"Disconnect in Prenatal Care and Birthing Policies"

I am receiving care for my first pregnancy at Albany Hospital, with the model of shared GPO and midwifery care at the hospital. There are no clear options for MGP care or private home birthing care in the area. If there are, these were not discussed by the GPO at the beginning of my pregnancy. 

I have done the hypnobirthing course offered by WACHS which was so amazing. Very positive, with a focus on natural birthing and our bodies ability to give birth with minimal interventions in ‘low risk’ women. The midwives presenting do not describe ‘ the medical system ‘ as a positive place to give birth however. 

I have since felt such a disconnect between the care offered and the potential care which, as I understand it, has been shown to give the best outcomes. It seems policy based descriptions of inductions, CTG, and birth time frames set by bed management policies are becoming overwhelmingly clear as factors that will dictate how my birth will go in the hospital system. I do feel there is a place for hospitals and GPOs on standby, however for low risk women, why are such policies still in place without strong, up to date research showing the benefits? 

In the broader community, I believe most positive birthing experiences (with no ‘birth trauma’) describe midwifery led care, with one consistent midwife throughout the pregnancy that knows the mother. This has not been offered by Albany hospital despite frequently described benefits. Furthermore, positive homebirthing often includes water birthing - I have been told this cannot be guaranteed if labour commences on the weekend and the on call GPO is not trained - this is really disappointing.  

As I understand it, there is still a policy to be offered induction at 41+3, despite the birthing EDD being very estimated and my cycle likely differing from the next woman by multiple days.  As well as the ‘doubled risk’ of complications after this time as actually being, I believe, very very tiny in real numbers. 

I do not want to be induced / have instruments or have a c section if my birth slows, just because there is seemingly pressure on bed management and flow. 

It is a horrible position to be in, knowing the disconnect between current practice and apparent lack of research to support these practices continuing. I feel as if I will be on a backwards step in my labour as believe I will have to try and advocate for my wishes continually against bed flow pressure and overestimation of ‘risk’. 

I hope WACHS will initiate research at their site to show that slower and non linear births and less interventions can still lead to positive birth outcomes. I feel research into non linear births and what is ‘normal’ needs to be done. 

I hope that midwives are trained in assessing birth progress without routine VEs and that GPOs and regional directors will support Mums using birthing suites for as long as needed, without pressure to be induced if there are no significant risk factors arising. 

In my opinion, this would help mothers to be feel more comfortable in giving birth , while still being in the hospital if complications did arise.  I hope this issue is addressed locally until the research body catches up to inform best practice. 

This perspective is written from a pregnant mother, with the information available / presented to her by WACHS antenatal classes and broader community perspectives - and the fear / emotion of an upcoming birth in ‘the system’. 

Thanks for your time considering this perspective.