Monday, November 30, 2009

I try not to go all political on this Blog, I really do. Believe me, if I let loose it'd be nasty! But this deal with the proposed amendments to the midwifery legislation is very close to my heart! Here is my submission to a senate inquiry on the matter. I hope you will find it thought provoking. If you wish to add your own submission, check out how on the Save Home Birth Blog

To Whom it May Concern,

I wanted to tell you about my experiences with both public maternity care and care from an independent midwife.

During my first pregnancy my medical care was through the Queen Victoria
Maternity Unit, Launceston as a public patient. I often sat for two hours or more waiting for appointments with team midwives at the QVMU (Queen Victoria Maternity Unit) and I doubt I saw any one of them more than twice. Most of the visit was spent with them reading my notes before doing a brief check and sending me on my way. One of the few times there was an “issue” some papers were sent to the obstetrician who then called me and let me know a prescription was waiting for me at the pharmacy. I was not informed what the prescription was for, nor was there any discussion about what my current condition was.

My baby was delivered by a midwife who was lovely but who I had never met before that day and her secondary midwife was a woman who I had a bit of a personality clash with. The birth was a ‘good’ birth but quite a few times my wishes were ignored because I had not been able to discuss them fully with the midwives before the birth. I also had some ongoing issues with nerve damage because of an action taken by one midwife after I asked her to stop. Something that took months to recover from and that could have been easily avoided if she had listened to me or had the time/inclination to read through my birth plan.
After the birth, I was shuffled out of the birthing suite within 20 minutes because of there were more and more women arriving and they needed the room.

After the birth, I was roomed with a woman who would often walk out for hours on end leaving her baby unattended and would play audio tapes of herself swearing in labour to entertain visitors who came at rest time. I went home with my three day old baby with little or no rest because of my rooming conditions and no ongoing help from medical staff. When I called to ask what I should do about persistent issues (caused by the nerve damage) I was told that there was nothing I could do and given no support.

I say this NOT to belittle the staff at the QVMU, many of whom work very hard and go above and beyond the call of duty. They are obviously overloaded and working within a culture that does not encourage individual tailoring of care. I describe my first experience to show the contrast between my care at the hands of the public system and my care at the hands of my private midwife.

For my three subsequent pregnancies and the current one, I have been cared for by an Independent Midwife. When being cared for by my Independent Midwife I rarely wait more than five minutes. Review of notes takes only a couple of minutes and the rest of my visit is spent thoroughly checking everything out and discussing how bub and I are going – with my other children and husband often involved in the process if it is appropriate. The smallest of issues are noted and carefully watched. When there was a small issue with iron levels during my last pregnancy, I discussed it thoroughly with my midwife, went into the QVMU (with a detailed copy of all of my notes from all of my pregnancies) to see the obstetrician on duty who discussed my condition with me and ordered some blood tests. I was called when they were in by the obstetrician who explained the results and said he was perfectly happy for me to go ahead at the birth centre. I then got a call from my midwife who checked that I was happy with what was happening.
I was completely satisfied with the way my midwife was able to collaborate with hospital staff to deliver the best possible care for me and my baby. Many of the staff at the hospital were privately supportive of my choice to employ an Independent Midwife and seemed quite happy for some of their very heavy workload to be alleviated. I was pleased that we could make use of the expertise of the staff available at the hospital without the added cost of having to go through a private obstetrician. My Midwife had the freedom to refer me as she needed to and collaborate with available medical staff without being restricted in her ability to care for me and my baby.

All my babies at the birth centre have been delivered by highly trained and experienced midwives who I have chosen and are philosophically aligned with in terms of birth practice. All three births have been fantastic and my after care went on for two weeks in my own home. The midwives were “on call” for me 24 hours a day and they make a point of keeping themselves up to date training as lactation consultants. Their expertise and availability has assisted me in establishing breastfeeding and having wonderful recovery periods after the births of my children. This level of care is rare even in private hospital situations and is unheard of for someone who lives a 45 minute+ drive from the nearest city as I do.

All this was at my own expense, and I’m happy to pay if I need to. Although I would love to see this level of care made more accessible to alleviate the load on the public system in Launceston. I personally believe that if more women employed Independent Midwives, the hospital staff could give greater time and attention to the care of women who have high risk pregnancies. I also believe that continuity of care, as provided by an Independent Midwife, could prevent many issues in pregnancy, birth and post-natal periods.
I believe that the proposed amendments will greatly diminish the standards of care I experience in any further pregnancies. I believe that the proposed amendments will remove my option, as a rurally located mother, of having experienced and professional staff attending my needs during the postnatal period. I believe the proposed amendments will jeopardise the continuity of care I experience before, during and after birth. I believe that the proposed amendments will subject my care to the scrutiny of bodies who are wholly unsupportive of independent midwifery and who are not committed to a higher standard of care for women outside the hospital setting or support of midwives. I believe that the proposed amendments will remove MY right to choose who my health care provider is and place that choice in the hands of professionals who are openly opposed to independent midwifery, independent birth centres and home birth. I believe that this restriction of my choice will take place with no proof that such a restriction will benefit either myself or my baby. In fact I believe the proposed amendments will not only violate my rights, but will jepordise the health and welfare of myself and my future babies.

This is my story and my thoughts, I hope they help you to make an informed decision on your own stance on this issue.

I thank you for your time,

Jessica Guest
Soon to be mother of 5 and voter

1 comment:

Anonymous said...

Hi Jess,
I can so relate to what you have said about public health care facilities for birthing mothers.

My last experience was with the Wallaroo hospital, who employed agency nurses when I had my daughter, and I had a really bad run-in with the head agency nurse, so I went home after three days - enough was enough!

I had health issues, so I needed the care of a hospital environment, but I would have loved to have had an independent midwife.

Keep up the good work,