Monday, September 20, 2010

#4 CHANGE BIRTH CHANGE CESAREAN CUSTOMS

Virginia and I are about to close BIRTHING FROM WITHIN’s very first Introduction to Mentoring workshop in Australia!! We were privileged to meet 24 amazing and interesting women (one came all the way from Abu Dhabi), many of whom will join the BFW program and family—and become childbirth mentor ‘pioneers’ in Australia.

After presenting our module, “Cesarean Birth in Awareness,” Maggie, a warm and experienced midwife told us a story about a seed change in Australian birth culture.

Three years ago midwives at Canberra Hospital (Canberra is the capital of Australia) pushed for a humane change in how families experience cesareans. Now, at Canberra Hospital, cesarean-born babies are no longer separated from their mothers in theatre (operating room). When a baby is born healthy, it is immediately placed on its mother’s chest, skin-to-skin, wet and sticky. There is no blanket barrier between the mother and baby; the baby is not swaddled. Most of the time, the baby breastfeeds during the first half hour in the operating room! When the mother is taken to recovery, her baby is tucked inside her gown, skin-to-skin.

How did this change come about? It wasn’t easy. “There was a big fight before this could happen,” Maggie recounted. “Some of the midwives wanted to continue swaddling the babies before they were placed on the mother, while other midwives believed the babies could go directly to their mothers.”

Maggie told me her own story about adapting to this radical change in policy. She had taken a leave from her position as hospital midwife for a few years and returned after this policy had changed. During her orientation, Maggie’s mentor told her that now all babies—including babies born by cesarean—stayed with their mothers continuously and would be put directly on the mother after birth.

“So the first cesarean I attended, I dutifully took baby from surgeon, wrapped it, and then took it to mother. My mentor came over, unwrapped the baby and placed it on its mother so there was skin-to-skin contact. My mentor left the room and I swaddled the baby again because it was so engrained in me that babies had to be wrapped up because theatre is cold. So we had a dance: my mentor unwrapping baby, and I wrapping baby. It took me a while to understand skin-to-skin meant whole body contact,” not just the face.

The other change at the Canberra Hospital is making the theatre (operating room) warmer so the mother and baby are warmer. The new temperature is about 23°C, or 73° F. Other midwives in our workshop shared that a lot of hospitals in Australia no longer routinely separate babies from mothers, even in cesarean birth.

WHEN WE TALK ABOUT CHANGING BIRTH IN OUR CULTURE, EVERYBODY'S SMALL AND GRAND EFFORTS MATTER. BIRTH TOUCHES EVERYBODY. SO EVERYBODY MUST SPEAK UP: MOTHERS, FATHERS, GRANDMOTHERS, DOCTORS, MIDWIVES, DOULAS, NURSES, WRITERS, AND ARTISTS. WE CANNOT WAIT FOR THE POWERS THAT BE TO CHANGE BIRTH FOR US. WHEN MILLIONS OF US CHANGE OUR ATTITUDE AND EXPECTATIONS, AND WE SPEAK UP, WE BECOME THE CHANGE WE ARE WAITING FOR.

Stay tuned this week for more blogs related to changing birth in our culture by changing cesarean birth. Looking forward to reading your comments and experiences as we all “dance” between old thinking and new thinking.

Love from “down under,”
Pam and Virginia

3 comments:

  1. That is absolutely amazing. I have read a some about "the natural cesarean" which has just came into conversation again just yesterday! It would be interesting to hear how that change came about. My co-mentor and I were talking last night what seed it would take to make this happen in our local hospital. Perfect timing for this story of yours, Pam! It is heart warming.
    Kristi

    ReplyDelete
  2. If only this happened in all of Canberra's maternity units. Calvary Hospital, the other public maternity unit providing services on behalf of ACT Government (who own Canberra Hospital), wraps babies after caesarean delivery, then separates mother and baby during recovery except in very rare cases - a couple of hours wait to see your baby is typical. Calvary's rate of first breastfeed within the first hour perfectly matches their rate of vaginal delivery - because babies cannot stay with mothers in surgical recovery.

    It's nice that Canberra Hospital have made this change. But frankly, Canberra's maternity units still have a very long way to go. I hope that more Canberra women tell hospitals they want change, because it's the only way it will happen. Consumer organisations like Maternity Coalition and Caearean Awareness Network Australia are good organisations to join if you want to make an impact in Canberra.

    ReplyDelete
  3. so lovely and hopeful to read. i am a doctor working at a hospital where all cs are done under general!!!! baby goes to incubater and waits until mom ready and awake to receive baby 1-4 hours...!!! Sadens me deeply as I am a active supporter of conscious gentle birthing but not in a position at the moment to question.

    ReplyDelete