A recent Facebook post suggested women were choosing to ‘free birth’ because they feel midwives and doctors are ignoring their needs. This was a very upsetting and concerning article as I strive to give care that is tailored to the needs of the women I care for and work alongside. However, it very quickly hit home that the reason behind such actions being taken by women was due to the medical interventions imposed by health professionals not respecting women and their choices over their own bodies!
I was then contacted by a lady looking for a vaginal birth after caesarean section (VBAC). Her opening line stated ‘I am allowed to try a normal birth’. My heart sank. This single sentence destroys all that I have entered my profession for. Following this I received another request by a lady who stated ‘They want to induce me at 40 weeks exactly because I am over 40’. I asked the lady what it was SHE WANTED. Her reply was simply, ‘I don’t want to be induced’. I asked if she had been given any information about the risks and benefits around induction, to which she said no. I then asked if she had been informed of any other options such as sweeping the membranes, or complementary therapies. Again, she answered ‘no’. Time and time again I am contact by women who feel the reasoning behind the doctors wanting to initiate labour is questioned, examples I hear often are:
* I am considered large for dates, so they want to induce me at 38 weeks. I have had ultra sound scans with estimated weights but I have read that these can be wrong.
* I saw in my notes the doctor had written ‘induction discussed’, but he just said he would sort a date at 39+2 weeks. I have no idea what it is or if I wanted, he seemed in a rush.
* My baby was conceived through IVF so I know when my baby is due; however, they are going with the scan date. In other parts of the UK induction is not offered until 40 weeks. This is my first baby and they want to induce at 39, but I feel very strongly I want to wait because although my circumstances MAKE me higher risk, but I don’t have any of the other underlying issues to increase what I feel is a minimal risk to let me choose?
As a midwife, it is within my professional code of conduct to ensure I advocate the wishes of women, especially when women feel they cannot. I cannot help but feel that we are failing women through:
• not giving them choices in their care; and
• informing them of the risks with balanced information of any benefits
Only then can we ensure women have true informed choice and as such are able to reach THEIR OWN informed DECISION – NOT being coerced into a medical procedure because a healthcare professional feels it is their expertise in which women’s choice does not matter.
WOMEN’s AUTONOMY must be RESPECTED.
As such Complementary Therapies have a huge role to play in maternity care, both to nurture the midwife to mother relationship and offer enhanced care which supports women-centred choices. It is here I feel the fractured relationship between myself as a midwife and health professional can be restored. I am shattered and floored by the fact that I am one professional that women feel are ignoring their needs. In my consultations relating to birthing options I discuss with the woman what she wants, consider the requests of health professional’s interventions and provide information as to the procedures involved.
Additionally we talk about guidelines and why medical professionals may feel they must intervene. I nurture women who nurture their baby’s and arm them with the evidence based information they require to make informed choices about THEIR birth. If a woman’s labour doesn’t start in line with the health professional’s timescales, I know I have given my wonderful ladies all the information, methods that can help at home and treatments that may assist spontaneous labour to commence in a safe and natural manner for which they have control.