Birth - a little consistency would be nice.

Yesterday my wife and I visited the obstetrician our nominated obstetrician has filling in for him while he was away over Christmas. My wife, Jenny, is expecting (6 months) our second child and my fourth. Being somewhat older than average, the baby having a single umbilical artery and having had an emergency Caesarian section last time around, Jenny is, not unsurprisingly, keen to see the birth proceed with as little excitement as possible.
Now my wife is extremely fortunate that we have an obstetrician at all. In Wellington at the moment we know of four who are still practising, one of whom is not taking on new patients. All the others have quit. Interestingly all the midwives I have ever met have quit as well. In fact there are precious few of them left either and increasingly women are being assigned hospital midwives from a pool. People whom, while probably nice enough, birthing women have never met before.
Birth is a pretty big experience for all involved. Unfotunately human beings, with their collosal skulls, are not well built for their mother's pelvis's and birth canal. Thus the process of giving birth is visceral, painful, immodest and even at times humiliating. Going through the process of grunting and shoving something huge out of your lower orifice is not something you really want to do in front of popcorn-munching strangers.
Back in the 1980s the idea that women wanted more control over this process, wanted to form a relationship with those helping them and didn't want to be treated like patients was big news. But it led to an explosion of mystical feminist nonsense which made midwifery back into witchcraft unassisted by fetal heart monitors, sonography and sensible anaestheia. Indeed midwives did not even have to be nurses! Doctors, particularly GPs, were told they shouldn't have anything to do with this feminist miracle which is birth. Which, when many GPs are women, is completely loopy.
During the 90s independent midwives were, reportedly making a killing, and GPs were reluctantly retreating, warning that babies and mothers would be at risk. And, surprise, surprise, some babies did die because some illtrained witchy midwives did not recognise when they were out of their depth and the babies were in trouble. Of course good midwives ( and I have to say all the ones I ever 'worked with' fall into this category) did have nursing training and were very good at ensuring the safe delivery of healthy babies.
But now even midwives are giving up. The bureaucracy having tried to replace expensive GPs with slightly less expensive midwives is now finding that too much. The result is that even midwives are hard to come by in Wellington. Essentially women are being driven into private care by a system that is hostile to anyone who would practice in it. So today we have a system that serves no one except administrators trying to keep their budgets down so the Minister of Finance can report another whopping surplus.
To my mind this system needs an overhaul.
The best system should revolve around a woman's GP for the first 25 weeks of gestation. Essentially until this point the foetus is not viable without its mother and the health of the mother in all respects is paramount. From 25 weeks a woman should be able to choose her own midwife, preferably an independent one, with whom she can establish a rapport. That midwife must be a registered nurse. If the GP believes it is advisable an obstetrician should also be consulted. Then when the woman is in labour the midwife should be in attendance and advise the obstetrician and GP. Women should have the choice of a birth at home only after their first child is delivered at a suite in hospital. The suites now are very friendly and much safer. Every midwife should be required to monitor the foetal heart rate. If there is any problem the midwife should have expert assistance on hand immediately. If not a new baby will be born as safely and as privately as the mother likes.
To my mind the fact that this was once exactly what we had, and now don't, shows that the Government is responsible for withdrawing services from women in this country. In my view women should be making as much noise about this critical issue as they can.

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