Response to a comment
Agatha wrote a comment which I felt I should respond to.
- Gestational diabetes is a "diagnosis waiting for a disease" so it’s lovely to hear someone else agree! I love reading Michel Odent’s views on this subject.
- GBS screening is a 36wk screen for group B step and it is POINTLESS - I’ve blogged on this before, but you can hunt around for some more information on the interwebs too.
- I commented that many women attend lots (10+) of appointments during pregnancy, and I should probably explain that I’d rather quantity over quality. If the midwife knows the woman and the woman knows the midwife and doesn’t just feel that she is presenting to be ticked off as attending her appointment, and that the care was personalised and one-to-one and continuous, it’d be a different story. I dislike attending appointments, as a student, where the woman walks in, is kind of talked at rather than listened to, has her blood pressure checked and fundus measured then patted on the head and sent on her way. What is the point of this? If there’s no dialogue about *why* these things are done, is the full potential of these appointments realised? I think not, but I may be wrong having never been pregnant myself.
- Ultrasounds bother me because I’m not entirely convinced that they’re harmless. Women do love them but when you see the fetus curl up and away from the probe, and react to it, you have to wonder how much harm is being done by this and how much benefit there is. It also goes back into the "we’re just reassuring women that Nothing is Wrong, rather than being able to prove that Everything is Ok". Those two things are actually quite separate and different.
- CTG monitoring in general annoys me - not evidence based and not always monitored closely, and usually means the woman is in bed.
- Delivery rubs me the wrong way because it is such a clinical term when used in the context of c-sections and you deliver pizzas, not babies. It’s the whole connotation of someone else giving a baby unto the mother, rather than the woman doing the work. I had to think long and hard about why that bothers me so much Agatha and I appreciate the poke to do so! I use the word "birth" myself, because that’s what it is, and given the name of my blog you can probably guess that "catch" is a term that I use and I have used around me quite a lot. Tastes in words change, and "catch" is more in vogue these days with the people I learn from, but this may vary around the world. It also does describe more of what I do - I coach and support and guide and in the end have a babe slip into my hands, safely, before being handed on to the parents (not always - I’m a fan of encouraging mums and dads to catch their own babes!!).
- Clocks in the room mean people watch them slavishly. Delivery rooms here have windows and natural light - I can’t imagine working in a room without some kind of outside light during the day!
- The 38wk due date thing annoys me because I see a lot of women spend 3-4 weeks upset that their babe is "late" and scared because of that!!
- The baby size guessing game - if you are experienced in palpating babies and guessing their size based on that (I’ve seen a midwife who can do this and be within 50g of the birthweight!) then yay. But when women get an ultrasound that has a 15% margin of error either way, this annoys me because they obsess with the upper limit and are then unable to hear anything I might say about pelvises and breathing babes out.
- I find it interesting that you think birth is unnatural as soon as a woman enters hospital. I will have to ponder more on that.
- The woman being at the correct height is really important OH&S-wise - I damaged my pelvis/back last year and need to be very careful with it even now, so I use the bed to my advantage (yay also for being 5′5" tall!!). But there are ways of doing it that are degrading still and these are what I’m talking about.
Belated reply but oh well…
Personally I found the number of appointments half reassuring and half pointless. It was good to have my bp checked and to see if bub was engaged in the later ones, but apart from that they really didn’t tell me anything I didn’t already know. I was telling the midwife what position the baby in each time, I knew if it was worth checking anything out, etc, etc. I think the best idea would be maybe 4-5 set appointments and then the opportunity to make more if the mother felt them necessary.
Here is a good link on ultrasound info and the potential risks involved. Short summary is that they have never been shown to do no harm, no standards are present and the WHO reccommendations of number and time span of scan are almost never being followed.
http://www.joyousbirth.info/articles/uscauseforconcern.html
Colcks. Clocks are evil things in hospital birthing situations in particular. Women are not machines. We each labour differently and to our own timetable and our babies. This means that timing contractions has only limited use. Some women will never have regular ctx, some will have clockwork ones right from the start. Some women will have 2 rh labours, some will have 4 day loabours, none of these things are wrong or requiring of assistance but if a woman is in hospital with a ‘long’ labour she will be said to be ‘not progressing’ and will be augmented. There quite a few known risks to augmenting labour and ARM, especially if bub is not quite in the right position yet, but these things are done routinely if the labour is consiered to not be progressing to the desired timetable. Erm, yes, I’m ranting, sorry
I just find that clocks might be useful occasionally but they should no way be highly visible and they shoudl not be used as the only way to determine if labour is going smoothly.
In my opinion, it is a pretty rare case that a baby grows too big for it’s mother to give birth to it, we wouldn’t be here as a species if that happened too often! Therefore, what does knowing the size beforehand actually achieve except paranoia?
I would have to agree that birth is unnatural as soon as you enter hospital, we are mammals, we naturally would seek out a warm dark comfy place to birth and probably not have anyone around except 1-2 trusted people to look after our needs. Hospital sure as hell ain’t that environment! You are on a timetable, you are being monitored, you are being intruded upon in extremely private ways yet you are supposed to be listening to your body and working with it…
Due dates in general are kinda silly really. My bub was fully cooked at 39 weeks, I have a friend with all 3 bubs needing nearly 42 weeks, yet it’s abitrarily set at 40 weeks and anything later is an aberration? Yeah, ok.
Anyway, sorry, this really wasn’t aimed at you or meant to make you uncomfy or anything, I just wanted my opinions as someone who has been there heard
I definitely think midwives are great to have around, I just think that midwives in the hospital system are not being left free to fulfil their role of ‘with woman’ due to systemis pressure.
Comment by Ness — February 17, 2008 @ 3:41 pm
Hi there, just a quick note to wish you best wishes and say that I have mentioned your blog on my blog, to recommend it to the students I teach. cheers Sarah
http://tinyurl.com/3dxbvy
Comment by Sarah Stewart — February 18, 2008 @ 6:33 pm