In response to Dr. Michael Gannon’s comments in the article ‘Mothers Suffer in Silence’.

 

 

 

This article was published in The West Australian on 15th July 2019 and it’s not one I could just walk away from.

 

 

 

There are some points in which I completely agree with Dr. Gannon. I agree that Australia does have a long way to go when supporting women who have suffered a physical trauma at birth. I would add we also have a long way to go when supporting women who have suffered a psychological trauma at birth.

 

I also agree there is so much more that could be done regarding gyncological services for women across WA.

 

I do, however, find it hard to find much sympathy for the obstetricians and their frustrations at having to deal with this ‘increasing cohort of empowered women who aren’t necessarily better informed.’ After all, it is these women who are having the babies. Regardless of whether Dr. Gannon believes they are ill-informed or not, it is their body and their baby and therefore their decision.

 

I question why Dr. Gannon finds it so frustrating that women should be able to make their own decisions when it comes to the birth of their baby.

 

 

 

What does the AMA say?

 

 

 

The Australian Medical Association’s Position Statement on Maternal Decision Making (2013) outlines as much. This statement includes;

 

 

 

• A pregnant woman has the same rights to privacy, to bodily integrity, and to make her own informed, autonomous health care decisions as any competent individual, consistent with the legal framework of that jurisdiction.

 

 

• A pregnant woman’s capacity to make an informed decision should not be confused with whether or not the doctor (medical practitioner) considers her decision to be reasonable, sensible or advisable

 

 

• Most pregnant women strive to achieve the best possible health outcomes for both themselves and their unborn babies.

 

 

• Doctors play an important role in supporting pregnant women to make fully informed health care decisions by providing advice on the risks and benefits to both the woman and the fetus of lifestyle and medical treatment options. Doctors should provide women with opportunities to ask questions and express concerns over the advice given.

 

 

 

In the interest of brevity, this is not the full statement. The full statement can be read here.

 

Dr. Gannon states that there is ‘reams of information’ that comes from a non-evidence base. And there may well be. However, there is also a great deal of information freely available to women that is evidence-based and comes from credible, reliable sources. Medical professionals such as Dr. Sara Wickham, Dr Sarah Buckley, and Rebecca Dekker (Evidence-based Birth) provide evidence-based information to parents for the very purpose of enabling them to make educated, informed decisions.

 

 

 

I would also argue that some of the care routinely prescribed to women during their labour, such as continuous fetal monitoring, have no clear evidence-based benefits.

 

 

 

 

When labour goes for ‘too long’

 

 

 

If Dr. Gannon is concerned about women who are ‘left in labour for too long’ perhaps he should read Optimal care in childbirth: the case for a physiologic approach by Goer and Romano. After a review of the evidence, they suggest using a variety of strategies should labour have slowed down due to external factors. These strategies include;

 

 

 

• Permission. The birthing mother’s natural behaviours, including movement, should not be restricted “unless there is a compelling medical need to do so and the person has made an informed choice to comply with the recommended restrictions’.

 

 

 

• Physical environment. Women should be afforded privacy, a birth environment that helps them feel safe, gives them the ability to move around and be supported to remain upright.

 

 

 

• Practices that restrict mobility should not be used unless absolutely medically necessary. This includes anything that would restrict the woman to lying down on her back on the bed.

 

 

 

• People – women should be able to express their concerns, needs or emotions ‘without fear of being judged or pressure to comply with staff preferences or expectations’.

 

 

 

If these strategies were implemented, we may see a decrease in not only the physical trauma Dr. Gannon refers to but also the psychological trauma experienced by some women.

 

 

Perhaps, as a way to lessen the frustration experienced by some obstetricians, they should be proactive in the education and information to empower women rather than prescribing a one-size fits all care plan.

 

 

Imagine what that would do to help lessen birth trauma.

 

 

 

Hi there, I’m Kate Vivian. The Mum, and the Bright, behind Bright Mums. I am a Mum to 3 gorgeous girls, a Hypnobirthing Australia™ practitioner, a Positive Caesarean Birth practitioner and a pre- and postnatal certified personal trainer.

My mission is to help women find the joy in pregnancy and beyond – even on the most challenging days. For some women, this might mean feeling strong and confident in their changing body. For others, it will be feeling knowledgeable and confident as they approach their birth. And for some women, it be having the tools and techniques to be able to relax and remain calm through their pregnancy, birth and into parenthood. Whatever your joy looks like, I am here to help you find it.

As a Mum who has experienced a caesarean birth, an instrumental-assisted birth, and a completely natural, drug-free birth, I know the difference it can make when you are prepared for labour and birth. My Hypnobirthing Australia™ Positive Birth classes and my Bright Mums pregnancy exercise classes will help you prepare your mind and body for birth, so that you can approach your birth feeling calm, relaxed and confident.

To find out more about Positive Birth Classes, click here

If Bright Mums pregnancy exercise classes are more your thing – click here