The Hospital Birth, The Hospital Rules
Last week, the new midwife and blogger at Belly Tales posted about her anxieties in her new role as a midwife in a hospital. I was a little surprised by some of her description, including “room 8 needs another dose of cytotec, room 10 needs another note written on her at 2:00 pm, and room 5 and 7 need a note written at 2:30, and room 10 will need a note as soon as the cytotec is placed…” and so I asked her:
I was interested to see in your description how “medical” the treatment of the L&D patients seems to be, despite having a midwife on hand. Any thoughts on that?
I’ve heard the saying, “You go for the hospital birth, you go for the hospital ride.” I apologize, but I can’t remember who said it at the moment. The idea is, don’t expect better, normal treatment of birth from even very progressive-seeming providers, if you’re going to have it in the hospital, and this is something I’ve been thinking a lot about lately.
Belly Tales responded to my question with a new post today on hospital providers. She says something similar:
First of all, this is hospital midwifery and hospital birth. Unfortunately, you almost have to think of it as a different species of midwifery all together. Because this is occurring inside a hospital, and there are hospital regulations to follow, there are protocols in place which limit the amount of freedom a midwife has to manage her clients in a more traditional “midwifery” manner, and there is a constant push-and-pull of politics and power at play.
The blogger also notes that many of the women she attends aren’t there actually because they’re seeking midwifery or normal birth care, but that the midwives are able to make some improvements in how birth is approached even in these women who aren’t seeking out normal birth options, through their presence and advocacy.
Still, sometimes the hospital environment overrides the midwifery presence. Belly Tales writes:
…one of the doctors stormed in (having just finished a c-section) and threw a little hissy fit, right in front of the patient: why is this woman STILL pregnant?!? Why haven’t you started pit? What are you guys doing in here? Start pit! This is ridiculous. Etc. etc. Nevermind the fact that he hadn’t been paying attention to her all day; she was a midwifery patient, and we had been managing her, but now that it was 5:00 pm and he was signing off to the oncoming doctor he wanted her to have been delivered ages ago, because I guess it looks bad that he’s had a patient all day who still hasn’t delivered…
The rest of the post is excellent and describes how she and the other midwives attempt to navigate “the hospital ride” on behalf of their patients.