD perspective, but it is the pits. in a country town where some family lives there used to be a midewife centre. (basically because there wasnt a hospital close enough to deliver babies). the centre was really successful. until they closed it down. the claim was funding, but the rumour was that the local hospital (which is not at all convenient to the people in the district, not to mention extremely dangerous - my aunt was having a heart attack and they sent her home with a bottle of mylanta) was basically getting narky about the drop in numbers of women birthing there and applied pressure. the end result was that women were (and are!) holding off (and rightly so!) until the very last minute to go to the hospy and have their babies, resulting in many being delivered in carparks, on the side of the road etc in extremely terrifying circumstances. Seriously, WTF is so bad about Midwife-led centres???? what freaks the establishment out so much? is it that they can't make money out of it? i find that hard to believe! i mean, if McDonalds fast food restaraunts can make money outta the cr#p they serve as 'food' surely....

I have to say that I am waiting for the day that BB opens its own Midwife Centre!! bring it on!!!