Maternity wards have a problem with attitude

The Slovak Spectator, 7. 7. 2015

Maternity wards in the Trnava and Bratislava regions were recently called out for violations of human rights. Were the claims exaggerated? A mother who gave birth both in Canada and Trnava compares.

No matter what country, the birth experience is highly dependent on individual hospital staff, their characters and attitudes. I had friendly doctors both in Canada and Trnava. My last birth in Slovakia was three years ago, and apparently things have improved since then in Trnava. There are, however, some overarching themes that differentiate Slovakia from other Western countries. The most important deficiency in Slovak hospitals is not a matter of money, equipment, or expertise, but of attitude.

With my first child, in Canada, I had admittedly an excellent doctor. “Look,” he said to my husband and I, “if birth is done to you, we did something wrong.” The birth, I felt, was a cooperation between us. For example, when I wasn’t progressing fast enough, he recommended a course of action, told me what it was and why he suggested it. I had wanted a birth without drugs and said I would rather not use them. He agreed to wait a few hours and then revisit the issue. When we talked about it again, I agreed to his suggestion.

The point is not whether or not I had my way, but that I felt that I had a role in the decision making. I had my ideals and physical symptoms, he made recommendations based on knowledge and experience, and we found a path together for a safe and beautiful birth. In Slovakia, on the other hand, the attitude can best be described by one nurse. With my second child, when I requested that an unnecessary procedure be delayed, the nurse snapped, “Since when does the patient tell the doctor what to do?”

(The procedure in question was a drug containing oxytocin, which makes contractions stronger to speed up delivery. This is given to everybody and I was told beforehand I could not opt out altogether, although it could be done after the baby was born, to speed the delivery of the placenta. I had been in the hospital all of ten minutes before giving birth and ended up laying on the delivery table for eight hours, so the hurry was purely for convenience.)

Practitioners in Slovakia feel that they are the professionals, with knowledge and experience, and that therefore they know best. Sometimes what they ‘know best’, however, directly contradicts new research and current practice in Western countries, like the position for delivery.

On my third time labouring, again in Trnava, I did not want to lay on my back with feet tied in stirrups and requested the new table, which they have. I instinctively felt what research has shown, that this is not an optimal position for giving birth. “No, no,” said the doctor and nurses, “this is the best way. Trust us, the old table always works the best.” They dismissed my request as unimportant because to them, it is part of a new fad. My request was unsubstantial because I may have read it on the internet, because I do not have a medical degree.

Well, the old table may work best based on the options they had in the last 50 years, but I don’t feel like they gave a fair trial to new methods. I can say with 100-percent surety, based on experiencing three births in three different positions, that I will never ever put my feet in stirrups again. Ever.

There was, fortunately, an improvement in attitudes of the nurses in charge of babies after birth in four years. Perhaps I happened upon a bad shift, but after my second child I swore I would not go back to Trnava, in part because of some Very Grumpy Nurses. I returned, however, the third time around, when I found out that I was expecting twins. As Slovakia has one of the highest rates of increasing c-sections in Europe at 30 percent, I was afraid that I would be forced to have a cesarean. A friend is a doctor in Trnava, and she agreed to let me try a vaginal birth though I could tell the idea made her a little nervous.

Incidentally, birthing twins naturally in Trnava was rare enough that a plethora of people came to watch the birth. I was distinctly annoyed at so many people being present, I was not a show to watch, but didn’t have the energy to start fighting.

The attitude of the doctors and nurses is precisely why a woman would want a doula, someone to advocate for her while she focuses her energy on labouring. While it is indeed an improvement that a woman can now bring in one person to delivery, I would argue that another person should be allowed, precisely because of the attitude of the hospital staff.