Remain Calm - St. Michael's Hospital, Toronto

May 10, 2019 - Modern obstetrics is rife with condescension, medical paternalism, and misogyny. Sometimes it's subtle, and sometimes it's not. Take these examples pulled directly from the website of a well-regarded downtown teaching hospital in Toronto, Ontario.

Although their multidisciplinary team includes world class clinical experts and cutting-edge medical researchers, their web copy could certainly use an update. Here are some highlights:

“It is important to remain calm, let them proceed with what they need to do, and ask them to let you know when you can ask questions."  - The Obstetric Justice Project

“It is important to remain calm, let them proceed with what they need to do, and ask them to let you know when you can ask questions." - The Obstetric Justice Project

"You will be taken care of by a nurse who has special training and experience in deliveries. From time to time a doctor may examine you and discuss your progress as well as any worries as they arise. Worries do sometimes arise during delivery and most of the time there is ample time to explain interventions with you, so that you understand and consent to any procedure (knowing how you will benefit from it and what the risks are). There are unfortunately some instances where something happens quickly (with you or with the baby) which requires fast treatment. If this happens, the medical team will have to treat quickly and will explain the situation later. It is important to remain calm, let them proceed with what they need to do, and ask them to let you know when you can ask questions."

"In fact, the most important factor during delivery is to remain calm. If there is anything abnormal or unhealthy occurring this will be explained to you in due course.”  - The Obstetric Justice Project

"In fact, the most important factor during delivery is to remain calm. If there is anything abnormal or unhealthy occurring this will be explained to you in due course.” - The Obstetric Justice Project

"In fact, the most important factor during delivery is to remain calm. If there is anything abnormal or unhealthy occurring this will be explained to you in due course. If no one has said that anything is out of the ordinary, keep in mind you are experiencing the normal discomfort of labour. This is one of the rare medical crises that is happy and with an unbelievably amazing result. Remind yourself of this... take comfort from your partner, family members or friends (and choose people around you who decrease anxiety and distress).”

“You are there to breathe and cope and push the baby out when the time comes.”  - The Obstetric Justice Project

“You are there to breathe and cope and push the baby out when the time comes.” - The Obstetric Justice Project

“Remaining in control of yourself and your fear is the one major way for you to help your labour along. Let the doctors worry about any abnormalities and, if none have so far been discussed with you, rely on their care for you and your baby. You are there to breathe and cope and push the baby out when the time comes."

“your ability to remain under control and not panic is vital to good labour”  - The Obstetric Justice Project

“your ability to remain under control and not panic is vital to good labour” - The Obstetric Justice Project

“Research has proven that good support (from family, partner, friend, doola) improves the progress in labour and decreases the amount of medication given for pain during labour. This could mean that less pain is felt by you or that you simply deal better with it. In fact, your ability to remain under control and not panic is vital to good labour (both in terms of oxygen delivery to the baby and the speed/ease/flow of labour itself). Choose someone who you trust, has the ability to make you feel assured/safe/less anxious/more brave. It is okay to have loving, intimate family members wait outside the room if they do not have this effect, and especially if they have the opposite effect."

“Pregnancy is not the time to lose weight, nor is it the time to become obese or diabetic.”  - The Obstetric Justice Project

“Pregnancy is not the time to lose weight, nor is it the time to become obese or diabetic.” - The Obstetric Justice Project

"One of the least fun things about pregnancy is the inevitable weight gain during this stage of life. For some, the losing control of our appearance (especially weight) can be frightening and even depressing. Remember that pregnancy weight is not like weight gained by inactivity or unhealthy diet. Just as the body naturally gains pregnant weight, it also has ways to naturally (and GRADUALLY) shed it off after the pregnancy.

So what is the SHOULD of weight gain in pregnancy? The medical truth is that it depends on your pre-pregnancy weight and body mass index. Pregnancy is not the time to lose weight, nor is it the time to become obese or diabetic."

“She will ask you about how frequent your pains are, what they feel like, and if you’ve had anything unusual coming out of the vagina. She will put you in a bed and ask you to change your underwear”  - The Obstetric Justice Project

“She will ask you about how frequent your pains are, what they feel like, and if you’ve had anything unusual coming out of the vagina. She will put you in a bed and ask you to change your underwear” - The Obstetric Justice Project

"Once you do arrive at the hospital you will have to report to the triage desk on the maternity ward located on 15th floor of Cardinal Carter South. If you do not know where this is you can ask at any desk and you will be directed. The nurse is the first to see you and get an idea of what brings you in. She will ask you about how frequent your pains are, what they feel like, and if you’ve had anything unusual coming out of the vagina. She will put you in a bed and ask you to change your underwear (even to put a gown on in some cases). She will put a baby monitor on your belly to measure the baby’s heart rate as well as your contractions. She may check your vagina to see how dilated you are and if the doctor needs to check you right away. She will also take your blood pressure, temperature and pulse. Depending on how you are feeling she may ask you to do other tests and even start some blood work or an IV."

“ The liquid pours into the vagina and then into your underwear. This can happen as a large fluid gush from the vagina, which is unmistakable and has inspired many Hollywood films."  - The Obstetric Justice Project

The liquid pours into the vagina and then into your underwear. This can happen as a large fluid gush from the vagina, which is unmistakable and has inspired many Hollywood films." - The Obstetric Justice Project

"Breaking the Waters - This happens when the balloon of liquid around the baby breaks. The liquid pours into the vagina and then into your underwear. This can happen as a large fluid gush from the vagina, which is unmistakable and has inspired many Hollywood films. However, if the hole in the ‘balloon’ is very small, the leaking from the vagina will be very little and may be hard to notice. If your underwear feels wetter than usual (ex. as though someone keeps pouring water over it) change your underwear, dry yourself off and check again in one to two hours. If you again notice wet underwear you should call maternal triage (416-864-5252) to be checked."

“Try to Relax, get back to your normal routine, and look forward to the next pregnancy.” -  The Obstetric Justice Project

“Try to Relax, get back to your normal routine, and look forward to the next pregnancy.” - The Obstetric Justice Project

"Pregnancy loss is common and, although you may not know it, many of the women around you have gone through it. Miscarriage during the first 14 weeks happens in one quarter of all pregnancies. It usually happens after natural mistakes in the making of the fetus. This abnormal fetus would make a very sick baby. Thankfully, our bodies recognize this and end the pregnancy early on. There are a few preventable reasons for early pregnancy loss such as smoking, cocaine, or heavy alcohol use.

Should this unfortunate outcome happen to you, please keep in mind that it was likely a natural process, which saved a very sick baby from being born. Remind yourself that this is common and that many of the women around you have gone through it at least once. If you have told people about your pregnancy you may start hearing the miscarriage stories of many women. If you find this distressing, tell these women gently that you would rather not talk about this issue. Try to relax, get back to your normal routine, and look forward to the next pregnancy. If you find yourself having a very hard time getting back to ‘normal’, let us know. We are here to help and to keep you safe during this difficult time."

“Pregnancy is temporary and you have the pleasure of knowing that when it is all over, your own naturally beautiful skin and hair will return.”  - The Obstetric Justice Project

“Pregnancy is temporary and you have the pleasure of knowing that when it is all over, your own naturally beautiful skin and hair will return.” - The Obstetric Justice Project

"Most women talk about how both skin and hair become more beautiful during pregnancy, and this may be true! Due to the increased hormones (estrogen and progesterone) in the blood stream, blood vessels in the skin swell and cause a ‘glow’ or flushing which can be very attractive. Hormonal changes also act on hair roots to stop them from dying. This means that women may have more hair during pregnancy.

Hormone changes during pregnancy can also result in acne, coarse hair, or even hair in unwanted places (such as the face or body). If this is you, do not worry too much. Pregnancy is temporary and you have the pleasure of knowing that when it is all over, your own naturally beautiful skin and hair will return.


Sources:
www.stmichaelshospital.com, May 2019


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