8/14/2020 0 Comments Opinion-Editorial - inductionPhotography: https://billbaren.com/pick-a-date-ep-18/ 43% of first time birthing women are being prescribed medication to induce the natural process of labour [1]. This number has increased by12% over ten years even though the World Health Organisation (WHO) recommends reducing unnecessary birth intervention [2]. Australian families are open and trusting of their care, yet they are not offered the full breadth of information around deciding on their baby’s birthdate. Their human dignity is being violated as this does not give women informed agency to participate in the decisions that affect their body and babies. The ‘Dignity of the human person’ is more than just being ranked evenly and focussed on the well-being of all. It is about having the rights to more than just the necessities in life, more than just a healthy mum and healthy baby. It’s the right to have our self-worth respected and to participate autonomously in the natural processes of our body without being controlled by an organisation’s policies and procedures [3]. The policies, procedures and recommendations within the medical setting are being guided by fear and litigation. The advice given misses relevant information about potential risks and negative outcomes for mother and baby. A risk that is often not discussed is that one drug intervention can lead to another. Inductions can be seen as the ‘gateway drug’ leading to pain and other medications that potentially result in a caesarean section. Caesarean rates are currently at 29.3% [1] when the WHO globally recommends a rate of between 10-15% [4]. Birthing women who had an induced labour had increased rates of haemorrhage (severe bleeding), longer hospital stays, more hospital re-admissions, caesarean section, hysterectomy, trauma and sometimes even death [5] [6]. Induction results in more stress and respiratory illness in the newborn. This leads to more separation from their mother, interrupted bonding, and less breastfeeding leading to many more illnesses [6]. These outcomes then hinder the realisation of the common good. ‘The Common Good’ can be defined as an extension of human dignity but for the greater community. Focus is applied to a structure that assists in the flourishment and fulfilment of the whole group [7]. The common good is a collaboration of the community to implement a framework to aspire to live together in a common space in a manner that supports all. This can also expand to injustice on a local and global level. The impacts of unnecessary induction affects us all in an economic [8], ecological and emotional [9, 10] way and do not reflect a framework of collaboration [7]. I was one of those women prescribed the medication to push along my labour. Now more educated, I realise this was unnecessary and lead to further pain medication due to its increased, non-physiological effects. This ultimately led to an instrumental birth, cut perineum and me and my baby being compromised during birth and for an extended time postnatally. As a birth worker I have witnessed many women being induced without true medical need or informed consent. I have also supported families informing themselves at each point of their journey, often making an informed refusal of medication offered. No matter the outcome, families informing themselves tend to come through that process far more emotionally and psychologically intact with the general feeling that if they did have an induction it was medically necessary [11]. When working with families and addressing the dignity of the human person and the realisation of the common good in my future practice as a midwife, I will address the WHO recommendations to reduce unnecessary intervention by working to provide continuity of care, not intervening too early and avoiding overuse of continuous electronic monitoring (CTG) [2]. I will also be mindful of ensuring that the advice of an induction is given and accepted with full informed consent [11]. With the statistics and outcomes being reported over and over again, it is not evident the decision for induction is being made on true medical need as recommended by Guerra, Cecatti [5]. It is also not evident that the human dignity of the birthing woman or emerging baby is being fully respected and ultimately the realisation of the common good within our Australian community. It is up to the next wave of informed and compassionate maternity health professionals to advocate for these changes to ensure humanity is preserved at a global level. References 1. National Core Maternity Indicators 2017: Summary Report, A.I.o.H.a. Welfare, Editor. 2019, Australian Institute of Health and Welfare: Canberra. 2. WHO recommendations: intrapartum care for a positive childbirth experience. 2018, World Health Organisation: Geneva. 3. Catholic Social Teaching. 2019 [cited 2019 16/12/2019]; Available from: https://www.socialjustice.catholic.org.au/social-teaching. 4. Betran, A., et al., WHO Statement on Caesarean Section Rates. BJOG: An International Journal of Obstetrics & Gynaecology, 2016. 123(5): p. 667-670. 5. Guerra, G.u.V.n., et al., Elective induction versus spontaneous labour in Latin America. Bulletin of the World Health Organization, 2011. 89(9): p. 657-665. 6. Mack, K., AWHONN recommends reducing overuse of labor induction. 2014, Eurekalert: https://www.eurekalert.org. 7. Velasquez, M., et al. The Common Good. 2014 [cited 2019 17/12/2019]; Available from: https://www.scu.edu/ethics/ethics-resources/ethical-decision-making/the-common-good/. 8. Callander, E.J. and H. Fox, What are the costs associated with child and maternal healthcare within Australia? A study protocol for the use of data linkage to identify health service use, and health system and patient costs. BMJ Open, 2018. 9. Delicate, A., et al., The impact of childbirth-related post-traumatic stress on a couple's relationship: a systematic review and meta-synthesis. Journal of Reproductive & Infant Psychology, 2018. 38(1): p. 102-115. 10. da Silva Lima, B.C., et al., Feelings amongst high-risk pregnant women during induction of labor: a descriptive study. Online Brazilian Journal of Nursing, 2016. 15(2): p. 254-263. 11. Jenkinson, B., S. Kruske, and S. Kildea, The experiences of women, midwives and obstetricians when women decline recommended maternity care: A feminist thematic analysis. Midwifery, 2017. 52: p. 1-10. MARKED: HD
0 Comments
Leave a Reply. |
JoWife, Mum, Doula, Student Midwife, Event Producer, Website Concocter, Cancer Transitioner, Dancer, Circler, Yogi, Organic, Suburban Hippie Archives
May 2022
Categories |