Thanks for the replies. Pixie I gotta spread the love, but your post was right on the money. I think the whole idea of 'choice' in childbirth is a bit of a misnomer.
There are so many variables, it is impossible to plan for each one. I do not think women should just take what they get though, but as pixie suggested there needs to be closer collaboration between patient and care providers.
My sister is a care provider and seriously she us overworked enough without having to forge meaningful relationships with every patient, but I think this is inherently part if the problem. We have systematized health to such an extent there are major gaps between expectation and reality. Women in labour need special care, new mums need special care, and yet so often they are left feeling like they recieved substandard care. Some of this can be attributed to high expectations, but seriously some if it is just substandard care (like kate07's case).
If we just take the expectations angle, then I can see why people would question why we build these expectations in the first place? But the same could be said for any group fighting for their rights, somehow we feel things could be better, despite being systematically told they have to be this way. Feminists and civil rights activists spring to mind...both were told they 'needed' the shackles of their oppression, but somehow they fought against it, and no doubt there were those who found it easier just to accept the status quo and stay within their gendered\racialised roles. Does this mean change should not be sought, or expectations changed?
Part of agitating for our rights is the process of confronting the position of being oppressed, and I think bellybelly does this to people. It shows them that the stance if natural birth and breastfeeding is oppressed in general society (gee just look at the daily telegraph), but of course this means it appears to only advocate these things, which is not entirely true, but it makes it hard for many people to navigate their way through their own experiences in comparison to many here on BB.
Typing on phone with breastfeeding toddler, hope that makes sense...
It's hard when everyone has different expectations.
How realistic are those expectations in the first place? With my first I assumed the ob would be there for longer than 5 minutes, I know now that isn't realistic but maybe because you are paying them a packet you expect it
Next time I thought I had continuity of care with the local dr and we discussed everything under the sun at our appts. When the time came no one bothered to call him in because someone had the idea he was on holidays ( he wasn't). I'd built a relationship with him and I would have felt a lot better had he been there as things weren't what I expected. All I had was a middy there stretched across three rooms and the chick next to me screamed louder, and my poor sister had to drag her out of the other room when I needed help.
You can't foresee that....
In any case after all this I decided on a Doula so I could be assured of continuity of care at the time I might need it most. The system isn't perfect so I made sure I had what I needed in case of busy nights/full moon/dr on "holidays" whatever.
I don't think the expectation of having a middy with you at all times in labour is unfair, but maybe not realistic at all. For me I think feeling unsupported can lead to fear/stress and plans out the window.
I always try to encourage someone to think about a Doula.....then I run the risk of them getting annoyed thinking I'm saying their husband won't be a good birth partner - but I will always pass on "there won't be someone with you all the time ok?"
Pixie, great words about continuity of care. This was biggest bugbear while I was pregnant. I still believe to an extent the lack of continuity of care for me was a huge factor in the death of my baby. I did not have a relationship with any midwife or doctor who I spoke to when I was worried about my daughter so they dismissed me as a anxious first time mother and didn't treat me seriously. To top it off the one doctor I saw left the hospital the day she gave me the last ultrasound and didn't pass on the information about how the ultrasound went. I effectively got "lost in the shuffle".
My choice of birthing hospital was taken from me by the doctors and I was forced to birth where I did not feel comfortable.
As first time mother I felt I was fairly realistic. None of my care met even those expectations.
Birth plans set us up for failure. They do not take the intervention that will be imposed on us into account enough.
We need to fight the intervention OR give up and accept it. We should stop assuming that at the moment we actually have any choice in birth because we don't. We can be "lucky" and have things go our way but we do not have any control over the actuality of birth and certainly no control over the people caring for us in this dynamic situation.
Lulu I don't think the expectation of having a midwife with you at all times during labour is unfair, I think it is what most women would prefer, but in our system the resources simply aren't there. If you pay for an independent midwife, you are either giving birth at home (which is not everyone's preference) or in a hospital where said midwife's hands are tied. The system is stretched way too thin, information is patchy, wrong and difficult to obtain. Once you become a consumer of the maternity services system you realise just how little the government/ public (and even private) health system cares about it.
I agree with kate that in the current hospital system (I can't comment on homebirth as I don't know) it's not so much a question of choice, education or control - we can be lucky or not, and neither outcome is a reflection on who we are. It's pretty disgraceful that in large measure how we experience the birth of our babies comes down to luck.
ETA - Thanks Fleur
I can answer for homebirth and say the hiring of an IM is a guarantee you will at least be accompanied throughout your labour (usually by two midwives and assuming you call them in time to come lol).
I am appalled that women in hospital do not necessarily have anyone there for them (and I know two women whose husbands almost missed the birth coz they were trying to find a dr or midwife). People have an idea that hospital is a place you will be looked after but I think I received much better care at home. I live in a big city though and felt safe knowing I could go to hospital if needed and my midwife would be there for me at all times.
The cost of a midwife is expensive to some, but we paid using the baby bonus. It was also less than many private obs who do not offer after care in the home (daily then weekly visits until 6 weeks) plus a midwife offers breastfeeding advice.
I kind of think the choice is actually stay home and take full responsibility for your own and babies health or go to hospital and hope your emotional wellbeing is catered for as well as the 'healthy mum, healthy baby' outcome is. At the moment we kind of think homebirth style of births (no intervention, drug free etc) can happen in hospitals or even birth centres, but that seems like it is unlikely. It sets up unrealistic expectations. It also does not take into account the reasons why some women need intervention. I really think the majority should birth at home, so hospitals can use resources helping those in need.
Birth is not an emergency every time. Why do we always asssume the worst?
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