Wednesday, July 02, 2008

THE D I Y MIDWIFE

I had heard recently that some expectant mums were buying gadgets so that they could listen to their unborn babies whenever they felt like it. That didn't bother me - I assumed they went to one of the online supplies stores, and bought a Doppler device similar to the one I use. They're quite expensive. I suppose if you could buy an ultrasound machine some people would want one of them too. Along with all the other gadgets and monitoring devices that money can buy.

I have seen new mothers with their digital scales set up proudly in the colour and theme coordinated nursery, so that they can weigh their babies whenever they want to. Much more high-tech than the simple spring scales with the cloth 'what the stork brought' holder that I use.

The other day I was in a new client's house and saw a plastic pod with straps and a earpiece. The woman told me she bought it at [big store - unnamed]. The pod sits over the front of your belly and the straps go around your back, and you put the earpiece in your ear and listen to your baby. Not much different from the continuous electronic fetal monitoring that goes on in hospital, except a fraction of the price! So now you can have continuous electronic fetal monitoring whenever you like.

Listening to your own baby is not new. Anyone who has been pregnant and knows how to use a stethoscope has probaby listened. They are likely to get pretty bored listening to a heart beat. Whether the availability of this gadget is going to help or harm the birthing process is another question.

Some mothers-in-waiting like to check what's going on by feeling inside their bodies. One client told me she would get her man to examine her in labour to work out how far dilated her cervix was, so that she could decide when to call me. OK, I said. It's not rocket science. Anyone can give permission to another adult to digitally or otherwise penetrate or feel any part of their body.

Some people are into DIY, Do It Yourself, everything. Perhaps they are breaking some unspoken taboos by stepping inside what had previously been the territory of a professional group - in this case midwives.

Midwives often question how useful it is for us to listen to the baby's heart beat, how frequently. There is no evidence that any particular schedule of listening improves outcomes for the baby, but we do it anyhow. There have been times in my midwifery experience when I have detected a baby who was distressed, and the heart beat pattern was the tell tale sign. I have seen mothers tragically lose their babies in this situation, when the action taken was too little, too late. Everyone who has worked in acute maternity care has seen that, and would do anything they could to prevent it happening again. If they could.

If I thought that listening to an unborn baby continuously was going to help that mother give birth spontaneously, I would go out and buy one of these little gadgets. But I don't - I think it would be more likely to interfere with the mother's ability to work harmoniously with her body as labour progresses, which would increase her perception of pain, and slow the progress. Babies may in fact be harmed by the interference and subsequent interventions.

I don't want to write more detail in this blog - the topic is huge. I have just touched the surface.

To anyone who is going down the DIY pathway, I would encourage you to speak to a midwife. In order to monitor your own progress, especially in labour, you would need to maintain an active calculating-thinking brain, your neocortex. This brain activity will inhibit the deeper, more instinctive brain, that is needed as you release your mind so that your body can engage in the wonderful process of birthing your baby.

Your midwife does not - can not - do it for you, but goes with you.

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