As a birth advocate, birth professional, and someone who is highly invested in women-speak - I feel that there is a definite need for there to be a qualitative review of what I have taken from this year.
Earlier this year, in my pregnancy, I encountered the community of women who were able to finally experience midwifery again. Previously, I had been lucky enough to be under the care of a midwife but unfortunately had the right to a home birth stripped away under legislation. Many times I have asked myself why I didn't just go it the unassisted route anyway - it's what I wanted, I don't think we were under-prepared to accept a baby into the world in our own bed. It wasn't like I didn't consider the thought, and looking back it would have been an experience to cherish for the rest of my days.
My husband - the love, the father, the other accepting arms - was not ready to take that step. I made the choice to honor his wishes and to accept my own bias when making the choice to have a hospital birth. I do feel that it was a choice - we were free, nobody would come to my door and arrest us. I don't believe that our children would be apprehended (although, I do have some wonder if the social services people wouldn't be curious and want to follow us). I don't think it would have done any damage to our baby, although - I don't know. We weren't against intervention if needed. I would have gladly accepted a c-section if that is the way the cookie crumbled. I'm a nurse, too - so there is that to factor in as well.
I really did some soul searching, and I know from the community that many of us thought about bucking the hospital and just having our babies without the hands of anyone. Why didn't we? When talking to friends and other women in the community there were many reasons discussed. Some of us had previous hospital births that really weren't awful - nobody died, our babies came home with us eventually, and maybe the interventions were prudent or seemed to be appropriate for the time.
In looking back - where do I need to heal from my three births?
1. I had an episiotomy without consent in birth number one. My baby was taken to "nursery" and hooked up to IV's, put into a warmer, and monitored for six hours before I got to hold her. Initiation of breastfeeding took too long and we ended up with jaundice and a longer stay than we really needed. I didn't sleep for five days, and at several junctures needed to send my baby to the nursery for "rest". Was told that I had to leave my baby under the bili lights instead of holding her, and I had no idea if I should let her cry or take her out.
2. Of course, we had our midwife loss at 27 weeks. At the hospital, we were left to our devices mostly with our doula, but I still think about why I wasn't given anything for nausea through my IV (I was begging for Zofran, or anything to help stop the vomiting), and the nurse didn't listen to my request not to have the IV in my hand and blew two attempts in my swollen and poor veins. We were in a semi-private room with a woman that had a lot of problems. One nurse came into my room at night to help my mucousy baby, held her upside down and "shook" her to get the mucous out. It was a horrific moment, to watch the nurse man-handle my new baby. It took longer than anticipated to get on the road home (only a few hours, so that is NOTHING worthy of complaining about... but it just seemed like it was only paperwork holding us back, why did we have to "wait"?)
3. Having to stand in emerg and "register" with a baby crowning. It was super dramatic. We had heard stories of the midwife having to stay with us through most of the active labor, and that didn't really happen (but looking back I'm kind of okay with that anyway). Having to transfer at that point in labor wasn't ideal, there was no parking "close" to the hospital doors. ER didn't have a proper wheel chair and there was probably no way to get upstairs without the one we used (but we made do).
In talking with other local mothers this year, the things that ring the loudest are that our midwives were tasked with too many clients, and not nearly enough funding for programs. There was no clear/defined pathway of care. Many women were placed on waiting lists to access services and some where completely unable to get midwifery care - and had very little communication of where it was at through their pregnancies. Some of us (like myself) were told YES home birth was possible, and then NO, and then YES, and then MAYBE... and even more disappointing were told that it wouldn't be possible on weekends, some evenings, and during regular midwifery days off.
None of us directly blame the midwives, per se. We wish there was more communication. It wasn't a sense of entitlement to have a midwife, wasn't to fulfill a trend or a need to brag-book about having a home birth. We all just wanted something under the midwifery model of care.
There was mother-speak about the confusion. Most of all. We talked about it being a new program, about us as pioneers of a new movement in health care. We talked about privately funded midwifery, and we talked about the political actions needed to advance our self worth to the health care system. This is, after all, a boom time in our province and it seemed like it wasn't a priority. None of our election desires were discussed or debated, and both parties had mediocre platforms in relation to midwifery.
We were all given the opportunity to give feedback to the health region via surveys, similar to "customer satisfaction surveys". Some of us sent in postcards from the post card project, some of us talked to the client rep at the hospitals.
Also discussed was the bed-sharing policy at the hospital being changed. We all felt very sad for the story of the mother and babe who were in the media this year, and we talked about possibilities and solutions. The word on my street was that women were feeling like their breastfeeding success would be less with the new policy, and that it seemed like a decision based on legal implications rather than family centered care, or something rooted in evidence.
In a few instances, women had a very difficult time getting appropriate care with their babies. Whether it be accessing consults, pediatric specialty care, and post partum appointments - and even involvement from public health - women had issues and a general lack of consistency.
This is the story of 2011. It's a new program, and birth - so to speak- of the program is labored and highly emotional. It's no different in ANY area of health care, in ANY place in Saskatchewan. Does it mean we will stop? Does it mean it's okay and we will weather the growing pains? Definitely not. It does mean that a rise is definitely needed in maternity services and in healing our community.
I think our ladies do need to come together to talk - but, on the larger scale - what next? We've already re-hashed our stories, but little else has been done. I think this is where health care wins - we move on with our day to day lives, our babies, our scars - and we figure it's really not our time to worry about what is next. It's pretty easy to get lots in the shuffle (don't I know it...where did half of my energy go?) of babies and families. Our husbands are tired of listening to us (at least mine is) complain about how horrible our experiences were - when, really - it's not all that bad.
Think about the REASONS we're sitting on our hands?
- fear of disclosure beyond our accepting circle
- the amount of work required
- re-visiting those moments
- calling to question the actions of others who aren't willing/able to change
- lack of time to put into a cause outside of our families and other places we expel ourselves
- our babies are healthy
- our babies are NOT healthy
- we seem like it's relatively okay
- we are not revisiting it right now
Think about the REASONS we need to rise?
- our sisters in birth are experiencing more instances of birth violence
- our mothers experienced birth - ask your mother how far it has come
- technology is coming
- we can have home birth BUT our c-section rate is still increasing
- midwifery is still only available to a select portion of the population who can beat a waiting list
- stories continue to emerge about how birth experiences are shaping life forward
- we are hopeful for something better
Think about what you can do. How you can help; what you want to contribute.
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