October 10, 2003

Surprises in Spain

It is lovely to be back in the Acuario Birth Centre. This small private clinic has a lovely peaceful atmosphere and is a centre for village life in this small town. We (Rachel McLeod, the workshop convenor and I) arrived here late at night, having altered the plan to stay in Valencia, because there was a woman in labour in the clinic who needed Rachel’s attendance. While Rachel watched over the birth, I slept in a spare hospital bed - the first time I have been “in hospital” for almost 30 years!

The group who assembled next morning for the workshop had come from all over Spain and included an obstetrician, several physiotherapists, two male midwives and some midwifery students. I decided to alter the format of the program this time and begin with a video of a normal, natural birth. I chose The Birth of Neko Pilara, a lovely video from New Zealand, which shows labour at home in the first stage and a planned transfer to hospital for the birth of a large baby, who is caught by her father, supervised by two midwives.

I asked the workshop group to watch carefully and to note anything that they saw happening that was different to the way they usually manage birth. They were quite amazed, and afterwards the comment came that it would have been easier to look for any similarities rather than differences! They had never seen a birth like it.

One lively discussion that developed was around the need for episiotomy, which is a standard procedure for all women in Spain. In the video, Neko Pilara’s mother has thick perineum, which stretches well as the baby emerges, although she does have a small tear. I found it very unusual to be discussing the merits of tearing over episiotomy with a group of western midwives (I would expect this discussion in South Ease Asia, for example) and they were hard to convince. I will try again, using the wonderful squatting video from Brazil to demonstrate how it can be done.

All of the group expressed the view that they were looking for a way of offering women something different during labour and birth, and there was an interesting debate about the power of the doctors and their rigid control of the birth protocols. Today we will explore some practical measures they can try and I will offer them some of my standard ploys to enable them to get around these protocols. We have already talked about using the women’s expressed wishes, recorded in the notes, to enable them to avoid unnecessary protocols and this was a novel idea - the doctors here don’t ever expect to be sued by unhappy women, it seems!

I am looking forward to another fascinating day with these midwives.

Posted by andrea at October 10, 2003 06:07 AM

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