Even as a student midwife I do enjoy sitting down and watching an episode of OBEM, as do millions of other people. I love listening to all the different stories and of course seeing these beautiful babies being born. However, watching OBEM now is much more difficult than in my pre-student midwife days.
It is frustrating seeing everything we have been taught and all of the theory go out of the window in these programmes. My main bug bear (and something I repeat throughout the duration of the programme) is the number of women giving birth on beds; and the number of midwives that do not appear to suggest anything different to these women. Not only does it frustrate me on behalf of the women giving birth, but it frustrates me that this is the message being conveyed to all of the obsessed, hormonal and heavily pregnant women sat on their sofas watching.
It is something that has been proven and that is easily observed… If a midwife and a woman walk into a birthing room together, the woman will immediately gravitate towards the bed. I've seen it happen, and as a student midwife I have had the chance and the time to explain to women about the benefits of different positions.
There are times when labouring and giving birth on the bed is advisable. One of these times can be when a CTG monitor is required, another element that has a cameo on every episode of OBEM. A CTG monitor should only be used if there is a clear rationale for it, however it is an intervention that is often used unnecessarily on women. A CTG monitor does not necessarily force the woman to lay down, however most women feel more comfortable in a non-upright position, and often it is easier to maintain a clear trace this way; despite this, women should be encouraged to mobilise. Other reasons a woman may need to give birth on the bed is if she has a medical condition, if a forceps or ventouse delivery is required and with the majority of women who have had epidural pain relief.
Another aspect of the particular OBEM episode I watched this evening was the lack of encouragement the midwife appeared to offer this woman. The woman asked for an epidural - which is perfectly fine, but the midwife just said "okay."Although it is our role as midwives to facilitate women's choices, I felt like the woman should have been offered some words of encouragement and reassurance on how fantastically she was coping. My feelings are not because I wanted to the midwife to try to change her mind, but to remind her that she has faith in her, whatever her choices may be.
My biggest criticism of OBEM is how unrealistic it appears. It doesn't show the blood, or the amniotic fluid, or the delivery of the placenta. Nor does it show the women being checked and sutured. It doesn't demonstrate the business of the wards. The majority of trusts strive for 1 to 1 midwifery care, however this is not always something that can be achieved for the entire duration of a woman's labour.
I also believe that it needs to show a timescale. The way the programme is edited causes labour to look like: a walk from the car to the labour room, a few puffs of entonox, a vaginal examination and 2 minutes of pushing. For the sake of all the pregnant women watching, a time scale would give them a more realistic idea of labour. So that they understand that if they've been in labour for 12 hours and push for an hour and a half, that is not a failure, that is not slow progress, that is normal labour.
I guess that's it really, to summarise this, I don't believe that OBEM shows an accurate representation of normal labour and normal midwifery care. In practice I tell my ladies that it is a lovely programme to watch, I enjoy it, it's good television, but I advise them to take it with a pinch of salt and enter their own labours with an open mind.
N. x
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