Autonomy

Well, the newly renovated Holly LDRP (labour delivery recovery and postpartum) rooms have opened at BC Women’s. Fresh, clean, great glass tiles, most with windows...(ok - avoid Room 18 if you want to sleep - the lovely sunshine streaming through the skylights can be a bit startling in labour.) Now there are close to 30 birthing rooms at this hospital.

However, on any given day, there is still the possibility of being diverted to another hospital. There is either an unexpected baby boom in Vancouver, or every labouring woman is trying to get into the BC Women’s birthing suite. Soon there will be a campaign to alert Lower Mainland women to the joys (and quietude) of other hospitals. Admittance to the hospital will be like the old days when you had to prove that you lived within Vancouver city limits. So, if you live in Burnaby or New Westminster, consider the option of local hospitals, which are closer, and much less crowded.

I love attending births in all different settings, and I am awed to see how women are affected by their surroundings. It’s interesting how women’s movements differ in each venue. In a hospital setting, I don’t think I’ve ever seen anyone leap into a squatting position on the edge of a bathtub, tight in her husband’s arms. But on Monday night, at home, THAT particular position worked for my client. Without hesitation or comment, the midwife rolled up her pants and climbed into the draining tub, to support her. A few minutes later, the baby was born with the couple standing together, feet firmly planted on the ground. What power and autonomy!

I have seen autonomy in the hospital, but it takes much more effort from the labouring woman. One woman said to us, “I have to do this on my own. I’ll be in the dark in the bathroom. You can pop in to listen to the baby’s heartbeat - but don’t say a word. I’ll tell you when the baby’s coming...” This was her first birth. How did she have such strength and inner knowledge? She knew that her doctor, husband, nurse and doula were supportive of her decisions, whatever they might be. We all sat on our hands, silent in the room. Boy, that was challenging for three women!

One woman who gave birth at Burnaby Hospital last week said all the staff were incredulous at her wish to birth without intervention or medication. They couldn’t understand why she waited until she was 9cm before arriving at the hospital. “We’ve been waiting 5 hours for you!” But, she wanted to birth on her own terms - and she did, without fuss or complication. Well, there was a bit of excitement when she was earlier escorted up to the birthing floor by firefighters (who just happened to be outside when she arrived) who pushed her down corridors on an office chair!

So, new tiles, old tiles, windows or no windows, home or hospital... what matters is that we all need to flow with a labouring woman’s instincts. We need to put the woman’s needs first, be respectful, calm and unobtrusive. This is challenging in a busy hospital. So, if you’re pregnant, take a while to think about how we can help you to be autonomous and move freely in labour, whatever your setting.