July 30, 2003

Interview for a new book

I’ve been talking to day to Susan Ross, a midwife and childbirth educator whom I have known for about 20 years. She’s worked in several hospitals, mainly as an educator, but is now working independently.

Her current project is a book she is writing, titled “Doing it Your Way”. It is intended for expectant parents and she has been interviewing key people in the birth field and parents who are all contributing their thoughts on what it is like to give birth to a baby in today’s world. She had come to interview me for the book and to explore some of the issues that are impacting on the birth scene today, as well as my own personal involvement over the past 30 years.

Talking to Susan was easy - we have many shared experiences and have seen many changes over these past years. It was interesting, for example, to discuss the current demands for epidurals and caesareans. There is no doubt that women today are older, smarter and more life-experienced than ever before and that we live in a world where technology is kind and education is highly prized. What is fascinating is the way labour pain has been “sold” as a problem that can be solved by technology (machines and drugs) and the way women have embraced this approach without question. For an educated bunch, they seem to ask few questions. We threw lots of thoughts around about the role of obstetricians in driving these demands and the various vested interests involved and considered what might eventually drive changes back towards normal, unmedicated birth (but we didn’t find the definitive answer to this one!).

We also chewed over the problem of doulas and their impact on women, midwifery and the health care system. I am still very unhappy about the concepts that underpin many of the doula services that are springing up and the motivations that are driving people to take on the role of a doula. I can see how they are popular with women who are looking to buy services: a cleaner for the house, a doula for the birth and a nanny for the baby. Where will it all end?

Posted by andrea at July 30, 2003 05:10 PM

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Posted by: blackjack on January 19, 2004 09:55 AM

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Hi Andrea,
Hope you are well. I have been reading your thread of doulas with interest. The thing that I have stuck in my head is this: IF women WERE supported as a number one rule in the current system then entities like doulas and even CARES would not need to exist. But the reality is that until all women are offered a supportive system where you can choose your care provider etc then there are some of us who have to play the russian roulette of the public hospital system....not all of us get thru without scars (metaphoric and/or physical ones!).

In my role of support person in CARES often I have women who are planning vbac and yet no matter how well versed they are in evidence-based care, facts on stats and risks etc, and how determined they are, many find themselves being unsupported and manipulated whilst in labour. Our vbac rate is now below 20% and you could argue that many of those who are lucky enough to be able to birth vaginally after a cs, the experience can be less than satisfying due to the way in which women are treated.

I know I dont need to preach to the teacher about language and philosophy of care in the labour wards! You know that I support midwifery led care and the empowerment of women to be the decision maker of their own care. but do we just leave the women who are birthing today to fend for themselves whilst promising them that in the future (hopefuly near future) that they wont have to because they will one day be able to have a known and trusted midwife?

I have been asked to support women during their births now, as I support them during their pregnancies. I have not said yes to date due to the ages of my own children. But in all honesty Andrea, the reality is that even some midwives are less than supportive to woman focused care and if a woman develops a trusting relationship with me during her pregnancies and she has a faith that I have faith in her, knowing from personal experience the hurdles she may face, then how can I continue to say no?

I try to refer women to continuity of care models and link them with independant midwives, but as vbacs many of them are exluded from woman focused care models and some of them can not afford a IPM.

is doula care better than nothing? Because at the moment, in the case of VBAC, there is very little.
love to you and hope to see you back in Adelaide again soon!
from Jo

Posted by: Jo Bainbridge on June 9, 2004 10:11 PM