My life as a student midwife...

Saturday, June 7, 2008

Questioning the obvious and proposing the unlikely...

Despite getting used to the occurrence of getting to work and being made aware of the amount of inductions and caesarean sections, it still gets to me. I do understand that there is a time and place in which they are needed but shockingly, the facts that Michel Odent spoke of are becoming more real and evident. I have been reflecting and addressing my frustration over this and trying to formulate some plan to change this trend particularly as I am due to take the leap next year and finally drop that infamous word 'student' from my title.

I am aware of the mass opinion that I will be up against when I finally do become registered but I am hoping that I continue on the path I have laid and stand strong and make a difference. Obviously it will be a challenge given the politics and legalities of the system but given my incessant need and want to bring birth back to what it is or in todays culture, what it should be, I will fight until the bitter end.

I have grown complete and utter despise for induction and looking back on my own experience, think myself lucky that it went reasonably smoothly. Almost every induction that I seem to witness fails or causes complications that inevitably result in a section. I am close to summing it up in my head - induction = delayed c-section. I choose my words carefully because in the delay between induction and section comes intervention. I am trying to find the words to express what I am feeling in relation to the future of this rather bold and forthright equation because I am sure that amongst the mist and the clouds, there are many that are pushing for something along the lines of - induction = c-section or worse birth = c-section.

The worrying thing for me has been the encroaching nature of the beast on length of gestation. Once upon a time it seemed safe to leave a woman to bloom until 42 weeks. Four years ago, knowing very little and being as naive as I was, I had to beg the doctors to induce me at term + 12 days. They wrote on my notes - IOL for social reasons. Now compare this to what I am seeing today

  • IOL from the EXPECTED due date
  • Social induction from around 38 weeks
  • Failed induction due to unripe cervix (GO FIGURE!!)
  • Vernix covered babies at T+ gestation (hmmm)

And thats only the start of it. Although I do not like to generalise, it seems that by majority we have lost touch with our bodies and hence when pregnancy miraculously occurs, we have no idea when we conceived, when our last menstrual period was or even care. I can understand this because sometimes the last thing I want to think about is my period and how annoying it is but what I am trying to highlight is the fact that, our bodies, our cycles, our ability to produce life, sustain it and give birth to it have become second, third, fouth, etc, to higher priorities.

I am deliberately making this point to try and justify in my minds how there always appear to question marks near or around the estimated due date. Deliberately because I want to make the point that its only an ESTIMATE!!!! Normal pregnancy gestation is 37-42 weeks, look in any text or reference and this will be clearly written, yet somewhere and somehow someone decided that that wasn't good enough. We need routine, structure, a timetable!

As far as I can gather the EDC or EDD was only created to give them woman some insight as to when labour may start. I dont think it was ever meant to be THE be all and end all OR the determinant of what will or wont happen. So unfortunately this date has been manipulated in such a way that it warrants the rights of OTHERS to make a decision as to when a baby is born.

I sat up thinking about this last night with the knowledge that primips or first time mums in general will go into labour post their due date and wondered with the understanding that we have, that being that between 41-42 weeks gestation is still safe, what would happen if we shifted the EDD to equal a gestation of 41 weeks rather than 40? Come into play politics and legalities but all that aside, what would be the outcome particularly as I am aware that 40 weeks gestation is an average gestation.

Nothing much changes. There is still an EDD, there is still that date to linger on, there is still room for manipulation. The truth of the matter is, nothing in this world is set in stone, nothing is stagnant, things change. Given that as humans we manipulate and influence so much, how can we be sure that we haven't done the same on the normal gestation of pregnancy? Its obvious we have had an enormous influence on it in a surgical, medical way but I am talking more of the physiological, psychological and environmental way. If the human race has the ability to F*#$ the planet as it has and influence global warming, seasonal shift, pump hormones into the food we consume, control life as far as messing with genes and cellular bits and pieces and possibly initiate many of the natural disasters that have occured in recent years (or months!), whats to say that we haven't done the same to pregnancy, the initiation of labour, a babies' birth??

Food for thought and my need to question...

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