Thursday, 3 September 2015

Better Births?

It is very difficult to break away from the TV image of women lying down on beds to labour and give birth. Society has done a great injustice to women where birth is concerned by allowing programmes like One Born Every Minute where women's faith in themselves to birth their young is eroded week after week.

Research has shown us (Lawrence et al 2009) that women who remain mobile and adopt positions that they are comfortable with during labour have less analgesia and labour much quicker. The mobile elements found on most CTG machines today are not just there as a fancy add on, they are there to be used to help keep women in charge of their labour by staying off the bed. Hand on heart, how many midwives reading this can say they have ever used the mobile CTG attachments or have strived to keep women off the bed while obtaining a necessary CTG trace in labour?

If we are truly going to obtain better births for our women then we have to start with the basics, often lost when working within a busy hospital obstetric unit. Normality is often the last thought on our minds as we strive to follow all the guidelines and protocols available to 'keep women safe'. Once a woman is in labour from IOL then we have the power to stop any further interventions that may cascade her into an operative birth.

The USA have obstetric nurses in their obstetric units and they seem to be nothing like midwives. The internet is full of unhappy women who feel they have been violated by hospital care received in labour. Obstetric rape is often the cry from these women who are desperately trying to reclaim the lost art of birthing within the doctor led services available in America today. This is one model of care that we must strive to stay well away from by supporting midwives to look at their practice and reflect. Am I being truly 'with woman'?

Student midwives are our future and yet the number of students who pick up the very bad habit of calling contractions 'pains' to women really drives me crazy. I once mentored a student, well into her second year, and she had never laboured or birthed a woman off the bed. This was all she had ever seen and she was quickly becoming an obstetric nurse without her even knowing that there was a choice.

Women need knowledge. We can give them this knowledge during parent craft classes that teach them how to labour as nature intended. Relaxed and confident, giving them the choice of mobilising or simply sitting on a comfy chair or birth ball. When was the last time you even saw a birth plan, have women simply given up writing them as they learn to expect the carnage they see on TV?

Better birth is an achievable choice for most women going into labour today with the right support from their midwife. We need strong midwives, confident in the simplicity of normal birth, lets rise to the challenge and make a difference today.

Lawrence AM, Lewis L, Hofmeyr J, Dowswell T, Styles C, (2009) Maternal Positions and Mobility During the First Stage of Labour. Published online 2009. Available on the internet from: The Cochrane Collaboration and Wiley Online Library.

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