Saturday, 10 November 2007

Choice and Childbirth

It saddened me recently to read an article in a professional midwifery journal which was written by a woman who had recently given birth in a private hospital in London. In this article the woman described her journey of care in the private sector. The article is centred solely on the wondrous care that the ‘doctor’ (obstetrician) gave this woman and her partner and I quote:
“Choosing the right consultant was critical to a happy and calm pregnancy”!

Excuse me, but I was led to believe that choosing the right ‘midwife’ was critical to a happy and calm pregnancy? Midwife meaning being with woman – obstetrician – this word is derived from the Latin word obsterix meaning ‘standing before’.

Yes, that is surely what private obstetricians do with great ease and charm – stand before and hold their hands out for a very fat, lucrative pay cheque which they spend laughing their heads off at the silliness of these women who fall prey to their seductive charms of claiming to ‘always being there’ and ‘yes of course I will cancel my holiday to make sure I am there for the delivery of your baby!’

There is something slightly obscene about the private male obstetrician who seduces these vulnerable women by promising to ‘always be there’ whatever the time of day or night, always at their beck and call – almost like a marriage or a relationship. Are these women really choosing private care for the right reasons? Does this love and care that is lavished on them by a male at a vulnerable time in their lives make up for a big gap in their own relationship? Do the women think that the male obstetrician is superior to the female midwife? Does this smack of patriarchal forces still at work in a society when we are supposed to have moved on from this?

Back to the article in question - the midwives were only mentioned briefly right at the end of the article and their care was only in the post-natal period. I know that the NHS struggles to provide maternity care given it provides a ‘gold standard’ of care on peanuts but at least it is still true to the midwifery profession and against all odds tries to support it and enable its growth.

Yes, women have a right to a choice where they have their babies and how they receive their ante-natal care but the question is are the women who pay privately for it ‘being short changed’ in that the only care they receive from a midwife is at the end when they have had their babies?


Random Thoughts to Amuse said...

I must agree with you 100% on this post. I had five pregnancies, two births and have only one child.

My first three pregnancies miscarried at the beginning of the second trimester. I was under the care of an obstetrician. After the birth and loss of my fourth child (fourth pregnancy) I gave up on my doctor. She had an awful manner and basically cast me off and said that I would not have children.

I then moved on and found my "Angel".. She not only worked through my emotional distress but she got to the root of why I miscarried the first three times.
I honestly feel that if it were not for her, I would not have my wonderful fourteen year old daughter, today.

I think Midwifes offer so much more than delivery. It would take up much of your space here if I were to write it all down.

Dark Daughta said...

Thank you for these very simple, yet often hidden questions and truths.

Agatha said...

I don't think that these women are being ripped off or deluded in the SLIGHTEST. There is a significant proportion of pregnant women who THRIVE on medicalised care in pregnancy. They love it! I saw one today - 'aren't you going to take more bloods? can I have an internal scan? can you weigh me? can I have another appointment next week?'

There are some women who are over the moon at the idea of an OB. A Midwife is for 'ordinary' women, any woman in the UK can have one of those. You have to be 'special' to get an OB! Crazy, I know...

Besides, who are we, as midwives, to question a woman's choice of healthcare provider? I agree with the woman that you quoted that choosing the right consultant was critical to a calm & happy pregnancy - FOR HER.

Women always remember the people who were horrible to them. If she'd said 'choosing the right MIDWIFE was critical to a calm & happy pregnancy.' - we would say 'oh yes, well done you for excercising your right to choose' - so why judge her for choosing an OB?

She certainly doesn't given a damn about the meanings of our job titles, does she?

Anonymous said...

I must say that I am appalled by the level of prejudice in this blog. Yes, I do think that anyone who chooses private maternity care has more money than sense, particularly as the accolade for the highest maternal mortality rate in the country is held by a particular private London hospital. However, if we advocate choice in childbirth we must respect this even if we disagree with the choice taken.

As for me, I can vouch for how important it is to have the right consultant. I was an elderly primigravida with IVF twins. Knowing that I was a high risk pregnancy, I made sure that I chose my consultant, who even came from his private practice when he knew I was in labour. Yes, I had normal deliveries times two, but it could have been very different and I certainly did not want any of the registrars to come anywhere near me.

Anonymous said...

This post is so funny to me, in an ironic sort of way. Where I live (U.S.) people who pay "out of pocket" are doing so to access midwifery. Insurance pays for ob care.

Yes, we have an inverted triangle of care ... and not much to show for it.

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Anonymous said...

midwife vs. obstetrician
Grow up. If either professional is condemning the other this is a huge red flag. Midwifes know and do things O.B.s don't. And vice versa. The goal of both professions is happy healthy mothers and babies.