When I was first interested in midwifery I joined lots of groups dedicated to a vision of true midwifery – radical midwives, real midwives, grassroot midwives. Basically midwives who felt that the medical model of childbirth had taken over and women needed to connect and trust their bodies.
I want to stress I feel strongly these groups are important and have helped make changes that have improved care over the last few decades. If, for some very odd reason, there was a radical midwives vs. obstetricians football match say, I would definitely be rooting for the midwives. They would be the hearty underdogs (both in societal status and probably as football players given we are mostly middle-aged overweight women).
But sometimes your team isn’t completely fair, and I think we shouldn’t fear to point that out (except maybe if it’s got anything to do with BREXIT because everyone is so angry and emotional then you risk losing limbs).
This is an article that is worth reading about induction. Now I seem to keep getting stuck on antenatal ward and unnecessary inductions make me weep. Poor women can be there in a long drawn out and painful process, making them exhausted before they are even admitted to labour ward. One of the most under-discussed aspects I think is that should labour ward be horribly busy the midwife in charge will not let you continue with an induction. This means women are essentially left in latent stage like a plane in a painful holding pattern.
And the article makes a good point as it highlights a case where a baby born after a long induction is covered in white vernix. This means the baby was almost certainly not overdue. An error was made somewhere along the line and the writer feels it should be recorded as a serious clinical incident. That has a formal NHS-defined meaning of an event which resulted in death or serious harm. I’m not sure I agree with the writer completely – serious harm in maternity services normally relates to very significant issues – but I certainly think if we see a woman that has been persuaded to have an induction for no reason we should somehow learn from the experience so it doesn’t happen again.
But the article is resolutely one-sided. The title itself implies that all inductions are immoral or at least risk something terrible and hence not justifiable. I’m not going to get into a discussion on why doctors recommend induction but I think it’s a safe starting point to say that there is some evidence to suggest that in certain cases induction reduces perinatal mortality. Or in other words less babies die.
I guess it’s ok to be one-sided in an opinion piece but the other thing I find unpalatable is the language used – in particular: “someone has convinced them that it is safer for their babies to be forced out, rather than to stay in their mother’s warm velvety uterus”. Now I feel bad to pick up on something that’s been written in a heartfelt way – and probably better written than the stuff I do – but…..for fuck’s sake – no-one’s uterus is velvety – and even if it was that still wouldn’t necessarily be a valid reason for the baby to stay inside it.
It’s that sort of language that (maybe excessively so) really winds me up. It widens the gap between the medical profession and midwifery that makes day-to-day working together more uncomfortable. It also tends to make midwives the butt of medical jokes (I’m guessing I’ve already mentioned the whole ‘madwives’ thing – there are some trying to reclaim the word but it’s not terribly respectful).
I just hate certainty sometimes – there’s too much of it around in so many parts of our lives. I just tend to think (see hesitancy of my writing – the style algorithm hates it but what do I care!) the truth is always a lot more fuzzy and hazy than anyone with certainty thinks.