January 03, 2003

Fun and games in Sydney's newest maternity unit

I’ve just come back from my first experience of the new Prince Alfred Women and Babies Unit (formerly the famous King George V Hospital) in Sydney. I was supporting my friend Lisa during her first labour and she had chosen a private obstetrician and the labour ward.

The birth went very well, and although it was very hard and painful for Lisa, she did it all by herself, without medication, and gave birth, after 8 hours, to a lovely little girl.

The fun and games started when we arrived at the hospital. I won’t go into details about the staff we initially met or their insistence on routines, or their task rather than woman orientation - these behaviours will be added to my reference material for workshops! The midwife who was finally allocated to Lisa’s care was a New Zealander, and sensitive, flexible and very calming - a real bonus and she facilitated the birth beautifully.

The new facilities are spacious and well equipped. Plenty of room to move about and a generous bathroom area with a deep bath in the middle, a flat floored shower area and three shower heads (two on flexible hoses). The first thing I noticed was that there was no bath plug. Since Lisa always enjoyed baths, and I wanted to get this set up so it was available should she want to use it. I asked for the plug and was met with horrified looks and stern commands “the policy of this hospital is that no-on will use the baths!”. I couldn’t believe it - I immediately thought of the Royal Women’s Hospital in Brisbane where the plugs were all taken away - could this still be happening? Not to be deterred, I found a plastic bag and screwed it up and jammed it into the plug hole. Then I discovered that the water pressure is so low that to have more than one shower running at a time reduced the flow to a trickle. The bath was going to take about an hour to fill! The first midwife came back, noticed the very slowly filling bath and called for reinforcements. The charge midwife arrived on the scene and attempted to read me the riot act. She was flapping about in such a state - “the policy of this hospital is not to use the baths”, “we don’t do this kind of thing here - if you want this you have to go to the birth centre” and “none of us are trained in how to use water, so it can’t be used”. I enquired about the policy - it was not written down, just a verbal instruction, so I said that if it was not written down, then there was in fact, no policy, and we could therefore do as Lisa wished. I also explained that Lisa was a private client and that we would consult with her obstetrician about this decision as well. Of course Lisa overheard this conversation (which was in the next room) and in the way that women do to appease professional angst, said she would not use the bath if this wasn’t encouraged. Ridiculous - where is the woman centred care, I wondered?

A little later, her obstetrician arrived. I knew he had had a long history of supporting home birth midwives and was very relaxed and familiar with water births. He agreed that this was a ridiculous situation that had to be dealt with. However, not tonight!

Our kindly midwife said that the staff had fought long and hard to get the baths installed, but until the midwives were “trained” they were unwilling to try them. We were not asking about water birth, I should add, just getting into a bath to ease the labour pain, but no, that was taboo. How do they intend to get experience without giving it a go?

This hospital has been on the drawing boards for years and has taken a long time to construct. You would think that knowing there would be baths available when the new unit opened, that the staff would have prepared with a suitable water birth workshop, or at least visited their own Birth Centre, where water births have been done for years! The lack of planning and foresight is so typical on bureaucracies, but is infinitely frustrating for women.

No doubt things will settle down in time and these facilities will eventually be fully utilised. I hope the “us and them” attitude that is also apparent between the Labour ward staff and the Birth Centre will also disappear - I was pretty shocked by the “we don’t do that sort of thing (normal births?) in this unit - you have to go to the Birth Centre for that”. Perhaps that was why the new unit has prominent labels everywhere - “Delivery Suite” - Lisa gave birth in Delivery Room 8 - funny really - I saw her give birth to a baby, not a parcel!

I will be writing to the hospital with some feedback and the suggestion that they do some staff retraining as soon as possible. They could also use an “active birth “ workshop - some of their staff have forgotten what woman centred midwifery care is all about as well.

Posted by andrea at January 03, 2003 11:03 AM

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