I am a community midwife who provides whole care for home and 'natural' hospital births. Whilst hospital can try to mimic the 'naturalness' of home, it invariably fails. It takes more than wallpaper and pretty curtains, intermittent monitoring and ambulation to change an entire philosophy, one that cries out to women that they *need* the safety of a hospital because their bodies are really unable to cope with childbirth, that pain is to be doctor controlled and expected to be terrible.
Women in my care have free choice regardless their past history. In four years I have used pethidine once at a homebirth and gas and air twice. This isn't because the women can't have pain relief, they don't ask for it!
I don't have to be 'laid back' in my care for the women; they direct and I observe. These women are never 'patients' so they do not adopt the 'sick role.' When women are empowered their babies are rarely compromised. We build a relationship of trust and total control for the woman. I realise that this style of care does not exist much in America, but it is up to us as women and midwives to support the best and least patriarchal care that we can.
-Astrid Osbourne, midwife, West Midlands, England
Reprinted from Midwifery Today E-News (Vol 1 Issue 36, Sep 3, 1999)
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