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I’m pretty fed up with reading stories in the papers from those who are either pro-midwife or anti-midwife, and as a result, anti-obstertrician or pro-obstetrician. When I wrote an article recently for Mamamia.com.au, I was shocked at the amount of comments it received, many of which were telling tales about ‘horrible midwives’, and others hitting back at these comments. Some were downright nasty, and others accused me of making up the story. Yes, my article talked about a particular interaction I had with a particular midwife whose views I didn’t agree with, but that wasn’t the point of writing it.

Recently, there has been huge debate in the media about homebirths, fuelled perhaps by the tragic death of a mother in Victoria while birthing at home (reported here in The Age) and Danni Minogue’s failed home birth (which required her to be transferred to hospital – reported here).

Recent laws passed here in Western Australia regarding recognition of the unborn baby as a legal life led to statements from the WA Australian Medical Association (WA AMA)* calling for the criminalisation of mothers who insist on a home birth despite prior knowledge of pregnancy complications (reported here). This week, there was a story highlighting the lack of obstetricians available in Western Australia and suggesting that more GPs (as well as midwives and specialists) need to be trained to help cope with the growing number of births each year. This led to letters in the papers suggesting that we don’t need more doctors, just midwives…you get the idea.

The two camps seem to be divided by their philosophy of birthing as either a ‘natural’ event or a ‘medical’ event. Those who feel it is ‘natural’ blame the medicalisation of birth for causing more intervention and resulting physical and emotional trauma.

The only thing that this polarisation does is risk alienating mothers, who are often confused and vulnerable about such a major life event as having a baby, and make them feel that they have to choose between the options and wave their flag firmly in one camp. It also splits staff in both the public and private health care sectors, causing overt and covert tension between ‘nurses’ and ‘doctors’ rather than encouraging cohesive team work and coordinated care for patients.

I am a doctor and of course recognise the value of medical intervention in pregnancy. Personally I would not choose to have a home birth, but I do not believe in unnecessary medical intervention either. I have had obstetric-led care for my three pregnancies, and have been very happy with it. However, I also see a midwife at every antenatal appointment, and my two labours so far have been largely managed by fantastic midwives. I have also had potentially serious medical complications which have required medical input, but have every confidence that even if I hadn’t chosen to be managed by an obstetrician, I would have been referred to one by my midwife when the complications became known.

Perhaps it is because I am medically trained that I believe that while childbirth is natural, it was previously a major cause of morbidity and mortality of newborns and mothers, and still is in many developing countries. In 2010, Australia had a maternal mortality rate of 5.1 deaths per 100000 live births, but the rate in Afghanistan was 1575.1/100000 and Malawi 1140.1/100000 (reference here). Our access to good, integrated midwifery and medical care makes childbirth as safe as it can be.

We need — and have — great midwives and great doctors who all work towards making our pregnancies and births as safe and enjoyable as possible. Let’s stop asking people to choose and be grateful that we have such easy access to both.

*While I have been a member of AMA WA, this statement does not represent my views.

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Me on mamamia….

I had an article published today on mamamia.com.au – you can read it here.

I wrote the post not long after my first child was born – over two years ago now, and finally submitted it a few months ago to mamamia. It’s essentially the story of an experience I had on one night in hospital after my daughter was born, and my feelings of powerlessness after an interaction with one particular night nurse. It’s been really interesting reading the comments on the article, particulalry to hear about others’ experiences – good and bad. I do want to point out that I am definitely not ‘anti’ hospitals or ‘anti’ midwives at all, but rather I wanted to share one experience that I had to highlight how hard it can be to ‘speak up’ and follow your instincts when you are exhausted and vulnerable.

I have had lots of positive experiences too and with my second child, my experience was far better. The midwives caring for me at the moment with my third pregnancy are great and I am having my third child in a hospital too. With each child though, I am of course more experienced and secure with my plans and choices.

Do feel free to comment – it’s an important area to discuss I think…

 

 

I have just spent a lovely weekend at the Perth Writers Festival, which was held on the grounds of the University of Western Australia, a great spot. I’ve only ever been to the odd event here and there at writers’ festivals, but this time I went for the whole three days. There was a great mix of sessions from emerging and established authors, as well as some more thought provoking and ‘political’ sessions on religion, food and ethics.

The writing sessions I enjoyed most came courtesy of writers Rohan Wilson, Favel Parret, Janette Turner Hospital, Craig Sherbourne, Craig Silvey, Jo Nesbo, Johan Harstad, Charlotte Wood, John Birmingham, Eliot Perlman and Cate Kennedy.

I also went a particularly harrowing session by Nigel Brennan, a photojournalist who was kidnapped in Somalia, and a more delightful and hunger-inducing session on good food by Matthew Evans

The only down sides? The 15 minute wait for coffees, and the very rare Perth rainshower during Women of Letters which meant a move from the beautiful outdoor venue to a tent! And of course the amount of money I spent on a huge pile of new books…

If you went along, I’d love to hear your thoughts…

I have just read this article in the Guardian and sighed when I read it. It refers to an article published a couple of weeks ago in the British Medical Journal (here is the article, but it requires a subscription/payment to read it all) where a research group (Fewtrell et al) questioned the policy in the UK to recommend exclusive breastfeeding of infants for six months. Just to be clear, exclusive breastfeeding means that for the first six months, an infant is given breast milk only: no solids, no formula, just breastmilk.

This follows the WHO guidelines, and the Australian government recommends the same. I should emphasise that the researchers are not recommending formula over breastmilk, and they are talking about the introduction of solid food, not formula.

What are they worried about? Well, the researchers are worried about links between late introduction of solids and iron deficiency, a potential increase in food allergies, and of coeliac disease.

I’m sure that this is going to confuse mothers even more. Any new mum knows that they are bombarded with a huge amount of advice from friends, families, and experts. I know that when I had my first child, I spent a lot of time consulting baby books and the internet for every little thing. But with my second child, I didn’t have the time, or inclination, and used a much more intuitive style of parenting.

I didn’t manage to exclusively breastfeed for six months, despite knowing that it was recommended, and despite having every intention to do so. My first child started solids at about five months, but my second was grabbing food from my plate at four months and I knew she needed more than breastmilk. I didn’t believe that something magical happened at six months of age that was missing at five and a half months, and so I did what I thought was best for my children – which is what mothers have been doing forever.

I’m curious about how many mums do actually manage to breastfeed exclusively for six months. I am very pro-breastfeeding, and had every intention of doing so, but for us, it didn’t work out and I did start solid food earlier (even though I continued breastfeeding for about a year with them both).

Did you manage?

I’ve had an article published today in the Medical Journal of Australia called Doctors and writing: stranger than fiction? It’s available here on eMJA, but it does have a paywall so is only for subscribers unfortunately. It’s in the paper version too which may be more readily accessible, especially to those of you in the medical field.

It’s been quiet here otherwise, but I should be more active soon. I’ve been trying to write the first draft of my second novel, and also been busy organising a new website which will be coming soon. On top of that, I’ve been a bit sick as I’m pregnant with my third child! I’ll post details of the new website when it’s available.

Doctors who…

I’ve recently come across a website that may be of interest to both medics and writers. It’s called ‘Doctors Who…’ and is an initiative of Varuna, The Writers’ House in the Blue Mountains of NSW. You can see the ‘Doctors Who’ website here.

Varuna, the house, was previously owned by writers Eleanor Dark and Dr Eric Dark, a medical practitioner, hence Varuna’s interest in the link between medicine and writing – an area that I too am very interested in.

I found out about this website through a post on Twitter announcing a creative writing competition for medical students and doctors hosted by the MJA and Varuna. You can read more about this competition here, but if you want to enter, be quick as the closing date is soon. I’ve sent an entry in, even though short stories are not usually my strongest form of writing, but I need to keep sending my work out there.

There are links on the ‘Doctors Who…’ website to doctors who combine their medical work with other interests including advocacy, creativity, innovation and creativity. There are some big name writers on there, including Peter Goldsworthy and Nick Earls – worth a look.

 

I’ve kept a list of all the books I’ve read in 2011, and on skimming through them, there were a few that stood out as exceptional reads. I’d love to hear of you agree or disagree with them, or if there are any that you think should be on the list…

Traitor by Stephen Daisley

The Family Law by Benjamin Law

Bereft by Chris Womersley

Past the Shallows by Favel Parrett

Rocks in the Belly by Jon Bauer

Caribou Island by David Vann (this is probably my favourite book of last year)

A Visit from the Goon Squad by Jennifer Egan

The Sense of an Ending by Julian Barnes

 

Now I’m clearing out the 2011 books and starting a new list for 2012…

 

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