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Knickers

The conversation turned to knickers on the last day of the workshop in Northern Ireland. We were talking about how we can help women feel safe in the hospital environment, so that their adrenaline will be as low as possible during labour, and their oxytocin and endorphin levels will remain high for a comfortable and efficient labour.

We were compiling a list of things that a woman may want to bring with her from home to make the hospital labour room more like home, and the issue of what she would wear during labour in was raised. Someone mentioned that nighties were preferred by women and I suggested that this would instantly make the woman feel like a hospital patient. How about an old T-shirt, or an old button up shirt, I suggested?

It then transpired that women were usually asked to take of their knickers when they were admitted and they were then left off for the duration of the labour. I was astonished. It was explained that this was necessary for the initial vaginal examination (mandatory) and then the rupturing of the membranes (also routine). When I asked how women then mopped up the inevitable dripping amniotic fluid that would appear with every contraction, I was told they would be asked to hold a sanitary pad between their legs! No wonder they stay on the bed and didn’t like to walk around, I suggested - how could any woman feel safe and at ease while trying valiantly to keep a possible soggy pad between their legs to prevent making a mess on the floor?

They were a bit stunned at this thought - I don’t think anyone had really considered the implications of this simple requirement for women to shed their knickers in labour. It is a good example of how routines can get established and be accepted without any consideration or re-evaluation. So many simple hospital practises fall into this category, of being performed by rote, on the basis of “it’s what we always do”.

I trust that these midwives, who were caring and considerate, will take another look at everything they do and put themselves into the position of the women in their care. Once you see things from the labouring woman’s perspective, it is easy to appreciate how a simple measure like asking her to keep her knickers on can make a huge difference to the way the labour unfolds. Of course, the routine vaginal examination and the rupturing of membranes was another topic for animated discussion, and that was another whole story!

Posted by andrea at October 30, 2005 05:40 PM