Thursday, July 9, 2009

Pit to Distress

There's been a hubbub of late over Facebook on the recently outed term, 'pit to distress', wherein a provider will amp up Pitocin until the baby goes into distress (or shot across the room) so that a surgical birth can be performed, and the LDRP room turned over.

I think back over my time as a doula and I can't say any of my clients stick out to me as having experienced this but I'd have to go through my records because honestly my memory sucks. (Trust me, there's nothing worse for me as a doula than to run into a client who knows me but who I don't remember.... DOH!)

There's a follow up to the initial article here - and after reading it (also check out the links at the bottom of that page) I got to thinking about this looming wall that women and defenders of Birth (with a capital B, as in, unhindered, supported Birth) throw ourselves against.

I have stated many times (probably not in a recent enough post here that someone could pull it up but if you know me personally you know this about me: the current state of maternity care (if you can call it that) is NOT the doctor's fault.

Ha! Yes, yell at me, I can handle it.

It's not the doctor's fault. It's not the mother's fault. It's not the insurance company's fault.

Every one of those facets are looking out for their own interests. Women are looking to get through birth with the least amount of trauma and the highest illusion of safety. Doctors are looking to get women and babies through birth with the least amount of potential liability and insurance companies want to save money and not get sued either.

Blaming doctors is convenient and easy. And that is not to say that they bear no responsibility - in fact I am saying that we ALL do.

It is the culture of birth that must be shifted.

The culture where the number at the bottom of the spreadsheet bears more weight to us than the safety of women and babies, of preserving families.

I am not saying I have answers on how this has to happen and I know it is happening in myriad ways - every country and culture has their successes and failures where it comes to birth/maternity care. Some have more successes and others have more failures.

One of the fundamental things holding us back from progress in my opinion is the absolute unwillingness for doctors to converse with the many other facets of care that arises in birth. Long have I fantasized (and I know I'm not alone here) about a summit of people who cared primarily about providing the safest and highest quality care for women.

We can develop these questions and grow our outrage but at the end of the day our platform is the childbirth class - the quiet meetings of women at playdates discussing their birth stories - and in conferences where women reveal and are revealed in their own stories.

After reading this insanity about 'pit to distress' and how it is not an accidental consequence of events but an intentional sequence set to force women and their babies down a path without their consent or knowledge - I want women to stand in the streets! I want families to write articles to newspapers and blog for the revolution of maternity care- that the compass always be pointed toward true north - safety balance with compassion - and that no entity, group or individual, be allowed to sabotage that course.

I adore my obstetrician- I want so much in so many ways to follow in his foot steps. When I hear about things like 'pit to distress' I suddenly feel pain in my ovaries that require me to make an appointment with him wherein I can pepper him with questions about his practice, things he's seen, the right-ness and wrong-ness of it and how women can avoid it in the future. I also recognize that he is wonderful but not infallible and a part of me does not want to find out that he has consciously participated in this.

I think I've been hearing about the cesarean rate for so long (and now, being one of those numbers), that it just doesn't fire me up anymore. I know there are incredible organizations and individuals that are watching, recording and performing their many brands of activism around that.

For me, this fires me up- not the term or the fact that it's happening but that it has come to this at all. So where do we go from here? We've learned that women, while under anesthesia, were having their vaginas invaded without their explicit consent by students, we've learned that in some states the cesarean rate is approaching 50%, we've learned that women are being systematically lied to by providers (midwives are not without dirty hands!), that women were being given medications that were causing their uteruses to burst and their babies to die despite the outcry, and now we discover 'pit to distress'.

Enough is enough.