Friday, August 8, 2008

The business of being born in Dunedin

At last, after a long wait, I have finally had the opportunity to see this documentary.

On the worst night of the year, wintery showers of sleet and hail we went to Logan Park High school to view this film. There was a fairly small group of us, not surprising due to the weather. None the less enough hardy souls made the effort to cover the costs for the Otago region of the College of Midwives. It was a mixed group with good number of student midwives and midwives from Queen Mary maternity center. A few independent midwives and sprinkling of consumers.

I had a fairly good idea of what to expect from the online discussion that has been generated. I will not go into the details of the film, others have done that much better than I could. I have to say it is very similar to "Giving birth: Challenges and choices" produced by Suzanne Arms in 1998. Marsden Wagner features in both of these films with a very similar message. This new film is longer and more in depth, it is also significantly longer at 1 hour 30 mins as opposed to 35 mins for the Suzanne Arms film. It has more births and stronger historical overview of how America lost midwifery in the first place. Overall the material and the information was not something that is new to me. The benefits of being upright and mobile in labour were highlighted. The importance for no restriction on the pelvic joints was mentioned and the ability of the woman to move through out the birth. The benefit of water was highlighted.

Overall it is a good film but I think for those, like me, who have been involved in the business of birth for a while the information was not new. It has been around for a long time. I think that obstetricians and midwives have heard this all before and they either agree or disagree with the arguments. None the less it is a good to reiterate, and clearly in America the message desperately needs to be heard. The real value in this film is to women who are thinking about birth. It is a shame therefore that there were not more consumers in the audience. It would have been good to have some sort of debate scheduled for the completion of the film to allow us to talk about how this might impact on us and our situation in Dunedin. To talk about what, if any, relevance it had for us. It is also a shame that the film is not more available so that midwives could show it to women. The arguments are valid and well presented, why is it so protected? I understand that the marketing of the film has stimulated interested and created a whole culture around it which I beleive has been having an impact in America, which is great.

The question that remains to be asked is how does this apply for us in New Zealand. We have the most supportive legislation for midwifery care in the world. All women can choose midwifery care for normal birth. One would think that all choices should be available to all women. Any woman should be able to birth at home if she wishes. The benefits of birthing outside of the hospital should be explained to women. All women should be able to birth in water. The benefits of birthing in water should be explained to them. All women should be able to decline obstetric intervention in the absence of clear and apparent medical risks. Most women should be able to birth in the care of a midwife without ever having to see a doctor. If this is the case why is our caesarean section rate so appallingly high, 22.7% in 2002
, (the last available statistic) and would appear to be much higher than this now. What do others think about this. As reported by Paul Kruger in response to the screening of this video in Sydney Australia "The Royal Australian and New Zealand College of Obstetricians and Gynaecologists says there are a range of complex factors to explain the high caesarean rate, including the older age at which women are giving birth, and litigation against doctors". What do you think about this? Does this video have any relevance for us? Or is it only important for women in America?


Sarah Stewart said...

What interests me is that this film has sparked a discussion about home birth and the AMA is trying to lobby for homebirth to become illegal. Whilst that does not affect NZ at the moment, there is the potential for those attitudes to filter through to us. So I think it is important for us to mindful of this and be proactive in making sure it doesn't happen here.

Hannah said...

I get to see this next month! Very excited!!

Carolyn said...

good to see you are still around Hannah. I am sure you will enjoy the movie.

infomidwife said...

This was a great documentary - I think it should be more widely available. It has created debate and opened a few eyes of people who have not really given the birth process a second thought. The excuse of the rising rate of lititigation is wearing a bit thin, it really has not increased and it is fear based.
lets keep promoting the documentary.

mammal said...

"We have the most supportive legislation for midwifery care in the world. All women can choose midwifery care for normal birth."

in germany, it's teh law to have a midwife present at _every_ birth. only in case of emergency is a doctor allowed to deliver a baby alone.

"Eine Hebamme leitet die regelrechte Geburt ab Wehenbeginn völlig selbstständig ohne Arzt (nach § 4 Abs. 1 Satz 2 Hebammengesetz (HebG/D) und nach §3 Abs. 1-2 Hebammengesetz (HebG/Ö). Nach diesen Gesetzen besteht die Hinzuziehungspflicht einer Hebamme, das heißt, ein Arzt darf nur im Notfall eine Geburt ohne Hebamme durchführen."

unfortunately in a hospital athmosphere the midwifes tend to behave as subalterns as soon as a doctor comes into the room.

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