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