Being a squeaky wheel

The squeaky wheel gets heard.

When I wrote the other week about the challenges I was going through with the prenatal care and the respecting of my birth choices.( you can read about it here ) I was in a place of an almost limbo, I had made my choice of where I was birthing but I still didn’t know how care was going to happen for me. I knew what I was needing to do for me and my baby. I felt knowledgeable and safe with my choice and I was really just looking for some back up to go with it.

The unfortunate issue really was not really safety, which is what they tried to sell me on to start with. It was politics and possibly someone making sure they get their share of the money. That is not where the medical system should be making choices for birthing women but alas that is where we sat. So I decided to do something about it. Talking with different midwives wasn’t getting me anywhere, so I choose to go higher. I went to the College of Midwives of BC. I got myself informed about policies, procedures and standards of care. I decided to become a thorn in the side of my local midwifery group. Now this really is something I never thought I would do. Sure I like to stir the pot and stand up for others rights but I have never spearheaded my own quest. And I was on a quest, I was on a quest to have my informed choice rights respected. I was on a quest to be free to birth my baby at home regardless of my previous births. I had my information and I started making connections. I began to learn about other women who were not respected and their choices were made for them, not for safety but for archaic policies that have been debunked. ( nothing by mouth, clock watching, consistent monitoring)

So I sent an e-mail to a few people and the initial response was less than supportive. Like I said in the previous post. They were able to stop and limit midwifery but they didn’t have a standard of care that everyone had to follow in regards to birthplace choice. I was enraged and angry I didn’t understand how they could do this to women. It is worth mentioning that midwifery has only been regulated in BC for the past 20 or so years. They put some wonderful women through the ringer because of this regulations and limits that they placed.

Then I went to my next midwife appointment, honestly I went in prepared to fight for my rights. I had all my ducks in a row I had all of their Standard of care and Code of Ethics printed. I had studies, I was prepared. Well pretty much. I still had a knot in my stomach because I hate confrontation but I felt strongly about this. I wasn’t just fighting for me and my baby any more I was fighting for the women in my area who just like me were being held down due to a scar.

The first few minutes of the appointment were a bit awkward. Then it happened, we started to talk about what the plans were. My anxiety spiked and I was ready, hubby held my hand as we waited for what they were going to say. Then she told us that they would attend my HBAC ( homebirth after a cesarean) While they were not necessarily endorsing this, they felt that it was a safer and better option for me. Both hubby and I were flabberghasted, I’m pretty sure my jaw hit the ground. They didn’t give much for reason just that they felt that they needed to respect my choices. There was some talk of reason that I would choose to transfer, which are only if truly medically necessary.

We were delighted and shocked. It has been a long road to get to this point. There has been tears and frustration. There have been moments when I wished December would never come. Though now I have learned that if you believe in something and you know it is right you have to fight for it. Change can not be made when you sit idly by hoping some one else will do it. So for now we have our support back up plan but we also have our comfort level of knowing, our baby this time will come into the world in a much more respected manner.

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Politics, policy and other BS

” All that matters is a healthy baby.” This statement strikes guilt through a mom that is suffering trauma from her birth. Birth trauma is a very real thing. Often it involves losing control, having procedures done to you without consent, and doctors and midwives who have a different agenda than the birth mother. There are times when things change and things happen but how you are treated can greatly affect how you feel. Being respected in choices that are beyond your control, having someone talk to you in a respectful manner, as opposed to being treated like a less being.

Birth is a very raw and real time for families. It is a time where you are literally sitting at the cusp of life and death. It can be magical and wonderful, or it can be terrifying and traumatic. Birth is a very normal and natural thing but it does come with risks for everyone. Know one knows how any one birth will go, you just jump in when it’s time and go for the ride of your life. It is much easier to survive and come out unscathed if you are respected and feel safe.

With the birth of our fourth child coming up soon, the birthing time is very much on our minds. This is our final planned child and we would like this birth to be a healing and joyous experience. Unfortunately we are hitting road blocks along our way that is leaving us to change what our original plan was. Unfortunately I am not really sure why these road blocks are in place, as I can’t seem to get a real straight answer.

Now I understand that there are some concerns and questions in the medical mind about this pregnancy for me. This is going to be my first baby after having a caesarean section with my third child. Apparently in the community that I live in that leaves me ineligible to have a home birth. Our problem with this is surrounding communities will attend a HBAC ( home birth after cesarean ) but mine wont. They used to but now they wont and no one will give me a straight answer as to why. I have heard many different answers, but none are really what I feel to be a valid answer. They work as answers but they really fall more into the cop out range for answers. So I went with the next logical choice when I can’t get an answer from the practitioners I went to their governing body and asked them for a policy or reasoning. I really thought that a governing body that is paid and regulated would have some sort of concrete out lined list of requirements. I thought that said governing body since they are always saying what a midwife can’t do and where her scope end would also say where her scope is and require them to fall within it. Guess what? I was wrong.

I had decided to try and connect with the College’s ” Quality Assurance and Clinical Practice Policy Director”. I figured she would be the best person to speak with seeing as my questions were well within her title, so it should be in her job description. I simply sent her an e-mail a week ago and this was that e-mail.

Hello

I am a mother to three children and expecting my 4th in a few months time. I am writing this to inquire what the Colleges standards and policies regard a homebirth after 1 c-section. I have two previous uncomplicated hospital vaginal births before my third child which resulted in an unknown tachycardia in both mom and baby, resulting in a c-section. With testing that was done following the birth I have had an OB state that there was no reason to repeat c-section. 

The main reason I am writing this to the college is after looking through the Colleges page. I have read the code of ethics and the standards of practice. As well I have read the study that you actually have on VBAC’s listed. Also I have talked with various midwives, and been hitting walls within communication. I feel that I am getting conflicting information on the policy of a homebirth within regulations. I desire a homebirth for my 4th and final child and I wish for a clear stated communication about what is required by the College and if there is some informed choice policy that can help me reach my desired birth. I understand it is the College of midwifery’s goal to give women freedom in their birthing and I feel that I am not receiving this model of care. I am being spoken to strictly in fear and limited information thus not actually allowing my my rights to informed choice. 

If you can please get back to me I would like to progress in my planning and preparing for this birth. I do not wish to cause issues but I do desire that my rights be respected. 

The response I got back was a bit unexpected actually. I thought they would just send me some paperwork, that outlined a policy and to do with it as I please. Instead they wanted my contact info so they could speak with me.. I figured this could be a good thing they want to know more so they can set this right and allowed the informed choice right that I have in my birth. Once again I was wrong.  Being wrong really stinks.

So I gave them my info and she called me. Luckily it was during C’s naptime so I had time to talk without being too interrupted.  I explained to her a bit further about the fact that the community I was living in was refusing to respect my informed choice and attend my birth at my home. Unfortunately I didn’t have a recording device to put the entire conversation out there. Though here is the summary, and then my thoughts on each point.

  •  You need to respect your midwife and her comfort levels ( while this is understandable. What about MY comfort levels? I am the paying client, don’t we need to respect me?)
  • You can always find another caregiver. Or travel to a city where they will attend you.( This sounds wonderful and like the option I would be going for except in my community there is no one who will attend. I tried this already, I got shut down. I don’t have anywhere else to go to see a midwife, it’s not like I have a secret house somewhere. The other option is to rent a hotel room, the time of year doesn’t exactly allow for a bunch of freedom in this. I also feel that travelling to a different city in a different home kinda defeats the purpose of staying home. )
  • We can’t force a midwife to attend a HBAC. It is up to them and their community as to how they want to attend births ( Okay so you can regulate and tell women who have been doing midwifery for years what they can’t do and take their career away. Though you can’t have the group that you have specially selected to be midwives to follow the woman’s’ right to informed choice about her birth? )
  • You need to keep communication lines open. If they still wont attend then find a different provider. ( I have been keeping the lines open. Apparently I wasn’t very clear though, I’m talking and no one seems to care)
  • Ultimately everyone needs to be safe and comfortable. ( I didn’t really understand this statement, to be completely honest. I just felt like I was being dismissed)
Through out the conversation she kept telling me to just change providers. I really felt like she didn’t care about the situation or the facts that are going on. I felt like I was getting lip service from the people that are supposed to be creating and upholding a standard of care for midwives. Finally at the end she did tell me that there is a form that we can work though. It is for when a client is refusing recommended care, but then she said that my midwife might not even know about the document?!?!? I fund it very odd, I will be e-mailing her to get a copy of this document so that I have it, just in case. She also told me to bring copies of the Standard of Care, Code of Ethics and the study on VBAC’s on the college’s page. This honestly really made me wonder what is going on within this governing board. If I need to be bringing these things into my midwife. Shouldn’t she be fully aware of their policies and procedures?
So now I sit with a few options in my corner and I know what we are likely going to do and we are comfortable with our choice. My fight is feeling now more for women who don’t realize they can fight for their choices. That having a surgery does not always limit your choices. That we as women and people have rights to informed choices about our birth and that we are allowed to make those choices. We don’t have to let doctors or midwives decide our and our babies birth. We have a voice and we can stand up. I’m tired of being held down and I’m going to do this the way I feel that will be best for me and my baby.

Do I have a choice?

Pregnant and scared. Usually that is what is to be expected of first time mothers. Who knows what is going on with your body. The last few generations of women have lived in this shrouded fear of birth. Birth is now scary and painful and awful. But was it always this way?

NO

Have you chatted with your grandma or great grandma? I’m sure she will have a very different view on birth and her stories will be very different from those you see on TV. Back then birth wasn’t as scary. Sure there were complications but the view of birth was different. Birth was just as much of a part of life as death was. It was natural. Often had at home with a wise women or midwife in attendance with other women around to help.
Now don’t get me wrong medical advances have saved lives. Though sometimes you need to ask the question at what cost. Birth trauma runs rampant in our developed civilized North American culture. Pregnancy and birth is a disease that needs to be managed. Tests need to be taken scans need to be done, often with high false positive ratings.
With my first I signed on with a wonderful doctor team. They were really nice to me but my appointments were so rushed. Questions asked, requisitions forms handed to me not really knowing what they were looking for just told that I needed to get these test done ” for my baby’s safety”.  Blood pressure, fundal height fetal heart tones and away they ran. I had to have test redone because I didn’t know I was to fast before. Tests redone because they had a high false positive rating so they just had to make sure. I was young and while I knew I was going to refuse some testing ( amino, & genetic) the rest of these tests were never an option. I saw this doctor group again with my second child, very much the same process.

20 weeks

With my third I had moved and in a new area. I decided to try midwives. I was surprised, they asked for my consent before giving me any requisition forms for tests. we discussed what the tests were for and why they needed them done. Some tests they suggested on passing on due to no risk factors. It was a different experience for my prenatal. I felt like my opinion mattered, I was important.

Really it boiled down to respect. I felt like my midwives took time to respect me and the choices I had with my body and my baby. In the days of women stomping around shouting about freedom and choice it is amazing how many are not actually pushing for their choice. To know what is being decided about their body. Sure it could just be a blood test or a ultrasound, but WHY? Why is this test necessary? Is it even? What are the risks? With all sorts of odd studies coming out about different interventions and tests holding very damaging effects, we need to ask about our choices.