Well, according to RANZCOG – antenatal care is important – even vital – for the health and well being of women. In fact, so important that a woman I helped last year, who had to transfer into hospital for complications during the birth, was punished for having “no antenatal care”. Her baby was isolated from her, (he was separated from her for an ENTIRE night – despite his normal newborn behaviour for most of that night), checked, poked, prodded and tested all because of “NO ANTENATAL CARE”. That is what is actually written in capital letters in her baby’s chart as his number one problem. Hmmmm. I have two issues with this assertion – the first is that standard “antenatal care” actually promotes wellness in baby and mother or even that it actually prevents complications; and the second is that because this woman chose not to partake in the “antenatal care” on offer at this particular institution than it amounted to “no antenatal care”. Apart from seeing me, a privately hired registered midwife 5 times (for a minimum of 2 hours each time), her local GP 3 times, and a midwife that was employed by her doctor’s surgery 3 times, an ultrasound at 22 weeks, and complete antenatal blood screen work up at the beginning of her pregnancy, this woman apparently had NO antenatal “care” and thus “endangered” her baby. Please someone hold me back while I scream!! HOW DARE THEY IMPUNE THIS WOMAN’S CHARACTER like they have? I personally know her to be acutely aware of her own responsibility and how her own actions will affect her baby’s health and well being. She and SHE ALONE knows the best for herself and for her baby. We are currently composing letters of formal complaint about the treatment this woman received at the hands of the hospital concerned, so I have to be careful about what I say and cannot give you details of her abominable and illegal treatment. So I will rave about “antenatal care”.
“Care”?? Since when can the standard antenatal service provided by hospitals and many private obstetricians be described as “care”? In a previous blog I discussed a woman who at 36 weeks was given her first bit of dietary advice when they discovered that she was carrying a large baby. True “care” would ensure that these issues would be discussed in depth at the very first meeting. But that is not the focus of standard antenatal care - visits usually involve examining how big the mother’s uterus is growing, where the baby is positioned (ie head down or up) and listening to the baby’s heart tones. It also consists of many screening tests that women are given little if any information on the consequences of submitting to. Women are certainly not encouraged to research all that is available and consent to what they feel they need to – incompliance with any of these tests is seen as dangerous and risky behaviour and women are treated accordingly.
“Care”?? Since when can the standard antenatal service provided by hospitals and many private obstetricians be described as “care”? In a previous blog I discussed a woman who at 36 weeks was given her first bit of dietary advice when they discovered that she was carrying a large baby. True “care” would ensure that these issues would be discussed in depth at the very first meeting. But that is not the focus of standard antenatal care - visits usually involve examining how big the mother’s uterus is growing, where the baby is positioned (ie head down or up) and listening to the baby’s heart tones. It also consists of many screening tests that women are given little if any information on the consequences of submitting to. Women are certainly not encouraged to research all that is available and consent to what they feel they need to – incompliance with any of these tests is seen as dangerous and risky behaviour and women are treated accordingly.
No, it is not ‘antenatal care’ that the medical profession seek to give women, but ANTENATAL COMPLIANCE that they seek from them - - - “You must have ALL tests that we say you should, and you need to comply with ALL protocol that we say you should, because we say so, and not because there is good evidence for it, and certainly against your own better judgement and researched opinion.”
The 3rd edition of the Collins Dictionary lists “care” with 13 different meanings or contexts in which the word can be used. Those applicable to our topic today are the following - - -
1. To have regard or consideration
2. To provide physical needs, help or comfort
3. Careful or serious attention
4. Protective or supervisory control
Now let’s see. When a woman enters the care of a GP, private obstetrician or hospital antenatal clinic does she receive numbers 1 or 2? No she receives number 4 as a priority and maybe in some circumstances number 3. The medical profession is "big brother" - monitoring size and supervising screening compliance. Standard maternity “care” is basically set up to make sure a woman has the proper screening procedures – to make sure it is a “normal” pregnancy (can’t have congenital abnormalities mucking up our peri natal statistics now can we?) as well as comply with standard protocols that have been designed for the organisations benefit – not for the benefit of the individual woman. Antenatal visits are brief – lucky to be 15 minutes long, and NO information is given in adequate amounts so that a woman can make up her own mind about anything. No care or nurture is given about a woman’s individual circumstances, and only information that is deemed “acceptable standard practice” is ever presented to women. Most women DO NOT KNOW that they HAVE a choice about the course of their “care”. I once had a doctor actually say to me in private conversation that “informed consent” with pregnant women was “impossible”. Why? Well due to the fact that pregnant women were hormonal and their perceptions were altered about what is best for their baby, “how on earth COULD they make rational decisions based on the facts” when “they were ruled by emotions”? Excuse me? Who on THIS EARTH has a bigger stake in the welfare of baby and mother than a pregnant woman and her partner????? Since WHEN does the medical profession care about the outcome of a birth MORE than a mother and father??
My aim during pregnancy is to “nurture” the women that come to me to assist them achieve their desire for a natural birth. The definition of “nurture” is as follows
1. The act or process of promoting the development of someone
2. Something that nourishes - to feed or support, educate or train
Pregnancy is a wonderful time of exploration - emotionally, spiritually and pysically. Women transform during their pregnancies and it is always amazing to watch. They carry a very deep power if it is nutured and encouraged to develop - and this changes not only their birth experience but their experience of motherhood. I do not use the terminology “antenatal visits/care” – not because there is anything wrong with the meaning of the words themselves, it has just come to imply an authoritarian/subject; supervisor/supervised relationship. The connotations these words bring up is of long waiting times, brief visits, reams of paperwork and test after test – and compliance with the system. I believe pregnant women need nurture – they need to feel cherished and important. They need individualised nurture - someone to met them where they are and walk alongside them in their journey. They also need someone with accurate information and statistics that they can discuss things with to help them come to a decision about what they do or do not think is important for themselves in this pregnancy. They need to develop a relationship with the person that they have asked to be at their birth – what will ultimately be their most powerful yet most intimate moment. They need to be assured that both they and their baby will be respected at all stages along the way. They need to feel safe. So I have “pregnancy visits” and I aim to “nurture”.
The 3rd edition of the Collins Dictionary lists “care” with 13 different meanings or contexts in which the word can be used. Those applicable to our topic today are the following - - -
1. To have regard or consideration
2. To provide physical needs, help or comfort
3. Careful or serious attention
4. Protective or supervisory control
Now let’s see. When a woman enters the care of a GP, private obstetrician or hospital antenatal clinic does she receive numbers 1 or 2? No she receives number 4 as a priority and maybe in some circumstances number 3. The medical profession is "big brother" - monitoring size and supervising screening compliance. Standard maternity “care” is basically set up to make sure a woman has the proper screening procedures – to make sure it is a “normal” pregnancy (can’t have congenital abnormalities mucking up our peri natal statistics now can we?) as well as comply with standard protocols that have been designed for the organisations benefit – not for the benefit of the individual woman. Antenatal visits are brief – lucky to be 15 minutes long, and NO information is given in adequate amounts so that a woman can make up her own mind about anything. No care or nurture is given about a woman’s individual circumstances, and only information that is deemed “acceptable standard practice” is ever presented to women. Most women DO NOT KNOW that they HAVE a choice about the course of their “care”. I once had a doctor actually say to me in private conversation that “informed consent” with pregnant women was “impossible”. Why? Well due to the fact that pregnant women were hormonal and their perceptions were altered about what is best for their baby, “how on earth COULD they make rational decisions based on the facts” when “they were ruled by emotions”? Excuse me? Who on THIS EARTH has a bigger stake in the welfare of baby and mother than a pregnant woman and her partner????? Since WHEN does the medical profession care about the outcome of a birth MORE than a mother and father??
My aim during pregnancy is to “nurture” the women that come to me to assist them achieve their desire for a natural birth. The definition of “nurture” is as follows
1. The act or process of promoting the development of someone
2. Something that nourishes - to feed or support, educate or train
Pregnancy is a wonderful time of exploration - emotionally, spiritually and pysically. Women transform during their pregnancies and it is always amazing to watch. They carry a very deep power if it is nutured and encouraged to develop - and this changes not only their birth experience but their experience of motherhood. I do not use the terminology “antenatal visits/care” – not because there is anything wrong with the meaning of the words themselves, it has just come to imply an authoritarian/subject; supervisor/supervised relationship. The connotations these words bring up is of long waiting times, brief visits, reams of paperwork and test after test – and compliance with the system. I believe pregnant women need nurture – they need to feel cherished and important. They need individualised nurture - someone to met them where they are and walk alongside them in their journey. They also need someone with accurate information and statistics that they can discuss things with to help them come to a decision about what they do or do not think is important for themselves in this pregnancy. They need to develop a relationship with the person that they have asked to be at their birth – what will ultimately be their most powerful yet most intimate moment. They need to be assured that both they and their baby will be respected at all stages along the way. They need to feel safe. So I have “pregnancy visits” and I aim to “nurture”.
Just last week a precious mum was at the end of her pregnancy and "totally over it". She needed friendship, nurture, love and a change of scenery. So we packed the children up, got together with two other mums and went to the beach. During the hour drive there and back, we had plenty of time to discuss her upcoming birth and all that was on her mind. We swam and played and laughed and ate some yummy food. Oops - I didn't check the baby's heart tones - guess it wasn't "antenatal care" after all!
Nope, not "antenatal care", just "with woman" nurturing - sounds perfect to me ;)
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....what you are doing for women is living the wisdom from Anita Diamants classsic novel, 'The Red Tent', what a gift to be treated with love, wholistic care and respect when developing life. Respect to you.
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