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Why does it matter where and how women give birth?

Bashi shares her story of her two caesarean births and her VBAC2 to an auditorium full of midwives at the University of Western Sydney's Place of Birth Conference held at Westmead Hospital.

Thank you.  It is an absolute privilege to be with you today.  I am standing here before you because, in September last year, something remarkable happened to our family, something I am very eager to share with you today.  After 2 so-called emergency caesarians at one of Sydney’s premier private hospitals, I had a baby who weighed more than 4 kgs, naturally, and without intervention, with the help and exceptional care of my private midwives.  In obstetric parlance, I am now known as a successful VBAC2.  I defied the odds given to me by a number of doubting obstetricians just months before.  Never again will an obstetrician tell me that I am unlikely to go into labour or to give birth naturally because I am too small or my baby is too big or because I do not fit into her dogma of what constitutes “normal”.

Bashi and Family
 Bashi and her three beautiful children

But that was not the most remarkable thing about the birth of my beautiful little baby.  The most remarkable thing about Baby Connor’s birth is that, without our even knowing or hoping, the pregnancy and birth helped me and my family heal from the pain and trauma of those previous caesareans.  It put an end to my 7 year long battle with post natal depression and its devastating impact on my marriage, my children and my career.  This birth has changed the course of my life and that of my children’s future, in particular, my daughter, forever.

I have since wanted to tell my story to anyone who will even spare me a minute of their time.  I think some of my girlfriends are secretly hoping that my speech will give them all a well deserved break as I have been pounding their ears about my wonderful midwives for some months now!  But for those of us who have experienced even part of what I am about to tell you, the talking has only just begun.  So many of us have endured this pain and trauma in silence and in shame.  We feel shame because somehow, despite having no control or real support through the process of birth in a hospitals, we are often told that the outcome is  either our fault or due to a problem with our bodies.  And there are simply thousands of us – you will find them on the internet, all trying to ease their pain by sharing their stories in silence. The stories are disconcertingly similar; a trusting new mother, a hospital, a bullying obstetrician, use of drugs and technology in place of gentle touch or attentive care, and a labouring woman at the centre, confused and punch drunk from the negativity, disrespect, and alienation she is facing during one of the most intimate, vulnerable episodes of her life. These stories talk of marital breakdown, post-traumatic stress disorder, post-natal depression, isolation, shame, anger, a fear of childbirth and hospitals, and most concerning – an enduring inability to bond with or care for their children.  This is modern obstetrics at its best.

Seven years ago, before I had a child, it never occurred to me that my chosen place of birth and caregiver would so profoundly change my life, for good.   After all, this is Australia, where the equal, legal rights of women are enshrined in law. Having come from a medical family, I expected the medical profession to lead the charge on such a front.  More importantly, I assumed that a fundamental aspect of modern obstetrics is a sophisticated understanding of the delicate emotional state of a pregnant woman, particularly during labour, and the implementation of systems of care aimed at fostering and protecting that emotional state.  The result – superior care for mother and baby  - is, after all, a hallmark of a civilised society.

This is one of the reasons I believe that so many new mothers flock to private hospitals and engage private obstetricians.  We are told that continuity in care is only available through a private obstetrician and that a private hospital is best equipped to handle pregnancy, birth and postnatal care, and to promote mother-baby friendly initiatives.  This is what my obstetrician told me when I first went engaged her services.

Having tried them all; obstetricians, private and public hospitals, and a private midwife, in my experience, nothing could be further from the truth.   For my last pregnancy, I engaged a private obstetrician through a public hospital, and a private midwife concurrently.  I was in an unique position to compare the services I received from both ends of the spectrum.  It is my humble view that hospitals and obstetric care don’t even begin to compare with the care that a private midwife can offer.

So how did I go from one end of the spectrum – the private hospital, to the other end of the spectrum – the private midwife?  It was a long and arduous journey and, in truth, my hand was really forced by the care I received for my first 2 pregnancies.

I began my journey into parenthood as innocently as any new mother.  My GP recommended a private obstetrician.  I had never heard of a private midwife.  I assumed everyone gave birth in a hospital.  I accepted her advice.  Aside from an early period of hyperemesis, I really enjoyed a healthy pregnancy.  I was young, fit and healthy, didn't drink or smoke, the baby was healthy and developing well, my blood pressure was very good, and I suffered no complications throughout the pregnancy.   My body responded immediately and well to good food, gentle exercise and sleep.  I found myself, like so many pregnant women, drawn to understanding and nurturing my body with natural, healthy practices, developing good habits that have stayed with me to this day and to the benefit of my children.  I enjoyed it and I soon felt my baby’s pleasure and well-being as well.  It was a really special time.

Unfortunately, my obstetrician didn’t share my confidence.  She seemed able, in the brief 15 minutes that she spent with me every few weeks, to anticipate or burden me with information about everything that could possibly go wrong with the pregnancy.  I am sure she thought she was being very thorough, but there was really nothing wrong with me and I knew that.  I began to leave every appointment with this growing anxiety, worrying about whether I would even make it through the pregnancy, yet utterly ignorant of what I could do to help myself or improve my circumstances.  As the frequency of the visits increased, so too the anxiety that we experienced between us!  For instance, we never really discussed my diet or good eating habits, yet I was weighed at every visit to see if I was too fat, or too thin or possibly diabetic.  I was told to do a battery of tests without any discussion of their purpose.  When I asked about them, I was simply told that we would discuss the results if a problem arose.  And my obstetrician seemed to look very hard for problems, even where they didn’t exist.  She was particularly concerned with the size of my feet and my height, my husband’s size and weight, but she didn't explain why until after my baby was born.  We never talked about my birthing preferences or plans.  When I asked about labour and birth, I was told it all depended on how I coped with labour, but she actively avoided any open discussion about what was involved.  She suggested I attend the hospital birthing classes but warned that they placed too much emphasis on natural birth.  In the last 6 weeks of the pregnancy, I received constant comments about the small size of my feet and its possible correlation with my pelvis, the large size of the baby’s head, concern that the baby’s head had not engaged because first babies “nearly always engage before labour”, followed by comments that I may be unlikely to go into labour “in time” or at all.

As the days went on, I felt that I was being pushed in a direction that I did not want to go, although this was never openly discussed with me.  The appointments were so rushed, I decided to call the hospital instead and talk to someone in the labour ward.   The midwife I spoke to was reluctant to talk, and sent me back to my obstetrician.  I tried to ask my GP, but she also told me to talk to my obstetrician. 

I began to feel really isolated, so I asked my husband to come with me for the second last appointment, at which time my obstetrician again noted that the baby’s head had not engaged and that I was unlikely to go into labour.  We were also regaled with the statistics on stillbirth after the 39th week of pregnancy.   We were then offered a solution; an induction and her confidence that it would greatly increase my chances of delivering naturally, provided we did so before the baby got any bigger.  I still resisted, but we were booked in with the hospital just in case we changed our minds as it was a “busy time of year”.

In the days that followed, I received a phone call from a midwife at the hospital nearly everyday, telling me that I was expected for an induction.  I had not yet reached 40 weeks, I was feeling fine and experiencing plenty of Braxton-Hicks types sensations.   Finally, my obstetrician rang me and strongly repeated her advice, insisting that we would be safest, even if I was to go into labour naturally, in a hospital setting.

The induction was put to us as a matter of convenience – to speed up labour and to ensure a natural birth.  We had no idea what was involved.  I didn’t know, and certainly wasn’t told, that an induction would involve breaking my waters so there was no turning back.  That if the induction failed, I would have to have a caesarean.  That there were known side effects with the use of syntocinon, including fetal distress.  That the pain would be so great, that I would be completely unprepared for it and more likely to ask for an epidural.  That an epidural could slow the labour, increase the likelihood that the baby and I would become very tired, and therefore increase the chances of fetal distress.

The pressure was too great, and in my ignorance, I relented, thinking I could always change my mind.  I cannot tell you how much I regret that, even to this day.  The day of the induction began quietly enough: my waters were broken and a drip was administered.  I was put on a monitor, and left alone for several hours.  I felt some contractions but they seemed relatively mild.  We tried to ask someone but it seemed everyone was too busy to even stop and check.  I remember playing cards, thinking this whole labour pain thing was rather overrated!  Suddenly, in the late afternoon, a midwife came tearing into the room to check on the drip and confirm that it was not working properly.  She quickly raised the dose, telling us we had some catching up to do.  The effect was immediate and overwhelming.  The pain became excruciating and I felt suddenly nauseous.  The midwife said to my husband, “She can’t take the pain”, as if I wasn’t even there.   She then offered me some gas, which I took before throwing up.  I hadn’t had anything to eat or drink for hours and I felt exhausted.  As the vomiting got worse, I became distressed.  My midwife had left the room after the gas incident without really saying anything, and we never saw her again. 

A short time later, I heard someone call out “Last chance for an epidural before I go home.”  Of course, I gratefully accepted.  Before I knew it, I had been strapped to a bed and put on a monitor.  I began to shake and throw up repeatedly.  Shortly after that, my obstetrician came marching into the room.  My husband and I were told that the monitor was showing signs of fetal distress.  According to my obstetrician, my baby couldn’t cope with labour and I needed to consider a caesarean.  I was shocked.  What had just happened?  How had it come this?  Can we just stop this, I asked.  Yes, but since my waters were broken, it would not be safe to let me go home or leave things for more than 24 hours, so I really needed to make a decision now.  My obstetrician then spoke separately to my husband and expressed her concerns for the safety of the baby.

Fathers have become the latest weapon of choice in modern obstetrics.  Raised on a diet of Hollywood style dramatic births, it doesn’t take much to infuse them with fear and panic.  The less fathers know, the better they become at being cannon fodder in the hands of an obstetrician with a resistant client.  “If you knew what I knew about vaginal birth, you wouldn’t even be contemplating putting the baby through this”, said my obstetrician.  What happened next has proven to be the greatest test to our marriage and the absolute trust that my husband and I once shared.  He appealed to me to think about our baby and, in that instant, gave voice to the fear that seemed to occupy everyone in the room except me: that I was not capable of acting in my baby’s, my own flesh and blood’s, interests.  It broke me.  I gave in, signing that form like a guilty criminal expressing contrition. 

Worse was to come.  As soon as I signed that form, the atmosphere in the room lifted.  I suddenly received more hospital assistance in preparation for the caesarean than I had during all those hours of labour.  This was a well-oiled machine, poised for operation, easily kick started by a simple consent form, even if signed in distress.  The sense of urgency and concern that had been oppressing me until then simply disappeared.  Of course, I didn’t know that once the syntocinon had been turned off, there was no fetal distress and so there was no emergency.  At this point, it was all about convenience, for my obstetrician and for the hospital, but not for me.

It took 2 hours to get to theatre.  Hospital attendants joked about the 6pm queue into theatre as if I wasn’t even there.  I felt just like one of those cows on the conveyor belts being shipped into Jakarta – alone, terrified, bewildered and in shock. 

As I lay there sobbing, vomiting and shaking, I was cut open and my baby removed.  Outwardly, I tried to put on a brave face.  Inside, I was screaming – I don’t want this, why is this happening to me?  I desperately wanted to just run away.  I kept telling myself that I had to do this – I was saving my baby.  We soon discovered that my baby was small – a 3.1 kg baby, with an APGAR score of 9:10.  So much for a big baby and so much for fetal distress.  I was only then told that it was too cold for the baby in theatre and that he was being taken back to the ward.  After a brief touch of the cheek, my baby and my husband were led out of theatre.  So much for skin to skin contact.  As hospital staff dragged and flopped my limp, naked body from one cold slab to another, and wheeled me out of surgery, I felt this horrible sensation in my body.  It was as if someone had drained all the blood out of me.  I felt faint and became desperate to see my baby, to be with him, to hold him, but I was told to be quiet and considerate in recovery.  It was more than 2 hours before I saw him and by then, he was fast asleep.  My baby was then rudely awoken and shoved against my breast, as he screamed in protest. He had a strong neck and he fought back, the brave little soul.  I was unable to sit up and hold him or just soothe him.  I felt so helpless and useless!  That initial struggle proved impossible to overcome, even after 18 months of nursing, and served as a constant, daily reminder of that first terrible introduction, for both of us. 

My husband was blissfully unaware of the way I was feeling.  My obstetrician had told him that, with a little pain relief, there was no reason why I couldn’t recover from what she referred to as a “straightforward procedure”.  There was, apparently, no difference between the major operation I had endured and a natural birth.

There was nothing straightforward about the impact this surgery had on me.  The pain was difficult enough to manage on its own, let alone with a newborn and my shattered emotional state.  We found ourselves constantly battling busy midwives who either forgot or who provided us with the wrong medication.  Alone at home, every effort to lift or feed the baby came with pain – I soon found myself avoiding holding or cuddling my baby unless I absolutely had to. 

I also couldn’t shake the fear and panic that had been imprinted into me at hospital.  I began to imagine all sorts of terrible things happening to me or the baby, leaving me helpless to protect him.   This got worse over time, not better.  I began avoiding situations where I felt out of control.  I stopped leaving the house.  I lost touch with family and friends.  I gave up my job.

I tried to speak out about what was happening to me soon after the birth but I was quickly shut down.  “You’ll be fine”, said the lactation consultant at the hospital, “Think how lucky you are that your baby was alive and well.”  At our 6 week appointment, I was told that my body had let me down, it had failed to respond to a fairly standard induction treatment.  I tried to tell myself that this was part and parcel of having a baby and that I was no different to anyone else, but it simply didn’t work.  No matter how hard I tried, I couldn’t understand or accept what had happened to me.

By the end of my baby’s first year, I had been diagnosed with severe post natal depression and my marriage had disintegrated.  I was told that I was having trouble adjusting to motherhood, which simply wasn’t true.  I loved being a mum, I just never felt well enough to enjoy it.  I found the attitude of mental health professionals quite confronting as well – most simply shrugged their shoulders, offered me medication and told me to move on. 

Three years later, not long after we had heard about VBACs, my husband and I decided to have another child.  I contacted my obstetrician and informed her that I was going to have a VBAC.  I assumed that she would advise against it and at least give me my medical notes so we could find someone else.  To my surprise, she offered to manage the pregnancy and to help me achieve a VBAC.  The hyperemesis was worse this time, and I had a toddler to care for, so I accepted, thinking that I could stand up for myself this time. 

As I recovered from the hyperemesis, I began to realise it was just more of the same.  Somehow, I had gone from engaging her services to her “allowing” me to attempt a VBAC.  I became very anxious about the labour, so I hired a doula.  My obstetrician wasn’t happy about that, but she conceded because she didn’t expect me to even go into labour.  

I went into labour on my due date.  In the peace and comfort of my home, with my husband and doula, I enjoyed a most wonderful few hours of labour.

The minute we arrived at hospital, however, everything started to go wrong.  I was referred to as the “trial by scar”; no one even bothered to ask for my name.  Then began the continuous battle with hospital staff, both during and between contractions.  There was a fight over whether I needed a cannula, whether I should be constantly monitored, whether I had to lie strapped to a bed, whether the lights needed to stay on.  No one spoke for me, not even my midwife.  I had to concentrate, even through contractions, on responding to the constant interruptions.  There was the same sense of anxiety and panic, and it really distressed me.  At some point, I felt the need to push and my obstetrician arrived.  I was made to leave the shower, which I was enjoying, dry off and submit to yet another examination, in preparation for my obstetrician.  All the lights went on, and I heard people chatting and joking loudly, as if I didn’t even exist.  From the attention she received, you would be forgiven for thinking my obstetrician was the paying client, and not me.  As I was being examined, my waters broke.  Then, the labour just ground to a halt.  It was as if I had been rudely awoken from a wonderful dream.  I looked up, blinking with the bright lights around me, suddenly aware that a number of people were standing over me, shaking their heads in pity.   

To our amazement, no one seemed to know what had happened or what to do next.  My obstetrician quickly resumed her initial diagnosis – that my body was incapable of labouring and delivering a baby naturally.  She accused the midwife of making a mistake, she told me I had dilated to 7cms (which is where I got to with the induction) and that she didn’t think I would progress without help.  She suggested an epidural and syntocinon to get through the last few centimetres quickly.  It wasn’t long before I was tied down with drips and monitors, wrapped up and left to contemplate that looming caesarean.  I was “given” the extra time it took for my obstetrician to make her morning rounds.  That message didn’t get through to my baby, because she immediately showed signs of fetal distress.  I cannot begin to explain how stressful it is to lie there, hoping against hope for a change in my fortunes, wondering how I was going to cope with the challenges to come.  And as I lay there sobbing, waiting for my obstetrician to return, midwives would storm into the room, check the monitor and glare at me accusingly before storming off again. 

I finally called my husband over and bitterly conceded to a caesarean.  I don’t remember much after that.  I closed my eyes so I wouldn’t have to see anyone.  I remember thinking about my grandmother and how much I longed to see her.  As soon as I heard my baby’s newborn cry, I felt that familiar sensation of completely running out of energy.  I didn’t care that it was hours before I saw my baby.  I didn’t try to feed her because she was already fast asleep.  I couldn’t even hold her, and I was told she couldn’t lie in my bed with me, so she lay alone, wrapped up in a plastic basinette.  I sent my husband home to see our toddler and, finally, as soon as I was alone, allowed myself to cry and cry and cry some more.  All around me, I could hear people talking, hospital announcements and the noise of machines, but thankfully no one heard me and no one bothered to check on me.  I was hungry and thirsty, I hadn’t had anything for almost 48 hours but no one even stopped to ask. 

Late that night, I awoke parched, sweating profusely and lying uncomfortably in a pool of blood and faeces.  I still couldn’t move, so I called for a nurse.  No one came.  Half an hour later, I called again.  This time, a nurse arrived to yell at me for calling twice.  She told me that I could stay as I was till morning and brought me a cup of water, which she left by the bed.  I couldn’t lift myself up to get the water and I was too afraid to call for help again, so I lay there till I eventually fell asleep again.

In the morning, a trainee nurse walked into my room and said something about  having to get up and walk.  I barely heard her.  I pulled the covers over my head and pretended I wasn’t there.  She stood there for a few minutes and then left.  I didn’t see anyone until my husband arrived in the afternoon.  He was furious at the state I was in.  My obstetrician was called in.  She tried to speak to me and seemed genuinely surprised by my physical and mental state.  Hospital staff had nothing to do with me.  The only thing my obstetrician could manage during our 5 days in hospital was to refer me to the hospital’s post-natal depression unit.  It took this specialist 5 days to get to me, and even the hospital couldn’t wait that long – I was discharged, and told to wait outside my room to see her.  When she arrived, the only thing she could offer me was a few more phone numbers and the promise of a follow up phone call.  In the days and months that followed, I stayed acutely depressed, contemplated suicide and separated from my husband.  We were a mess.  We had been chewed up and spat out by a hospital system that lacked the facilities to recognise, let alone accommodate, the trauma that had been inflicted upon us.  So this is the gold standard of private hospital care – where babies are pulled out as quickly as possible, and healthy, happy mothers are cut open, emotionally shattered and sent packing with a smile.

Enough is enough, we said.  Never again.  We had an enormous amount on our plate – illnesses we had never before encountered, including post-traumatic stress disorder, marital breakdown and 2 young children who were depending on their broken, emotionally shattered parents to get it together.  Whatever happened to the Hypocrathic oath – physician, first do no harm?

Then came Baby Connor.  A surprise, and a blessing.  The pregnancy proved to be a real challenge.   I struggled with hyperemesis and the care of 2 young children throughout the pregnancy.  I became iron deficient.  I was very tired and my immunities took a beating.  Despite all this, I was determined to find a caregiver that would work for me.  We met with obstetricians and asked about VBACs.  One told me I had a 10% chance of success so I shouldn’t bother, and that he could schedule a caesarean at 39 weeks, before he went on holiday.  Another said he wouldn’t risk a VBAC because I had had post natal depression.  All of them conceded that inducing my first baby, before term, was a mistake, but that the consequences were mine to bear.  I found the dismissive attitude towards the mental health of pregnant women quite distressing.  I was rarely given straight answers to critical questions, like, what is your caesarean rate, or what is your preferred hospital’s caesarean rate or how many VBACs have you handled and how did you manage them?  How does your hospital deal with PND?  I realised, to my surprised, that the obstetricians I interviewed were offended by my approach, as if I was questioning their authority, rather than seeking the best possible care.

I finally found an obstetrician, English trained, honest and empathetic enough to give me some comfort.  I engaged her, but I still wasn’t satisfied.  I knew my obstetrician wouldn’t be there to support me in labour, so I called the public hospital – Royal Women's - and asked some questions about their attitude to VBAC, how much time I would be given, and who would attend to me in labour.  They told me to speak to my obstetrician.  After half an hour of that old buck passing with which I was now very familiar, I had had enough.  I turned to some internet research on VBAC.  This is when I found myself stepping into a whole new world.  I read stories from all over the world.  Stories that told me I wasn’t the only one who had been through that trauma, that it wasn’t my fault, and that others, like me, had been left isolated, punch drunk and struggling to pick up the pieces.   Most telling was the reality that what had happened to me was regarded as a standardised, even systemic, form of widespread abuse being practised in hospitals, in Australia.  I gave this information to my husband who was shaken to his boots.

I also read about women who experienced traumatic births in hospital who then turned to private midwives.   I decided to call a private midwife and talk to her.  This proved to be the first step towards a wonderful journey of learning, empowerment and healing for me.  Everything changed as soon as I started talking to Jane – perhaps because she was the first one who wanted to hear every detail of my birthing history and who was willing to help me make sense of it all.  And boy, did we talk!  She bore the enormous task of not just guiding me towards the preparation of this birth, but also the job of helping me shed my doubts and focus on believing in myself.  No stone was left unturned, no question left unanswered.  The more we talked, the more I remembered, understood and learned.  I read Dr Sarah Buckley’s latest book “Gentle Birth, Gentle Mothering” and realised there was a biological reason for the way I felt after those caesareans.  My body had never been allowed to release the hormones critical to my recovery and well-being.  I learned about labour and how it could be disrupted by fear and anxiety; how it is enhanced by dim lights, peaceful surrounds, gentle touch and calm, supporting voices.  The lessons were also very painful at times.  To know that I had agreed to speed up or force my body into labour, without realising that the syntocinon was causing fetal distress.  To know that my body, if left alone, would have safely and gently delivered my babies and supported my fragile state of mind, instead of the mind bending pain my family has endured for the last 7 years.  To realise that I have been misled by someone I trusted – it was all very hard to take.

At the same time, both my husband and I embraced the incredibly supportive, nurturing and highly involved care of our midwife with a great measure of awe and respect.  A caregiver who wanted to talk in detail about diet, massage, sleep, and exercise?  Who wanted to meet my children, and talk about where and how I wanted to give birth?  Who encouraged a birth plan and then worked through every aspect of it, and discussed possible outcomes and alternatives before I was in labour?  Who spent hours working through my fears and doubts?  Who came to my home, checked over me while I rested and then gave my husband useful tips on how to care for me?  Who , throughout my labour, NEVER LEFT MY SIDE, who held my hand, kept her head and focused on ME, even while hysterical hospital midwives were being abusive and disrespectful, and an obstetrician was carrying on like a petulant child right next to us?  THIS is the gold standard in maternity care that should be offered to all women in this country.

So did I learn anything from my experiences?  Most certainly, I did.  I learnt that there is a vast difference between a natural birth and a caesarean, not just in terms of the immediate physical outcome and recovery, but also in terms of my long term emotional and physical well being, and its corresponding, profound impact on my baby.  Despite this, and if recent statistics are anything to go by, caesareans are still being peddled as routine procedures, which in my view, does not even come close to constituting informed consent, and is a lawsuit waiting to happen.  I have learnt that you can go to a hospital healthy and happy, and be sent home a shattered, damaged mess to cope with a newborn, alone.  I learnt that financial abundance is no indicator of a hospital’s standard of care – like any organisation, abuse and aggression can be so systemic, staff are simply oblivious to it and its damaging effects.  I learnt that despite the alarming rise in pre and post natal depression, our governments and the medical profession have failed to look closely at the causes or to challenge caregivers, or to review and implement changes, for fear of treading on the toes of well financed medical lobby groups.  I have learnt that there is a biological basis for my post-natal depression, and I am walking proof of it.

I am also living proof that the pathological approach of obstetricians is contributing to a rise in caesarean rates and unnecessary interventions.  There was nothing wrong with me until my obstetrician made it so.  Of course, you may say that my 2 so-called emergency caesareans are not statistically significant on their own, but then, neither was my obstetrician’s theories about a small pelvis, the size of my feet and my inability to labour naturally.

I thought I would wrap this up by saying something about homebirths from a social and legal perspective.   The medical profession has, both historically and in recent times, done much to paint homebirth as a fringe-dwelling activity of the socially disenfranchised, who apparently indulge in homebirth regardless of the personal risk or cost.  It seems to me that every public discussion about homebirth turns into a race toward that familiar obstetric stomping ground – the risk of fetal deaths.  Don’t get me wrong – fetal deaths are an important measure of maternity healthcare but the powerfully emotive content of that topic detracts from the other equally important person in the equation – a baby’s mother.  When I hear these debates, I wish I could give people a little insight into my darkest, loneliest and most painful periods soon after my hospital experiences, when I struggled to care for myself, let alone a newborn baby.  It is not a good outcome by any measure. 

The truth is, while everyone thinks they have a right to dictate a woman’s choices in birth, no one considers it their responsibility to pick up the pieces afterwards, particularly when, even with the best of intentions, things go wrong.  In my case, money was not a barrier to seeking help, but we nevertheless struggled to find support that went beyond copious amounts of expensive medication and all of its glorious side effects on my and my babies.  I shudder to think of what would have happened, had we suffered financial hardship as well. 

In my view, this social pressure we are placing on new mothers who already have so much to contend with is just unconscionable.  That we have a medical profession that is knowingly engaging in this conduct and actively seeking public support for it, despite the resistance from women, and despite the alarming rise in negative outcomes, is very concerning indeed.   It is no wonder Australian has one of the highest rates of perinatal depression in the world.

Our laws protect a woman’s right to choose where and in what circumstances she has her baby.  We know how important these laws are.  Women are carers.  When we enhance the autonomy and freedom of a woman, we raise the living standards of her community and her children.   With so much resting on her shoulders, it is vital she is given the information she needs to make an informed choice or to provide informed consent to a procedure that could affect her wellbeing or her ability to care for her family and children.  Anything else is an assault on her and on her family.  It really is as simple as that.

Martin Luther King once said, “Darkness cannot drive out darkness, only light can do that.”  Private midwifery has, in my view, provided that light.  The care I received in my last pregnancy provided me with the understanding and knowledge I needed to express what happened to me as a result of my experiences in hospital.   Our family was finally given the chance and the breathing space we needed to recover, to heal and to bond in ways that was denied to us until now.  I know many, perhaps too many, women who have not been so fortunate.  For that, my gratitude knows no bounds.

Written 16/03/2012

Comments

26 comment(s) on this page. Add your own comment below.

Melissa
Sep 7, 2012 11:48pm [ 1 ]

What an incredible, arduous journey Bashi. Thank you so much for sharing your story.

Judy
Sep 21, 2012 9:15pm [ 2 ]

An incredibly powerful read. I cried and rejoiced with you! Thank you for sharing your story to help others.

Angela
Sep 21, 2012 9:16pm [ 3 ]

Thankyou so much for sharing your storing and promoting natural birth and overcoming birth trauma.

Karin Adams
Sep 22, 2012 8:55am [ 4 ]

This is almost my story too word for word (cept my first was 10/10 apgar and second was forceps) my third was a home water birth and a healing of so many wounds thanks entirely to the trust and support of a very experienced private midwife (Jan Ireland in Melbourne ) whom I will thank for the rest of my life

Jeanette
Sep 22, 2012 6:18pm [ 5 ]

Thank you so much for sharing this clear, detailed and unarguable account of the medicalisation of birth and the trauma it causes. My greatest fear is my own vulnerability at the hands of people who refuse to listen to what I need or help me, and of being further bullied. I also understand the physiological nature of birth, and have chosen to educate and empower myself, which is why I have chosen a private midwife for a home birth (my first child), and am confident that I will receive the best CARE possible in having done so. I sincerely hope that every Australian reads your article, and that it serves to change the face of birth here. Thank you again for your articulate and measured share, and I am so pleased you received the care and healing needed so badly in your third birth. Congratulations

Liv
Sep 22, 2012 9:57pm [ 6 ]

That was so well written! Thank you for putting all your heart and soul into that story. I gave birth at home 9 weeks ago with two midwives and I had a terrible private hospital birth for my first child 3 years ago. I cannot describe how different the two journeys were. Birth with caregivers on your terms is amazing! I'm so pleased you found healing through your VBA2C. You go girl!

Yvette
Sep 30, 2012 7:59pm [ 7 ]

I just keep wondering how we can get doctors and midwives and politians to read and reflect on your story. Thank you Bashi! As a midwife I am ashamed of your treatment, as a third time mum who after two previous vaginal births had to battle a hospital and doctor's and then reward myself and my family with a wonderful vaginal homebirth which wouldn't have happened without my own midwives support I say I hear you and understand!

Sarah D'Astoli
Sep 30, 2012 9:10pm [ 8 ]

My sister had an obstetrician in a private hospital for her prenatal care, who told her that her pelvis was too small to give birth to a baby, and booked her in for an elective casearian section. My sister had an average size 7 pound baby. So much for the theory that the birth had to happen before the baby grew too big. My concern is that obstetricians are scheduling births for their own convenience and not considering the long term consequences for mothers and babies.

Pam
Oct 1, 2012 1:42am [ 9 ]

Bashi, you have written words in an order that will strike the hearts and minds of women all around the globe and offer much needed HOPE. As a birth professional I support all births but feel such conflict and sorrow when a client chooses a hospital birth and caregivers that manage their patients with the manipulative tool of fear. Thank you for sharing your story. I'm sorry that your journey had to involve such heartache and mental and physical abuse. Sincerely. I will share your story with my clients in hopes of saving them from the horrors you have endured. You offer your wisdom with such clarity, gentleness and hope-like a balm of healing ointment for all who read and contemplate. Thank you from the bottom of my heart.

Salli
Oct 1, 2012 3:20am [ 10 ]

Your story is so touching, and horrifying and then inspiring all at the same time!! Thank you so much for sharing! I've had 4 beautiful children, the first and fourth were "emergency" caesarians and the 2 in the middle were successful VBACS, albeit both on the days I was due to have repeat caesarians. I am currently 38 wks with number 5 and am fighting to be able to have another natural birth. I'm "morbidly obese" and they continually tell me all the terrible things that can happen with a vaginal or caesarian birth, what with haemorrhaging, scar rupture, placental abruption, etc etc . Duh, It's going to be one or the other and its such a shame they are using fear tactics to try and get me to do what they want. (Have an elective caesar) So far it's just making me stay away from the hospital and not answer their calls! sigh Why do i have to fight to be allowed to let my body do what it's proven it can do.. twice!!! Wish me luck!!

Amanda
Oct 1, 2012 6:42am [ 11 ]

OMG - your first birth sounds like my second. I have had three emergency caesereans, the first was eventually done under informed consent and I feel it was the right thing to do and still do. My second birth, I had the most amazing midwife and I had dilated to 8cm (only got to 4 with my first) and was doing wonderfully. Change of shift and all of a sudden my child had foetal distress and another emergency c/s (two hours later with no monitoring in the interval) apgar 9 and 10. Got my birth records and when he was born it stated I was 9cm dilated, baby was at +2 station and doing well. He was in the perfect position LOP with head fully flexed I just wasn't given the time as I was a TOS and it was a Sunday morning and the theatre staff and OB were there to do another c/s. That was almost 4 years ago and I still haven't gotten over it. Third was emergency c/s due to antepartum haemorrage from clot and partial placental abruption at 35 weeks. I wish I could have the opportunity to have the healing birth that you have and I it makes my healing a little better to know that there are women fighting the system to do so. There will be no more children for me and my partner, however I hope that I can stop women from birthing like that.

Margaret
Oct 1, 2012 7:02pm [ 12 ]

Thanks so much for telling your story so well. Particularly the part about people pushing for intervention having to pick up the pieces afterwards. This is such a powerful story to counteract the fearmongers who reign worldwide.

Jillian
Oct 3, 2012 7:56am [ 13 ]

Thank you for this story. I am a student midwife and you have reminded me exactly why I chose to study midwifery. It saddens me how many women receive appalling care and feel unsupported during their pregnancy and birth. I really hope that I can make a difference in women's lives, like Jane did for you.

melissa
Oct 3, 2012 8:53am [ 14 ]

what a well written story. i hope i am as lucky as you. i also had an emergency c section for my first baby, after a long labour (made longer by epidural) and even though neither i nor my baby was in any distress i was told if i hadnt progressed by now i probaly wasnt going to and should have a c section. i suffered post natal depression and anxiety after that birth. then i attempted a vbac with my second child, got to 9 cm then developed a maternal fever and fetal distress, most likely due to the epidural and had to have another c section. i suffered antinatal depression during that pregnancy and was fine after due to the fact i was already on antidepressents before i gave birth, and i am still on them today almost 2 years later. i am now trying to concieve my third and last baby and i will be attempting a vba2c, this time with an independant midwife, and a lot more knowledge up my sleave.needless to say i WONT be having another epidural and i will be staying home for as long as possible!

Susy King
Oct 5, 2012 8:27am [ 15 ]

So sad to read you story and have heard many similar one's from friends who have gone through private obs. I would just like to say that I've also had very positive experience with midwives in the public sector. I went completely public for both my births which meant that most of my pre and antenatal care was from public midwives. I have to say I was very lucky to have some amazing midwives who supported my husband and I when we were "pressured" by an obstetrician to have an induction after my waters broke. With their guidance and support I was able to make the decision to go home and went into spontaneous labour within a few hours and delivered my beautiful daughter naturally with no complications. This then empowered me to make similar decisions when the same thing happened with my second birth. I also think that our pre-natal classes helped as our public midwife talked about the "cascade" effect of induction, epidural, foetal distress, caesarian etc. My husband and I had the opportunity to discuss a birth plan which meant that my husband was well versed in my wishes. When I was crying out for an epidural in an intense period of my labour, my husband was able to express my more rational wishes and he and the midwives worked together to gently support me through more natural forms of pain relief. I'm so grateful for the education and care I got from my midwives and wish that everyone could have my experience. As Bashi says, women are so vunerable in this period of their lives. "informed choice" should be just that and not an opportunity for medical staff to pressure you into things!

Stephen Hemsley
Oct 7, 2012 10:56pm [ 16 ]

My wife went through 2 c section births and as a pharmacist, I trusted the medical profession to be doing the right thing. After a 22 year journey we have found there is so much more to medicine than what is provided by the "sick care" system. This web site will help people immensely and I congratulate everyone for sharing. There are some amazing supplements out there that help with postnatal depression, whether you have a c section baby or not. Research into wild yam. They support your natural hormones and after childbirth, is one of those times you need extra support both physically and emotionally. My wife calls them her "White Gold" or "Happy Pills" and we have both benefited from this "natural" knowledge.

Denise Hynd
Nov 23, 2012 8:20am [ 17 ]

I wish this presentation had been in Parliament House Canberra?

Comadona
Nov 23, 2012 6:08pm [ 18 ]

I've been there too, many years ago. I finally had a beautiful easy of my 4.3 kg daughter at home after 4 utterly horrendous births (3 C/sections and a forceps - all induced for being post-dates). You are so right - a lovely normal birth can do some wonderful healing. It couldn't fix my marriage, but it did lead me to become midwife and I now look after women at home, including VBACs. Thank you for so eruditely telling it like it really is!

monica
Nov 23, 2012 8:38pm [ 19 ]

I am so glad you found peace. Thanks for sharing your story. It was empowering to me. I rejoiced right along with you when you finally received the gift of a wonderful birth. the way it's meant to be.

Kim Watkins
Nov 23, 2012 9:48pm [ 20 ]

Thankyou so much for allowing us to read your journey. I am appalled but not surprised to read what occurred during your pregnancies and labour and am so sorry that you and your family suffered so badly. It would be nice to think that every potential obstetrician (and current ones) read your story before they started working. I have met so many women like yourself that have been healed through a positive birth experience - but what about the ones that never get this? We should be ashamed as a wealthy developed country that these practises continue on a daily basis, more often in the most 'prestigious' hospitals! Thankyou again for your story

Melissa
Nov 24, 2012 12:35am [ 21 ]

Bashi, thank you so much for sharing your story. I had an emergency c-section following a long and bungled labour with my first and an elective c-section with my second. You have helped to validate the very real emotions and trauma I experienced with the birth of my 1st child within the hospital system. The fall-out from that experience has created many challenges including reactive depression and a fear of child birth. I was so delighted to read about your positive experience with your third birth with the help of your private midwife. You are a beacon of hope.

Zoe Collins
Nov 24, 2012 9:51am [ 22 ]

I read your story with tears in my eyes. I am so grateful I had a sister who, through her own experience with a hospital birth found a community of home birthing women and went onto have her own home births. As a young woman I was privileged to attend one of these births. When it came to having my own children, a home birth was a natural choice. Through the support of my sister, midwife and partner my birthing experiences we safe, informed and empowering. My only hope is for all of us to work as sisters and spread the word to other women (and medical staff/politicians) about the benefits of private, one on one midwifery care. Informed choices made by informed parents. I am always horrified by the time allowed by by women with their doctors during pregnancy. My appointments with my midwife were always long and thorough. These also involved cups of tea and cake and sometimes flowed into lunch. No stones were left unturned. We talked through every scenario and made plans accordingly(together). I will note I am not anti medical. I also saw a gp during pregnancy and consulted with the hospital in case we had to turn up on their door step. I know everyone has a different journey. It is very hard to give advice to someone who is already caught up in the fear of the hospital system. I hope through this forum, women can do their own research and learn from other experiences. So I guess, if you are pregnant and you feel you are not get the care you need, ask questions, do research and most importantly listen to your instincts.

sam
Nov 24, 2012 1:15pm [ 23 ]

Thank you Bashi and love to you and your family. I have been lucky enough to have one to one midwifery care for 3 normal births, 2 of them at home. My only engagment with the hospital system for my first birth was a compulsory 36 week obstetric check to enable me to access the labour ward with a community based midwife. Here I was lucky enough to jag an African registrar who felt my baby and rejoiced " ahh a big baby, you are lucky, a very healthy one" ...how important language can be to a vunerable mum, and how culture and change opinion... I went on to birth my very healthy 4.3 kg firstborn pretty easily.

Marion
Nov 25, 2012 2:55pm [ 24 ]

Thank you so much for sharing your journey. Mine is similar but with my first child lost at 17 weeks pregnant. My daughter, who is 3, was born via emergency c section due to, I suspect, a huge amount of unrecognised grief, and severe depression followed. In an effort not to repeat that experience I had a midwife who agreed to an HBAC, and I got to 10 cm at home. We had to transfer to hospital due to meconium and decels and had my beautiful boy with the help of venteuse. But it was amazing. I was doing it, totally involved in all the decisions and totally supported. Despite not being able to breastfeed him due to tongue tie and a stay in hospital with him on a nasal gastric tube, I remain depression free and am enjoying motherhood and life in a way I haven't for years. Birth has the potential to be such a transformative and healing experience and I am so grateful to my midwife and but also proud of me, for being informed, fighting for what I needed and trusting myself to know what is best for me and my family.

Midwife Cess
Nov 28, 2012 9:31am [ 25 ]

Thank you so so much for sharing your amazing wonderful story with us, I'm a midwife who works in a public hospital and I sometimes feel such guilt b heartache about how the birth process panned out for some women I care for due to the obstetric intervention, I need to be more experienced more confident and be better able to empower my women through the natural birth process thank you so much for reminding me why I became a midwife and why I love my job :)

sara menke
Nov 28, 2012 11:46am [ 26 ]

As a midwife, I am so sorry that you had such horrible experiences for your first two births. Thank you for sharing your story. I think all women should read it so they can prepare themselves a little.

I wish you all the best for your future with your beautiful little family. I am so glad that you can now share something positive after all the horrid things that you endured. You are such a brave woman. Thanks you

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