Pregnancy is an exceptional time in a woman’s life, so it’s best to take it easy. But how can you if the childbirth plan you’ve been preparing for weeks is falling apart? The change in the law that concerns pregnant women and newborn babies is very controversial. Is there really something to be stressed about and what can be done to stay calm?
Perinatal care under attack?
The Medical Activity bill has electrified the media because the Minister of Health will no longer set the medical standards in the regulations but will only provide guidelines for the organisation of healthcare services. What are the practical implications of this? ‘The opponents of the amendment are concerned that the many years it took to develop the specialist medical standards will go to waste. The standards ensure that women have the proper care during natural labour and identify the most appropriate method of pain relief. The standards also incorporate guidelines for dealing with complicated pregnancies, certain difficulties and obstetric failures. The Chief Medical Council, however, argues that the standards relate to normal, typical situations and as every case is different the standards should not be mandatory provisions of law. In the opinion of the Council, doctors should take advantage of the recommendations and guidelines that incorporate the best practices, however, situations in which medical staff would be afraid they may be acting illegally should be avoided, in the best interests of the patients’ he/she adds.
Giving birth no longer civilized?
The Rodzić Po Ludzku (Give Birth in Civilized Conditions) foundation is concerned that the changes may make meaningful issues dependent on the head of the ward, the doctor, or the customs on the maternity ward – issues, such as the decision regarding the position that the mother gives birth in, the availability of a bathtub, shower or a private room, the uninterrupted contact of the mother and the newborn just after birth, or help and support with breastfeeding. The Ministry of Health assures that they are not abandoning perinatal care as such, and the only thing that may change is the format in which it is regulated. The current medical standards will remain in force until the end of the following year at the latest. They will be replaced with new perinatal care standards which will be developed in cooperation with representatives of the Rodzić Po Ludzku foundation, along with all the relevant organisations. Detailed medical protocols will be developed by medical associations and teams of experts, in accordance with current medical knowledge and scientific evidence. Opponents are concerned that if the standards are no longer in law it will be impossible to cite them in potential court cases of patient abuse.
Changes, but not everywhere.
It is difficult to predict the actual effects of the amendment until it is tested in practice by the first pregnant women. Uncertainty regarding the scope of care during pregnancy or labour may be disturbing for expectant parents and may prompt them to look for alternatives to the public facilities. ‘The nine months when a new life is budding under the woman’s heart is an exceptional time, during which the expectant mother needs peace and quiet. Stress can have a harmful effect on the growing baby. Changes in perinatal care that affect public medical facilities may also convince pregnant women to give birth in a private facility (where the amended law will have no effect). ‘For some time now we have been noting more and more interest in pregnancy management and childbirth services. Considering how heated the debate regarding the changes in legislation is, we expect this tendency to continue.
Take care of your comfort
Despite the storm in the media, remember not to lose sight of the fundamental issues, such as the informed choice of the facility where you and your child will receive professional care, as that choice will have a real impact. Whichever facility you choose, public or private, check their care standards and amenities – make sure the facility ensures privacy, whether you can be accompanied by a loved one during labour, and whether you will be able to receive pain relief if necessary. Consult a doctor about the recommended referral level of the hospital in which you should give birth. ‘The first degree hospitals are intended for expectant mothers with uncomplicated pregnancies. Second degree facilities, including our hospital, ensure the safety of women who experience complications during pregnancy and provide specialist care for the babies immediately after childbirth.