Dear Doctor,

Dear Doctor,

I’ve become quite adept at taking a deep breath and smiling politely at doctors in my social circle, those who attend my courses & those I meet professionally when discussing birth. With friends who are doctors it’s easier to have a reasoned debate – there’s a mutual respect and friendship there already. In the other areas it’s tricky – it’s often not appropriate to get into a heated debate, and, depending on who I’m engaging with, it’s sometimes clear that that is how it will go, if the individual concerned takes offence at being questioned or, heaven forbid, corrected! So, here’s my open letter …..

Dear Doctor,

First of all I’d like to acknowledge how fortunate we are to have such highly qualified professionals available to care for women when needed. Lives are saved and women have relatively safe options around pain-relief during labour which can be a positive choice for them. On the whole you are kind and respectful to women in your care.

What do you think about people like me? Honestly?

I’d like you to understand that just because I’m a Hypnobirthing Practitioner & NCT Teacher, that doesn’t mean I’m encouraging parents to march into the delivery suite waving a laminated birth plan bellowing “I’ve been on a Course, I know my rights!” whilst disregarding out of hand your opinions/suggestions. I’m not in the business of telling people what they should do or think, of bringing about misguided feelings of guilt, or of bandying about unfounded information. I’m also not solely focused on natural/normal birth without intervention. I provide evidence-based information for parents & encourage them to ask questions so that they are able to make their own INFORMED choices about what’s right for them and their baby (without information no ‘choice’ is being made) so that they don’t come away from birth saying “what the hell happened there?!”

My aim is to support parents to have a positive, confident pregnancy and birth experience, because I KNOW that with the right preparation and knowledge they absolutely CAN whether they’re planning a caesarean birth, home birth or anything in between. It’s important to me to point these things out, because honestly, about 90% of doctors I meet immediately make the assumption that I’m some hippy, natural-birth militant.

I totally ‘get’ that you and I may have completely different experiences of birth. I’m guessing that although you may have experienced more women in labour than I have, these will have been in an obstetric environment. As a doula, I have experienced birth in different settings – home, hospital, birth centre. I know that the environment a woman births in and the support she has will make a difference on the management of her labour as well as her own perceptions of pain and coping. I know that what’s going on in her head WILL influence the way labour progresses and her experience of it.

A doctor on one of my courses once said to me “my view of birth is completely skewed – I never see normal birth”. At a conference I attended this sentiment was echoed in a talk given by Amali Lokugamage Consultant Obstetrician and Gynaecologist and author. She explained that obstetricians are continually immersed in crisis medicine rather than physiology: a large part of their workload involves complicated cases, and medical students have little education or experience of truly undisturbed birth. I recognize that these influences may affect doctors’ subconscious minds – the emotional baggage that’s not visible to us but may, over time, promote an ethos of body-frailty which will can influence how they guide women as to the best management of their pregnancy and birth: a primal response to avoid litigation. Quite frankly, physiological birth may not be at the forefront of their minds.

There are risks and benefits associated with any type of birth and these need to be weighed up according to the individual woman, baby and situation – not just hospital protocols.

I know that you will encounter many parents who feel scared and vulnerable and WANT to be told what to do, who will unquestioningly do whatever’s suggested by healthcare professionals. However, there are plenty of parents who do have questions, who are really informed about the benefits and risks of a straightforward/normal/natural birth and also those associated with some interventions.

Medical professionals need to be very careful in their reactions and the way they express their opinions because people listen to them, they believe them. I have so many examples of doctors and even occasionally midwives NOT taking care in this area but here are 2 examples that spring to mind, because with each of these there was definitely an element of attempting to put ME ‘in my place’, albeit indirectly:

Another doctor on one of my NCT courses years ago made it very clear that he had no belief in women’s bodies to birth their babies. He would challenge everything that didn’t fit with his very limited viewpoint. He scoffed at the thought that any parent would question his opinion, he was, in fact, thoroughly unpleasant ….BUT he was a DOCTOR! … consequently there were some in the group who took every one of his non-evidence-based opinions as gospel, even when he announced to the group of expectant parents the completely untrue statement that he had “literally seen vaginas exploding” …. How dare he? It’s that kind of shit that women hear all around them in the horror stories they’re bombarded with – they shouldn’t be hearing it from a doctor. It’s that kind of shit that’s creating the fear and anxiety in parents that’s not helpful, not healthy and has the potential to impact negatively on how they approach and experience pregnancy, labour and birth.

Last month I was at a meeting with healthcare professionals when one of the doctors – looking straight at me as if I personally was responsible, said “ what do we do about women coming up with ridiculous questions just because they’ve been on stupid natural birth websites? I haven’t got time for this nonsense and it’s happening more and more!” …. Erm, I’m sorry? Are you suggesting that women don’t do their research, seek information and respectfully question suggestions you make? … again, a doctor shouldn’t be spouting that kind of shit. It’s totally unacceptable.

Worth pointing out that my immediate response to both of these docs was fairly scathing, leaving them red-faced and cross, but, hey ho. The way I see it is, if someone’s happy to take the risk of projecting in that way, they’ll have to just suck-up any reaction they receive.

Recently I’ve had quite pleasant discussions with 2 doctors who were genuinely gob-smacked at the non-biased, evidence-based information given to their NCT group from their teacher. It wasn’t what they were expecting – one of them said “before the course I thought I was going to need to be continually correcting the NCT teacher”. Now, putting aside the fact that this enforces my opinion that some doctors have a fairly inflated opinion of themselves, my overriding question is “why?” …. Why would a doctor assume that a qualified birth educator would just be spouting rubbish?

And, I guess I’ve come full circle and that’s the point of me writing this open letter.

Maybe nobody will read this, it doesn’t matter. The idea that I’m some airy-fairy, lentil muncher, promising women orgasmic births is one that most doctors I come across have to varying degrees. It bugs me and I’m bored of it, quite frankly. It’s done me good to get it off my chest and down in writing.

If you have managed to wade through this to the end, I’d enjoy hearing your comments.

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