Waiting for Agnes

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Oh baby August 21, 2010

Filed under: Midwifery — titchandboofer @ 3:38 am
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It isn’t often that the newspaper makes me cry anything other than tears of frustration. In fact, I haven’t gone out and bought a paper version of the papers for a while, usually flicking through the online version suffices. But it’s election day and here it is a crisp and sunny morning, perfect for walking our hilly streets and smiling at people conspiratorially – did you vote? I voted! We are all voting! The power! The responsibility! The democratic process at work, right here in our local primary school! Isn’t it a bonding thing, all of us here at the school hall, all for the same reason? It makes me want to do crazy things like talk to our neighbours and eat sausages in bread at ten in the morning.

Now we are home, the small one and I. He is snoozing in his bed, face buried in his sheepskin, arms flung wide. And I have the newspaper to spread out on our table, to mark with rings of tea from an overflowing mug, to ponder, to sneer at, to exclaim over, to sob into. Tucked just under the front cover, with its ubiquitous bloody photos of JG and TA, is this story of Grace Wang, her husband Jason and their baby Alexander. To summarise, baby Alexander is two months old. His brief time in the world has been spent by his mother’s bed in the high-dependency unit of a Sydney hospital. During her labour with Alexander, Grace elected to have an epidural. Instead of anaesthetic, an antiseptic was injected into her spinal canal. Grace is now a very sick woman, whose condition has thus far only worsened. Her prognosis is uncertain due to the uncommon nature of this complication. This is a woman who may not get to go home, who may not ever care for her son, who, simply put, may not survive.

When people contemplate the risks of childbirth I can guarantee this is not one of the factors they are considering. Midwives’ and obstetricians’ minds turn to events such as pre-eclampsia, shoulder dystocia and haemorrhage which can complicate a woman’s pregnancy, labour and birth. Parents try not to imagine a prolonged labour or a distressed baby leading to a forceps, vacuum or caesarean birth. They try and wrap their minds around what labour pain might be like, pitting their everyday ‘pain threshold’ against their predicted pain of contractions, bargaining with themselves about what they will withstand before they ask for intervention. They (and I know I am generalising wildly here) tell themselves that they will do their best, but in the end ‘all that matters is a healthy mum and a healthy baby’. They trust that when push comes to pull out that they will get accurate and complete advice. Mostly, statistically, they trust that they will be safe in hospital. And mostly no-one really believes that today, in ‘the safety of hospital’, in Australia, that women can be injured or die during childbirth. Obviously, in far far away, foreign-type places, where women get about squatting in fields to have their babies, this might happen. Because they don’t have hospitals. And people can imagine how babies might die during birth. Because they’re not in hospital, or they are in hospital but they were in the private system, or the public system, or born in water, or born on a weekend, or or or….

I get it, I get why no-one wants to believe that things can spin out of their control, leaving a mother or a baby without the other. It’s just too awful to contemplate. But the risks are real. And whether or not it’s warranted, all intervention adds risk. That’s right – even if a baby needs to be born by caesarean, the risks are not discounted by this necessity. I realise that the natural progression of this argument skirts dangerously close to blaming the victim. That is not my intention. I cannot blame Grace for a catastrophic drug error. Drug error. Sound quite banal put like that, doesn’t it? I can, however, blame a system that has seen epidural administration turn into a procedure that many people assume to be no more risky than popping a couple of paracetamol. I cannot count the number of couples that have been astonished by the reality of an epidural. ‘What do you mean in my spine?’ ‘What do you mean I’ll need a catheter?’  ‘What do you mean risk of nerve damage, paralysis, instrumental birth, incontinence?’

I know that there are times when epidurals are necessary. I’m also very aware that what happened to Grace is so rare as to have only happened once before that anyone is aware of. Yet it could mean her son Alexander grows up without his mother. And for that I cry.

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