How's this for an odd headline: "Maternity hospital may bar mums-to-be"?

[MotherDuck]

This has to be one of the oddest maternity issue headlines I've seen. The context is a state funded maternity care system - mothers don't pay unless they choose to engage a private obstetrician.

http://stuff.co.nz/stuff/0,2106,3889581a10,00.html

Here are the first few lines of the article:

Radical plans to tackle overcrowding at Christchurch Women's Hospital may mean low-risk pregnant women are barred from giving birth there.

Under proposals yet to be put out for consultation, pregnant women who are deemed unlikely to have complications during labour would be directed to primary birthing units, such as Lincoln, Rangiora or Burwood, or advised to have a home birth.

An epidural for pain relief would not then be an option.

The scheme has been welcomed by midwives, but they concede mothers may have "a mixed reaction".

If you read to the end, you will see that there is still a lot of educating needed about the safety of homebirths.

But maybe, costs alone will force the truth to come out.

[sapphire_chan]

Cool, women who want natural births won't have to fight with their care providers and families to get them. Women who want epidurals can figure out ways to raise their blood pressures before exams and chow down on sugar before GTTs and get their doctors to designate them high-risk.

[Romana]

Disclaimer: The article is no longer available, so I'm going by what is in the OP's post.

I firmly believe that all women should educate themselves and have all choices available to them. I can't agree with this kind of plan because I DO support a woman's choice to choose an epidural.

I also support a woman's choice to choose a c/s. I do believe, however, that it should be "difficult" to get a purely elective c/s in that mom must do her research and/or show that she understands the risks of c/s and wants one anyway, for xxxxxx reason.

Forcing interventions on a woman during childbirth, one way or another, is a kind of birthrape. And I use that word sparingly (actually, I don't think I've ever used it before). But I also think that forcing her to birth in a particular way is a form of birthrape.

Women should have choices, and be empowered to make them thoughtfully, intelligently, and fully informed. I know not all women will do this, but I don't think that's a good argument for denying choice.

I know, sapphire, that you were saying what you said tongue-in-cheek, but I do also think that women should not have to resort to extremes to be "permitted" to make choices about the way they birth, and a system like the one described in the article may lead to that kind of environment.

This kind of system also suggests to me that once again, the women who will be denied choice are poor(er) women. If you're wealthy enough to engage a private OB, you can have your epidural. That kind of system just leaves a bad taste in my mouth.

Julia

[intorainbowz]

:

That is very worrisome.

If we want any birth choices, then they all need to be on the table to women, esp women who are making an educated decision.

Well said.

[sapphire_chan]

Originally Posted by Romana9+2

I know, sapphire, that you were saying what you said tongue-in-cheek, but I do also think that women should not have to resort to extremes to be "permitted" to make choices about the way they birth, and a system like the one described in the article may lead to that kind of environment.

As opposed to the system in the US where women *don't* have to resort to extremes to be "permitted" to make choices about the way they birth? I think it's about time physiologically normal birth is the standard and for the people who want interventions to have to jump through hoops.

[zoebird]

this can be quite beneficial, i think.

the big problem that i see in the US medical system is a medical equity problem. people who can afford care can get it--even if they don't need it--and those who can't afford care can't get it or they have limited access because the doctors are busy with so many clients who don't need to be there. i feel this way about more than just birthing, btw.

i find it really frustrating that hospitals are bringing in low risk women when they don't need to--a birth center or homebirth would function and they should support that to make room for the real emergencies, whethre that woman is rich or poor.

but, that's a whole other thing. thanks for sharing the article. i think that hospitals are starting to think right about these equity and expense issues. hopefully, it will bring abuot more choice for individuals in regards to their care overall.

[Romana]

As opposed to the system in the US where women *don't* have to resort to extremes to be "permitted" to make choices about the way they birth? I think it's about time physiologically normal birth is the standard and for the people who want interventions to have to jump through hoops.

:

Sapphire, I didn't advocate the current U.S. system. I just as strongly feel that women should be free to make birth choices in the U.S., whether that is an epidural or no epidural, fetal monitoring or no fetal monitoring, homebirthing midwife, UC, etc. I am currently involved (in a volunteer capacity) in the slow process of attempting to legalize lay midwifery in my state. I also stated in my post that I thought women seeking something extreme, like elective c/s, should need to jump through a few hoops (by showing they're educated about the risks and have chosen anyway, for xxxx reason).

And I absolutely agree with you that physiologically normal birth should be the "standard." But I don't think we should eliminate the other options available to women. Personally, having experienced birth, I would call my NCB "horrible." It was great for about 12 hours, then excruciatingly painful for the next 8 hours. I can understand why some women felt the availablility of analgesia like epidurals during labor was a positive achievement for the women's liberation movement. (I'm planning NCB, hopefully homebirth, for next time, despite not having a great experience with it.)

That being said, I believe the current medicalization of birth disempowers women to become educated and make choices. Instead, your OB will "take care of you" and you have "nothing to worry about" because your OB is so "wonderful." But forcing women to have unwanted unmedicated natural births is not, in my opinion, the way to achieve a more natural birth standard.

I myself am in a difficult situation because my state currently has only 3 practicing, legal homebirth midwives. I ended up with a UC for my first birth because of this (we transferred to the hospital at 19+hrs labor). I consider that resorting to extreme measures to avoid a bad hospital scenario. And I am thoroughly disgusted that I face the same choices for my next birth.

That does not, however, mean that I feel we should deny choice to any woman, just because after having educated myself I choose homebirth. Most of us here choose homebirth if we can. But I feel that women can reasonably come out on the other side and choose hospital birth and even elective c/s. If she has thoughtfully and intelligently obtained information and made her decision, that woman's decision should be respected.

Just as unnecessary c/s should not be foisted on women seeking NCB by unsupportive providers and hospital policies, so should vaginal birth not be imposed on those women who seek the opposite experience. I feel that informed choice is valid, whether I agree with the specific choice or not. (That is a broad statement and meant to apply to birth and reasonable people, not to anything/everything medical or to people with diminished capacity, etc.)

I think anyone who resists a woman's right to choose the nature her birth does all women a disservice. We should get excited about spreading information and educating about birth so all women can make intelligent decisions, not seek to limit their choices because we feel we know which choice is superior.

Julia

P.S. And finally, let's remember who loses the right to choose, here - only those who can't afford a private OB. Again, that really bothers me.

[sapphire_chan]

Thanks for clarifying your comments. Sorry for the sarcasm.

I still see this move as positive. Couple of reasons. Firstly, I really do believe that women who *want* epidurals will have an easier time getting their doctors to sign off on them being high risk than women who don't want epidurals have getting their doctors to sign off on them being low risk. Secondly, right now the only people making a push for "let's let everyone make their own educated decisions about birth" are those who are part of the natural birth movement and maybe being on the receiving end of having to work for their choice will get the women who are fine with the current medical model of birth to start advocating for patient choice.