Saturday, 10 March 2018

International Women's Day

My client at the moment is aiming to have a VBAC (vaginal birth after caesarean). She has also developed Gestational Diabetes. The two things are not linked except in the fact that they both conspire to make her a "high risk" patient.
On Thursday she had an appointment with the diabetes educator, that is an expert in diabetes not birth, and the educator told her that at under five feet tall she would not be able to achieve a VBAC and should book in for a caesarean.
I have no desire to be a militant, doctor hating, suspicious, against-the-system kind of doula and I spend a lot of time reassuring mothers that nobody in the system is trying to do anything to upset them, just to be responsible and accountable but incidents like these make me into a liar. These situations where people step outside of their professional boundaries and say inappropriate things have the potential to derail a woman's confidence long before she has even a niggle of labour.
I wonder would a diabetes educator even dream of telling a man he was too small, too fat or too thin to have normal sexual function? Or would they stick to the task of diabetes education?

The timing of this pronouncement, on International Women's day, subtly underlines how far we have yet to go in the quest for equality and I am proud that one by one, I help womyn to find their subversive voices.

13 comments:

  1. Sigh. And hiss and spit. What in the name of all that is holy does height have to do with a vaginal birth?
    And hooray for the subversive womyn's choir.

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    1. The height myth often rears it's ugly head and even small subversions are worth it

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  2. We shall be subversive in the name of our own good and with our own voices, not echoing the voice of the subjugator.

    My mother had me vaginally, my brother by C section because of placenta previa, then sister vaginally. With fourth and fifth child she was not allow a trial to see if she could, so she had two more C-sections. She was not happy, but way back then, there was little she could do.

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    1. patients were completely unheard in those days!

      "not echoing the subjugator" i like that phrase

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  3. As you say, why not stick to diabetes education instead of making inappropriate unrelated comments? Too true, the quest for equality (or better still liberation) has a long long way to go.

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    1. Liberation is a better word. Thanks!

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  4. Why even take the diabetes "educator" seriously? Surely, it's the obstetrician's advice that counts?

    "Height"? I thought it was shoe size to determine ease of exit at point of birth.

    Anecdotally, one of my aunts, a miniature Marilyn Monroe lookalike, was tiny. Shoe size three (European). She gave birth to four children - none of them by C section.

    Other than that I fail to see what the subject you raise has anything to do with equality and/or Woman's Day. Woman's Day? Why do we need a woman's day? Is there a man's day? Until we do away with quaint little "woman's day" true equality won't be achievable.

    U

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    1. I think that when we are vulnerable and doubting our abilities, it is easy to be derailed by any random comment, no matter how thoughtless, uninformed or throw away it is so what diabetes educators say about birth does count, even though it shouldn't.
      Shoe size is just used as a different way of measuring height. I don't know why the height idea persists, plenty of small women have babies easily and plenty of taller ones don't, as you point out in the case of your Marilynesque Aunt.
      I have to admit that the subject seems poorly linked to IWD but as I said, I don't think men would be served the same amount of hogwash and with the timing as it was, I just had to comment.
      I once would have thought that having a day just for women smacked of defensiveness or inferiority complex, I might have agreed that half of the population barely need a special day but I have seen several thought provoking pieces online and I'm sure there are many more conversations going on in real life, all provoked by IWD and it is this that we need: conversation, about the big issues as well as the small ones.
      The is no men's day for the same reason there is no able bodied, cis gendered, white skinned, well off people's days: the systems we live with default to those people already. Every day is their day

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  5. What an excellent response. Considered, thoughtprovoking and respectful.

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  6. I understand your concern, but I would reserve judgement on the diabetes educator if there is any question of exactly what was said to the expectant mother. Having had gestational diabetes with my first baby (and being a small mother also) I know that my doctor was concerned about getting the diabetes under control ASAP to reduce the chance of a large baby, which would presumably lead to a difficult delivery or a C-section. A concern about baby's size may have been expressed to your client, but been taken as more of a command to have a C-section rather than a concern. Remember the telephone game? After something gets repeated a couple of times, it can change beyond recognition. Your client may have given you the shortened version, or a misunderstood version. I'm not saying it didn't happen just the way you've told it, but I am saying it's possible.

    I've always tended to see too many sides to a story, to the point where a cousin used to ask me how many hands I had (I was always saying, on the one hand "X" but on the other hand "Y" but on the other other hand "Z" . . . and apparently it's not something I've grown out of :))

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    1. Of course you are right, I don't know what was said, only what was heard and there are genuine risks to babies of diabetic mothers.
      This story seems to be recurring and I always find myself struggling to reassure increasingly anxious mothers who are usually doing well and managing their sugar levels quite capably. Maybe the mention of large babies and caesareans could be confined to those who don't comply with good management practice.....there must surely be some more middle ground

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    2. For sure - and especially if you are hearing about this over and over!

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