The whole thing got my brain buzzing though and after sifting through the numbers what is written below is my personal response. I have a fair bit of experience in the birth field and I have seen a considerable number of babies come into the world, so I don't think my reaction is unfounded or my words on the matter, ill-educated.
I also recognize that I am in the Greater Toronto Area, not in a rural setting, and so the thoughts generated for me are a result of what I have witnessed in this, large community. I can't speak to births in smaller, more rural settings. This post is entirely my personal opinion.
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(I think the idea of the survey is lovely but the reality of what happens and what people report in a survey are two TOTALLY different things. As an example: I am thinking about the instances of PPD that are reported and the amount of support moms say they have as two prime examples of what is seen “in the field” and what moms report to their care providers as being very different.)So, Ann and Annie, I have read the article you linked to and I have to say that, for the most part, I am not impressed. As a labour support provider (aka doula – although I don’t like that term) in the Toronto area I have had the honour of being invited to attend the births of more than 200 babies over the last 10 years. While the majority of my births take place in the west end of the GTA, I have attended births at most of the maternity hospitals in and around the city.
Many of the recommendations made in the article (with the survey results) sound great but the reality of the birth situations is that it doesn’t happen. The problem with asking moms to fill out a form like this is that they think they are saying one thing and the medical community – or whomever it is that “interprets” the survey results – reads what the moms have said very differently. I.e.: moms say they laboured upright because they weren’t completely flat on their back and the medical community reads that to mean that these moms must have been UP and even out of bed; not the same thing at all.
Or what about: “half of the women say they had the same person provide care during pregnancy, and during labour and birth?” This is just about impossible in the Toronto area. Perhaps, in very small, rural communities it is more likely because there are fewer care providers catching babies. The problem with a survey like this is that expectant moms will read it and get their hopes up. The survey says NOTHING about the reality of 3-5 minute OB/Gyn appointments (after lengthy waits before getting in for their scheduled visit) followed by 5-10 minutes with their care provider (or **a** care provider) at the time of their birth. This isn’t enough time to create a relationship built on mutual trust and disclosure. It is enough time to establish that the doctor must know what she or he is doing because they are able to have mom in and out of the appointment visit so swiftly. What gets missed by these brief encounters? Abuse victims? Moms who aren’t eating properly? Moms who can’t get the rest they need? Moms who have horrible leg cramps in the night and don’t understand how to resolve them effectively? The list is endless.
The article stresses the need for support and how continuous support can be extremely beneficial however forgets to mention that a doctor and nurse combination health care team are unlikely to be able to provide that resource for mom. This isn’t for lack of desire on their part; it is simply rooted in the reality that they are too busy to be able to offer this service.
I honestly believe that the base information in and provided by this survey has the potential to be useful. What will the entire birth community do with it? That is anyone’s guess. Just as they may know, in science, that putting a baby skin-to-skin with mom immediately after birth has immeasurable benefits for both the mom and baby the actuality is that very few practitioners actually put it into practice – even in hospitals where it is the written protocol for straight-forward, low-risk births.
I hope this survey and the results it gathered go somewhere beneficial. The cynic in me thinks it will be nothing more than filler for the recycle box.
Posted by Sam
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8 comments:
I'll play the devil's advocate for a moment. I didn't have a problem with the short appointments with my obstetrician or the short amount of time that the attending obstetrician was at my birth. I didn't view my pregnancy or my birth as something that needed a significant amount of medical intervention and therefore I was thankful to have as little of it as possible.
That said, I did want support for my pregnancy and for my birth. I found that support in my husband, my doula, some excellent books and Web sites, and a strong community of friends online and offline.
Support is key...medical support, not as important in my view.
i agree with PhD. I had medical support, but it was the wrong kind. I wanted a natural childbirth and initially had the support of my doctors and family. but as soon as the doctor put her best interest forward (quick birth with no complications), everyone (besides me) agreed to a ceasarian. hence my support for a natural childbirth turned to support for ending labor and having the baby safely. in my eyes, the ceasarian was administered too quickly in the labor process and the support ended up being not the kind i needed. lesson: what doctors say and do don't always match. choose your support wisely.
Great response!
I lived in a smaller community (Leamington -- you've probably never heard of it.. lol) and I think there was a total of 3 OBGYNs. I could have driven to Windsor, but it was more convenient to stay in town.
I was lucky -- I never had to wait more than 10 minutes for my doctor and was always with him for 10-15 minutes.
I think it will be interesting to see how the experience is now that I'm in a big city like Ottawa.
I think that my doctor and his nurses were a great support in that aspect but aside from my family the best support I had was with the Building Blocks For Better Babies programs.
It was easier and I felt most comfortable about asking questions and inquiring about my nutrition. (Although my doctors and nurses always made sure to inquire about it on my, very, frequent visits)
I did not, at all, have the same support in the hospital that I had at my doctor's office.
But that's a whole other conversation lol
I really enjoyed your view on the survey!
True enough. I hear what you are saying.
In my experience the reality, for moms who don't require the same support from the medical community as others, is that somewhere you learned what your options were and where to source information that helped you feel confident with the care, etc that you had. Many, MANY moms that I meet don't know how to build that confidence. The brief appointments they have with their OB/Gyn doesn't allow them an opportunity to find out where to get help, information, or resources as needed. Most tell me about how they always go in with a list of questions and because the appointment is so rushed they come out with just as many questions, if not more.
(Side note: many of the classes I teach are in a hospital setting and many of the moms I meet have been conditioned to believe that birth is something to be frightened of.)
I suspect that there are a number of moms who feel similarly to you, I don't meet as many of them. I meet moms who are scared to death and feel as though they don't know what to do to alleviate that fear. I think my job is to help them learn what they need to learn in order to make their experience as positive as it can possibly be. Often the moms I meet are having babies number 2 (or more) and want to make their next experience better than their last.
I am REALLY glad that you had a great support network. I wish more families had it.
@Nicole - I think it is impressive that there are 3 OB/GYNs in Leamington. I heard on CBC News yesterday that there are only 5 OB/GYN's in Gatineau....!!!!!
@ PhD in Parenting & @Nicole:
I was thinking the same thing.
Ps - Nicole, when I lived in London I learned where some of the smaller, southwestern communities are. Haven't visited there though. Have family in Blenheim too.
I am lucky ( I think) to live in the West End of Toronto and be the mom of 2 great little boys. With my oldest I was under the care of an OB and it was awful. She is a very nice doctor but far to busy to be in the business of caring for moms. She was pro intervention and I was not. She was not present when I gave birth to my son and in fact I had to call to find out the name of the doctor who was. When I went for my 6 week check up she asked me about my delivery which indicated she never read anything about it. Thankfully I had a wonderful labour support person and supportive family. With my youngest child I was under the care of a midwife who still to this day can remember the birth of my son who is 2 years old. I believe we need, heck I know we need to move away from viewing birth as a medical procedure. We need more midwives in Ontario.
Sam, I think you've made a lot of good points. When I was pregnant, I wanted to get a midwife but I didn't realize that I had to call the second I found out I was pregnant! I ended up with an ob/gyn and I didn't even get in to see her until I was 7 months pregnant. I never doubted her ability, but I was about to become a mom for the first time and I needed some one-on-one time for information and/or support. There was never time for that kind of conversation.
My daughter's birth was fine, but it wasn't the birth I had envisioned. A doula would have been a great help, but having one just wasn't feasible financially. When I was filling out forms later for Rachel's documents, I couldn't even remember the name of the doctor who delivered her. I only met him when I was ready to push and to be honest, his name didn't stick with me! I'd like to see a lot of changes to how pregnancy, birth and early motherhood are handled here in Ontario.
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