Membrane Stripping - Page 2

[MsBlack]

Well, I actually very much appreciate these recent comments--quite the needed slap for me. I guess I told 'one side of the story' and didn't really include the other--overgeneralizing entirely and I'm sorry--I can totally see how I was offensive to some. I just hope you can see how in another way, it is out of my respect for women, and my ultimate trust in women's power, wisdom, and ability to create their own realities, that I painted that picture. I would never want any woman to believe that the power to change this lies anywhere but in her own hands. However...and this is a big however....

I DO quite agree that responsibility ALSO lies with the HCPs...maybe it is that I am so cynical about them...they have had too much power for too long and I don't *see* them taking responsibility! The rewards they gain from maintaining the status quo are way too large and fancy for them to willingly surrender those.

And I mean that I literally do not ever see this happen with my eyes, although I also mean that I don't *fore*see that they will begin to take responsibility (as a group), since they enjoy such a privileged status. They really will (as a group) continue on this path unti women simply stop accepting it. There are individual HCPs (like me, and pamamw and others I've met here and elsewhere) who have grasped the grotesqueness, the ugliness, the s&m dynamics of the conventional 'HCP-client relationship'...and who are taking steps to create a whole new and (ideally) egalitarian connection/cooperation. But we are in the minority. Most cannot see the forest for the trees, cannot imagine a better way, do not question the status quo.

It is outrageous to me that a woman....in this case a woman who IS informed and has taken steps to be in charge...gets duped and violated by something like her 'self-chosen' VE during late pregnancy. In a case like that, the violation to my way of thinking is FAR more overt than the HCP who is simply behaving 'routinely' with a fully compliant/nonquestioning client--because this HCP already KNOWS that the client wants to be her own decision-maker. The HCP is fully aware that she IS making a sneaky power play about which the client can do nothing at the time. This is awful. I am so sorry this happened to you, Ellie'smom...and I am so angry at that mw.

I think it is true that such things as prelabor VE should NOT be offered, nothing is gained by them at all. Many many things that are not evidence based SHOULD be dropped from maternity care by law, if not by rational decisionmaking by HCPs. I also think it is true that women need to stop accepting VEs (and the other stuff)...unfortunately, by late pregnancy, most women are beginning to lose patience, and want SOME sign that labor might soon occur...it is hard to resist that VE, hard to remind oneself that a) the info gained is actually USELESS, you STILL won't know when labor is going to start no matter what your cervix is like that day and b) that 'simple VE' could well turn into a membrane stripping, and/or water breaking...and there goes your natural, uninterfered-with birth...at least, you have just opened a door to a ton of intervention, angst and heartache, not to mention feeling angry at your HCP and/or possibly like a big dolt for agreeing to the VE in the first place (not that I know your feelings).

Anyway...I hope this revision of my ealier statement makes my position about all this a little more clear.

[cfiddlinmama]

Thank you Ms Black for your words! I mentioned this in the other thread, but I'll recap:

It happened to me. I thought I was informed. I thought I was taking steps to protect myself. I didn't know that I should refuse a pre-labor VE though. I had lots of prodromal labor and the CNM offered to check me at 37 weeks "to see if anything was going on." Of course I was curious! It hurt like crazy and when she pulled her fingers out they were covered in blood. She said something like "we'll have you in labor in a day or two." She was right. I had ds2 2 days later. There was no asking, no informing, nothing. Just assuming that's what I wanted. I was horrified then, and I'm horrified now. Much more now that I have more knowledge.

I'm doing my best to let other women know that VE's before labor are useless and they have every right to refuse them.

I've been very mistreated at the hands of 3 different CNMs. I've heard a lot of stories of women being treated badly by "midwives." It breaks my heart. Midwives are supposed to be different....

[dinahx]

Cfiddlinmama: I have also been mistreated by a CNM, sucks, huh! My yoni was covered in Genetian Violet, which I was told at the time was "very natural" by a Midwife who I trusted! When I got home I realized nope, not natural, byproduct of the Steel Industry! Banned from Animal Feed! Now I am not sure that I even want to get pregnant, because what if that blue dye residue is still in my uterus (haven't had a cycle since DS 17 months)

Anyway, MsBlack, what can we do to stop this? It *is* assualt, IMO, when it happens w/o informed consent. I was thinking of collecting reports and reporting it to the ACOG??? There must be some way, short of lawsuit . . . The media? I know the whole relationship and model is wack, but to me, this is the ugly, ugly tip of the iceberg and I really can't take it lying down!

[Romana]

Originally Posted by MsBlack

Membrane stripping without consent would not happen nearly so much if:

women did not lay down and spread legs for any internal exams prior to onset of active labor;

women made sure, repeatedly throughout prenatal period, that their care providers knew, in no uncertain terms, that it is MOM who is in charge of care, NOT HCP;

women would stop reading things like 'what to expect', or at least only read it knowing that that book is essentially 'basic training' in how to be a nice, compliant patient for your HCP's convenience and ego-comfort. If they would only read it mainly as a way to 'know thine enemy' and be forewarned/prepared to deal with what the med model expects of women;

women would come to love their beautiful powerful bodies and know with full confidence that pregnancy and birth are normal events that do best with support rather than interference and do not, most of the time, require a medical person's 'help', supervision, etc--and that even when a particular woman or pregnancy does seem to need med help, that it is still her right and responsibility to be The One In Charge;

Membrane stripping, and other useless 'routine' actions by HCPs, will stop when women stop accepting them.

This is all well and good . . . but not easy in practice. I did all of the above. When my pro-BF, pro-NCB, homebirth-attending family practitioner told me at my 37 week visit that he'd be doing a cervical exam at my 38 week visit, I said politely, "I'd prefer not to have any cervical exams before labor."

Doctor practically had a panic attack. Became very flustered. Basically told us that he wasn't comfortable with doing a homebirth for us (which had been the carrot on the stick for the whole freakin' pregnancy, and we hadn't gotten "official approval" yet). All because I said I'd prefer not to do a cervical check prior to labor. When I could finally get a word in, I politely and calmly asked why he wanted to do one. The answer was to check that the baby was head down. Now, he'd been saying baby was head down by palpation for 10 weeks, but I've since heard both "That's reasonable" and "That's silly" in response to his reason for the exam.

The upshot of the mess was that we decided to try to find a new HCP (at 37 weeks). Did not have any luck before I went into labor at 38w2d, had a long labor at home and, not having switched care yet, called that doctor when we finally transferred to the hospital (better someone NCB-friendly than random OB).

It sounds so simple. Don't take your pants off. Don't spread your legs. It isn't that simple and easy. I could have had a peaceful, uneventful homebirth. Instead, I had a solo labor with dh (which actually was great), waited through a very long transition (7hrs, not so great) at home because I was a FTM and didn't want to get stuck at the hospital with a HCP I didn't feel comfortable with . . . not knowing if I was in active labor or what . . . It was a crappy situation to be in. And it was much more difficult for me, and certainly totally unsupportive from a HCP standpoint, *because* I did all the things you recommend above. If I had stayed uneducated and uninformed and agreed to everything my doctor said and been a good little patient, I'd have had my homebirth like the other couple seeing that doctor in my Bradley class did.

I agree with PPs that the onus needs to be on HCP to a great degree to practice evidence-based medicine and offer and respect informed consent and informed refusal. I can assert myself all I want, but at the end of the day, when my HCP says at 37 weeks, or 42 weeks, "Well, it's my way or the highway, Missy," my only options are unsupportive HCP or UC. I will never understand why politely refusing a 38 week cervical check was a deal-breaker for my HCP. A point of discussion, something we could have evaluated and possibly found an alternative - fine. A whopping, "And I was just starting to feel like I could trust you guys"? What am I supposed to do with that, except feel like you'll panic if I do anything other than be a yes man during my birth? And how can I walk into something as crucial as birth trusting you when you need me to say yes unquestioningly to everything you recommend? The experience taught me the very valuable lesson that while a HCP may be more philosophically aligned with my views in terms of natural birth, that does not necessarily mean that HCP will respect my opinion or preference when I diverge from his or her SOP.

[MsBlack]

Romana--I hope by now you've read my 2nd post that is a little more inclusive in the responsibility department

As for what can we do--well, I'm not sure tho I do have ideas. I'm a big proponent myself of UC and otherwise 'walking away from the Big Institutions', and DIY health/healing care. Which is easier said than done, I know--and can be for some situations, a pretty complex thing what with family pressures, income and insurance stuff, CPS fears. Don't mean to oversimplify by any means.

Still--I do think it's important for us to reclaim health and healing, first by learning about our bodies and how to achieve and maintain health, second by learning about natural healing methods we can ourselves use, and 3rd, by supporting non-med. natural practitioners where feasible. I will tell you from experience that the more you do this, the more empowered you will feel--and the LESS likely you are to take sh** offa anybody no matter what their rank/status in society. You reclaim your body/health, your power...and suddenly, ain't nobody seems all that much more 'powerful' than you are...docs become less intimidating for one thing--so if you decide to use one for something, it gets easier and easier to remain in charge.

Besides--What if they had a med system and nobody came? so I'm saying that through the above tactic, you are not only helping yourself/fam in a proactive way, but you are also sending a msg to the Med Inst. which relies on your dollars for it's benefits (fighting *against* them, not only *for* yourself).

There are some other things that can be done, if people will do them. Of course, any woman who experiences abuse --or simply non-evidenced based practices that she objects to and which compromise her care wishes--then she can complain. She can complain to the HCP, to the med board, to the newspapers/media. She can tell her friends about this HCP and cut into his/her business. She can get involved in politics--our legislators make laws that mainly support whatever the AMA damn well pleases. This will stop as soon as enough consumers speak to their legislators and object to this trend--and again, get it publicized. To me, the gov't power and gigantic profits that have been attained by modern medicine represents one of the greatest obscenities of our times--one of the greatest betrayals of democracy and freedom--one of the worst things possible for human and planetary health--one of the greatest capers of a special interest group attaining gov't cooperation for it's greedy ends. When people start to see this more for what it is--when more and more people both back away from it, as well as speak out against it--then we will see significant change in this situation.

But nothing will change without our insistence that it does. Small actions matter. YOUR experiences of abuse or simply having your reasonable, evidence-based wishes honored, are important enough to be used in this struggle. I firmly believe that the individual does have to speak for herself (as my first post said), if she expects anything to change--it is useless to wait for this change to be handed to you. I believe just as firmly that HCPs need to have, and continuously update, evidence based practice--and that they will begin to do when consumers DEMAND IT.