Would you give birth in a midwifery led unit?

[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.

[BellyBelly]

Obstetricians never were designed to care for women who have normal births. They are surgeons, they are specialists and they should be doing that all day every day - not caring for normal birth. That is and always was the job of the midwives, but going way back, there was a smear campaign against midwives when Obs popped up and they needed a job. Watch the Business of Being Born for an insight. As I think Trillian said, they forget midwives have been in the business of birth for much longer. They came in, and took over. We do need them and they do save lives - but not in the realm of normal birth - that is midwives work. I am sure you wouldn't like your boss taking over your job and telling you how it should be done.

Again as I have said, there is no obstetric crisis or shortage in Australia. There is an obstetric monopoly making them this busy, tired and prone to prefer inductions and c/s! Not saying they are doing a bad job but they are doing the WRONG job.

[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.