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Jan 12

‘A Mother is Born’ – A documentary

A group of three medical students from the University of Alberta examine the issues of “woman-centered care” and the various birthing options available for low-risk obstetrics.

The issue of decision-making with regard to one’s birthing experience has been a hot topic for some time now and one that has been responsible for significant changes in Alberta. Until recently, the only birthing options available to Alberta families were an obstetrician/physician-assisted birth in the hospital, or an unassisted birth in their home. Obstetricians are physicians who are reproductive health specialists, have advanced training in complex obstetric cases and are trained surgeons. These specialists are vital for handling high-risk pregnancies and emergency birthing situations. However, many obstetricians are finding, along with much of our medicare system, that they are spread too thin among their patients to be able to provide the individualized care and time they would like [reference 1].

While physician-assisted birthing is responsible for saving the lives of many neonates after high-risk pregnancies [reference 2], research evidence indicates that planning a home birth is just as safe as a hospital birth among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives [reference 3]. Natural birth

A midwife is a specialist in normal pregnancy and birth whose scope of practice includes providing primary care to low risk women and their newborns through pregnancy, birth and 6 weeks postpartum. Registered midwives have complete access to laboratories and diagnostic services; are able to prescribe and carry select medications, and consult or refer to other specialists when needed [reference 4]. Midwives work within the philosophy that pregnancy and birth are normal and natural life events so are present to enhance those experiences promoting wellness in women, babies and families [reference 5]. Complementing the work of midwives, Doulas are experienced in childbirth and provide continuous physical, emotional, and informational support to the mother before, during and just after childbirth [reference 6]. Inter-professional cooperation between midwives and physicians can help ensure that our families have adequate and safe birthing options to choose from. The utilization of doulas, nurses and other birth attendants can help make the birthing experience more satisfying.

            Consistent with the scientific evidence and the reality of an overstretched medical system, and following extensive public pressure, the Alberta government announced in 2009 that it would cover the costs for expectant mothers who choose to deliver their babies with a midwife [reference 7]. With this announcement, Alberta has officially welcomed registered midwives as an addition to our current birthing specialists. Being a very new addition to the list of mainstream medical services, midwives are often misunderstood, or missed altogether as a potential option for Alberta families. Three medical students at the University of Alberta recognized this knowledge gap in their program and worked to start educating their peers by putting together a film titled “A Mother is Born”. The potential role for doulas within the birthing team is also discussed in this film. We are pleased to have the opportunity to share this film with anyone who is interested.

            The documentary “A Mother is Born” will be shown on 19 January at 4pm at Able Body Health Clinic.  Admission is free, but we do request an RSVP to bbtfilmlethbridge@gmail.com so that we can provide adequate seating and refreshments.

For additional information about the documentary, see ‘Birthing Babies Together’ – A University of Alberta Medical Student Initiative where you can also watch the documentary trailer!

References

1) The Society of Obstetricians and Gynaecologists of Canada. http://sogc.org/wp-content/uploads/2012/09/BirthingStrategyVersioncJan2008.pdf

2) Centers for Disease Control and Prevention. Pregnancy Complications. http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregcomplications.htm

3) de Jonge A, van der Goes BY, Ravelli AC. et al. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. BJOG 2009;116(9):1177-84.

4) Alberta Association of Midwives. What is a midwife? http://www.alberta-midwives.com/aam/what-is-a-midwife/

5) Alberta Association of Midwives. Midwifery philosophy. http://www.alberta-midwives.com/aam/what-is-a-midwife/midwifery-philosophy/

6) Association for Safe Alternatives in Childbirth. Doulas online in Alberta. http://www.asac.ab.ca/alberta_doulas

7) Alberta Health. Benefits and Services. http://www.health.alberta.ca/services/midwifery.html

Comments (3)

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  1. January 15, 2013
    We will show the film at 4pm and again at 6pm on Saturday to accommodate for the number of people interested in viewing. Reply
  2. January 19, 2013
    Thank you very much for the invite to the showing and I appreciated the chance to do so. For the most part, I was favourably impressed. It showed a definite leaning towards focusing on birth as a normal, event that should, for the most part happen in a natural way. I was pleased to see that the professionals featured were quite supportive of natural birth. I do believe that if this is supposed to be used to educate medical students there should be more of a focus on the mother and the baby and less on the process of birth and the importance of the caregiver. The caregiver is important, but giving only a token nod to the mother and baby is not productive. And it wasn't exactly only a token nod, but I felt the focus was more on the professional and less on what normal birth should be about. If more mothers and their partners were interviewed, more visuals of normal birth, and not just tidbits were shown, that would do more to push forward the idea that mothers and babies are the primary important people in the whole equation. They are the most important and the only ones obligated to be present. Everyone else is expendable and only invited as a privilege guest. I have many strong opinions on birth, mostly as relates to myself (I have birthed all my babies at home, with only myself and my husband present. We have 5 children so far) but when it comes to others, I believe it is important for education and support. Whatever choice a mother makes, she needs total support in that choice and that needs to come from everyone who comes in contact with her. We need to move away from the dialogue of what's best for mum and babe, and more to the dialogue of 'here is information, become educated, I will help you to find the information you need, but the choice is totally your own, and I am here to support you in that choice with no bias or judgement.' It is coming closer to this, but we have a long ways to go. I have not a thing to complain about, in regards to my births. They were amazing, empowering and beautiful. But most importantly, I was the one in charge and in control of the decisions made. I was the one who was birthing. No one else was involved in that process and no one else had a right to make any decisions for me. The language that is used is important. Women don't deliver, doctors don't deliver. Babies are born and mothers birth those babies. Women giving birth are not patients. They are birthing women. This is the case whether they are at home, in a birthing centre or at the hospital. Whether it is a natural, non interventive birth or an abdominal birth. By giving the power back to the women giving birth, we bring birth back to where it originates from. Women and babies. I did like the poem/letter and I appreciated the professionals and their insistence that birth should not be intervened with so quickly. It just seemed the commentary was more clinical than it needed to be. If more of a cross section of women birthing in different environments as well as visuals of those births (at home, hospitals and birthing centres, completely natural, interventions and surgical births) it could do more to push those who will watch this for educational purposes to research more and question possible preconceptions. Reply
  3. January 23, 2013
    Thank you for your comments and participation in the discussion, Mary. I did forward this to the film makers and they were also grateful for your remarks as well as everyones. They wanted to reiterate that their "goal was to create a film that was respectful, balanced and evidence based. Instead of furthering the divide, we wanted to promote collaboration. I have watched some birth films that have presented the medical community terribly and in my opinion deepened the mistrust and miscommunication between groups." You are right that any one besides the mother and baby are extras but for some women, those extras are very welcome and maybe even needed at some point, which also needs to be acknowledged. Additionally, one of the film makers stated "We did make the film in large part to educate current learners so that their experiences are positive before they start practicing medicine. And we are enthusiastic that the students take what they learned from the film forward with them in a respectful manner. Also, it is absolutely necessary for the public and birthing women to be aware of the options available to them. As the attendee [Mary] posted - it is about education on the part of the birthing family and non judgement on the part of the care-provider." I and my family at Able Body Health Clinic are pleased that we had this opportunity to open the discussion in southern Alberta, it is just a small start to a large transition in our community. Just as a note, one of the barriers to increasing the footage of normal births is that it is an intimate event in a family so the film maker worked with what footage they were graciously donated. If anyone else is willing to contribute clips from their own births I think they would be grateful and try to include it while they make further edits to the film. Reply

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