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Trust - A crisis in maternity care

by lizzi (follow)
Helping plant the seeds of positive birth. www.sproutbirthing.com.au
Birth (105)      Obstetric violence (3)     
It’s time to talk about trust. I’m going to go way out on a limb and suggest that a lack of trust is one of the biggest issues facing maternity care in Australia and that most other problems stem from it.
“Yay!” I hear the care providers exclaim. “It’s about time we talked about trust. Those women need to start trusting their care providers. After all we are the experts and just want the best for you and your baby.”

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"Just trust me, I'm a doctor." I don't think so! Image courtesy of Wikimedia Commons.

Sorry people, that’s not where we are going with this.

The onus is not on women to “Trust us. We know better”. We didn’t just wake up one day and suddenly stop trusting our care providers. No-one tapped me on the shoulder and said “You can’t trust them. They are evil.” What happened was that we discovered that our care providers were not worthy of our trust. That our trust in them had been breached. In a big way.

DISCLAIMER: When I talk about “care providers” I really mean “the maternity care system”. Some care providers are trust worthy and some aren’t. Feeling hard done by when someone says that they don’t trust their care providers? Be thankful that you’re not a politician…One of the least trusted professionals around.

So how did we come to the conclusion that care providers were not trust worthy?

Well…We caught them with their pants down. Enough times to make us really start to question. The following scenarios are REALLY common. As in, I hear instances of these every single day. And they are instances of obstetric violence and are an abuse of pregnant women. So you need to ask yourself if you have ever or allowed another practitioner to:

*Told a woman that she MUST follow hospital policy. Hospital policies are for hospitals and their staff. Women are under no obligation to follow them. Not even if it makes your life easier and your paperwork a bit lighter. This is a LIE.

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NOTHING is compulsory and this machine can not guarantee anything. Image courtesy of Wikimedia Commons.

*Told a woman that the reason for her caesarean is because “the baby is too big”. Because when she goes on to vaginally birth a bigger baby she’s going to tell everyone she meets that you are a liar.

*Implied that you can guarantee an outcome. I’ve heard OBs tell a women: “You must have CFM or we can’t guarantee that we’ll pick up a rupture.” Ummm…you can’t guarantee anything so stop lying!

*Played the dead baby card. During my first pregnancy I had a doctor tell me that I must be induced or my baby and I would die during the night. By the following morning the baby was not born, I was not in labour and no-one died. I started to wonder what else I was being lied to about.

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It's hard to trust people who allow the bullying of pregnant women. Image courtesy of Wikimedia Commons.

*Pulled a bait and switch. This is one of the most common ways for trust to be lost. I hear far too many stories of women who are told that they will be supported in their birth choices right up until the moment the care provider needs to step up and support them. Then they change their mind. My own midwife told me that she would support me declining induction until 43 weeks…at 42weeks 4days she told me that she hadn’t been able to sleep all week because she was scared that my baby was going to die. If your word is worth so little how can I trust you with my baby’s life? Sickening.

*Told a woman that she is or isn’t allowed to do something. This is a really big one to me. Because the only person who is allowed to make a decision in regards to my pregnancy and birth care is me. This is the law. It’s also in the AMA position statement on maternal decision making. Why on earth would trust someone whose ethics are so low that they don’t even feel the need to follow their own professional organisation's code of practice? Seriously – If you don’t have enough respect for your own peers and supervisors to “follow the rules” they have laid out why would I trust you to have any respect for me? And what other aspects of the code of practice are you not following?

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Where's the respect for pregnant and birthing women? Image courtesy of Wikimedia Commons.

If you are behaving in an ethical (and legal) manner and reporting those care providers who aren’t then that’s great! I’d love to hear your stories about how you provide respectful care and work to ensure that you are worthy of the trust that women place in you. But trying to force women to “just trust us” while women are being abused by maternity care providers on a daily basis is really low and shows a complete lack of understanding about what women are facing in maternity care.

Upset about women not trusting their care providers? Then it’s time to step up and ensure that care providers are behaving in a way that is worthy of our trust.

#Obstetric Violence

Further reading about obstetric violence and culture:

Obstetric violence - Stop burying your head in the sand!

Obstetric violence - Assigning responsibility

Obstetric violence - Victim blaming, victim shaming

Birthing revolution - The fight against cultural conditioning

A letter to my midwife

Evidence based care - No thanks!

To the Australian Medical Association - please remove your opinion from my vagina!

The Australian Medical Association - Breaching their own position on maternal decision making
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Most women that I meet on the maternity ward do not have a clue. They lie down on the bed and act like they are ill or something. Labour is not an illness to be got over by lying down and resting. Lying down in labour is very painful, leading to cries of "get me an epidural, NOW". If women took charge and knew how to act in labour then my life would be easier. Stay upright, on a chair or ball, and learn a relaxation technique to use in the pregnancy and for labour. Its not rocket science! I have had 2 out of 4 pain free labours so I know it can work. www.painfreelabour.blogspot.co.uk
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