Newcastle Baby 2023

| 2023
Nat: “How do you balance this ‘intuition’,
with the level of responsibility on your
shoulders”?
Dr AB: “The responsibility sometimes we
perhaps overstate, because essentially this
is a normal process that on most occasions
looks after itself. Birth is very different to
other medicine where you are dealing with
something broken and you work to fix it.”
Nat: “We could call you an old, wise,
obstetrician, couldn’t we”? [we both laugh
at the use of the word “old”]. “How are you
different to a newer, fresher, OB in the field?”
Dr AB: "Well I think, it would be a natural
thing for someone younger to come in and
want to control things and minimise risks,
and they find it difficult to relate to the total
uniqueness of every birth, it’s just seen as a
‘way of having the baby’, and that’s ‘not
much different to a caesarean’. That's not
a criticism by the way, that's probably close
to how I started out.”
We discuss communication styles
Dr AB: “I talk with each woman, not in
terms of ‘this is what you have to do’, or
‘allowed to do’, but instead I will say: ‘this is
probably what’s advised for you and now
you can consider this, in your situation”.
Nat: "How many trainee OBs have you
passed this onto?"
Dr AB: "Quite a good few, I hope. But it’s
met with active and passive resistance.
Because of the social circumstances of
birth there seems to be a need to discuss
risk in a blunt and authoritative way. I don’t
think anyone deliberately does it, but
women often feel scared into decisions -
the women say this themselves.”
Nat: “What’s the solution?”
Dr AB: “I’ve been having discussions with a
professional negotiator, a mother, who we
worked with for her birth, she is proposing
a “negotiating paradigm’. You would tell
the pregnant woman the risk, but also
acknowledge other significant needs
in the woman, that will modify how she
understands that risk. The discussion would
also acknowledge the needs of the OB.
Not just one person has the ‘answer’. The
problem is, stats are often mentioned as if
we do have the certainty, but it’s anything
but a certainty. In the cold light of day,
statistics about risk, are only averages.”
This frankness reminds me of how Andrew
spoke up about OBs “overtreating women”
in “Birth Time, the Documentary”.
Nat: “If one of your children were birthing
your grandchild what advice would you
give them?”
Dr AB: “I did have this recently! My son's
partner was birthing and I will be direct
here, I was concerned because she was
planning to birth in our hospital. I was
worried; is she going to be railroaded, with
the best of Intentions, into this and that?
I was worried that small, mild problems,
could mushroom into huge ‘potential
problems’ and her special birth experience
be taken from her - inadvertently.”
Nat: “What did you say to her?”
Dr AB: “My advice to her was to get into
one of the Midwifery groups. I also got
my son and her doing a private birth
course - which was great for them. This
approach later helped to cushion her from
the world of potential problems and even
when small mild issues did arise (a bit of
blood pressure), her birth was able to stay
special.”
Thank you Andrew, Natalie.
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21/10/22 12:31 pm