​​"Your birth. Your body. Your baby. Your choice. Your way. Even when the shit hits the fan and you have to change your original plans."


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Do you want 1-on-1, 100% focused on YOU support during your pregnancy and birth? Do you want someone willing to listen who really HEARS YOU? How about a source of unbiased up to date information? Someone who doesn’t have a hidden agenda? Who trusts in, and believes, in you? Who doesn't pretend to be someone that they aren't? Someone who will give their all in supporting you to the best of their ability and beyond?
If your answer is a resounding YES!!! and you live on the North Side of Brisbane send a message TODAY to arrange a no obligation interview.​

Anyone who knows me well will know that I am a huge advocate for respectful, evidence based, consensual medical care. You would also know that I am hugely against inadequate medical care when medical care is absolutely necessary and INSANELY AGAINST biased and coercive based medical care.

If you didn’t know any of that, then congratulations! Now you know and I won’t have to say it all again later on.
Before I really get started on what this blog post is about though I’d like you all to picture something in your minds for me:

• A man goes to the emergency department of his local hospital at night for excruciating lower abdominal pain, non-stomach-bug-related vomiting and inability to walk without aid.
  The pain doesn't respond to any of the standard pain relief medication normally given when people present with severe (currently) unexplained pain – paracetamol and ibuprofen doesn’t work, the maximum doses of endone or buprenorphine doesn’t work. Usually when that happens the nurses consult with the on call registrar and stronger pain medications are ordered (morphine, fentanyl etc).
  The man gets to stay in the hospital for a couple of days or so days with regular morphine and/or fentanyl and/or every other strong pain relief available to try and get the pain under control while having in depth investigations to find out exactly what is causing the pain (by in depth I don’t just mean the standard urine and blood tests and maybe an ultrasound – I mean the full kit & caboodle testing to rule out everything from appendicitis to cancer to an obstructed bowel). The man walks out of the hospital with his pain under control and either a diagnosis or a referral to a specialist who can diagnose him.
  
  

Now I ask you to picture this:

• A woman with a pre-existing incurable and generally painful disease goes to the emergency department of her local hospital at night for excruciating lower abdominal pain, non-stomach-bug-related vomiting and inability to walk without aid.
  She is only given one endone every 4 hours and two paracetamol every 6 hours. When she tells the nurse that neither of those pain medications is helping at all she is given a heat pack and told “that will help” (what the nurse hasn’t been told is that the patient spent the previous 6 hours before rocking up at the hospital at home taking the buprenorphine she normally takes for severe pain related to her pre-existing disease with a heat pack so hot that it is burning the skin on her lower abdomen). Only the basic tests (urine, bloods and an ultrasound – a basic one that cannot pick up the disease that she has and has been proven in the past to not show serious things that were happening within her body) – are done and she’s left to suffer and cry alone in her bed on the ward while still in excruciating pain. After about 12-18 hours, and maybe in a rare case after a second overnight stay, she is sent home and told to “wait it out” as it is assumed to just be a 100 times nastier than normal flare up of her incurable condition – no in depth testing has been done, the pain is still not under control and the woman in question can barely walk let alone speak up for herself as she’s pushed out the automatic doors with no real help and told to see her GP in the morning, all so the hospital can make room for someone “who really needs the bed”.
  
  

After visualising both of those scenarios can you see the difference between the two? The differences between the tests that were done and the treatments that were given? In how both patients are cared for and the results that both received? In when and how they went home?

The man received better treatment, his pain with an unknown cause was taken much more seriously and given top priority to find out what was wrong, and he was given adequate pain relief and left the hospital with the pain in control and a plan in place.

The woman wasn’t given adequate treatment, was given inadequate pain relief, was brushed off and mostly ignored, and, potentially even more dangerously, her pain was solely attributed to a pre-existing condition with only minimal investigation done - what if it had been her appendix getting ready to burst? Or what if part of her bowel that wasn’t visible on ultrasound had ruptured? Or what if her fallopian tube and ovary had twisted right behind her uterus where it can’t be seen clearly and had gone into torsion which can result in the loss of an ovary if it isn’t picked up in less than 6 hours of onset and can be deadly if it is left untreated? All of these are valid concerns but sadly a lot of them are brushed off and ignored if there isn’t anything visible on an ultrasound or if the symptoms don’t exactly match what most doctors have been trained to recognise.

If you can’t tell already I’ll explain this now – there is HUGE inequality between how men and women (and this is not even going into how those who don’t associate as either are often treated!) are treated when it comes to the quality of the medical care given to them.

In some ways - and some places - we are still very much in the dark ages with how women experiencing reproductive, lower abdominal and pelvic issues are treated in hospital settings. This is not to say that there aren’t some wonderful care providers out there because there are, I’ve personally met some of them, but they are few and far in between and the chances of one of them being on duty when you end up in hospital are really slim.
You may think that these are just random scenarios created in the fertile darkness of my crazy mind but I must sadly inform you right now that this isn’t the case.

These scenarios are both based on very true stories – the inspiration for the man’s scenario came from a combination of my own husband’s experience and the experiences of random men who have shared their stories online, the woman’s scenario actually happened only this past week, and the woman’s scenario is also, I am very sad to report, the real life outcome that happens to hundreds of women every single day all around Australia.

When I randomly questioned a group of women (some who have children and some who don’t have children, some with a painful health condition and some without any known conditions at all) about the two scenarios above the answers were empathetic towards the woman’s scenario and many shared their own experiences.

• W- “It is like you have written the experiences of myself and my husband”
  
  
• Another, Anonymous, responded with – “The world is sexist as if a man says he is in pain he is surrounded by help but a woman has pain she is told to deal with it.”
  
  
• P says – “It's BECAUSE pain associated with women's reproductive organs is accepted as "normal".
  
  
• From B – “I'm a part of a huge Perth group and I honestly just saw a story like this on there, but it was a mental health thing. They kept the person in overnight but then said they assessed her and she wasn't deemed worthy of a bed and was discharged even though she went in with suicidal tenancies - yet someone else (male) posted their experiences with the same hospital in the same mental health unit and couldn't stop praising the hospital saying how great they were for him and how they must have been leaving something out for them to have kicked her out. Yet, when copious amounts of other women came along and said they experienced the same thing, said male 'joked' that men have it harder anyways which is why they're better looked after.
  I know it's not the same thing but in some aspects is because it shows that there are some discrepancies in care.
  I have seen this before myself and been a part of it. A few years ago, I presented to the ED with chest pains and numbness down my arm. I got taken in 2 hours later, put on an ECG machine and monitored for an hour maybe 2 before told I could go home. Given pills for the pain and dizziness I was feeling at the time too. Nothing worked and I felt so horrible and tired that while on the ECG machine, I fell asleep. Next morning, woke up and felt horrible and the pain wasn't gone but dulled down.
  A couple years later, XH goes to hospital with exactly the same as what I was feeling and ended up staying overnight and having all tests run on him under the sun (Luckily they did cause they found gall stones but still) and I remember just saying to him that he was get preferential treatment cause he was a male - little did I know how true it actually felt.”
  
  

Every single day in Australia women are treated as second class patients compared to their male counterparts and have their pain ignored, they are told to “suck it up”, that pain is “normal” (pain is not “normal”, even the scientific literature agrees that pain isn’t “normal” and is a symptom of an underlying issue that needs to be treated) and that we just need to live with it, to go and see a psychologist or therapist because it’s “all in our heads” and if we “fix our heads” the pain will “go away” (it won’t, physical pain can’t just be stopped by a psychologist or therapy, it needs adequate physical medical treatment and pain relief as well and even then it may not be “fixed”).
What can you do to change this? There are several things and I’ll outline them below.

• Contact your local members for parliament. By sending your local members for parliament letters outlining your anger at how women are treated in the healthcare system you can help to promote more awareness by making them aware. Not all of them will respond or take it seriously, but some will take action on it.
  
  
• If you or someone you know has been on the receiving end of this sort of treatment lodge a complaint with your local hospital. While most of the time you’ll only get a generic apology letter it is known that the more times that complaints are made, and the more people who kick up a huge stink about how they have been treated, the more that problems are taken seriously and the better the treatment will be for similar scenarios in the future.
  
  
• If you or someone you know are currently being treated inadequately in a hospital setting and located in QLD you can call 13HEALTH and quote “Ryan’s Rule” (you can find the details of Ryan’s Rule here - https://www.health.qld.gov.au/cairns_hinterland/html/ryan-home)
  
  
• If a specific doctor has treated you or someone you know like this you can lodge a complaint with the Medical Board (http://www.medicalboard.gov.au/~/link.aspx?_id=60F806737FE14B28AF314FB306B4BFBE&_z=z) and also with the Australian Medical Association (https://ama.com.au/tas/health-complaints)
  
  
• Share awareness amongst your friends, family and anyone else who will listen. Many won’t be interested and some may even ridicule you but there will be people who are receptive to what you have to say and will listen and take action themselves.
  
  
• Continue to advocate for yourself and those who rely on you for their care. If you don’t advocate for yourself you can’t change how you are treated. As part of advocating for yourself you can ban any practitioner from treating you or being in charge of your care and can request another practitioner if needed. You have the right to receive the best healthcare and treatment possible (and also to refuse any healthcare that you don’t want to have). The more people who advocate for better healthcare for themselves and others the more that Australia’s care providers will see how much people aren’t willing to put up with substandard treatment.
  
  

Lastly I want to say this – in order for the treatment of women in the healthcare system to be improved those who are in charge of our care need to be taught that we women are equal to and just as deserving of high quality medical treatment as our male counterparts who are also patients. They need to learn that our pain is real, that it exists physically and that a lack of adequate treatment is not only detrimental to our health and well-being (as women) but also to that of our families and friends too. Care providers need to take our pain seriously and provide adequate pain relief (not just minimal pain relief) and need to be educated on the various diseases and conditions that can cause it – not just the basic information from one paragraph in a medical text book but actual first hand information provided by a specialist in that particular field. They also need to respect us not only as fellow human beings but also as people who are intelligent, educated, able to recognise when something is wrong with our own bodies (it is our body after all and no one knows it better than ourselves) and able to make informed, intelligent and needed decisions for ourselves without being coerced, manipulated, forced or scared through fear mongering into making a decision that we otherwise wouldn’t make.

Recently I saw a question on a pregnancy and parenting page asking about being induced at 37 weeks for a “Big Baby” (estimated to be around 9ish pounds/4-4.5kg by 40 weeks). This particular mum-to-be didn’t feel comfortable with being induced then, and did say that, but was seeking advice and support that it was the right thing to do.
I did what I usually do, I advised of the risks, the benefits, that the estimated weight was not “Big” at all and many women birth babies even bigger than that vaginally and after spontaneous labour with no issues at all, and reassured the mum-to-be to follow her heart – in that if it didn’t feel right then tell her doctor that she didn’t want to be induced and would wait until baby decided to arrive on his/her own.

This kind of question is becoming more and more common these days, women being told they are having “Big Babies” estimated to be between 9 and 10pd (which isn’t “big” as such, it is just another variation of normal size) and will be induced between 37 and 38 weeks gestation because of that. These women are apparently not being given any choice in the matter, they are being told it WILL happen, that they NEED to be induced as if they don’t their baby will get stuck (shoulder dystocia) and die because it is too big to be born vaginally.

For the record, this is not evidence based medical practice, this is fear mongering and scare tactics and outright lying by medical professionals in order to get an expectant mother to do what THEY want her to do. A 9-10pd baby is not big, 11+ pounds is “big”. 9-13pd babies are born all around the world all the time without any issues when the mother is able to move around in whatever way she finds comfortable and as a result assist the baby in manoeuvring through the birth canal. In these cases there is no respect for a mother’s decision making, no allowing the woman’s body to do what it was made to do, preventing the natural physiological process of birth from occurring when the time is truly right and making women around the world afraid of a natural body process. To add to this a small baby is just as likely to get stuck as a larger baby if baby’s position and mothers position while birthing are not ideal. There are ways to prevent it and to reduce the chances of it happening, and early induction is not one of them and has a higher chance of shoulder dystocia by preventing the mother from adopting natural birthing positions due to the CTG monitoring and in many cases an epidural as well when the induced contractions become too much for the mother to bare and increasing the chances of baby being malpositioned when artificial rupture of the membranes (amniotic sac) is done as part of the standard practice of induction, traumatic physical and emotional intervention with the use of ventouse (vacuum), episiotomy, forceps and physical pressure on the mothers abdomen, and fetal distress from the induction itself resulting in either the above mentioned interventions or an emergency cesarean occurring.

But what I've mentioned just above is not what prompted this blog post. What prompted this is the lack of up to date knowledge in obstetricians and other mothers who were “fans” of this particular page and answered this particular question.
These “fans” were promoting induction at 37 weeks with no major risk factors or true need, stating that it was “term” and “baby would be fine”. This information is incorrect, not only have the WHO and ACoG, within the last 12 months, updated their guidelines of when “term”, “full term” and “post dates” are, but an induction at 37 weeks for no reason other than an ultrasound weight estimate (proven to be inaccurate in the majority of cases) shows that baby is measuring larger than average. The new guidelines state that “term” is now from 39 weeks to 39+6 weeks after recent research showing that a lot of important brain development occurs in-utero between 37 and 39 weeks and babies who stay in longer have less physical issues than babies born before 39 weeks gestations (eg feeding issues, regulating of body temperature issues etc), “full term” is now from 40 weeks to 42 weeks gestation, and “post dates” is now from 42+1 weeks onwards.

What does this mean for pregnancy and birth and going past 41 weeks gestation? Well frankly it means that every woman should now have a much higher chance of being able to go into labour naturally when their baby and body are really ready without the need to be induced, whether it is at 37 weeks that their baby decides that he or she is ready, or at 43 weeks, AS LONG AS all obstetricians and doctors follow the ACoG and WHO guidelines, which unfortunately for all of us women is not the case. Sadly most obstetricians and doctors do not follow these guidelines, they follow their own guidelines and the hospitals outdated policies on “management” of pregnancy and labour. And “management” it is, they are “managing” us like animals, inducing when they want, cutting us open when they want, giving us medication when they want, telling us what we can and can’t do, scaring us and putting the fear of death into us, only telling us what they want us to know and not what we need to know, essentially taking away our basic human rights and preventing us from making our own truly informed choices and decisions by not providing all of the information and only telling us what they want us to hear.
There are of course exceptions to this, there are some wonderful and truly amazing obstetricians and doctors out there who treat women with respect and dignity that they deserve and do everything that they can to inform women of ALL of the risks and benefits, accept a woman’s choices without trying to change her mind, support her unconditionally in those choices and go out of their way to try and give the woman the birth that she desires. They are few and far between, a dozen or so in every state, a few hundred or so in every country out of a hundred thousand or more obstetricians and doctors around the world that are trained in high risk pregnancy and birth.

“So what?” You might say, “They are trained in pregnancy and birth, they know what they are doing.” Yes, they are trained, in “HIGH RISK” pregnancy and birth, the types of pregnancies that might be dangerous for mum and/or baby. They are NOT trained in natural physiological childbirth, they are not trained in the kind of birth that does not need drugs to make it start, that does not need intervention or constant monitoring, that does not result in a mother on her back in a bed unable or "not allowed" to get up and move around and physically help her baby to get into a better position for birth, they are not trained in allowing a woman’s body to do what it was made to do and treat every woman the same as if they have the same risks as every other woman. Every woman, every body and every baby are different with different risks and different needs, we do not all fit into same mold (eg not everyone has a 12 hour or less labour just as not every woman has a very long 55+ hour labour), but obstetricians and doctors are trained to fit everyone into the same mold with the same risks regardless our own individual risk factors, body shapes, histories, abilities and needs.

How can we change this? How can we make pregnancy and birth an individual thing again? How can we make obstetricians treat us with the respect and dignity that we deserve? How can we make them respect our decisions and choices without trying to scare us or bully us into what they want us to do? The answer is that every woman and every man must make the decision to stand up for themselves and their partner, to say NO, to make obstetricians and doctors understand that it is NOT a medical professionals or hospitals decision to make on when a baby comes into the world, to make obstetricians and doctors stop scaring women with generalised risks and outright lies, to make the maternity system in whatever country you live in stop and listen and change its policies for the benefit of ALL women, to make pregnancy and birth about the woman once again and not about the medical side of things. Women everywhere need to take their bodies back, to make sure that everyone knows that SHE makes the decisions regarding HER body and HER baby, and that hospitals, obstetricians and doctors are NOT the ones to make the decisions. Even in a life or death situation the mother has the right to decide what is to be done and should be given the chance to do so, even if there is only a minute available for her to make that decision that will affect her and her family for the rest of their lives, she should be the one to decide, not someone else who doesn’t have to live with the consequences.

So there you have it. We live in a medicalised world that is slowly trying to remove all natural bodily autonomy from women, that is trying to stop women from being able to choose if she has an induction or cesarean or waits until her baby and body decide that it is the right time, a world where women are being scared and bullied into inductions and cesareans instead of being given the right information and support to make a truly informed decision over their bodies and method of birth, a world where women are ridiculed for their decisions, denied good care, denied the right support that they need and are traumatised on a regular basis when they are in the most vulnerable state and position.

Can you imagine a world where women are supported personally in a way that fits their individual needs and wants and are empowered in the process? Can you see a world where a woman is able to choose whenever she wants if she has a home birth, an unassisted birth, a hospital birth, an induction or a cesarean without being judged, ridiculed or traumatised in the process? Where she is truly informed about the risks and benefits of every procedure instead of only informed that  the medical professional feels is all she needs to know? Where she can birth however she wants without being lied to or scared by medical professionals? Where she can trust those who are caring for her and supporting her to give her the power to make her own decisions regardless of where she lives, her body shape, her previous history, or what she looks like? I can, I can see that world, our world can become that world. If we all worked together to make changes, if we all supported one another in our individual decisions regardless of what they are, we can create that world and make it ours.

Jenna Edgley
Student Birth Doula
Placenta Encapsulator
FOOTPRINTS & RAINBOWS

Time and time again I see on the pregnancy and parenting boards and facebook groups women saying the same things; "My doctor won't allow me to do this", "my doctor won't allow me to do that" "my doctor will allow me to dilate at x amount an hour before doing a cesarean section", "my doctor says it is too dangerous for me to do this" etc, etc, etc.

When did we lose our faith in ourselves and our bodies to do things naturally? It seems like every year more and more women are putting their minds into the control of doctors and other medical personel and not thinking for themselves. It stinks of mental abuse.

Some of you who read this may think that I am going a bit too far in linking mental abuse with how we are treated by doctors, but the fact is that that is what is happening. Women are losing control over what they wish to do during labour and pregnancy. We are told that we CANNOT put on more than a set amount of weight, and if we do put on more than that set amount we are made to feel bad about it and put on a "pregnancy diet" to stop us from gaining any more weight.
We are told that we HAVE to dilate a certain amount each hour - and if we don't dilate that much we become disheartened and feel like we have failed, that our bodies do not work, when in actual fact our bodies DO work, but not to any doctors schedule, they work to their own schedule and just as we drag our feet and try to avoid something that we don't like our uterus behaves in the same way - if something isn't right, or we are afraid, or we haven't had anything to eat or drink our uterus will slow down, clamp up and not work as fast or as effectively as it could. And when the uterus slows down interventions are brought into play - breaking the amniotic sac, starting a pitocin drip, or mum is labeled as "failure to progress" and a cesarean section is done, which makes more risk for any future pregnancies and births.

Don't get me wrong, there is a time and a place for a cesarean section and other interventions, but they should only be used when there is no other option and mother and/or baby will become compromised or will die.

What gets my hackles up is that as a general rule in any hospital or medical setting we are no longer able to make our own decisions in regards to how we treat ourselves during pregnancy, in how we labour and how we birth our babies without fighting for it. We are told that we cannot do this and cannot do that. We are controlled and forced into a averaged block of women who deliver their babies within 12-24 hours and if we take longer than that to deliver we are labelled and effectively told our bodies have failed and do not know what they have to do in order to deliver a baby. We are treated like animals, pushed into one thing after another, in many cases our objections are ignored and we are not listened to at all. In other cases women are physically held down on the bed to labour on their backs.

Some of you may think that these things I have mentioned are a part of history from the 1950's and 1960's and even earlier than that, but the reality is that they are still happening today 50 and 60+ years later. Women are still being treated like this, some women are having drugs injected into them without ever having given consent, or they consent to having one pain relieving drug and are given another one instead at the doctor's orders. That can't be true you say? It is, I am one of those women who were given another drug instead of the one requested. I asked for Pethideine and was given Terbutaline instead, at 40 weeks and 2 days pregnant, all because the obstetrician on call didn't feel comfortable dealing with a VBAC delivery. I didn't find out about the Terbutaline until my youngest child was 2 days old when the paediatrician went through my notes with me to see if something had happened during labour that could have contributed to her post birth issues and low apgar scores, to say I was shocked was an understatement. it was just one more thing that made me angry and contributed to my post natal depression.

What happened to me is not a rare ocurrance, it is very, very common. Recently I saw a post by another lady on a pregnancy and parenting forum about the same doctor who did this to me. This same doctor contributed to the death of her baby in-utero by not providing the care he was supposed to. Between 34 and 39 week this doctor refused to see this woman and told her to just see the midwives. By the time he finally saw the woman after being called down to the emergency department when she was 39 weeks it was too late and the baby was stillborn.

Doctors like this are very common, they are in every hospital around the world and you won't know if you are seeing one until push comes to shove and your requests are ignored or you are given the "fear tactics" spiel about the risks you will take etc.


So take control of your body and your pregnancy and labour. Ask questions, say no, don't let others do things to you just because they can. YOU ARE IN CHARGE, not them!

Jenna
Student Birth Doula
FOOTPRINTS & RAINBOWS Birth Doula Services