On 28/02/2006, at 10:38 PM, diane wrote:
<x-tad-smaller>My Response.........................</x-tad-smaller>
Dear Miranda,
Prof Tracey is not an impartial observer, she is however, an expert in her
field. Very few studies are conducted by impartial observers. They may, like
you, review some of the studies that may make it in to the popular media,
and make broad, biased statements based on hearsay from people such as
anaesthetists.
Your statements indicate that you wish to reduce women's choices of place of
birth and mistakenly state that a woman can have a drug free natural birth
where there are specialists hanging in the corridors, or more accurately
sticking their heads, uninvited, into a birthing woman's room and openly
offering an epidural before he leaves the unit!! (Yes, this is true!!). Or
the obstetrician who invites himself into the room and wants to know why she
isn't progressing at the "right" rate, while policy and protocol has kept
her immobilised on a bed by a monitor, an intravenous drip and other
interventions which interfere with the woman's natural birthing hormones.
Dr Tracey's research was about proving the safety of small birthing units.
Outcomes for low risk women were compared according to size (number of
births per annum) of the birthing unit. The study found that women who
birthed in small units had significantly less medical intervention, fewer
caesareans and fewer neonatal problems than women birthing within a large
unit. Miranda, this study compares low risk with low risk in a variety of
settings, and the smaller units win hands down to the larger ones.
Keeping places like Ryde, Wyong and Belmont open, for those who are suited
to these services, avoids unnecessary wasting of resources in our
over-stretched health system. Would you take your child to a paediatrician
for a cut knee or a sore throat?? It is most likely you would utilise your
general practitioner, not the specialist.
I would also like to discuss your comment on being primarily concerned for
the health of mother and baby with little concern for the woman's lived
experience in childbirth. Any student nurse can tell you that the notion of
health encompasses far more than the physical aspect of the body. The
consequences of traumatic birth experiences can be profound for the woman,
baby, her family and the wider community. Post traumatic stress disorder is
not uncommon, post natal depression is very common and puerperal psychosis
can be triggered as well. The cost on the health system of birth related
mental health disorders is enormous and the literature clearly describes the
effects on the children and families of women with these problems.
Breastfeeding difficulties are also far more common when women have had
intervention in birth and in the early postpartum period. This equates to
further unnecessary costs to the health system, as it is well documented
that breastfed babies are far less likely to experience various health
disorders (too many to list).
You have acknowledged that the ideal situation is a woman having a natural
"delivery" (pizza anyone???), with a midwife. This would mean, according to
research, that the woman is far less likely to experience any such
complications, and that such complications, if they did occur, would be
recognised and appropriately managed in a timely and proficient manner. It
would also mean that a woman is far less likely to be desperate for pain
relief, as under the care and education provided by her midwife throughout
her pregnancy, she would have few fears and trust in the process of birth,
hence not embarking upon the fear/tension/pain cycle that has become
epidemic since the medicalisation of childbirth.
Miranda, you may well have had noble intentions when writing your article,
if the government was your target why demonise midwifery and smaller
birthing units? But no matter how many machines that go "ping" and experts
to decipher them exist in the birth place, some babies will still die and
occasionally a mother too. Sometimes heroic measures to save a baby, lead to
catastrophe as well, despite the outcome of a 'live' baby and mother. There
is a far bigger picture here. Much more than can be expressed in your tiny
column in a Sunday paper. If you really care about women and babies, talk to
women, see what they value and hear the stories of horror and birth rape of
some who have been irrevocably damaged by the 'management' of birth. It
takes more than reading and writing about a subject for ten years to fully
understand it. Women do have a choice to birth where the 'best' doctors can
care for them, what many women dont have, is a choice to birth where it is
'best' for them.
Regards
Diane
