Interview 56-Pregnancy

Age at interview: 32
Brief Outline: Two normal pregnancies. Felt well supported by midwives in making birthing choices. First birth was a water birth in hospital; hopes to have the same for second birth. More of this interview can be seen on the Healthtalkonline antenatal screening site as Interview 25.
Background: 1, aged 17 months at time of interview. Occupation' self-employed consultant. Marital status' married. Ethnic background' White British.

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She suspects that she might have been a slightly challenging patient to her midwife, whom she...

She suspects that she might have been a slightly challenging patient to her midwife, whom she...


 That was an example of, of her sort of collaboration with me I suppose in terms of how to proceed with my care, and it always felt that I was in control, which is very important to me. I suppose I was fairly well informed as a patient, as it were, and she of-, she said a couple of times to me, “That's not the sort of thing most people ask me”. Or, she did say to me, “You are very well informed”, you know, and gave me that feedback. 

But she, there was one example where I discussed with her at the late stages of pregnancy the fact that I didn't understand the need to clamp the umbilical cord straight after delivery, because I'd done some reading around it and I'd talked to a couple of friends and I couldn't appreciate why that was done. And the only conclusion I could draw from what I'd read was that it was actually sort of from a clinical expedience point of view that that was done, in order that, “Let's clear up the mess, let's get this baby sort of separated, and then we can get onto clearing up” [laugh], at a basic level. Whereas I was, was reading some stuff that would suggest that there was actually some benefits in retaining the umbilical cord intact for several minutes after delivery, in order that some of the goodness, nutrients, oxygenated blood from the placenta could be taken in by the baby before that supply got finally cut off. 
Because otherwise the baby would possibly have to reproduce those blood cells and so on for itself. And that for me seemed a much stronger set of arguments in terms of the baby's needs and to some extent my needs as a mother than some need for a doctor to sort, to clear up the labour room quickly [laugh]. And so I went to her and sort of explained what I'd read and said, “Am I missing something here?” And she, and she was very honest with me and she said, “That is to do with clinical protocol, and yes, you're right, that to a large extent the protocols around clamping and cutting the umbilical cord are not necessarily based on the baby's best interests”. 
She ended up essentially saying that to me, which confirmed my suspicions, and I don't sort of have a problem with that as such, although I think it's a bit curious. What I was then concerned about was, was my ability to express my wishes to not have that protocol followed tightly with my delivery if possible, and that I could benefit from having, to leave, leaving the umbilical cord intact for some time before then, until it stopped pulsating, until it, before it was cut. And so we got into that level of discussion and I felt it was very important from my point of view to be able to have those conversations. 
And did you, were you able to put it into your birth plan?
Exac-, yes I did. I did put it in and it happened and, you know, I felt, I felt very happy about that. But I needed her guidance to some extent and I think I - you see, I'm not even sure that if she'd have come back to me and tried to sort of, tried to give me, justify the protocol-based approach, I don't think I was particularly open to persuasion, because the evidence wasn't there that that was sensible from my patient, my own perspective. And so she could, she could deal with me as a fairly challenging patient, I think, and I think, you know, that helped to build a rapport and helped me to respect her and to trust her.
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