Wednesday, July 28, 2010

One born every minute: SBS documentary

SBS: Documentary

 The introduction to the US version of this 'documentary' explains:

"Every minute of every hour, a baby is born. But no birth story is ever the same. One Born Every Minute USA is an eight-part series that celebrates what it really feels like to become a parent.
Experience the high drama, humour and overwhelming emotion of child birth as new lives begin and others change forever.
This ground-breaking series observes the dramatic, emotional and often funny moments that go hand in hand with bringing a new being into the world, from the perspective of the soon-to-be parents and family, as well as the hospital staff".

In the lead photo to the US version of this series, a gloved hand, not the mother's, attempts to feed an obviously preterm infant, while the mother looks on with an intravenous line in her arm. The gloved hand is doing the important work.



The introduction for the UK version of the SBS documentary says this:
"Every minute of every day a baby is born in Britain. One Born Every Minute is an eight-part series that celebrates what it really feels like to become a parent, by taking a bustling maternity hospital and filling it with 40 cameras.
Filming from the reception desk and neo-natal ward to the operating theatre and birthing pool, this groundbreaking new series observes the dramatic, emotional and often funny moments that go hand in hand with bringing a new being into the world, from the perspective of the soon-to-be parents and family, as well as the hospital staff".

I am very bothered by both versions of this documentary. I am bothered because the lead photos (shown above and below) show a version of birth that is a complicated one.The mothers are not at the centre of care, which is where they should be.



The very pale baby being ventilated on the resuscitation trolley implies and transmits a subliminal message that birth is dangerous for babies.

That implication is wildly untrue and is a mean, cruel and dangerous association to put into the minds of people. That association undermines women's sense of self and sense of safety around birthing their babies.  I know sensationalism is what brings 'ratings' but good grief, preying on people's insecurities is despicable.

I was bothered because the assumption was and is, that the sort of maternity care that was shown in this documentary is 'normal'.

Yes, this maternity 'care' is normal if you think that women in labour should:
  • be apologetic
  • be treated like a nuisance
  • be told how busy everyone is
  • be surrounded by noise: telephones, pagers, beeping machines, talking
  • be confined to the bed
  • be strapped to monitors
  • be left with only their partners and other support people
  • have intermittent surveillance
  • be attended by a technician that gives pain modifiers as requested
  • be spoken to rudely
  • be threatened
  • be positioned in a way that ensures fetal distress
  • have their babies handled roughly
  • be separated from their babies

That view of normal maternity 'care' is what is at the back of the current wave of anxiety and mental health disorders in our population. How can I claim that? Our culture has been interrupting, disturbing and derailing mother-baby bonding and attachment processes for many decades now. Evidence is accumulating that early experiences shape personality, health and wellbeing.  Early emotional experiences have the most profound impact. There is nothing as emotional as birth. The corruption of the most primal and important experience in life, as evidenced in this documentary is startling in the way that such cruelty is accepted without any comment.

I have a very different view of maternity care and what is 'normal' during labour and birth.

In my world, a woman in labour is:
  • continuously supported by a midwife she knows and trusts
  • in an environment conducive to optimal physiological functioning - quiet, dimmed lighting, warm, private
  • free to move, be mobile and adopt positions that feel right
  • spoken to encouragingly
  • free to focus on themselves and their babies
  • supported by her partner and family as desired
  • free to drink and eat as desired
  • continuously monitored only if there is an indication to do so
  • treated kindly and with respect
  • able to expect her baby will be handled gently
  • able to have the benefits of skin to skin with their babies at birth
What's your view of 'normal' maternity care?

16 comments:

Julie Davies said...

Hi Carolyn
I watched the episode last night and also found it disturbing. It seemed that no one was listening to the mums distress or anxieties. I am facilitating antenatal classes at the moment and while watching the program was praying that no one was watching it from my class otherwise they will turn up next week with lots of fears and anxieties.

Carolyn Hastie said...

Hi Julie, thanks for your comment. The program is disturbing isn't it, for the reasons you say and because it shows the worst of what midwifery can be, sadly.

Perhaps though, the program could be a good discussion point? Many of the couples may well have seen it and so talking about the problems - asking the couples their views on what was depicted, could flush out a lot of unhelpful preconceptions etc. That discussion would five you an opportunity to present and explore ideas and strategies that are optimal. What do you think?

Julie Davies said...

Hi Carolyn
Yes you are right. It's a great group and already we have had some interesting discussions.
Julie

Carolyn Hastie said...

The fact that you are having good conversations shows that you possess wonderful faciltation skills Julie! Well done. They are fortunate to have you. Not everyone is able to leave the well tramelled path for discussion unknown. Yet, that unknown is usually where the learning is greatest and no one has to be the expert.

Mary said...

I have noticed many times in hospital and particularly in NICU, that mothers are very grateful if staff are "nice". They often use words such as, "They let me..." I find that quite disturbing. I've replied to women that "nice" should be a minimum expectation from any staff member whilst they are in hospital. Sad that women are grateful for crumbs at a time when they are most vulnerable.

Carolyn Hastie said...

Mary, that is a really important observation you have made. Do you have any solutions? What can we as educators and midwives do to turn that around?

Trina said...

While I agree that a mother should be able to expect a pleasant experience from the staff in maternity ward, the truth of the matter is that in our society, people are very judgmental -particularly when it comes to their personal views on child birth and caring for baby. These types of people wait until you are completely vulnerable- emotionally, physically and hormonally - and guilt you into doing things their way. When we can have all midwives giving the same information during the labouring, and especially after when learning how to breastfeed and settle your baby, the experience will be so much less stressful. Having said that, there are many wonderful, supportive caring and lovely midwives who do a FANTASTIC job!

Carolyn Hastie said...

You have raised some very important points Trina. Consistency of information is crucial, as you say. I'm delighted to hear that you have met some wonderful midwives. Sharing your experience, as you are, is great to help women feel safe and encouraged, ready for their maternity care journey

Lmr1985 said...

Carolyn, I could have written this blog. I agree with everything you have said and it is for that reason that I do not watch this programme.

This is not midwifery, this not maternity 'care', this is just awful.

Obem is in an ideal position to change our cultures' attitudes and beliefs that birth is laying flat on your back and screaming.

Where is the empowerment, the sensitivity, the beauty of birth?

I know that when I qualify I will be a sensitive, compassionate midwife.

The culture needs to change!

Carolyn Hastie said...

I'm so glad there are student midwives like you lmr1985 who are observant and passionate about providing the sort of environment that helps a woman feel safe and supported with kindness and appropriate attentiveness. The way that women and birth are portrayed in shows like OBEM is very undermining. The way the partners are portrayed is also very destructive and belittling. From the reports, Call the Midwife seems to be a little better, certainly the book was good, so it will be interesting to see what it's like. The fascination with birth series is interesting - do you think it could be a way of the population trying to get over how they were treated in hospital - either through being born or giving birth themselves?? ... the preoccupation is certainly interesting from a psychodynamic view point.

Wendy Wood said...

I agree with everything you say, but what concerns me is it does seem to have become 'normal' midwifery care, I have worked in and off in 3 different units over the last 15 years and unfortunately this seems to be the norm! I hope I have just been unlucky and other midwives can report different care. I think one issue is that as highly skilled professionals midwives have strived to increase the list of skills they have in the good faith that they can then provide continuous care to a women ie suture, venflons, breech etc however in this I think many midwives have simply lost the most wonderful skill of just being with a women and quietly observing, encouraging and supporting the woman in the belief that she can do it. We encourage women to not have trust in what their body is telling them ie not allowing a women to push when she has the urge, women are made to be examined before we 'allow' them to push. Really hope I load of midwives respond to this and reassure me this is no longer the case, but I have yet to witness anything different! Yep there are some fantastic midwives out there but sadly most of them are pushed to the fringes to offer their wonderful care and often end up in the community or independent to be able to practice with the woman at the heart of their role NOT obstetrics.

Emma Smith said...

I found a lot of aspects disturbing, one was that each time a mother had a spinal, resulting in having forceps delivery and no encouragement to have a natural birth etc. It puts the wrong message across. I could go on. I have 6 children and each birth was different, only 3 midwifes i had stayed with me all the way through which was nice rather than seeing different people each time!

Carolyn Hastie said...

Wendy, what's the answer? What do you think we need to do to change the fact that midwives are not practicing midwifery in the hospital setting?

Carolyn Hastie said...

Emma, you had what I'd consider optimal care and all women deserve that. Not a parade of strangers. You are right, the way that maternity care is depicted on the show does send the wrong message - to women, to their partners, to society as a whole. Thanks for sharing your experiences. We need more voices like yours, calling for what's right for women during their childbearing experience. We have the evidence, now we need the practice.

Sooz said...

There's a big difference between a L & D nurse (as in the US) and a midwife. I don't think people realise the difference. Women STILL have Dr-led care because that's what they see on TV, that's what their mothers did, so they think it's the best. We have women come to book into our hospital at 34-36 weeks who have no idea our midwives clinic even exists. But then, we get a lot of second time (and subsequent!) mothers who then come back and ask for midwife care, which is good! It is difficult in a country town with only male doctors to get any understanding. If they'd send them to book in earlier, around 20 weeks, like they should, we could then promote our clinic. We are shared care only as we don't have caseloading, but we could do so much more than we do, which is frustrating for all of us. However, one of the good things about being in a small country unit is that we don't have OB's hanging around, we don't even have a doctor on site unless we call them, so we do have a lot of midwife led births. We do not do epidurals as we don't have an anaesthetist to do them (he only does GA's), so if it goes pear-shaped it is usually straight to theatre rather than instrumental.
And one bloody doctor who keeps sending women for CT pelvimetry and scaring the crap out of them....grrr.

Carolyn Hastie said...

Good to hear from you Sooz. Thanks for sharing your experience and work environment - really good for the women and the midwives that you have so much autonomy. The word will spread and you will have too many to look after!! That's the dream and then, get more good midwives! Fascinating and terrible the way that the doctor can undermine women so quickly - what's that about do you think?