1.15.2008

How the Gynecologist Became God

Please, take this as it is - not as an anti-OB rant, but as a historical and medical dissertation on the advent of certain medical perceptions/practices.

Quite a strong statement, I know but with the recent trend it can almost ring true. I’m all in favor of gynecologists because they do have so much expertise and knowledge. They are trained and educated in high risk obstetrics and therefore see disasters lurking behind every door. When a women needs the care of a specialized obstetrician then I am 100% supportive but I’m not for all the proposed routine interventions they wish to offer low risk women and I cannot fathom how they expect women to just lie back and take whatever the almighty doctor decides is convenient for him or herself.

I’ve heard many times a nurse saying to a laboring mother…

“There dear, we need to:
- shave you / give you an enema /have you lie flat on your back /give you an epidural - (take your pick) because the doctor really doesn’t like it when
- he cannot see down there / you make a mess / he’s not comfortable delivering / when you are screaming and making a noise.”

The gynecologist's the new God, never to be questioned or inconvenienced. Woman have foolishly handed over their power to their doctors and in the process they are losing a most valuable part of the process of become parents - looking out for themselves and their families. Many women are mistakenly led to believe that they have very little choice in regards to how and where they birth.

It is a sad reality that women give birth on their backs not because this is how it is done but because the doctor won’t have it any other way. Midwives are regularly on their hands and knees with mothers. They are the greatest contortionists I’ve ever seen. They deliver babies in any position the mother chooses. Ever seen a gynecologist bend down and look from the floor up to see the progress a mom has made. Never!

More education needs to be given to the new family with regards to informed choices and basic rights. There are basic rights that each laboring woman can undeniably expect, all she needs is to know what they are. All woman have the power to take back what is theirs and make choices based on what they need and want.

The WHO (World Health Organization) states the following:

SUPPORTIVE CARE DURING LABOR AND CHILDBIRTH

* Encourage the woman to have personal support from a person of her choice throughout labor and birth:

- Encourage support from the chosen birth companion;

- Arrange seating for the companion next to the woman;

- Encourage the companion to give adequate support to the woman during labor and childbirth (rub her back, wipe her brow with wet cloth, assist her to move about).

* Ensure good communication and support by staff:

- Explain all procedures, seek permission and discuss findings with the woman;

- Provide a supportive, encouraging atmosphere for birth, respectful of the woman’s wishes;

- Ensure privacy and confidentiality.

* Maintain cleanliness of the woman and her environment:

- Encourage the woman to wash herself or bathe or shower at the onset of labour;

- Wash the vulval and perineal areas before each examination;

- Wash your hands with soap before and after each examination;

- Ensure cleanliness of laboring and birthing area(s);

- Clean up all spills immediately.

* Ensure mobility:

- Encourage the woman to move about freely;

- Support the woman’s choice of position for birth.

* Encourage the woman to empty her bladder regularly.

Note: Do not routinely give an enema to women in labor.

* Encourage the woman to eat and drink as she wishes.

- If the woman has visible severe wasting or tires during labor, make sure she is fed. Nutritious liquid drinks are important, even in late labor.

* Teach breathing techniques for labor and delivery.

- Encourage the woman to breathe out more slowly than usual and relax with each expiration.

* Help the woman in labor who is anxious, fearful or in pain:

- Give her praise, encouragement and reassurance;

- Give her information on the process and progress of her labor;

- Listen to the woman and be sensitive to her feelings.

* If the woman is distressed by pain:

- Suggest changes of position;

- Encourage mobility;

- Encourage her companion to massage her back or hold her hand and sponge her face between contractions;

- Encourage breathing techniques;

- Encourage warm bath or shower;

- If necessary, give pethidine 1 mg/kg body weight (but not more than 100 mg) IM or IV slowly or give morphine 0.1 mg/kg body weight IM.





Reposted with permission from Birthing In Awareness

1 comment:

Sally Loudmouth said...

They say that giving birth on your back is the worst position possible, unless you include hanging a woman by her toes, upside down! :)

Good job spreading the word so that more women have the information to make the best choice for them!

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