LETTER: Childbirth is an 'extenuating circumstance'

To the editor:

I gave birth by unplanned c-section in January 2023 at NBRHC, I am grateful to be the mother of a healthy beautiful boy and I am grateful to the healthcare professionals who were involved in our care.

I recognize I cannot possibly speak for all birthing persons' experiences, but I can speak from mine.

I chose to plan for a birth at the hospital. In preparation for your birth at NBRHC, you are informed a support person will not be permitted while you are in the unit's triage. You will be triaged alone. A small part of the birthing journey as a whole, but alone nevertheless.

If all goes as planned, you — the birthing person — will be assessed, examined, and monitored for an undetermined amount of time until you meet the hospital’s criteria to be admitted as a patient to continue your birthing journey in the medical environment.

As I walked through what my birthing experience might look like, imagining myself being internally examined while in the throes of labour laying on a stretcher alone in a curtained room without my partner’s hand, comforting words, or touch … this just didn’t feel right.

In an email communication with NBRHC's Patient Advocate, I was informed this standard process mimics that of the ER and pre-dates COVID-19 protocols. They described birthing triage as being "quite confined," but also stated there is no existing policy that excludes support persons. The Advocate assured me there are various circumstances where a support person could accompany the patient — a sensitive discussion, admission, or "extenuating circumstances," for example. They were willing to make an exception … only just for me.

I declined their offer, if they aren’t willing to change this practice for all birthing people, then one exception is worthless.

As an RN, I can appreciate the bedside staff's experience - honestly, a patient support person can be incredibly helpful or annoyingly detrimental to your shift. However, the value of having a support person to calm and comfort a vulnerable individual cannot be overlooked.

There is plenty of evidence-based information to support the non-pharmacological management of labour, too much to include here. Specifically here though, the psychological experience — feeling safe and comfortable — is highly important in the physiological experience of labour. This human experience piece, however, is not taken into account in hospital procedures.

Hospital nurses are typically overworked, underpaid and understaffed. I can appreciate the risk of “efficiency” having additional bodies present during this process. Unfortunately, this is what medical settings are directed towards valuing — efficiency, on paper — as opposed to individuals' experience and overall health and well-being.

Birthing people need people, they need partners and advocates and comforters and continuity.

I want to call on NBRHC to review their processes, a simple change to allow one support person to follow the birthing person into triage if they choose. There is space, there is evidence, and there is research to support it. I’d certainly bet they would receive better patient satisfaction reviews, maybe that will appeal to their ear.

Katie Callahan

North Bay