What is woman centred maternity care?
I have heard recently that rather than maternity services being described as 'woman-centred' they should be 'family-centred'. I tried this phrase 'on' for a bit and I've decided that I prefer woman- centred care. I'll explain why... Midwife literally means 'with woman'. When I first enrolled to do the Postgraduate Diploma of Midwifery I never really thought I'd be a midwife - I was doing it for some extra knowledge and skills. But within the first 2 weeks I had completely changed my mind - I wanted to be a midwife, I wanted to be 'with woman' during this extraordinary time in their life. Now, some are saying that this excludes the family - the partner, the baby that is in-utereo, other children. I say that it actually includes them whole-heartedly. If the woman so desires. You see, if you put the pregnant woman at the centre of your care, then by default she will include those who she wants to be included. The vast majority of the time this will include the unborn baby, the partner, and/or other children. It might also include her mother and/ our father, siblings, aunts and uncles, grandparents, close friends, or anyone else she wishes to be included. But let's say she doesn't have a partner, or other children, then it might just be her and the unborn baby. But then it might include her mother, or sister/s, or a close friend, but it might not. Maybe she's estranged from her parents, maybe her recognises another older woman in her life as her mother. But if you say 'family centred care' then what if the partner wants his (or her) mother to be involved? Their sister/s? An aunt or uncle? Where do we draw the line? In healthcare there is the very important law of confidentiality. As a healthcare provider I cannot disclose personal or health information about a patient or client to someone else, unless they are another health care provider involved in that person's care. Could I tell the pregnant woman's mother information about her daughter or the unborn baby? If I was providing family centred care the answer might be yes - because she is part of the family. What about the women's cousin twice removed? If I was to provide 'family centred care' who is my client and where would I draw the line in this confidentially? However, if I'm providing 'woman centred care' then there would be no confusion - she is my client and I cannot disclose any information to any other person without the woman's permission. If she says to me 'you can tell my mother anything to do with my pregnancy, but not my mother-in-law' then that is what I will do, even if the partner doesn't like it - because my first, and only, priority is the woman.
In family centred care what happens if a woman's wishes clash with that of say her partner? I can remember saying to my partner (initially in fun) 'if I want to swing upside down from the chandelier while in labour you need to help me get up there' but his reply was 'only if it's safe for the baby'. That almost made me want to try it!
Very few mothers would knowingly put their unborn baby in harm's way, but if a woman and her families views clash, then in 'family centred care' what would you do?
For example, what if the woman wanted to decline taking a certain medication during pregnancy (as is her right to do so), but the partner and other family members insisted that she take it? The woman may concede to the pressure of the family members, but ultimately the decision is hers since the medication is going into her body, and as a midwife I would support her in that decision (even if it goes against what I would do personally).
Some are also arguing that we shouldn't be using the word 'woman' either. But once again I will remind you - I am a midwife, I am 'with woman'. If a client comes to me and says 'I'd prefer if you didn't describe me as a woman or female' then I'd say 'no problem, what would you like me to say?'. Because they are my client and I respect their wishes. So I will provide you with woman centred care. If you want other family members involved then we well involve them, if you don't then we won't. And it doesn't have to all our nothing, or defined from the start - you can change your mind!
If you want your antenatal and/or postnatal care with a midwife please contact me - I would love to help care for you during this amazing time in your life! www.cherishedparenting.com.au/midwife-care-perth
