Thirty Years of Maternity Care

from a birthing mother’s perspective . . .

I have included this, as being a mother, shaped my experience as a healer and as an author. I would hope that the book/DVDs I have written including What Dads Can Do, allows parents to do what I did not — take charge and become empowered. Knowing all of what is found in this work would have made such a difference to my mothering and life.

The work of Dr Sarah J Buckley needs far more attention paid to it — she and Dr Michel Odent have really opened the baby centre birthing case wide open. I sincerely hope that the 1970s revolution in birthing (through le Boyer), returns with parents demanding a much more gentle and respectful birth for their new baby and family.

When I was researching the What Dads Can Do book, I was full of grief for the problems I had created through my previous ignorance. Please start to really think through why you are pregnant and what you want out of the experience. I thought I had through making informed decisions. But all along my pregnant way, my lack of understanding of how ‘normal’ happens, meant that even I was being lead astray by current best maternity practice — which often seemed to go  against what nature would have done. Where to start looking for alternatives? http://www.birthinternational.com/artic … ner03.html

Here is birth. (Dr Frederik leBoyer – author of Birth Without Violence)

http://www.youtube.com/watch?v=0o_8FwPJaNU

See birthing as it can be – awe inspiring

http://www.unassistedchildbirth.com/index.htm

http://www.activebirthcentre.com/

www.hencigoer.com She has written Obstetric Myths: Research Realities and, The Thinking Women’s Guide to Better Birth.

Early 1977

My own doctor — Le Boyer method at public hospital

When I first started out as a mother, birthing choices abounded. Women only went to obstetricians if they had a serious need for specialist care. The normal state of pregnancy was not that. Private health funds had few takers and obstetricians were expensive luxuries, and considered unnecessary, as there were many choices of venue and styles of birthing to choose from, to suit all tastes. All were considered safe, and no one worried too much about anything, as birthing, just as pregnancy was, was a very normal part of being a woman.

Most women had their own doctors; (GP’s) who had hospital privileges, and who went into the maternity areas and helped us deliver our babies.

As I lived in the hills behind Mullumbimby, it seemed that the sub-culture there, all sat in their converted banana sheds, and had babies, unassisted, as nature intended. Any number of ‘helpers’ abounded; though I chose to be in a hospital, as where we lived there was no running water, just electricity and telephone, and being practical, I wondered about such issues as the washing afterwards . . .

The le Boyer method was ‘new’ then, and I wanted my newborn to experience peace on entry into our world, so found the doctor who was embracing this philosophy in the local area, and started seeing him at six and a half months — my first medical check up. Why had I not gone to a doctor before? Because it was not my thing, I was well, my body was working. I had known I was pregnant, and that my body was really healthy, so I saw no need to have someone tell me this. What were they going to do anyway? Monitor and worry me, I saw no point.

On visiting with the doctor, he started the usual round of testing and appointments, which became more regular as I left my due date behind, and started to become more ’overdue’. I had managed to conceive whilst using every natural method I knew NOT to, thus knew that only one act of intercourse took place this month — on the 25th day of a regular 28 day cycle, whilst being premenstrual. Lunar astrological, mucous and past history all dictated and showed that I had ovulated as normal; in the middle of the month, yet, I conceived whilst premenstrual, and just prior to bleeding.

Four weeks ‘overdue’ . . .

Back then, as we had no other way of knowing, but through our senses, the doctors could only check the size of my womb, and then tell me that I had a very small baby. They were not interested in my version of conception dates, and kept adding the extra two weeks on. At 12 days overdue according to my actual first possible conception date, I weighted ¾ stone more than when non-pregnant (which is still many kilos lighter than I carry normally now). Hence, when I was nearly 4 weeks ’overdue’ by their calculations, I was told that the baby would be lucky to be 5 pounds, as I was so small, as was my belly. Placental failure they thought!!!!

I ignored them as I felt they had no idea what they were talking about — I was a vegan vegetarian; ate no animal products; was remarkably healthy and felt fine. Baby was getting bigger, I was eating no foods that would plump me up and I was all baby . . . so I ignored their increasing worries on my behalf.

12th February dawned and I felt different, so put off the planned enema. I had been frightening myself with what I would do this day and had decided to hurry nature along if now, 12 days after due date from conception (day 25 of a very regular 28 day cycle — only intercourse that month), I didn’t go into labour. So, I continued organizing the nut and dried fruit weighing — we had gone to Brisbane Markets and had a bit of a co-operative running. By about 11.30, the regular period-like cramps had set in, in earnest.

Not having been in labour before, I had no idea how it was going, so we loaded into the car and slowly drove (very difficult over all the bumps on a back country road) into Byron Bay, where the hospital was. After wandering along the beach for a while, I thought that possibly enough time had passed and that I was dilated enough to miss the enema and shaving that apparently awaited within the medical scene.

On arriving at the hospital I was only 2 cm dilated, and had plenty of time to be processed! The enema was not fun — retaining it whilst coping with contractions was awkward especially as it tended to strengthen at least the perception of the sensations.

As I was not allowed to be elsewhere than the bed, (being mobile and upright sorts out all these issues). I was in a large degree of pain, and the gas was offered. Once I had worked out to suck it in rather than breathe it, life continued. It was not a pain reliever so much as I went off somewhere else — total distraction.

Looking back at this birth, it was the easiest I experienced; what was not simple was that there was no one there guiding me, and really being there for me.

In times to come, it became very obvious that the only way to assist a woman birthing is to share the space — ‘midwife’ means ‘with woman’.

When baby arrived, he was exactly the weight and measurements of a ’normal’ newborn — even with still a bit of vernix on him. Labour started naturally, and he arrived 12 days after he was ’due’ according to his real conception date. Without the help of scanning devices we as gravid/bulging and not happy mothers were left to stay pregnant until nature decided on the baby’s eviction date. When distressed about being so over ripe and full, and wanting to meet bub, everyone just told us that we were ‘ladies in waiting’, and to enjoy the last few days of our pregnancy, as things were about to alter radically in our lives . . .

I had my baby my way — to a point — after sitting at the beach at Byron for an hour; I thought I was ready to birth. All gowned up, my husband, and a friend (with her 2 year old) and another friend who was the photographer, all got bootteed and hatted, and all came with me into the delivery room. It was a hoot for all but me, as I was on my back and eventually in stirrups. How do they think we can birth with our pelvises shut down 28% that way???

Baby was eventually dragged out, as I had been given 90 minutes to push him. It would have helped immensely had I been walking around, or at least upright — and then possibly I would have felt a pushing urge — so orchestrated pushing with lots of encouragement amounted to them going in and pulling him out with forceps. Much blood loss and distress as I was incapable of getting out of the bed, my husband was in the car park all night as he wasn’t allowed to stay inside with me; I hadn’t seen my baby, and had no idea if it was him I could hear crying in the nursery, or even what he looked like. So much for gentle birth /birth without violence – it did not feel like that to me.

A week later I felt that I had my baby and wanted to go home, but they were not happy about me discharging myself as I had been cut severely and I needed to heal. In my eyes I needed to sleep and to eat well to do this — neither of which were happening there. So I discharged myself to go home and learn how to be a mum as I went along.

Early 1984

Own doctor — private small ‘boutique’ birthing hospital

Seven years on, another dad, location, and pregnancy. Now scanning devices are new, and as malaria had been contracted whilst three months pregnant, I availed myself to ensure baby was not obviously harmed by the extreme weather he had experienced within. Thus, the date of conception was set, and agreeing with mine – we continued on, until labour started 3 days before the expected ‘due date’.

Water births were just beginning, but whoever was introducing these had rules — that the mother had to have been re-birthed, a new concept here also — and as I was pregnant, they would not touch me, so I was disqualified. So ended my wishes for what I considered to be ‘perfect’ for bub’s entry.

No one really considered private obstetricians as we could still have the doctor of our choice in delivery rooms — a publicly funded exercise of one to one continuation of care — that only ‘cost’ us, as we chose to go to Boothville, in Brisbane, where we had a stunning garden on top of a hill to walk about during labour, nice grounds, a grand old house to stay in during convalescence, and a great tradition of easy deliveries — with a theatre if required, and the major public/private maternity hospital, five minutes down the road, if specialists were required to come visiting.

Obstetricians being on site were still the marks of those who had plenty of money, and who were in an elite group — either through personal choice and status or who were deemed ‘at risk’ due to their past obstetric history. So I had a handpicked GP who actually was far too laid back for what was required.

Birthing happened, but I got stuck at third stage again — this time still not wanting the drug to clamp the uterus down. I had no idea that the membranes being ruptured was invasive and my going from 5 cm to fully dilated AGAIN in half an hour (shocking) would have the same consequences as the first time — a massive bleed.

Eventually a manual extraction of placenta (without anaesthetic —”just take a whiff of that gas Heather”, and there we are, good as new) . . . . except I did the-dying going-through-the-tunnel-to-the-white-light-journey and was sent back to be a mum . . . . lots of blood transfused; me getting highly allergic to the blood products; being packed in ice to stop the reactions, and eventually all settled into breastfeeding, happy days . . . and vast reactions to cold — starting with massive uterine cramps that were worse than labour for a few weeks when he started feeding as the cold/ice had penetrated within very deeply. This left me with a working knowledge of what NOT TO DO (for later) when in such a vulnerable state.

Late 1986

Private obstetrician — Boothville again

I considered that I fell into the latter category, (women who NEEDED extra help by now) as I felt that the standard of nursing/doctoring had let me down badly, I chose a very gentle man, whom I had watched as part of my Bach flower remedies /acupuncture/active birthing/doula-ing/homebirth trouble shooter days had led me to. He ‘allowed’ a friend to birth her own child standing on the high hospital bed (as hospital policy was against floor delivery). Watching her standing high above us was an inspiration — I figured he had the ‘balls’ to let her, and we could not catch her if she fell — he was my choice to do whatever I needed, again in the venue of my choice.

By now, obstetricians were gaining vogue, as private health care was appearing, and it was considered a mark of ‘having arrived’ to have a specialist, whom we really did not need, attend us. In my case, I had been the recipient of some very interesting antiquated nursing practices that had left me with prolapses, haemorrhages and the resultant ongoing healing issues, I had intended to have someone who appeared to know what he was doing, and who was a very woman/birthing, respectful specialist, to ensure my OWN body’s safety through this transitional time.

He was everything I thought I wanted. The baby decided to pull some stunts. I was innocent of the OP-ness of her position, due to the heavy masking acupressure we were doing on my sacrum, so it was not until an hour’s worth of pushing did not result in baby that on investigation, the obstruction was discovered. No backache!!

One and a half hours of transition though . . . . as I did not know what I do now, we were eventually parted in an epidural (in case of C-section) and Keillands rotational forceps manoeuvre, which was very gently executed — no grazes, splits or tears with an eight and a half pound baby. As I had pushed babies before, and had been for two hours this time before the anaesthetic took effect and my body was overruled, he turned her, and then I continued to push with the doctor just holding her with the forceps to stop her retracting between contractions.

This was actually the easiest it got for me, as I had surrounded myself with a friend who was also a healer, and staff who were in no rush. She was by now a brow presentation apparently and supposedly impossible to birth well alone, so I was right about needing a specialist — he was a specialist in helping me to birth my baby with the minimum of fuss to my body — a job very well done.

Late 1994

Public hospital – home water birth -Public C-section

After all this, I had decided to NEVER EVER have another child — especially as the last one was massively brain injured through an intra uterine toxoplasmotic infection and was requiring more of my life than I could have possibly imagined . . .

But, nature intervened and another (unplanned) conception meant that yet again I got to sample the obstetric choices of the times.

Things had moved on. I knew from being in clinical practice that I was now at 39 considered ‘elderly’ (there has obviously been a shift in thinking since then), and that with the obstetric incidents that had come my way, I was up for a considerable lot of debriefing after each hospital visit, (by then economic circumstances dictated the public sector).

After having been on the observing side of multiple patients and their stories, I realized that I did not have me to walk me through the horror that they would be trying to instil in me — fearful of all things that MIGHT happen from their point of view was not useful in my already very busy life. So I decided that I would engage a home birth midwife to do everything BUT aid me actually birth at home.

This was based on the costs I saw to myself of all the travel, parking, heat and walking, hassle medically generated, and lack of home support (single mother-ness called) and I had a highly autistic and hyperactive child at home who was still in nappies, still spoon fed, and who still did not sleep at night — at 8 years old. No family support, and little extra offered by government agencies. Not a good recipe for home birthing I decided.

So, the plan was my homebirth midwife to do all ante natal and post natal care as though we were doing a home birth, with her coming with me as the birth support person, and being MY (own heart and mind) midwife, and the hospital providing the baby with his midwiving journey. I knew that if I was feeling safe and supported, the baby was already cared for. With the hospital doing whatever they could get around the two of us, we would bundle into the car and go home after birthing to continue on as before, as though nothing had been different than standard home-birthing.

Well life intervened — I wanted to go ‘home’ (born in Kiwi land). I moved countries, and signed up for a home water birth. At last!!! What I had always wanted in NZ. . .  BUT my ankle gave way in mid-air, and I fell onto the very pregnant belly, which meant slight placental trauma and a very large clot now between me and where it joined the uterus. The home birth midwife refused to continue my care — I just became far too high a risk —and I was now a hospital case.

‘Elective’ C-Section

As there was no one to be with me, (actually being present for me and being what I had been to all the other women whose births I had assisted mum find herself and her path into motherhood), who had my overall experience, I gave in to the obvious necessity of a C-section. No point in hoping to NOT burst the clot and bleed out in labour. I had three kids who needed me, besides the one awaiting within.

So, it came to pass. The C-section, the haemorrhage and the whole package of tribulations as a single mother of now three dependent kids, one a newborn, another with almost newborn needs (Kathryn as  an 8 year old), but with attitude and no cuteness PLUS a gaping abdominal wound, and non co-operative nipples.

By now, I felt as though I had done the best I could in birthing babies, AND STILL they had had very interesting beginnings, and I had experienced a great cost to my being/body.

What could have happened differently (hindsight)

Stopped assuming everyone had my best interests at heart and done it all myself probably is still the take home message here.

BIRTH ONE. In hospital trying to get the most natural/gentle birth for baby. This was the easiest birth (medically), and the hardest for me as I was surrounded by people yet very alone.  It was at this birth that I decided to ensure that anyone I knew would not go through that degree of separation, as it was very traumatic being locked inside my head whilst all those people were waiting for me to deliver — literally.

Had they just got me up and wandering about, it would have been very different, as gravity and being active has been shown over and over to work wonders; it is as nature intends us to be.

Had they NOT broken the waters, I would have probably NOT haemorrhaged. That would have made my post natal life/breastfeeding a lot easier.

BIRTH TWO. Here again, had the waters been left intact, I would have had a better chance of not haemorrhaging. I was hassled into squatting — as the doctor and my husband were doing a great job of ensuring what I had said I wanted to do — was done, EXCEPT that we were not to know that with my previously broken coccyx, I had a very narrow pelvic outlet and squatting just was not doing it for him to emerge/me to birth. Eventually, another 90 minutes pushing Mr 7lb 10 oz emerged.

From here, the manual placental extraction probably would not have happened, and I would have then missed the resultant dramas with transfusion allergies and so on.

BIRTH THREE. I had no idea that baby being ‘OP’ was a problem. The home birth midwife who was doing ‘strips and stretches’ to get me going, the obstetrician who was so great at the end — no one mentioned having a baby in the wrong position slowed up/halted /invalidated vaginal birthing.

So, what with my insistence of doing perineal massage twice daily and sitting right back on my sacrum, to do it – as husband didn’t want to – the baby was well placed to be very stuck.

Not knowing that the acupressure on the sacral points would mask what was happening was meant that the obstetric ‘rescue was needed. That was put in place well but may not have been needed had everyone been paying attention. I was the patient and had no clue.

First time with an obstetrician, I had let down my guard, as I was being the patient. Teaching all my colleagues at all levels of training about acupuncture and pregnancy did not prepare me for the horrors of an obstructed OP /brow presentation — with no pain relief except the acupressure etc.

BIRTH FOUR. In NZ, the theatre staff hit the diaphragm as hard as possible after the abdominal cut was made, and the baby then shoots out the incision. Strange, but true. Both my sisters had had this happen and me being the patient, and losing my BP so very well prior to surgery after the epidural (not enough fluids being sent through my veins??? who knows??), I was not in the best state to be my own advocate.

Why was I in there at all having a C-section?? Possibility of the clot bursting. Well, the nurse was castigated for not hitting me hard enough and when she did it the second time, a geyser erupted as the clot blew . . . so another (post) natal haemorrhage to contend with. Had I been more assertive and not the patient, possibly this would not have happened.

The point of all of this …

Over the life of one birthing woman, the birthing culture vastly changed.

Since the advent of scanning – maternity is no longer mysterious or even safe for mothers and babies – fear and worry is the path to negotiate.  All that is mentioned is possible dangers/pitfalls.  Did everyone forget that when mum is not feeling safe, her mammalian fight or flight comes out – and she is far less likely to be happy and hence the baby suffers?  Whatever happened to ‘do no harm?’ – It is not about the careers and possible litigations, but of meeting your new baby in love – and where did that idea disappear?

Modern birthing in Australia is a trial.

What hasn’t changed is the naivety of the pregnant woman/couple hoping for the best. Expecting that the best will follow as it is your life is possibly naive, and at worst, is going to be really regretted in your own life. All along the way, people are at work. Please research and ask questions. The more something seems rammed down your throat, question it! If emotions are being manipulated, and if fear is the reason for doing anything – beware – is it their worry or something REALLY going on with your pregnancy?  Operator anxiety seems to run everything maternal – as though they do not trust their training . . .When something is offered as being in the baby’s best interest, ask yourself — is this something that has happened throughout humanity? Birthing is primal and it happens, in spite of us.

Whilst modern technologies can be very useful, are we not over-doing it? Do we REALLY need to know all that we do these days before nature takes its course? The induction and thus cascade into birthing trauma would be lessened, if like in the cases of this mother thirty years ago, nature was trusted to deliver when appropriate.

Where you may start thinking baby-centred

Anything from

  • Dr Frederik le Boyer
  • Dr Michel Odent
  • Dr Sarah J Buckley

Also explore the YouTube images available and articles around ‘unassisted birth’ or ‘free birth’, as these will show you how it can be done (I am NOT suggesting you go natural to this extent, but totally understand why you might. Who IS looking after the baby’s best interests is quite a question, once you do your own research and discover just how dangerous it is to be delivered with all the trappings of the modern obstetric codes.

 

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