Thursday, September 24, 2009

How does it go?

blah blah blah state of the world etc etc and btw i'm pregnant

congrats. where are you having it?

at home

oh
is that safe?

well yes - i have a private midwife and am well supported with my husband and friends

oh
but it's not safe to do it at home! think of the children!!!

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I have to bite my tongue because:
(a) it's none of your business where I have my baby
(b) not safe based on what? Have you looked at the research? Because in making an informed decision, I have done a lot of research. Have a look at Wikipedia or a recent Canadian Medical Association Journal article for easy understanding:
Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician.
(c) not safe compared to what?
(d) still none of yur business
(e) I don't think that FOR ME, birth in a hospital is normal, natural or safe and to have a normal vaginal birth in a hospital without unneccesary interventions is a miracle rather than the norm and those interventions cause problems. There are lots of potential downsides to birthing in a hospital - they're used for treating sick people, there is little to no continuity of care or carer, there are clocks everywhere, they are a business and fast turnover is of the essence, the definition of normal is very narrow and anything outside of it is scary to care providers, and the outcomes are no better for all the interventions.
(f) I am a fit young healthy woman and have no need to hire a surgeon for a natural life process, I have hired a professional and expert in normal birth, and am quite prepared for a natural birth, "pain" and all.
(g) There is no pain free way of giving birth, and I am prepared to work with the sensations rather than against them, so don't need to plan my pain relief now beyond having a spot for a birth pool and knowing that we have unlimited hot water.

Same goes with having ultrasound scans, or blood tests, or xrays, or pelvimetry, or combinations thereof.

Informed choice does not mean agreeing with you.

I don't have to agree with you and you don't have to agree with me.

How do I marry these opinions with being a student in the health care system though? I am quite capable in a professional capacity to offer you choices (or are they decisions between two options? A topic for another post I think), discuss them with you, note which you've chosen and go from there. It is none of my business what you do with your body or baby, except from a point of view of a professional discharge of my duties. When in a traditional care situation (hospitals) I can't care for the outcome of your pregnancy from anything other than a professional point of view, because I would burn out. And if I believed in ethical practice, which I do, I also believe in autonomy and the right to self determination in health care. And by the time I see people on a postnatal or labour ward, they've made their decisions and chosen their care path and it is none of my business to judge those decisions. I don't have to agree with yours and you don't have to agree with mine.

And yes, I could just say "local hospital" or "random doctor" and lie about where I'm birthing, to avoid these conversations and having to justify myself. Instead I just smile and say "I've hired a private midwife to undertake my care" and leave it at that. Which is hard and harder at the moment when I'm in a private hospital on placement. I just try to choose who I discuss these things with.

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And the upsides of birthing at home? Here are 10:
  1. I know where stuff is, and so does my hubby. That means we have some of the power back in this situation cause mw Julie will have to ask where things are!
  2. The house is colonised with our bugs already. I doubt there's anything nasty hanging around (dust bunnies not counted here).
  3. I don't have to go home after giving birth.
  4. I don't have to be alone unless I want to be.
  5. I don't have to ring a bell and wait for anything or anyone.
  6. There are no machines that go ping. Except for the microwave.
  7. There is not going to be a trip in a car in labour.
  8. I get the absolute and final say over who is going to be at my birth.
  9. I will not be up on a bed at a convenient height for my birth attendant.
  10. My babe will be born where they were conceived.
  11. I don't have to have a change of care provider mid-labour, or explain my birth plan, or decline drugs, scans, CTGs, vaginal exams, etc etc, at every turn.

4 comments:

Sarah said...

PING!

aunty-del said...

Informed choice does not mean agreeing with you

Love this! Wish I could say this to Dr Boss - I mentioned my osteopath appointment for a sore knee, she urged me to go to the sports physiotherapist down the road. I said "Ah-ha" vaguely, but thought "No thanks, I'm happy seeing Jen."

Not Jenny said...

The car trip in labour is horrid. Simply horrid. I did it twice, and regret at least one of those times.

There was bacterial meningitis sweeping through my hospital while I was pregnant with #3. It really solidified my decision to birth at home. Between that and the C. diff and MRSA I was so happy that my baby would be born at home around my own dust. (When you hit the third trimester nesting there won't be much dust left in your house....trust me!)

daharja said...

I birthed my daughter at home, and it was one of the best decisions I ever made.

I'm not having any more kids, but if I was, you couldn't pay me enough to have one in a hospital! Ugh!

My midwife was so professional and awesome that she even impressed my VERY anti-homebirth parents when they met her a couple of days after the birth.

They couldn't believe how knowledgeable, supportive and friendly she was.

And no clock-watching (you know, that nasty business where you go see a doctor and you always get the impression they're rushing you out! yep, none of that!)

The only reason normal, healthy women choose to have a baby in a hospital (I think) is because they just don't know any better, and they've been taught to fear their own bodies.

A very sad, and wrong, perspective on birth.