Care providers are creatures of habit

How I wish I could explain this to women who are pregnant or planning a pregnancy. There is a huge need for women to understand:

1. care providers are creatures of habit so you need to find out what they do through habit (which is not a bad thing necessarily!) rather than just what their philosophy is;
   
2. care providers are not going to change their way of providing care, just because you have a birth plan that says you don't want something they usually do;
   
3. some care providers can't remember your name, your preferences, your due date or your birth preferences and don't care about them either because it's all there in your file;
4. having an obstetrician does not guarantee you continuity of care or carer; and
5. care providers provide care in a system that does not know you exist and don't care specifically for You as a person.

This means:

1. Asking questions can be really hard, because unless you know people who have previously used that care provider, then you have no examples to go by. But ask questions from the beginning about how they'd manage something or advise you on something, and see what that says.
2. Again, it's hard to find out the information you need but an open, honest conversation about something that you do or do not want (cord clamping, episiotomy, induction before 42 weeks, breastfeeding support, injections, scans, etc etc) can tell you a lot about their approach.
3. This may or may not bother you. Work out if it does. If it doesn't, maybe ask yourself why it doesn't matter to you that your care provider remember who you are, even vaguely. Are you not worth that much of their brain time? If it does, work out if it's something that you want to face for the next year or so.
4. On so many levels, I understand why women assume this. It doesn't mean that your ob cares about you or remembers you (see #3 above). It also doesn't guarantee that they'll be there for your birth. And if you want any mother craft advice, they are also not going to give it to you. They are experts in gestation, and surgery. Pregnancy and birth are not the same things as these! You may birth when they're busy, out of town, at a conference, or with another patient. And how they are in clinic may not be how they are at the birth. It also comes in to #5.
5. The care you receive during your pregnancy, birth, post natal period and early motherhood should have everything to do with each other. But if you have an obstetrician, it won't. They will see you a couple of times postnatally but you'll be in the hands of the hospital you birth at, and basically without support for the rest of the time. If you go through a public antenatal clinic, it also won't. Same with a public system birth of most kinds - you'll be without support once you leave the hospital.

This post is brought to you by the gnashing of teeth responce I have every time a young, healthy woman signs up with an obstetrician for continuity of care or carer, without asking any questions or trying to see the bigger picture. And I am yet to work out how to say these things face-to-face without looking (more) like a weird midwife hippie.

What is the big deal about changes to midwifery?

It's not about whether you agree with birthing at home - it's about whether it should be made very difficult (if not illegal) to be attended by a qualified professional in the place of your choosing. It's about whether midwives should be allowed to register and practice as midwives in a setting of their own choosing, and in line with the guidelines that already guide their practice.

It's about women's rights as well. If the push was to stop elective c-sections, or the use of epidurals, then there'd be outrage! But because it will only affect a small number, it's apparently ok to take away this right?

And the small number of births probably has a lot to do with the fact that it will cost upwards of $3k to birth at home, whereas a birth in a hospital costs nothing, because one is covered by Medicare and the other isn't. This, plus the small number of midwives in private practice, means that a lot of women just aren't able to access the option, regardless of their preference.

My newest party trick

We heard the heartbeat yesterday so are pleased to announce here that we're baking an Easter bun!

From Hansard today...

"We have seen a much more progressive attitude in the private sector in Western Australia where the benefits of this legislation will also be immediately utilised. The private sector in Western Australia is poised and ready to deliver community health care to Western Australians in ways that have never been imagined before. I have one large charitable organisation in Western Australia which is currently examining the concept of providing home services which are a virtual hospital. They can employ nurse practitioners and other

health professionals to go out into patients’ homes and provide Medicare subsidised elements of health care ordinarily available only in hospitals. We know that that will have some distinct advantages in assisting people to remain in their own homes. Most of us prefer to be at home than to be admitted to hospital."

This was spoken regarding the nurse practitioners and midwives bill(s) before Parliament at the moment. But not relating to homebirth or midwifery services. This smacks of rank HYPOCRISY - that a Labor member can get the concept that people want to remain at home for health care, but not that they want to birth their babes and start a family in the privacy of said home.

Q: What do you think is the primary fact that causes women to fear, or not trust, birth?

A: Fear mongering from the press and medical establishment. Lack of options. Difficulty connecting with natural birth support networks.

Nine essential elements to achieving the birth you desire:

1. A deep conviction in your ability to birth
2. At least one person who shares this conviction to support you through the entire journey
3. Birthing with practitioners who are committed to birth rights, compassionate and normal birth and motherbaby-friendly standards of practice
4. Taking responsibility for your physical and psychological well-being and preparing yourself
5. Avoiding birth conversations with people who don't share your conviction
6. An ability to sort through or tune out all the conflicting and fear-based information and advice which bombards pregnant women
7. An ability to say NO
8. An ability to explore the unconventional
9. Patience

Insert witty subject line here

I slept for 12 hours last night. I was done done done at 8pm so I went to bed. I woke up at midnight and had a snack and a read for an hour, then Osk got home and I went back to sleep. And woke up at 8am. I am now drinking a coffee while watching the men at the building site behind our house pour cement from a cement mixer into another truck, which then has a LONG hose that goes up up up and then down down down so they can put it in the right spot.

I can see all of this because the back fence to our property belongs to the property behind us. As such, when the old house got pulled down and the block cleared, the load-bearing garden got taken away and so the fence has gradually been falling over into the property behind us. We had crazy weather on Saturday night and then meant one piece has now fallen off and sometime today I'm going to ask the workmen to nail it back up so we can have some (a) privacy and (b) modicum of security.

Just not while I'm in my pjs.

Things I have to do today:

• bank large cheque
• deal with uni because they are morons*
• return some purchases to KMart
• go to BigW to see if they have better alternatives than the ones I didn't get from KMart
• do an assignment
• buy nail scissors seeing as my Favourite Pair have gone missing
• bug Adelaide University for my payment summary
• go to gym

Right now I'm going to make oatmeal, the breakfast of champions, and wake TheHusband.

* I went into uni on Thursday. This is a pain in the backside but I went in to ask whether I could get excemption from the two assignments and one workshop I did last year and shoudn't have to do again this year (which I got). In the meantime I asked the enrolments manager to check why my enrolment was dicky. She couldn't see why so said "Unenrol and reenrol and it'll all be fixed". So I did step (1) of that when I got home and then discovered that I can't reenrol as it's after 07/08/09. So I have to get the uni to FIX this when it could have just been DONE on Friday when I was AT UNI. Which I DON'T DO VERY OFTEN as I'm an external student.

General updates are generally dull

So here are 5 things I want to say:

1. TheHusband deserves a medal for weeding a lot of the garden yesterday and now it looks slightly less than feral and a bit more like it could grow some things. The orange tree needs to be planted as it's thinking about fruiting.
2. I had dreams last night about making stewed apricots. What is with dreaming about food?
3. It is 27C here today. In August. It is freaking GORGEOUS out here on our back patio with the sunshine and a light breeze. This of course means it will be back to winter for the next 3 weeks as punishment but for now I'm enjoying the Spring out here.
4. I put on my big girl pants the other day and went to the university and chased down a lecturer and got her to sign off on me having an exemption from the two assignments and one workshop that I did last year, so while I have to repeat this subject I don't have to actually repeat it all.
   
5. I managed to get a formal dress for a formal dinner this coming Friday night, from a real bridal store (it was weird being in there having never done the Bride-y thing at all!) and it cost me $49 instead of $400. It's gorgeous too. And strapless. And red, just for something different.
   

Why I'm not a good candidate for a hospital birth...

Stolen from Gloria Lemay:

I'll tick the ones that I am not. See how I go :).

Must not be scared of needles.

Must not be claustrophobic or uncomfortable in confined spaces.

Must be able to go for long periods of time without eating or drinking.

Must be happy to share a bathroom with others.

Must enjoy sleeping on a mattress covered with plastic.

Must not have a rebellious or questioning nature.

Must accept the possibility of contracting antibiotic-resistant infections.

Must be confident with caregivers who are overtired and overworked.

Must realize that a limited amount of time can be spent in a hospital room before it is needed for the next patient.

Must like and trust electronic equipment.

Must be comfortable with cesarean rate of 30%.

Must accept that the mood of the nurse on duty will be a large determinant of the birth outcome.

Must realize that someone you have never met before will likely receive your baby.

Must realize that the written birth plan will be ignored.

Must be willing to have fluorescent lights turned on at all hours.

Must be capable of birthing without making loud noises.

Must look good in a flimsy blue gown that is open up the back.

Must be willing to be a teaching subject for student doctors who are learning to do pelvic exams, surgeries, and suturing.

*****

Not so well - I am happy to let students learn, which is a bit odd that that's the only one I didn't tick apart from being scared of needles. I heart Gloria btw and have had the pleasure of meeting her!

So what do I do with it?

I have an international cheque for about $30 AUD. If I bank it, I lose $10 so I don't want to bank it with my usual institution - but have no idea how else to get the $$. Suggestions?

Also - said banking institution now has (a) monthly fees $5/month (b) debit visa fee $2/month (c) bpay fee $0.50/each and (d) transfer fee $0.25/each, and I want to move away from this. I don't mind paying one fee but I feel completely SCREWED as a student to be wearing a LOT of fees.

My house smells like patties

I made one of my favourite inventions/recipes. I made this up shortly after I left home at the age of 16, and needed something easy and cheap to eat that wasn't takeaway. So here it is:

Take one bag of instant potato. Or 4 cups of mashed potato if you've got it. But I rarely do so I have been known to use any kind of brand of instant potato. Sue me for being trashy - it's the only time I've ever used it. Make it up with a little less than usual liquid as you need it to be stiff.

Take a 250g packet of frozen spinach and cook it as instructed. Don't squeeze the extra out but it shouldn't be Wet.

Take 1/2 an onion and brown it up in a bit of oil in a frying pan.

Drain a small ish tin of tuna.

Mix all of this in a bowl. Add a good handful of grated cheese, some salt and pepper, and an egg.

Pat together into little patties and in an ideal world, leave in the fridge for 1/2 hour minimum. If you're in my house and you want to eat them NOW, heat the same frying pan with a smidge of oil in it, and pan fry gently until crispy. I find you don't need to put flour or breadcrumbs on this, to keep them together or to get them to crisp up. You can pat them in something if you want - breadcrumbs with chili flakes, or parmasen cheese.

Eat. Eat cold. Put it on a roll or in a salad.

These are gluten free as made if you get gf potato or make it yourself obviously. You can make them without cheese and/or egg but reduce the water content when making the potato. You may need to rest them to do that as the egg and the cheese both bind the mixture.