I’ve been busy the past week researching and writing the last essay for my NCT antenatal teacher’s diploma and it is about “Informed Decision Making”.
Most of the essay I spent agonising over whether the educated, supported middle class mums in my classes had really exercised “informed decisions” because they had been a bit subliminally edged towards induction for dates and not for medical cause.
I switch on the TV and find myself watching an (edited) TV documentary about the “normal” birth of a young, healthy woman.
This lass has been induced: the syntocinon protocol requires constant monitoring which enforces supine posture which means maximum pain, leading to diamorphine offered. She’s knocked out by the diamorphine. Unsurprisingly with the synto, the baby’s heartrate gives signs of stress, so the midwife, rather interestingly, decides that as the mother is not fully dilated and the baby is showing signs of distress she must have MORE syntocinon – somewhat ignoring the likely cause of the baby’s stress signs – and therefore more pain relief, i.e. epidural. All this is conveyed in short sentences to a young woman who has not attended NCT classes or similar, who does not understand the implications of what is being done and who is in a drug induced haze …but is dimly aware that someone is trying to perform a vaginal examination. “Consent” for the vaginal examination is obtained (a murmured “yeah” but when the woman cries out “STOP” in pain, the midwife continues with the examination regardless. Consent? Informed? Decision? Are you having a laugh?