Why oh why does nothing ever change in the medical dominated
world of midwifery? Maybe it is changing but it is kept hidden from me and I
see little change in the 13 years I have been away from the labour room
rituals. Is there ever going to be a time when I accompany women to hospital
when they need to go for assistance but they are then treated with dignity and
the experience is one of joy ( and good women centred practice) in all
respects?....
Recently I took a client in to hospital with suspected early
labour at 34 weeks. I went home as nothing much was going on but 24 hours later
was called back by my client as all of a sudden baby was on its way fast.
When I arrived on the
labour ward I walked into the brightest lit room you have ever seen, every main
light was on but also a spotlight was beaming down onto a visible head. Two
male paediatricians were in the room arms crossed leaning against the window
a bored look on their faces.....doing nothing of course just waiting there
watching the woman in her most private time. There was also a doctor present
and 2 midwives, another person kept
popping in and out but I, and I am sure also my clients, have no idea who it
was. As the birth was so advanced and in front of so many people there was no way I could make any changes or even comment on anything
I saw, it would have been inappropriate and far too confrontational, but it
really was awful.
The woman was in typical labour ward position, propped up on
her back (this was a woman who was
planning a home birth and wanted everything natural) . She was being encouraged
to use the valsalver manoeuvre of sustained breath holding and pulling back on
her thighs. This manoeuvre has been demonstrated to be dangerous practice by the
World Health Organisation and has been labelled “practice be abandoned” as it
can cause fetal distress.
One midwife was standing next to me and I was able to
whisper to her " please consider not cutting the cord if this baby is well
as the evidence is clear that it is beneficial especially for premature
babies" of course I was ignored and when a healthy pink crying baby was
born a few minutes later the blood rich cord was instantly clamped, cut, the
baby wrapped in a towel and handed up to his mother. The mother was overjoyed,
of course she was, baby was healthy a good size and in perfect health. The irony of it was that as the midwife was
cutting the cord all the blood spurted all over her face and arms! She thought
it quite funny, I thought it quite sad! Shame the blood didn’t spurt into the
baby! If they were passing baby to mum
anyway why couldn't they have left the cord? It was what mum wanted and should
be common practice...its even in NICE now!
I helped mum to unwrap baby and the baby commenced to nuzzle
at the breast, I covered them both and that was where I hoped they would at
least remain, however after about 5 minutes the baby was taken from his mother
for a paediatrician to look at him. You could see he was healthy just by
looking at him in mums arms! All the Doc did was listen to his heart (yes it
was beating he had been pink and crying and breathing for a good while now)and
then the midwife commenced to put a nappy on him (did mum want this? of course the answer is that she didnt know
for she didn’t ask.... did she even stop to think that the parenst may have looked forward to
being the first ones to dress their baby?) She then wrapped him AGAIN in 2 towels and finally gave him back to mum with
no mention of skin to skin or feeding. As I see it this is nothing more than
labour ward ritual, this taking of baby
for a paediatrician to look at, it happens at Caesarean sections too yet a
midwife is completely able to assess at birth instantly if a baby needs a
doctor or its mother. Of course as I was there I encouraged the mum to unwrap
(again) put him skin to skin (again) and breast feed which he did beautifully
and instantly. Why does this happen ?If I had not been there maybe the mum
would not have unwrapped the baby and would have continued to hold her heavily
wrapped baby without attempting to feed or certainly not as early and quickly
as she did. At that point with him being born early, I considered skin to skin
and feeding was the most important thing for that mother and child yet the
midwives began immediately to pester the mother to stop feeding and hand him
over to weigh and get prophylactic antibiotics started. The only thing wrong
with this baby was he was 6 weeks early. He was a good weight, over well over
5lb and it was a spontaneous quick labour in a healthy mother. It seems so
bizarre that there was such a rush to get drugs into him that he may not need
but that they were more than happy to deny him the blood and feeding that he
did need.
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