Breaking waters and trimming fat

“I gave birth outside Waitrose.” The story is admittedly unusual enough to be featured in the Guardian magazine, but lots of these “I gave birth in [insert crazy location here]” stories seem to start in the same way.

Woman is having contractions. She thinks she’s giving birth. She travels to the hospital. The doctors tell her she’s “not far along enough” and send her home again. So someone who’s already travelled all the way to the hospital is forced to make a second journey home, in the knowledge that they’ll be making yet another journey back to the hospital later on. (And possibly a fourth journey home again, if they fail the test again, followed by a fifth journey back to the hospital, and so on.)

Hospitals are sending home women who are frightened, in pain, in no fit state to travel – and crucially – actually in labour. And they do it because the woman isn’t “far along enough”. Almost every woman I know who’s given birth in hospital has gone through the misery of travelling to the hospital and being sent home again before travelling back to finally receive medical help with her labour. I even know women who’ve been through the fourth and fifth journeys described above: to the hospital and home again, back to the hospital and home yet again, then finally back into hospital to give birth.

I’m no expert in childbirth or indeed in anything medical, and I’m happy to say I’ll never give birth myself. But it seems crystal-clear to me that the current system simply isn’t working. It isn’t working on a “basic human decency” level, because it causes so much misery and stress and pain to women in labour. And actually, it’s not working very well on a “getting patients care at the right time” level either. Hence the stories of women being sent home, then giving birth at home. Or in Waitrose. Or in the hospital waiting room. Or in a car on the motorway. Or in a lift.

OK, so if the current system for measuring “how far along” a woman is isn’t working, what system should we put in place instead? I keep saying I’m not a doctor, but I suspect the current system isn’t working because all labour experiences are different and there are no set-in-stone reliable indicators. So… why not go with what the person in labour actually wants? If she’s travelled to the hospital, and she’s in pain, and she’s frightened because she has no experience of this, and she wants help from trained medical staff, what’s the harm in keeping her in for observation?

The problem right now is that we’ve pared our medical service down to the bone. There’s no slack in the system for people who are maybe-giving-birth just to wait on a hospital bed; they’re taking up a bed that’s needed by someone who’s definitely-actually-giving-birth. There used to be some slack in the NHS that could be used for acts of kindness, like elderly people getting a lift home in a spare ambulance, or a nurse having time to chat to a lonely patient. Not any more, because we’ve “trimmed the fat” and “cut down on waste” and generally made our NHS mean and target-driven and unpleasant in the name of “efficiency”. What I’m saying is: does it really have to be that way? Couldn’t we imagine a world where we decided that trimmable fat was actually a good thing, because it creates jobs and gives us all a better experience of medical care? A world where you might be born to a mother who didn’t have several stressful hours of travel shortly before giving birth to you? I’d happily pay more tax for a national health service with slack in it, if it meant more kindness.

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2 Comments on “Breaking waters and trimming fat”

  1. smallbeds Says:

    I think in terms of letting you stay in hospital… this is where the Spanish health service manages to make itself look better. Their hospitals, built in the boom times, are frequently in as-yet underpopulated areas, apparently built in a frenzy of forward planning, to satisfy demand for decades to come.

    But while they have a historical surfeit of spare beds – so they’ll rush you in with a moment’s notice – they’re beginning to experience a topical deficit of staff – so they’ll barely feed you, assuming your family will do it for you. Or, in the case of my dad, leave him in hospital for six days, for no reason except it was a weekend, now followed by the Spanish version of Father’s Day.

    Heaven knows what happens if you start feeling peaky during siesta time; I suppose you can distract yourself from your burgeoning ill health by having a bellowing match with your family, until the whole of Spain stops pretending that they’re having a snooze.

  2. […] favour of “fat”, “slack” and “inefficiency” for a while now. My blog post about people being sent home while having labour contractions was trying to make the point that a bit of “fat” in the system is good. Of course the […]

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