Sunday, April 22, 2007

Something is rotten in maternal care

For the past week my wife, Jenny, has had a seat in a theatre where real lives are lost, saved against impossible odds or marred for life. It's not Big Brother. Its the Special Care Baby Unit at Hutt Hospital.
And what is happening down there is a slow motion tragedy of monumental proportions. It is the sort of tragedy of which Joseph Stalin said,"one death is a tragedy, a million is a statistic". It is the triumph of Stalinist idealism over reality.
What Jenny is seeing is what happens when birth becomes regarded as a cultural experience rather than an anatomical crisis. Women, whose babies could be delivered safely are facing the prospect of lifetime raising retarded or injured children, because they have entrusted their care to a midwife who not only does not know the first thing about birth complications but has deliberately elected to avoid the medical establishment for her own profit.
Staff are furious. They are placed in the invidious position of having to clean up after mistakes which any competent person would not make. Senior paediatricians say there are midwives practising today who would be struck off if they were registered physicians.
And according to Mary Jane Boland in The Sunday Star Times finally the stink is starting to reach the Ministry of Heath with a report into maternal deaths having risen 400% since 2003.
According to this report
"It will be the first time comprehensive statistics on deaths of babies or their mothers, and the causes, have been collated since 1995, which one committee member describes as a "disgrace"."
That's not a disgrace its a crime.
We have statistics and reports on every road death that occurs in this country. They can be mapped, compared and collated to identify common factors relating to every crash, be it fatal, serious or minor. All of this is to determine what is the common factors, what improvements need to be made and how such crashes can be prevented in future.
Driving is as much a matter of cultural expression as giving birth but we don't leave the safety of the public solely in the hands of those experienced in "cultural safety". Imagine the outcry if State Highway One at Taupiri were left solely in the hands of Tainui Tohunga because that might ensure "cultural safety".And yet this is exactly what is happening in the pivotal moment in any person's life - the moment they are born.
Birth is a natural event but on the other hand so is death. Often in history they went together. The mother of feminism Mary Wollstonecraft feared and avoided pregnancy like the plague for the simple reason it killed women in droves, and eventually killed her too. It was not midwifery which made birth safe for women and babies, it was timely and effective medical intervention.
And yet for the cultural safety brigade this is not so. Mary Jane Boland quotes:
"Maternity Services Consumer Council co-ordinator Lynda Williams said a key concern was the high rate of interventions in birth, such as elective caesareans, which elevated risks to women and their babies. "
Rubbish. My two sons Joshua and Oliver would not be alive were it not for medical intervention. My wife Jenny would almost certainly be dead as well. Interventions should happen whenever they are needed. Elective Caesarians do not elevate risks to mothers and babies they make safe deliveries for many women who might not otherwise be able to have them, possible. The high rate of intervention is due to women
a. choosing intervention ( it is their right)
b. being older when giving birth
c. because Darwinian selection has not been followed for three or four generations.
In other words its a simple choice, intervention or death.
What we are seeing is an ideologically driven group trying to sweep the deaths under the carpet through that Stalinistic rouse of fudging the statistics.
The big question is will the Minister of Health, Pete Hodgeson listen. If he doesn't the body count will continue to mount and the blood will be on his hands.

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