The other day the AMA (Australian Medical Association) in Queensland put out a statement that public hospitals are risking mothers and babies through the promotion of midwifery led care.
They want to combat this by forcing women to have obstetric-led care.
Iím not going to argue the statistics and study. If you are interested in learning more about the outcomes for mums and bubs when comparing midwifery-led and obstetric-led care then I highly recommend that you follow Hannah Dahlenís work. She is one of Australiaís most prominent midwifery researchers at the moment and has done plenty of study on this topic.
I want to talk about two very very glaring issues that I noted.
a) Public care IS obstetric led care.
The study was based on comparisons between private hospitals and public hospitals NOT between obstetric care and midwifery care. While I have no doubt that there are exceptions, in my experience all women who wish to receive midwifery led care in a public hospital require an obstetricians approval first. And almost every single woman I have encountered who birthed in a public hospital has had obstetric input into their care. Regardless of whether they wanted it or not.
If you truly want to compare midwifery led care and obstetric led care then you need to look at independent midwifery programs rather than obstetrically regulated hospital programs.
b) Once again the ongoing argument is missing the point and forgetting a key player. Women.
Every woman deserves access to whichever model of care she decides is best for her after looking at the pros and cons. Obstetrician led care is NOT without risk - to mother AND baby. Just as midwifery led care also has its risks.
You know what I really want to see - Mother-led care! Women coming in and saying this is the care that I have decided is best and safest for ME and MY FAMILY.
I am so fucking sick of this debate between midwifery-led care and obstetrician-led care. It keeps perpetuating the myth that pregnant and birthing women are passive recipients of care from an expert rather than the fact that women are entirely capable of being the experts in their own journeys and are completely capable of making the best decisions for their families.
Obstetricians donít own birth. Midwives donít own birth. Every woman owns her own birth. Regardless of what model of care she chooses.
On a practical level, what the AMA will find is that if they start forcing (even more) obstetric led care onto women, more women will simply opt out of the system. We already have women who are choosing to freebirth simply because we are sick of the shit the hospitals are dishing out to us. Do they really think that forcing women into a care model that they don't want (as evidenced by the number of women demanding midwifery led care and the waiting lists for MGPs) will make us all trust them and want more of this?!
As women learn more and more about the physiology of birth and the lack of evidence to support most routine obstetric recommendations they are turning away from obstetrics and looking for something different. I remember chatting with a midwife not too long ago about the routine abuse and bullying of women and she predicted that we would start to see a major push back from obstetricians as they look to reclaim the power in the birth room. And that is really all this looks like.
The AMA knows that women donít want to buy what they are selling.
But they know what is best for us and will give it to us no matter what we say.
But women, even when pregnant, are still human beings. We still have rights.
Are you going to stand up and fight for them?
Or are you just going to feed us to the regulators?
You can read more of my musing on birth politics at the following links:
lizzi, great article/rant - lol. I thought of you the other day as I met with my midwife. I have decided to take part in the MGP program at my hospital following the experience I had with them when I was pregnant with my first. I thought you would appreciate the attitude of my midwife and had to share with you. When we met, she said that she would make suggestions and recommendations, but this is "all about you. Whatever you want. You can choose to go along with my suggestions or not. You can choose to change your mind at any time. Again, this is all about you." I was chuffed. It's great to have that sort of support, and I would be crushed to have somebody else make the decision about whom I would like to go with for care.