Behind the Scenes - The Ongoing Battle

There's a lot I haven't said over the past few weeks. I can't and won't keep quiet any longer. Here goes. 

When I was an Emma's Diary blogger for a short time, one of my posts focused on the excellent maternity care I experienced at Medway Maritime Hospital in Kent. Here is part of that post.

Dear Midwives,

A short thank you note. For listening to my every request (coherent or otherwise). For taking the time to read through every word of my birth plan and discussing points you were unsure of with me. For offering advice, but not forcing it upon me. For speaking to me calmly and encouragingly. For our chats and jokes between contractions. For always being there and for explaining every little thing that was happening. For never letting me feel scared. For trying your very (very) best to honour my every request. For your caring, calming, smiling faces.

For my toast and tea once Emily was born. Nothing has ever tasted so yummy.

Sincerely,
Clare

[Full post here]

Reading that back right now has me in tears. It's nothing to do with hormones, sadly. And they're certainly not happy tears. My situation at the moment couldn't be more different...

This time, in Malta, I am dealing with a gynaecologist, not a midwife.

This time, my sheer mention of a birth plan has been smirked at. "Rip it up," I was told.

This time, I am fighting to be allowed the chance to labour naturally. Excuse after excuse has been crafted to push me into having a c-section. And when that failed, more reasons found, this time to attempt to convince me an induction would be needed. All still hypothetical of course but not exactly the start you want. (The first time my gynaecologist talked to me about the non-surgical childbirth procedure at the local hospital was yesterday, at my 36 week appointment - because I specifically asked her for details.)

Last time, I was relaxed and focused on what was about to come. This time, I am fighting what feels like an often losing battle simply to give me the chance to labour without unnecessary intervention.

Medicine is an amazing thing - but to support, and not replace, nature.

Sadly it seems that here in Malta childbirth has been turned into a production line, with surgeons waiting, scalpel in hand, for any little reason they can find to cut. I've spoken to so many woman over the past few weeks who have been pushed into c-sections for very vague (and sometimes unknown) reasons. It's shocking. Childbirth and nature are a beautiful thing, and so many women here are denied the chance to ever experience it.

These last couple of weeks, I have felt like a helpless, caged animal. I am full of despair and very much saddened. And the worst part is that because of everything they've tried to convince me will go wrong, it has begun to affect my confidence in my body's ability to do what it was made to do. Don't get me wrong - I'm not trying to be irresponsible. I am in no way trying to put my life and that of my son at risk. Should intervention be necessary, I will welcome it. But I want to know that the people making the decisions can be trusted not to be too scalpel-happy. I need to feel like I am in safe hands, which I currently don't. And to be told that intervention will happen regardless... that just doesn't sit right with me.

And to those who will still try and convince me that it doesn't matter, that all that matters is that me and my baby are safe (which is of course of utmost importance too, but still no reason to override nature for absolutely no reason), I only recommend that you read this: The Pot Plant Analogy

And if you want to argue that I am hallucinating or paranoid (as my gynae tried to do), remember that the C-Section rate in Malta in 2011 was 32.3% of births, and currently the highest rate of inductions in the EU. And here's some more light reading: 
Malta almost sees pregnancy as an illness (MaltaToday, 2012)
Induced births and high rate of births by Caesarean section (Times of Malta, 2011)
Malta's C-Section rate needs to be halved  (The Independent, 2009)

I should be able to be focusing on Emily during these last few weeks, enjoying our time alone - just me and her for the last time. Instead my every waking moment seems to be filled with research to find the information I need - information my gynae has warped, seemingly to support a different agenda.

Why was I told my placenta was low lying when it wasn't? 
Why have I been told I have an average amount of amniotic fluid, only to be told in the same breath that I'm carrying too much fluid?
Why am I being told that the baby not yet being engaged is a problem? Second and subsequent babies very rarely engage before labour begins.
Why am I being told I need to head to hospital at the first sign of labour and not be allowed to labour at home? The more time spent labouring in hospital increases the risk of intervention being necessary.

I've done the research, I'm no fool. I know this is all wrong! Why am I being treated like an idiot and told off for being informed? Why am I paying a gynaecologist to misinform, confuse, and upset me? My instincts scream bloody murder every time I think of all this.

So at this late stage in my pregnancy, we are looking into our options. As quickly as we possibly can. And there aren't very many options here in Malta. But we're trying. We have to. I will not sit back and take it. That's what created this mess in the first place.

And all the while, all I can think of is that brand spanking new midwife-led unit at Medway Maritime.... and the tears return. I shouldn't need to fight this battle, not at this late stage in the pregnancy, not at all, not when I had a perfectly normal delivery last time. I have to win this war. 

___________________________________
UPDATE, 08/03/2013
This morning I met a doctor who hugely supports natural birth. He rescanned me and could see no problem whatsoever with letting labour progress naturally. My placenta is very high and thus completely out of the way, the amount of amniotic fluid is perfectly normal, baby is in the position he needs to be and thriving. He also confirmed that engagement generally happens during labour with second babies onwards. We spoke the same language and were looking at things through the same lens. I will be continuing under his care and am now very excited about it all. 

I'll be clear - I am not saying that my previous gynae is a bad person. She probably has orders from above which she needs to follow. However, I firmly believe that patient and doctor need to be on more or less the same page about the way things are done in order for a patient to feel safe. I certainly believe that a patient should not be ridiculed or belittled for having certain opinions. A relationship like that will never work, in whatever scenario. 

So I'm glad I fought. I'm glad I found people to support me and give me the chance to have a second natural birth. They know who they are and I cannot ever begin to thank them enough. They have kept me sane throughout this. And Emily... well, I realised today just how awful I've been lately. Today I feel like a new person, on a new lease of life, and my relationship with her has already seen the benefits. Here's to the next few weeks until Baby A chooses to arrive, as naturally as possible.

I sit here writing this with a big smile on my face, celebrating with a piece of chocolate, while Baby A bounces with hiccups.