Monday, 15 July 2019

Maternal Healthcare - What did it look like for you?


It's been a strange process being in a 'system' of healthcare, monitoring, recording and ticking boxes. I have never realised the full impact of the 'pregnancy system' now i am sailing to the end of this journey i reflect on how let down i feel by the care I have been offered and being offered.
Since starting this fertility journey in 2015, I have attended more appointments then i can count and have been let down, disappointed and frustrated by so many inputs that have felt 'unhuman' at such a 'human' time. I don't want this blog to be a bashing of health professionals as wow there are some amazing one's out there, but what is interesting is the de humanisation jobs become for some and the impact that then has on the people accessing it.

The IVF process was mind blowing to us, we didn't know what to expect, we didn't know we had choices and we went with what was giving to us as we were so lost in a world of unknown. After every loss, explanations were brief and information was shared that wasn't helpful or didn't make sense. I remember one appointment being informed my miscarriage was a 'chemical miscarriage' so wasn't classed as a 'proper' miscarriage. For someone falling pregnant any loss is a loss, and to be informed that from a health professional was a huge blow. This same professional informed me my surgery properly wasn't the reason I had falling pregnant, again taking away any hope I had mustered up. It's strange the way people feel they need to say this stuff, sometimes some things are better left unsaid. It was from these appointments I started to learn more about my body and really connect with what was going on with it. I started to engage in the clinic in the way I needed too but use research as a tool to how i could support myself, something I wrote more about that here How to try and grow a baby!- I knew I was choosing to be in this healthcare system as we were committed and knew the help was what we needed however I chose to challenge and do what felt was best for me, which helped me feel I was taking control of what was happening and contesting anything that I didn't agree or believe.

I find as i talk to others, they feel worried or scared about doing this, going against the system of care we should be grateful for and yes i am but actually taking a step back, this is my body and my mental health and shouldn't i be looking after myself in all this?.

When falling pregnant we moved into the next 'system', we were quickly discharged from the clinic which felt scary as although they had challenged us in some unhealthy ways there was a weird safety developed through those appointments and that medical care. We had a scan at 7 weeks and found a peanut sized baby and a beating heart, from there it was to the doctors and the 'normal' maternal care. I was so excited and nervous for that first appointment, however was sadly disappointed as my midwife was tired, informed me of this, became quite stressed at the computer and paid no attention to us being an IVF pregnancy and any worries I held around this. Maybe there was a lack of education, maybe there was no need to be worried or maybe I just wanted more nurture and care at a time I was so happy but so incredibly nervous.

I left that appointment sad, let down and the excitement i thought i would feel dissipated quickly.
A number of years back I decided I wanted to be a midwife, I wanted to specialise in substance misuse or young people and felt I had the skills and care that could be offered in this role. I sadly wasn't accepted (due to my maths GCSE) however now look back and realise the medical side would have challenged me as what I have learnt and seen is that it is very medical in a lot of ways. I feel I can see a new branch of care coming through from the students I have worked with, maybe that's a varying approach or maybe it's new blood in the job, whatever it has that care has felt warm and supportive, however there still seems a set of procedures to tick and boxes to fill.

One of the things I have learnt in this long journey is what my needs are and what I want from this pregnancy, I have learnt from friends about their experiences and this has allowed me to make informed decisions about what I want and what feels right for me and my baby.

I don't agree we should have to just 'get on with it' as that's what it's always been like, how many times do we hear, well you didn't have that choice years ago, did you not or where we all just too scared to go against a system of care that develops fear and anxiety within us.

With being an IVF pregnancy they like to induce you at 40wks (your due date), I knew induction wasn't something I wanted (if it could be avoided), I therefore knew I would go to 42wks before this decision needed to be made. The NHS guidelines are now at 41wks, however only moved from 42 a few years back. Induction was first discussed with me very early on, my midwife didn't give me enough solid information to make me feel it was something that was necessary so I chose that I would refuse the 40wk induction. I am also part of a North East birthing group and enquired on this, finding out the risk was possibly around women over 40. I was then asked if I would like to be booked in at 41wks, which I refused and finally agreed at 42wks, with a statement of 'maternal choice' written down in my notes. What makes me frustrated around all this is the essence induction is discussed so early, like it's become a standard way of birthing, yes it is needed at times but do we need to be introducing into conversation so early?

Then there's the graph, the graph of anxiety, the graph that every women whatever shape or size you are, you have to stay on the graph and if you don't well it's time to head to hospital for another scan (bearing in mind this is all measured with a tape measure). I understand every doctors surgery can't have fancy scanning machines but that line needs to lend a little. Which I guess is why I am blogging as I feel the NHS system needs to become flexible with women's rights and needs around birthing.
I spoke to a friend recently and she asked if it's okay for me to have all these wants from my birth, I was astonished that in 2019 we still aren't fully informed or aware, that the birth is our birth, ours and our babies, meaning it's our choice how it happens as it's one of the most powerful experiences we will go through, it's the first journey you do together mother and child, shouldn't that therefore be your choice.

Conversations are hard and what i have learnt is that EVERYONE has an opinion, you take what you want, you chose what feels best, there's no right or wrong as it's what's right for you, but for me it feels this intrinsic sense of the NHS guidelines isn't always right and we should be encouraged to be flexible and not always feel we are harming our babies by not ticking the boxes. I drank wine throughout my pregnancy, the odd glass when i wanted it from the 2nd trimester, i ate soft cheese and runny eggs. I went to gigs, i walked miles and miles in Scotland on holiday, i taught yoga from day dot, i carried things around, i slowed down when my body told me too but i lived my life the way it felt right. I chose not to tell my midwife as i told her one thing and the concern on her face made me stop instantly. It's what's right for you and none of the above maybe but for me i knew what my body needed/wanted and what made me happy and surely if i am happy my baby is.

I feel lucky to be educated through friends and my own reading, I have taken a lot from instagram accounts such as Olivia at The Birth Rising and Emma at Mamalina around going slow, listening to your body and your birth rights. I have also been influenced by some incredible friends, by their honest sharing and empowering birth stories, there talking has allowed me direction in my own pregnancy and hopefully allowing me to make the right decision's for myself and my growing family.

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