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Suggested Readings for Expecting Mothers

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Instagram post 2196596835093592373_7041021708 #birthRights #birthDoula #Repost @chilledmamacathy with @get_repost
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Hospital policies give guidance to practitioners, which is really useful for big organisations. They ensure that the care is safe, and updated when new evidence comes along.  Policies ensure that all are receiving equitable care.  Midwives and doctors are obliged to adhere to their setting's policies, but you are not.

Policies are often based on population level outcomes, i.e. on average x happens. You want to make decisions on a individual basis.

Hospital policies have weighed up the pros and cons and made a decision on that population level.
You will want to weigh up the pros and cons on an individual basis; you may well give different weighting to the factors than those drawing up the guidelines. You will have additional factors to consider that the guideline committee didn't; such as looking after a toddler; living on a high rise; partner off on tour of duty.  Hospital policies will also have taken some things into consideration which will not be relevant to you, such as ease of carrying something out, buildings, staff time. 
Midwives and doctors sometimes feel under pressure to get 'compliance' to policies.  But that doesn't mean you have to comply. If their policy does not have provision for your wishes it is breaking human rights law, consent law, and NHS guidelines. Your individual midwife may feel she has to stick to the policy but usually a letter or email to the head of midwifery or consultant midwife is usually enough. Contact @AIMS and/or @Birthrights for any more assistance.

The Better Births report found that individualised care, rather than blanket policies, led to better outcomes for women and babies.

Have you thought about writing your own policy?  In fact, that's what a birth plan is.
Again, the @PositiveBirthBook is a brilliant resource for looking at all your options. There are even downloadable visual birth plan icons from the publisher @PinterandMartin . And just out this week Positive Birth Book Visual Birth Plan Cards to help you discuss the issues with your partner, your midwife, your clients. 
#mybodymybabymydecision
#autonomy #dignity #equality #privacy
#birth
Instagram post 2195676140528564671_7041021708 #birthRights #birthDoula #Repost @chilledmamacathy with @get_repost
・・・
December 10th
All women are entitled to respectful maternity care that protects their fundamental rights to dignity, autonomy, privacy, and equality.
Birthrights UK

Today is International Human Rights Day. Birth rights are human rights.

As the UK human rights in childbirth organisation Birthrights say in their leaflet on human rights in maternity care:
"Human rights require public bodies to treat you with dignity and respect, consult you about decisions and respect your choices.

Human rights law gives pregnant women the right to receive maternity care, to make their own choices about their care and to be given standards of care that respect their dignity." They go on to say
"Failure to provide adequate maternity care, lack of respect for women’s dignity, invasions of privacy, procedures carried out without consent, failure to provide adequate pain relief without medical contraindication, giving pain relief where it is not requested, unnecessary or unexplained medical interventions, and lack of respect for women’s choices about where and how a birth takes place, may all violate human rights and can lead to women feeling degraded and dehumanised." Birthrights, together with the BIHR - The British Institute of Human Rights , have a really useful booklet for midwives which goes through a number of cases. There are other examples on their website. https://www.bihr.org.uk/midwiferyhumanrights

Birthrights have a helpline so if you are wondering about your rights or what you should do as a midwife, then give them a call.

Find out more about Birthrights, read about their campaigns, download their leaflets. They also need volunteers and trainers. birthrights.org.uk

Birthrights is one of the two charities I am fundraising for during this Birth Rights Advent Calendar. We have already raised almost £200 for Birthrights. I would love to make it to £500. www.uk.virginmoneygiving.com/birthrightsadventcalendar

Rebecca Schiller, one of the founders of Birthrights, has a very useful book: Why Human Rights in Childbirth Matter

Human Rights in Childbirth are an international organisation.
Instagram post 2194982366550854188_7041021708 #birthRights #birthDoula #Repost @chilledmamacathy with @get_repost
・・・
Agnes Gereb is a Hungarian obstetrician who did home births. Threatened with being struck off, because obstetricians don't do home births, she re-registered as a midwife. Authorities then jumped on the fact that a baby died, even though it wasn't a home birth, the woman had turned up in premature labour at Agnes' clinic, and Agnes had sent her straight to hospital. Agnes was found guilty of malpractice and spent months in jail before being released under house arrest.

Agnes Gereb's story is featured in the documentary Freedom of Birth, made by One World Birth.  One of Agnes' clients, unable to have a home birth now due to the clamp down after Agnes' arrest, took the Hungarian government to the European Court of Human Rights , and won.  The landmark trial concluded, "the right to private life includes a right for women to make choices about the circumstances in which they give birth, including whether to give birth at home."
(taken from Birthrights leaflet on human rights in childbirth)

The good news is that, in June 2018, Agnes Gereb has been granted clemency by the President of Hungary.  This means she does not have to serve any remaining sentence, but it still means that she isn't free to practise midwifery. 
But it is not just Agnes. Even in the UK it happens. Becky Reed, midwife for the Albany Midwifery Practise and the author of Birth in Focus, was under disciplinary for three years before being exonerated. The Albany Practise was closed down even though it had an exemplary record of low intervention and high rates of breastfeeding, even though they worked in an area of high deprivation. What's more, 70% of women gave birth without even gas and air. Knowing and trusting your midwife makes birth less painful. 
In 2017 research was published which examined the Albany midwives records, showing the incredible outcomes for the women under their care.  This is now held up as a prime example of the impact of continuity of carer. 
Around the world women and midwives are facing challenges to their power. In Spain, in Italy, in India, in the USA, in Ireland.  There are restrictions on practise,
Instagram post 2194762273577268230_7041021708 #birthRights #birthDoula #Repost @chilledmamacathy with @get_repost
・・・
I meet a lot of women who feel the need to win their health provider over to their point of view, or at least show their midwife or doctor that they know their stuff. They want to show they are reasonable women, making an informed decision. 
Informed consent is much more than just giving consent to a test or intervention. It is also making informed decisions, and being given the all the options. Rather than accepting or declining an option from a preapproved menu, informed decision making means being given all the options, including a planned casearean, or giving birth at a midwife led unit/birth centre.

Following the landmark Montgomery ruling in the Supreme Court, clinicians cannot rely solely on printed information. "This means that there must be a genuine dialogue between doctor and patient and the assessment of risk must be sensitive to the individual’s characteristics. Statistics alone will not determine whether a risk is significant for a particular patient. For example, the risk of complications for future pregnancies after a c-section might be statistically small, but it would be more significant for a woman who wished to have multiple children than for a woman who did not."
Birthrights Consenting to treatment fact sheet

Turn the relationship around in your head. The appointments are not there for you to give information to the midwife or doctor about how informed you are, but for you to use their expertise to help you with your decision making. Midwives and doctors are highly skilled and knowledgeable. Use this.  Ask them lots of questions. Ask them for the research or websites you could look at.  Ask several different people if necessary. They are there to help you make your decision.  You don't have to get them to like you.  They are professionals. 
At the end of the day it is your decision. You do not need to get into an argument about it.  If they feel unable to support you, you can request to see someone else. You can also say, 'Thank you for your opinion, we will consider it, but at the moment we still want xyz. Please put it in our notes that we had this discussion
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Instagram post 2193810544367071113_7041021708 #birthRights #birthDoula #Repost @chilledmamacathy with @get_repost
・・・
"I'm just thinking about what's best for the baby." "It's not about an experience. At the end of the day it's about a healthy baby." "The baby is my patient and I am just doing what is best for them." "You wouldn't want to put the baby at extra risk, would you?" "Unfortunately in this country we don't have rights for unborn babies."
I find it highly offensive for any professional to assert they have greater concern for the baby then the parents. It is the number one thought and worry for women and partners, for nine months (and a lifetime after that too). The vast majority of women will always put their baby’s well-being above their own.

To come out with phrases like these is emotional blackmail.  It not only stops informed consent, but also breaks down the trust between parents and professionals. 
If you are a health professional, your job isn't to get women/birthing people to comply, it is to give them the information, guide their decision making if asked, and then support their decision, whether you agree or not.

Of course a healthy baby is the most important thing. Nobody knows that more than the parents.  We can be trusted to make decisions, we are adults, parents; we are about to make decisions for our child for the next eighteen years.  And it is rarely either/or. (More on this in the coming days.) Research is backing up individualised decision making. The huge national maternity review report, Better Births, concluded “It is increasingly evident that #personalisedcare means safer care and better outcomes.” And a healthy baby is not all that matters. You are not merely a vessel to grow baby in. You are a #dyad, you and your baby.  Your baby cannot have maximum health if you are recovering from a traumatic birth where your wishes and your body autonomy were damaged.  What’s good for mum is good for baby, and that’s good for dad/other mum too.
#mybodymybabymychoice
#birthrightsarewomensrights
#Birthrights #AdventCalendar
#birthrightsarehumanrights
#bodyautonomy
#birth #babies
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