I have recently switched GP, and along with that switch, I have changed my midwifery care too. I have not only moved across town, but across the country, and so it’s really quite interesting to observe the differences in how birth is discussed by providers.
I’ve been fortunate enough to get to speak to Mark Harris & Virginia Howes, both of whom I follow on social media, along with a stream of midwives, doulas and the like. A topic that crops up a lot is the use of language. As a mum-to-be, I’m constantly amazed at the lack of understanding about the importance of lexicon. As a midwife, in a position of “authority” (in the sense of influence, rather than dictatorial power), the language used with a woman is something I feel is very important to be mindful of.
Just as a side note: this is clearly not a rant at all midwives – within all professions, there are those who are great, and those who are in need of more than a little fine-tuning. My experiences left me so wound up that I felt compelled to put into writing, with the hope that even one person will read it and perhaps bring a little more awareness to this critical, and often overlooked, topic…
One day, I will get around to writing my birth story, so that this will have some background. For the time being, just know that my first baby was born prematurely in 2013. There was no labour, no contractions, just a faulty placenta and an emergency c-section.
When I first found out I was pregnant, I had just moved to Scotland. I went to the GP surgery at around 7 weeks but was told I needed to talk to a practice nurse first before I could be registered. I met with the nurse, explained I was pregnant, and was duly asked “which hospital are you planning to have the baby in?”. I said that with all being well, I was going to have my baby at home. Cue the smug half-smile and head tilt, followed by a “Well… I’m not sure that you’ll be allowed to have a baby at home. You’ll be under the consultant. I don’t really understand why you’d want a homebirth”. Apparently, that wasn’t quite enough patronising though. When I’d explained my reasons for wanting a homebirth, my logic behind it, and the fact that I’d trust a midwife to refer me if necessary, she went on to tell me a home birth horror story. It turns out that this nurse was a midwife in a past life. Seemingly she didn’t learn how fear and stress can negatively affect a pregnancy and therefore a birth. I asked her (politely) to respect my wishes and not share her negative stories with me, as I didn’t feel they’d be of any benefit. “Oh that’s fair enough” she said, “just know that no matter how close you are to the hospital, if things go wrong, you’re in trouble”. She then proceeded to tell me another horror story.
At 13 weeks, I went to my booking appointment with the community midwife. I pre-empted a repeat conversation, so pretty much opened up the appointment by documenting my previous encounter and requesting that it not be repeated. Again, I was told that I wouldn’t be “allowed” to have a home birth because I was on the “red flag, high risk” pathway. I would need to be under consultant led care, as it’d be safest. I explained to the midwife that I would rather be under the midwives unless there was a problem that prompted them to refer me to the consultant, in which case I’d do as I’m told, but that I wasn’t going to simply bypass normal physiology and go into the medical model of birth. Not that I’m saying it’s necessarily bad – it’s just not my thing, if I can help it. During that and my follow up appointment, every time I exerted my right to choose – whether to decline screening tests (on the basis that it wouldn’t alter our choices anyway, so what’s the point?), appointments with the consultants “just to get to know” them, I was made to feel like I was being silly. Like I was deliberately putting my baby at risk.
Today at 24 weeks, I have had a phonecall with the community midwife in my new location. She called to discuss my birth and of course asked which hospital I had booked to give birth in. I explained my preference to give birth at home, and also to use an independent midwife in conjunction with any NHS care that I may require.
I also relayed to this midwife that I’d like a referral for Cognitive Behavioural Therapy (CBT) in preparation for this birth. I had suffered with PTSD following George’s birth, and I have started to notice certain things creeping back in, which I’d like to resolve before it becomes an issue. Even knowing that I could be in a vulnerable emotional state, she continued to undermine my choices, ignore my feelings, and present herself not as someone looking to work with my preferences but quite clearly against them – to the point of manipulating me into changing my mind. Quite simply, I was stunned with how the conversation went.
I was told:
I would be going against medical advice to have a home birth (this was said repeatedly), and while it might be true, it was unnecessary to say more than once
I should hold off booking an independent midwife, as the home birth team is there and will do the same job
That any midwife would be negligent if they were to deliver a baby at home before 37 weeks, and would be breaking the law!!
It would be risky to have a homebirth as I have a scarred uterus (had she not heard of VBAC/HBAC?)
My independent midwife would have to answer to the supervisor of midwives anyway (implying that there was no point in choosing an independent midwife)
All of this was said with a few “oh but of course all of this is your decision” and “an independent midwife should hopefully be up to date on the research”.
Now I’m sure that she didn’t intend to make me feel this way. I’m pretty confident that if we were face to face, the body language and facial identifiers would allow her to recognise that I wasn’t a happy bunny, despite trying to maintain my composure. I just wonder how many women are being let down by the system, pushed into births that they don’t want, because of outdated safety fears pushed upon them sideways via unnecessary linguistics?
I am really disappointed. Midwives are our advocates. Who will advocate for our birth if they won’t? I was so upset when I got off the phone, the first thing I did was contact the independent midwife and confirm that I absolutely want to go ahead with using their services.
What do you think? Have you experienced similar? Are you a midwife who can see things from the midwife’s point of view? I’m open to all comments so let me know on Facebook or Twitter!
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