woensdag 19 december 2012

Why does it matter?

By Bashi Hazard

Bashi shares her story of her two caesarean births and her VBAC2 to an auditorium

full of midwives at the University of Western Sydney's Place of Birth Conference held

at Westmead Hospital.

Thank you. It is an absolute privilege to be with you today. I am standing here

before you because, in September last year, something remarkable happened to our

family, something I am very eager to share with you today. After 2 so-called

emergency caesarians at one of Sydney’s premier private hospitals, I had a baby

who weighed more than 4 kgs, naturally, and without intervention, with the help and

exceptional care of my private midwives. In obstetric parlance, I am now known as a

successful VBAC2. I defied the odds given to me by a number of doubting

obstetricians just months before. Never again will an obstetrician tell me that I am

unlikely to go into labour or to give birth naturally because I am too small or my baby

is too big or because I do not fit into her dogma of what constitutes “normal”.

Bashi and her three beautiful children

But that was not the most remarkable thing about the birth of my beautiful little

baby. The most remarkable thing about Baby Connor’s birth is that, without our even

knowing or hoping, the pregnancy and birth helped me and my family heals from the

pain and trauma of those previous caesareans. It put an end to my 7 year long

battle with post natal depression and its devastating impact on my marriage, my

children and my career. This birth has changed the course of my life and that of my

children’s future, in particular, my daughter, forever.

I have since wanted to tell my story to anyone who will even spare me a minute of

their time. I think some of my girlfriends are secretly hoping that my speech will give

them all a well deserved break as I have been pounding their ears about my

wonderful midwives for some months now! But for those of us who have

experienced even part of what I am about to tell you, the talking has only just

begun. So many of us have endured this pain and trauma in silence and in

shame. We feel shame because somehow, despite having no control or real support

through the process of birth in a hospitals, we are often told that the outcome

is either our fault or due to a problem with our bodies. And there are simply

thousands of us – you will find them on the Internet, all trying to ease their pain by

sharing their stories in silence. The stories are disconcertingly similar; a trusting new

mother, a hospital, a bullying obstetrician, use of drugs and technology in place of

gentle touch or attentive care, and a labouring woman at the centre, confused and

punch drunk from the negativity, disrespect, and alienation she is facing during one

of the most intimate, vulnerable episodes of her life. These stories talk of marital

breakdown, post-traumatic stress disorder, post-natal depression, isolation, shame,

anger, a fear of childbirth and hospitals, and most concerning – an enduring inability

to bond with or care for their children. This is modern obstetrics at its best.

Seven years ago, before I had a child, it never occurred to me that my chosen place

of birth and caregiver would so profoundly change my life, for good. After all, this is

Australia, where the equal, legal rights of women are enshrined in law. Having come

from a medical family, I expected the medical profession to lead the charge on such

a front. More importantly, I assumed that a fundamental aspect of modern obstetrics

is a sophisticated understanding of the delicate emotional state of a pregnant

woman, particularly during labour, and the implementation of systems of care aimed

at fostering and protecting that emotional state. The result – superior care for

mother and baby - is, after all, a hallmark of a civilised society.

This is one of the reasons I believe that so many new mothers flock to private

hospitals and engage private obstetricians. We are told that continuity in care is only

available through a private obstetrician and that a private hospital is best equipped to

handle pregnancy, birth and postnatal care, and to promote mother-baby friendly

initiatives. This is what my obstetrician told me when I first went engaged her


Having tried them all; obstetricians, private and public hospitals, and a private

midwife, in my experience, nothing could be further from the truth. For my last

pregnancy, I engaged a private obstetrician through a public hospital, and a private

midwife concurrently. I was in a unique position to compare the services I received

from both ends of the spectrum. It is my humble view that hospitals and obstetric

care don’t even begin to compare with the care that a private midwife can offer.

So how did I go from one end of the spectrum – the private hospital, to the other end

of the spectrum – the private midwife? It was a long and arduous journey and, in

truth, my hand was really forced by the care I received for my first 2 pregnancies.

I began my journey into parenthood as innocently as any new mother. My GP

recommended a private obstetrician. I had never heard of a private midwife. I

assumed everyone gave birth in a hospital. I accepted her advice. Aside from an

early period of hyperemesis, I really enjoyed a healthy pregnancy. I was young, fit

and healthy, didn't drink or smoke, the baby was healthy and developing well, my

blood pressure was very good, and I suffered no complications throughout the

pregnancy. My body responded immediately and well to good food, gentle exercise

and sleep. I found myself, like so many pregnant women, drawn to understanding

and nurturing my body with natural, healthy practices, developing good habits that

have stayed with me to this day and to the benefit of my children. I enjoyed it and I

soon felt my baby’s pleasure and well-being as well. It was a really special time.

Unfortunately, my obstetrician didn’t share my confidence. She seemed able, in the

brief 15 minutes that she spent with me every few weeks, to anticipate or burden me

with information about everything that could possibly go wrong with the pregnancy. I

am sure she thought she was being very thorough, but there was really nothing

wrong with me and I knew that. I began to leave every appointment with this

growing anxiety, worrying about whether I would even make it through the

pregnancy, yet utterly ignorant of what I could do to help myself or improve my

circumstances. As the frequency of the visits increased, so too the anxiety that we

experienced between us! For instance, we never really discussed my diet or good

eating habits, yet I was weighed at every visit to see if I was too fat, or too thin or

possibly diabetic. I was told to do a battery of tests without any discussion of their

purpose. When I asked about them, I was simply told that we would discuss the

results if a problem arose. And my obstetrician seemed to look very hard for

problems, even where they didn’t exist. She was particularly concerned with the size

of my feet and my height, my husband’s size and weight, but she didn't explain why

until after my baby was born. We never talked about my birthing preferences or

plans. When I asked about labour and birth, I was told it all depended on how I

coped with labour, but she actively avoided any open discussion about what was

involved. She suggested I attend the hospital birthing classes but warned that they

placed too much emphasis on natural birth. In the last 6 weeks of the pregnancy, I

received constant comments about the small size of my feet and its possible

correlation with my pelvis, the large size of the baby’s head, concern that the baby’s

head had not engaged because first babies “nearly always engage before labour”,

followed by comments that I may be unlikely to go into labour “in time” or at all.

As the days went on, I felt that I was being pushed in a direction that I did not want to

go, although this was never openly discussed with me. The appointments were so

rushed, I decided to call the hospital instead and talk to someone in the labour

ward. The midwife I spoke to was reluctant to talk, and sent me back to my

obstetrician. I tried to ask my GP, but she also told me to talk to my obstetrician.

I began to feel really isolated, so I asked my husband to come with me for the

second last appointment, at which time my obstetrician again noted that the baby’s

head had not engaged and that I was unlikely to go into labour. We were also

regaled with the statistics on stillbirth after the 39th week of pregnancy. We were

then offered a solution; an induction and her confidence that it would greatly increase

my chances of delivering naturally, provided we did so before the baby got any

bigger. I still resisted, but we were booked in with the hospital just in case we

changed our minds as it was a “busy time of year”.

In the days that followed, I received a phone call from a midwife at the hospital

nearly everyday, telling me that I was expected for an induction. I had not yet

reached 40 weeks, I was feeling fine and experiencing plenty of Braxton-Hicks types

sensations. Finally, my obstetrician rang me and strongly repeated her advice,

insisting that we would be safest, even if I was to go into labour naturally, in a

hospital setting.

The induction was put to us as a matter of convenience – to speed up labour and to

ensure a natural birth. We had no idea what was involved. I didn’t know, and

certainly wasn’t told; that an induction would involve breaking my waters so there

was no turning back. That if the induction failed, I would have to have a

caesarean. That there were known side effects with the use of syntocinon, including

fetal distress. That the pain would be so great, that I would be completely

unprepared for it and more likely to ask for an epidural. That an epidural could slow

the labour, increase the likelihood that the baby and I would become very tired, and

therefore increase the chances of fetal distress.

The pressure was too great, and in my ignorance, I relented, thinking I could always

change my mind. I cannot tell you how much I regret that, even to this day. The day

of the induction began quietly enough: my waters were broken and a drip was

administered. I was put on a monitor, and left alone for several hours. I felt some

contractions but they seemed relatively mild. We tried to ask someone but it seemed

everyone was too busy to even stop and check. I remember playing cards, thinking

this whole labour pain thing was rather overrated! Suddenly, in the late afternoon, a

midwife came tearing into the room to check on the drip and confirm that it was not

working properly. She quickly raised the dose, telling us we had some catching up

to do. The effect was immediate and overwhelming. The pain became excruciating

and I felt suddenly nauseous. The midwife said to my husband, “She can’t take the

pain”, as if I wasn’t even there. She then offered me some gas, which I took before

throwing up. I hadn’t had anything to eat or drink for hours and I felt exhausted. As

the vomiting got worse, I became distressed. My midwife had left the room after the

gas incident without really saying anything, and we never saw her again.

A short time later, I heard someone call out “Last chance for an epidural before I go

home.” Of course, I gratefully accepted. Before I knew it, I had been strapped to a

bed and put on a monitor. I began to shake and throw up repeatedly. Shortly after

that, my obstetrician came marching into the room. My husband and I were told that

the monitor was showing signs of fetal distress. According to my obstetrician, my

baby couldn’t cope with labour and I needed to consider a caesarean. I was

shocked. What had just happened? How had it come this? Can we just stop this, I

asked. Yes, but since my waters were broken, it would not be safe to let me go

home or leave things for more than 24 hours, so I really needed to make a decision

now. My obstetrician then spoke separately to my husband and expressed her

concerns for the safety of the baby.

Fathers have become the latest weapon of choice in modern obstetrics. Raised on a

diet of Hollywood style dramatic births, it doesn’t take much to infuse them with fear

and panic. The less fathers know, the better they become at being cannon fodder in

the hands of an obstetrician with a resistant client. “If you knew what I knew about

vaginal birth, you wouldn’t even be contemplating putting the baby through this”, said

my obstetrician. What happened next has proven to be the greatest test to our

marriage and the absolute trust that my husband and I once shared. He appealed to

me to think about our baby and, in that instant, gave voice to the fear that seemed to

occupy everyone in the room except me: that I was not capable of acting in my

baby’s, my own flesh and blood’s, interests. It broke me. I gave in, signing that form

like a guilty criminal expressing contrition.

Worse was to come. As soon as I signed that form, the atmosphere in the room

lifted. I suddenly received more hospital assistance in preparation for the caesarean

than I had during all those hours of labour. This was a well-oiled machine, poised for

operation, easily kick started by a simple consent form, even if signed in

distress. The sense of urgency and concern that had been oppressing me until then

simply disappeared. Of course, I didn’t know that once the syntocinon had been

turned off, there was no fetal distress and so there was no emergency. At this point,

it was all about convenience, for my obstetrician and for the hospital, but not for me.

It took 2 hours to get to theatre. Hospital attendants joked about the 6pm queue into

theatre as if I wasn’t even there. I felt just like one of those cows on the conveyor

belts being shipped into Jakarta – alone, terrified, bewildered and in shock.

As I lay there sobbing, vomiting and shaking, I was cut open and my baby

removed. Outwardly, I tried to put on a brave face. Inside, I was screaming – I don’t

want this, why is this happening to me? I desperately wanted to just run away. I

kept telling myself that I had to do this – I was saving my baby. We soon discovered

that my baby was small – a 3.1 kg baby, with an APGAR score of 9:10. So much for

a big baby and so much for fetal distress. I was only then told that it was too cold for

the baby in theatre and that he was being taken back to the ward. After a brief touch

of the cheek, my baby and my husband were led out of theatre. So much for skin to

skin contact. As hospital staff dragged and flopped my limp, naked body from one

cold slab to another, and wheeled me out of surgery, I felt this horrible sensation in

my body. It was as if someone had drained all the blood out of me. I felt faint and

became desperate to see my baby, to be with him, to hold him, but I was told to be

quiet and considerate in recovery. It was more than 2 hours before I saw him and by

then, he was fast asleep. My baby was then rudely awoken and shoved against my

breast, as he screamed in protest. He had a strong neck and he fought back, the

brave little soul. I was unable to sit up and hold him or just soothe him. I felt so

helpless and useless! That initial struggle proved impossible to overcome, even

after 18 months of nursing, and served as a constant, daily reminder of that first

terrible introduction, for both of us.

My husband was blissfully unaware of the way I was feeling. My obstetrician had

told him that, with a little pain relief, there was no reason why I couldn’t recover from

what she referred to as a “straightforward procedure”. There was, apparently, no

difference between the major operation I had endured and a natural birth.

There was nothing straightforward about the impact this surgery had on me. The

pain was difficult enough to manage on its own, let alone with a newborn and my

shattered emotional state. We found ourselves constantly battling busy midwives

who either forgot or who provided us with the wrong medication. Alone at home,

every effort to lift or feed the baby came with pain – I soon found myself avoiding

holding or cuddling my baby unless I absolutely had to.

I also couldn’t shake the fear and panic that had been imprinted into me at

hospital. I began to imagine all sorts of terrible things happening to me or the baby,

leaving me helpless to protect him. This got worse over time, not better. I began

avoiding situations where I felt out of control. I stopped leaving the house. I lost

touch with family and friends. I gave up my job.

I tried to speak out about what was happening to me soon after the birth but I was

quickly shut down. “You’ll be fine”, said the lactation consultant at the hospital,

“Think how lucky you are that your baby was alive and well.” At our 6 week

appointment, I was told that my body had let me down; it had failed to respond to a

fairly standard induction treatment. I tried to tell myself that this was part and parcel

of having a baby and that I was no different to anyone else, but it simply didn’t

work. No matter how hard I tried, I couldn’t understand or accept what had

happened to me.

By the end of my baby’s first year, I had been diagnosed with severe post natal

depression and my marriage had disintegrated. I was told that I was having trouble

adjusting to motherhood, which simply wasn’t true. I loved being a mum, I just never

felt well enough to enjoy it. I found the attitude of mental health professionals quite

confronting as well – most simply shrugged their shoulders, offered me medication

and told me to move on.

Three years later, not long after we had heard about VBACs, my husband and I

decided to have another child. I contacted my obstetrician and informed her that I

was going to have a VBAC. I assumed that she would advise against it and at least

give me my medical notes so we could find someone else. To my surprise, she

offered to manage the pregnancy and to help me achieve a VBAC. The

hyperemesis was worse this time, and I had a toddler to care for, so I accepted,

thinking that I could stand up for myself this time.

As I recovered from the hyperemesis, I began to realise it was just more of the

same. Somehow, I had gone from engaging her services to her “allowing” me to

attempt a VBAC. I became very anxious about the labour, so I hired a doula. My

obstetrician wasn’t happy about that, but she conceded because she didn’t expect

me to even go into labour.

I went into labour on my due date. In the peace and comfort of my home, with my

husband and doula, I enjoyed a most wonderful few hours of labour.

The minute we arrived at hospital, however, everything started to go wrong. I was

referred to as the “trial by scar”; no one even bothered to ask for my name. Then

began the continuous battle with hospital staff, both during and between

contractions. There was a fight over whether I needed a cannula, whether I should

be constantly monitored, whether I had to lie strapped to a bed, whether the lights

needed to stay on. No one spoke for me, not even my midwife. I had to

concentrate, even through contractions, on responding to the constant

interruptions. There was the same sense of anxiety and panic, and it really

distressed me. At some point, I felt the need to push and my obstetrician arrived. I

was made to leave the shower, which I was enjoying, dry off and submit to yet

another examination, in preparation for my obstetrician. All the lights went on, and I

heard people chatting and joking loudly, as if I didn’t even exist. From the attention

she received, you would be forgiven for thinking my obstetrician was the paying

client, and not me. As I was being examined, my waters broke. Then, the labour

just ground to a halt. It was as if I had been rudely awoken from a wonderful

dream. I looked up, blinking with the bright lights around me, suddenly aware that a

number of people were standing over me, shaking their heads in pity.

To our amazement, no one seemed to know what had happened or what to do

next. My obstetrician quickly resumed her initial diagnosis – that my body was

incapable of labouring and delivering a baby naturally. She accused the midwife of

making a mistake, she told me I had dilated to 7cms (which is where I got to with the

induction) and that she didn’t think I would progress without help. She suggested an

epidural and syntocinon to get through the last few centimetres quickly. It wasn’t

long before I was tied down with drips and monitors, wrapped up and left to

contemplate that looming caesarean. I was “given” the extra time it took for my

obstetrician to make her morning rounds. That message didn’t get through to my

baby, because she immediately showed signs of fetal distress. I cannot begin to

explain how stressful it is to lie there, hoping against hope for a change in my

fortunes, wondering how I was going to cope with the challenges to come. And as I

lay there sobbing, waiting for my obstetrician to return, midwives would storm into

the room, check the monitor and glare at me accusingly before storming off again.

I finally called my husband over and bitterly conceded to a caesarean. I don’t

remember much after that. I closed my eyes so I wouldn’t have to see anyone. I

remember thinking about my grandmother and how much I longed to see her. As

soon as I heard my baby’s newborn cry, I felt that familiar sensation of completely

running out of energy. I didn’t care that it was hours before I saw my baby. I didn’t

try to feed her because she was already fast asleep. I couldn’t even hold her, and I

was told she couldn’t lie in my bed with me, so she lay alone, wrapped up in a plastic

bassinette. I sent my husband home to see our toddler and, finally, as soon as I was

alone, allowed myself to cry and cry and cry some more. All around me, I could hear

people talking; hospital announcements and the noise of machines, but thankfully no

one heard me, and no one bothered to check on me. I was hungry and thirsty, I

hadn’t had anything for almost 48 hours but no one even stopped to ask.

Late that night, I awoke parched, sweating profusely and lying uncomfortably in a

pool of blood and faeces. I still couldn’t move, so I called for a nurse. No one

came. Half an hour later, I called again. This time, a nurse arrived to yell at me for

calling twice. She told me that I could stay as I was till morning and brought me a

cup of water, which she left by the bed. I couldn’t lift myself up to get the water and I

was too afraid to call for help again, so I lay there till I eventually fell asleep again.

In the morning, a trainee nurse walked into my room and said something

about having to get up and walk. I barely heard her. I pulled the covers over my

head and pretended I wasn’t there. She stood there for a few minutes and then

left. I didn’t see anyone until my husband arrived in the afternoon. He was furious at

the state I was in. My obstetrician was called in. She tried to speak to me and

seemed genuinely surprised by my physical and mental state. Hospital staff had

nothing to do with me. The only thing my obstetrician could manage during our 5

days in hospital was to refer me to the hospital’s post-natal depression unit. It took

this specialist 5 days to get to me, and even the hospital couldn’t wait that long – I

was discharged, and told to wait outside my room to see her. When she arrived, the

only thing she could offer me was a few more phone numbers and the promise of a

follow up phone call. In the days and months that followed, I stayed acutely

depressed, contemplated suicide and separated from my husband. We were a

mess. We had been chewed up and spat out by a hospital system that lacked the

facilities to recognise, let alone accommodate, the trauma that had been inflicted

upon us. So this is the gold standard of private hospital care – where babies are

pulled out as quickly as possible, and healthy, happy mothers are cut open,

emotionally shattered and sent packing with a smile.

Enough is enough, we said. Never again. We had an enormous amount on our

plate – illnesses we had never before encountered, including post-traumatic stress

disorder, marital breakdown and 2 young children who were depending on their

broken, emotionally shattered parents to get it together. Whatever happened to the

Hippocratic oath – physician, first do no harm?

Then came Baby Connor. A surprise, and a blessing. The pregnancy proved to be

a real challenge. I struggled with hyperemesis and the care of 2 young children

throughout the pregnancy. I became iron deficient. I was very tired and my

immunities took a beating. Despite all this, I was determined to find a caregiver that

would work for me. We met with obstetricians and asked about VBACs. One told

me I had a 10% chance of success so I shouldn’t bother, and that he could schedule

a caesarean at 39 weeks, before he went on holiday. Another said he wouldn’t risk a

VBAC because I had had post natal depression. All of them conceded that inducing

my first baby, before term, was a mistake, but that the consequences were mine to

bear. I found the dismissive attitude towards the mental health of pregnant women

quite distressing. I was rarely given straight answers to critical questions, like, what

is your caesarean rate, or what is your preferred hospital’s caesarean rate or how

many VBACs have you handled and how did you manage them? How does your

hospital deal with PND? I realised, to my surprised, that the obstetricians I

interviewed were offended by my approach, as if I was questioning their authority,

rather than seeking the best possible care.

I finally found an obstetrician, English trained, honest and empathetic enough to give

me some comfort. I engaged her, but I still wasn’t satisfied. I knew my obstetrician

wouldn’t be there to support me in labour, so I called the public hospital – Royal

Women's - and asked some questions about their attitude to VBAC, how much time I

would be given, and who would attend to me in labour. They told me to speak to my

obstetrician. After half an hour of that old buck passing with which I was now very

familiar, I had had enough. I turned to some internet research on VBAC. This is

when I found myself stepping into a whole new world. I read stories from all over the

world. Stories that told me I wasn’t the only one who had been through that trauma,

that it wasn’t my fault, and that others, like me, had been left isolated, punch drunk

and struggling to pick up the pieces. Most telling was the reality that what had

happened to me was regarded as a standardised, even systemic, form of

widespread abuse being practised in hospitals, in Australia. I gave this information

to my husband who was shaken to his boots.

I also read about women who experienced traumatic births in hospital who then

turned to private midwives. I decided to call a private midwife and talk to her. This

proved to be the first step towards a wonderful journey of learning, empowerment

and healing for me. Everything changed as soon as I started talking to Jane –

perhaps because she was the first one who wanted to hear every detail of my

birthing history and who was willing to help me make sense of it all. And boy, did we

talk! She bore the enormous task of not just guiding me towards the preparation of

this birth, but also the job of helping me shed my doubts and focus on believing in

myself. No stone was left unturned, no question left unanswered. The more we

talked, the more I remembered, understood and learned. I read Dr Sarah Buckley’s

latest book “Gentle Birth, Gentle Mothering” and realised there was a biological

reason for the way I felt after those caesareans. My body had never been allowed to

release the hormones critical to my recovery and well-being. I learned about labour

and how it could be disrupted by fear and anxiety; how it is enhanced by dim lights,

peaceful surrounds, gentle touch and calm, supporting voices. The lessons were

also very painful at times. To know that I had agreed to speed up or force my body

into labour, without realising that the syntocinon was causing fetal distress. To know

that my body, if left alone, would have safely and gently delivered my babies and

supported my fragile state of mind, instead of the mind bending pain my family has

endured for the last 7 years. To realise that I have been misled by someone I

trusted – it was all very hard to take.

At the same time, both my husband and I embraced the incredibly supportive,

nurturing and highly involved care of our midwife with a great measure of awe and

respect. A caregiver who wanted to talk in detail about diet, massage, sleep, and

exercise? Who wanted to meet my children, and talk about where and how I wanted

to give birth? Who encouraged a birth plan and then worked through every aspect of

it, and discussed possible outcomes and alternatives before I was in labour? Who

spent hours working through my fears and doubts? Who came to my home,

checked over me while I rested and then gave my husband useful tips on how to

care for me? Who, throughout my labour, NEVER LEFT MY SIDE, who held my

hand, kept her head and focused on ME, even while hysterical hospital midwives

were being abusive and disrespectful, and an obstetrician was carrying on like a

petulant child right next to us? THIS is the gold standard in maternity care that

should be offered to all women in this country.

So did I learn anything from my experiences? Most certainly, I did. I learnt that

there is a vast difference between a natural birth and a caesarean, not just in terms

of the immediate physical outcome and recovery, but also in terms of my long term

emotional and physical well being, and its corresponding, profound impact on my

baby. Despite this, and if recent statistics are anything to go by, caesareans are still

being peddled as routine procedures, which in my view, does not even come close to

constituting informed consent, and is a lawsuit waiting to happen. I have learnt that

you can go to a hospital healthy and happy, and be sent home a shattered, damaged

mess to cope with a newborn, alone. I learnt that financial abundance is no indicator

of a hospital’s standard of care – like any organisation, abuse and aggression can be

so systemic, staff are simply oblivious to it and its damaging effects. I learnt that

despite the alarming rise in pre and post natal depression, our governments and the

medical profession have failed to look closely at the causes or to challenge

caregivers, or to review and implement changes, for fear of treading on the toes of

well financed medical lobby groups. I have learnt that there is a biological basis for

my post-natal depression, and I am walking proof of it.

I am also living proof that the pathological approach of obstetricians is contributing to

a rise in caesarean rates and unnecessary interventions. There was nothing wrong

with me until my obstetrician made it so. Of course, you may say that my 2 so-called

emergency caesareans are not statistically significant on their own, but then, neither

was my obstetrician’s theories about a small pelvis, the size of my feet and my

inability to labour naturally.

I thought I would wrap this up by saying something about homebirths from a social

and legal perspective. The medical profession has, both historically and in recent

times, done much to paint homebirth as a fringe-dwelling activity of the socially

disenfranchised, who apparently indulge in homebirth regardless of the personal risk

or cost. It seems to me that every public discussion about homebirth turns into a

race toward that familiar obstetric stomping ground – the risk of fetal deaths. Don’t

get me wrong – fetal deaths are an important measure of maternity healthcare but

the powerfully emotive content of that topic detracts from the other equally important

person in the equation – a baby’s mother. When I hear these debates, I wish I could

give people a little insight into my darkest, loneliest and most painful periods soon

after my hospital experiences, when I struggled to care for myself, let alone a

newborn baby. It is not a good outcome by any measure.

The truth is, while everyone thinks they have a right to dictate a woman’s choices in

birth, no one considers it their responsibility to pick up the pieces afterwards,

particularly when, even with the best of intentions, things go wrong. In my case,

money was not a barrier to seeking help, but we nevertheless struggled to find

support that went beyond copious amounts of expensive medication and all of its

glorious side effects on my and my babies. I shudder to think of what would have

happened, had we suffered financial hardship as well.

In my view, this social pressure we are placing on new mothers who already have so

much to contend with is just unconscionable. That we have a medical profession

that is knowingly engaging in this conduct and actively seeking public support for it,

despite the resistance from women, and despite the alarming rise in negative

outcomes, is very concerning indeed. It is no wonder Australian has one of the

highest rates of perinatal depression in the world.

Our laws protect a woman’s right to choose where and in what circumstances she

has her baby. We know how important these laws are. Women are carers. When

we enhance the autonomy and freedom of a woman, we raise the living standards of

her community and her children. With so much resting on her shoulders, it is vital

she is given the information she needs to make an informed choice or to provide

informed consent to a procedure that could affect her wellbeing or her ability to care

for her family and children. Anything else is an assault on her and on her family. It

really is as simple as that.

Martin Luther King once said, “Darkness cannot drive out darkness, only light can do

that.” Private midwifery has, in my view, provided that light. The care I received in

my last pregnancy provided me with the understanding and knowledge I needed to

express what happened to me as a result of my experiences in hospital. Our family

was finally given the chance and the breathing space we needed to recover, to heal

and to bond in ways that was denied to us until now. I know many, perhaps too

many, women who have not been so fortunate. For that, my gratitude knows no


Written 16/03/2012

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