Abstract
In this chapter, we present a critical discourse analysis of policy and practice documents. The risk culture of the institution is more fully explored, culminating in a discussion of how particular practices are then fashioned as risky or safe. Two pain relief practices—the use of water immersion and the use of epidural analgesia—and the discourses of risk and safety that accompany them are compared. The effect of discourse construction on actual choice for women is then investigated, evidencing the practical impact of dominant discourses and further substantiating the inherent institutional contradiction unearthed in Chap. 4.
TESSA
I really, really hated it.
I just—ugh.
Totally overwhelmed
I can’t believe that women have been doing it
For thousands, millions of years.
I just think if it was up to me
Civilization wouldn’t keep going
Because I think it’s,
I can’t believe it’s normal!
I just can’t.
They said ‘Go take a Panadol and see how you go’
I said ‘Is taking a Panadol necessary?’
And they said
‘Well you should go take one’
And they said
‘Look, it happens to a lot of women,
Sometimes it goes on for days and then
When they get into labour they
Are just too exhausted to do it’.
And then they said
‘Well, are you going to take a Panadol?’
And I said ‘Look I don’t even know if I have Panadol in the house’.
They said
‘Give us a call back in 2 hours’
I didn’t take Panadol
But I was pretty upset by this stage.
Then he drove me straight to emergency.
They put me straight on the bed
Because I couldn’t walk at all
Then brought me to the room,
And I was freaking out.
I was really scared and in a lot of pain.
The student midwife was really good.
I was trying to get her to distract me
I was trying to get her to chat to me.
As soon as I got there they offered me the gas,
Which is fine I guess
But as soon as I got in there they said ‘Do you want the gas?’
I’m like ‘Oh, yes, yes’
Because I was in so much pain.
I didn’t really like the first midwife who was there.
She wouldn’t let me get in the bath.
They were drawing a bath for me
And she said ‘No turn the water off.
We are not going to use the bath’.
I’d signed a water birth form
(Knowing that I might not get one)
They said ‘There isn’t a water birth midwife here’
I said ‘That’s fine I want a bath anyway’
Then I said ‘Why aren’t we going to use it?’
They said ‘We don’t think we are going to able to get you out.’
I thought that was a bit strange
Because my partner was there,
He could have carried me out.
So I was just in the shower for as long as I could be
Then eventually went back onto the bed.
I was telling him ‘I am scared.
I don’t think I am going to be able to do it drug free
I am in so much pain’.
What I found worst about the labour—
The contractions,
Just in my hips.
It felt like it was ripping my body apart,
I couldn’t actually feel them in my tummy.
You know, this is a study on what influences pain medication
And it was, for me,
Other than the midwife offering me gas,
The pain.
It was absolutely the pain.
I felt really discouraged by the first midwife.
She was telling me I wasn’t pushing hard enough.
I just felt like I was a little kid getting told off.
I didn’t like that.
Then the midwife got replaced.
I totally didn’t even notice anyone there.
And I felt,
I just felt really discouraged
And broken
From the pain.
But that’s it. That was it.
Afterwards I felt good.
Holding the baby I felt good.
I was under no illusion.
I knew it was going to hurt.
But…everything other than the pain was fine.
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Notes
- 1.
If the authors of the pamphlet are relying on anecdote, it depends who you listen to. Most midwives we know support the practice. If they are citing evidence, then it should be referenced. Either way, this is not a balanced statement.
- 2.
Two cases of extremely rare complications from epidural have occurred in the last decade in Australia alone. In one case, a woman died of bacterial meningitis following an infection at the epidural site. In the other, chlorhexidine was mistakenly inserted into the epidural, leading to paralysis. Adverse events have also occurred in the United States and the United Kingdom.
http://www.smh.com.au/lifestyle/diet-and-fitness/call-for-ban-follows-horrific-epidural-error-20110330-1cgb9.html. Viewed Dec 2017.
http://www.smh.com.au/articles/2004/03/09/1078594364666.html?from=storyrhs. Viewed Dec 2017.
http://www.nbcnews.com/id/9818616/ns/dateline_nbc/t/routine-epidural-turns-deadly/#.VEJC2BZ0a4k. Viewed Dec 2017.
http://www.dailymail.co.uk/health/article-506607/Mother-died-epidural-injected-arm-instead-spine.html. Viewed Dec 2017.
- 3.
This paper was even more interesting given that it was written by the head of an Anaesthetics department. Contradicting the dominant epidural discourse, Ross proposes that the pain relief mission of medicine is too simplistic in the case of childbirth.
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Newnham, E., McKellar, L., Pincombe, J. (2018). A Dialectic of Risk. In: Towards the Humanisation of Birth. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-69962-2_5
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