I don't understand...

[Michelle_k]

Even though i'm not due for another 7 weeks, i've written up my birth plan and told DP EXACTLY what i dont want if things do go awry. i've also told him about what i DO want to happen. just in case (fingers crossed)

[Roryrory]

Kel that is awful.

Out comes the lawyer in me - surely it is the law that a patient is allowed to refuse treatment? Even to the point of refusing induction, c/s, and so on? This is one thing my DH keeps going on about (he will be a fierce non-interventionist when the time comes) I mean, parents refuse blood transfusions for their kids due to religious reasons and doctors have to got to court to force it to happen. Surely a woman has a legal right to refuse "treatment". It sounds to me like doctors in those situations take adavantage of the woman's vulnerability and bully them into things.

And Schmickers you are right on the language used. Boy wouldn't doctors start acting differently if they could be sued for unnecessary c-sections or interventioons. (Problem is they probably couldn't be - from memory the new med neg laws say you need at least 20% "impairment" to sue.....)

[Astrid]

Surely a woman has a legal right to refuse "treatment". It sounds to me like doctors in those situations take adavantage of the woman's vulnerability and bully them into things.

After my experience I spoke to the complaints area and as far as they were concerned I had a right to refuse treatment. I had refused an episitomy and the Dr in question threw off her gloves, had a tanty and refused to treat me unless I agreed to one. When you are in the thick of it it can be very hard to stand up for your rights. Wouldn't surpise me if Kelly is referring to the same hospital I was at.

[Roryrory]

When you are in the thick of it it can be very hard to stand up for your rights

I completely agree - that is all the more reason why it is so appalling! Imagine if doctors in, say, the Western suburbs were routinely denying the rights of poor or immigrant patients. Hmph - what am I sayig - it probably happens all the time (shaking head).

[MantaRay]

I truly think there would be many more homebirths if people knew more about the birth process and the agendas of the many in the medical profession. Unfortunately though, most women don't know, and believe that they will achieve their best outcome by medicalising a natural process. All I can say is that if I knew what I know now, I would stayed away from hospital - although I think I would have had a job convincing DH.

[~kaos~]

I think you described exactly why I am choosing to homebirth.

I've never been in a situation such as that described, and I have only had continuity of care from a known midwife for all my births. I have heard more than a few stories such as the one just told and it scares the beejeebers out of me. To me, it's worth the cost for quality care.

I know you can have a rewarding birth in a hosp, but I don't want to have to fight for it and explain every little decision I make (especially while in labour), so I choose not to put myself in that kind of position.

[Alan]

Kelly that is disgusting but unfortunately not as uncommon as some people might think. I started doing homebirths because of my disgust at how women are usually treated when in hospital. I have seen many threats such as that poor woman had to face and because “the doctor is always right” women are bullied into accepting what the doctor/hospital wants. I have seen doctors do an internal without asking permission or even telling the woman what they are going to do. It is often “lets just have a little look down there and see what is happening” then without any warning in go the fingers. I have seen doctors tell women outright lies just to get their own way. Unfortunately until women start to realise that doctors do not always have the woman’s best interest at heart I find it difficult to see the current situation in hospitals changing anytime soon. I can understand that for a lot of women and their partners the prospect of a homebirth can be scary but just look at all the research. For a non-complicated birth the safest place to bring your new baby in to the world is in the comfort of your own home. Another problem that I see as a major deterrent to a homebirth is the cost. Depending on the state that you live the cost can easily reach $4000. I personally try to keep my costs to a minimum and I have a number of very flexible payment plans. For example The last homebirth I attended was on Thursday. I have been seeing this woman since she was 16 weeks I have to drive 90klm for each antenatal visit, when she got to 38 weeks I moved to a caravan park in her town and will be staying there until Tuesday (5 days after the birth). For this service I will be charging a total of $1,700. The main reason I try to keep my costs low is that I want women to know that there is an alternative to a hospital and for most the alternative is a better choice. Perhaps if midwives ever get a medicare number than I may be able to increase my charges a little.

[Trillian]

I just don't know what to say to this. It really does make you wonder just how many women have unnecessarily procedures done like internals, epis, instruments etc just because they got the Dr offside and this is his 'payback'. Their arrogance clouds their judgement and I bet that if they did manage to convince a woman that their way was best, and ultimately had everything go pear shaped, that they would shirk responsibility and shift the blame onto the mother. They have no respect at all and as soon as women realise that it is their RIGHT to have the birth they want and that it is also their RIGHT to refuse unnecessary medical intervention then there would be a lot less women wondering why they are unhappy with their births.

[Roryrory]

Just been thinking about this overnight. Last time I went into labour naturally, DS was born on his due date, vaginally without manual assistance, no pain relief, etc - so I am pretty confident that things should go ok this time (I have chosen a birth centre for this birth). I am going to do a "birth preferences" list for the birth centre because I trust the staff and my body to do what comes naturally, but I have been thinking of preparing a highly "litigious" and strongly-worded birth plan in case I need to be transferred to the hospital system. I am thinking along the lines of "I am a lawyer and so fully aware of my rights to refuse treatment - any forced or unconsented medical intervention will be considered by me to be medical trespass" etc etc etc. I am also thinking of drawing up a formal medical power of attorney for my DH (who is strongly against unwarranted intervention)

Alan and those of you who have experience in the hossy system - do you think this would give me more of a chance of being listened to in the event I end up in hospital? I know it sounds OTT and like I am preparing for battle but that is truly how I see it.....

[BellyBelly]

Aurora, in the birth centre you have a great chance at birth the way it should be but at the same time you have to remember they are part of the hospital which has to follow hospital policy. Like my client, she hit 42 weeks and she was out. If you have meconium, inductions, epidurals - you are out. Its a low risk hospital basically. Given your first birth went well and this is your second, I would have every reason to believe this birth will go well, but of course, you will have a harder time if you are transferred. The fact that you were transferred to start with puts you into that category of not being right and needing help.... I agree birth centres follow the philosophy of most birth plans but you really need one in case you are transferred. It's a great start that DH is going to be your gorilla. A male gorilla (when his mate is giving birth) circles the perimeter and kills anything that crosses it So you can call him your gorilla.

I have had a client at the mercy who needed an induction, they were allowed to have waters broken first and wait for the drip, but only given something ridiculous like a couple of hours for labour to be established. And while something had started, it wasn't enough and she had massive pressure for the drip and told the baby could die. She had a condition, but not one that was urgent enough to induce her BEFORE the long weekend!!!! So after it, the pressure was on.

[MantaRay]

Rory, sadly a strongly worded doc could have the opposite effect and put the staff right off side too. Maybe write one but only get DH to bring it out if it is really necessary? Hopefully everything will go really well for you anyway so there will be no need.

[Ashlee]

I am definitely considering a homebirth for the next one (after doing it in hospital with only gas, I'm confident I can do it at home where I can feel comfortable, no CTG's strapped to me etc).

Do PM's have gas though? I don't know if I could do it without that at least?!?!

[Feathertop]

That's pretty sad isn't it? They are paid well to be on call and called in - I know when I was on call, I was quite happy to get called in as I knew the staff wouldn't do it without the need, and also I was being paid for getting up and coming in to work. If you don't like it, don't sign up for it!

Although the birth of our son tended to go down medical pathways, I was happy with every step we took to go as natural as possible. I had a S+S in the dr's office 3 days before with little effect (contractions but only low grade and not getting closer), then had the membranes broken in the dr's office and was allowed to walk around in the hospital to try to get things going for 6 hrs (no effect). The midwives really encouraged natural pain relief methods which was fantastic and really encouraged me to do it. Unfortunately we ended up with a c section but I found the process great as I got to do things the way I wanted as much as possible, I got to refuse the forceps (which in hindsight was a great choice as it would have meant terrible damage to me without delivering the baby) and they accepted that. My Dr was a GP Obs in a rural public hospital (I was his private patient) and he listened to every thing I said and abided by it.

[Roryrory]

Thanks Kelly - I think it was actually my 6 foot 6 gorilla saying "no" that stopped my OB using forceps last time. And MelR good point - to continue the battle analogy, there is no use bringing out nuclear weapons if the mere sight of an AK-47 stops the fracas....

[Tobily]

Oh this makes me so sad, angry and sick.

The fact that a male dominated profession get away with treating women entrusted to their "care" like this on a daily basis makes me so upset. If men had babies the concept of "informed consent" would be taken as seriously in obstetrics as it is in every other branch of medicine. As things stand now, it's a joke. Birthing women are physically and emotionally vulnerable and this seems to be exactly the reason they need to justify taking all their power and respect away from them when they SHOULD be doing the exact opposite BECAUSE they are so vulnerable. Just the other day I heard of a woman who had specifically requested no ARM during labour - this was completely ignored and her water was broken during an internal without her permission or any forewarning to her whatsoever. I don't understand how they get away with it either, if that was done to me knowing what I know now, I would have kicked that arrogant, disrespectful so-and-so in the head while he was down there

Kelly you did a wonderful job for your client and I guess the lesson we all need to take from these experiences is the reminder that this is WHY we need to do this work. Use that anger to spur on your efforts, because you do make a difference

[Astrid]

I was actually treated badly by a female ob, so it is not just men who behave badly.

[BellyBelly]

Yup I too have heard several complaints about female obs, specifically being cold and/or rough.

[Tobily]

Yeah I know female ob's (and midwives at that) do the same things - of course they do.

What I meant - and it wasn't clear - is that obstetrics IS a male dominated profession. The population they care for is 100 percent comprised of females. The gender imbalance that exists magnifies these issues. There is no other branch of medicine where you see the same dynamic.