The relationship between our health and our health systems

The relationship between our health and our health systems

We live in a world where formal complaints made about people, industries and services have become common place. Health care is not immune to this trend with complaints by patients against healthcare systems and providers continuing to increase worldwide.[1]

This is very evident to me in my role as a perinatal counsellor where I have observed a sharp rise in women, and sometimes their partners, presenting due to birth complications and feelings of having been let down by the health service and its staff. Usually, the relationship between health professionals and patients/clients is underpinned with integrity which helps to navigate through medical problems that can and do arise. However, at times there can be an element of health professionals who act unethically and disrespectfully, and ‘obstetric violence’ is one such example of this behaviour.

Obstetric violence refers to when women feel violated and that they have not been treated with dignity and respect by health professionals during the delivery of what could be called ‘routine care’. Examining a woman vaginally without her consent, not providing information about what is happening or about to happen, physical restraint during birth, bullying the woman into having certain procedures such as an episiotomy or a forced caesarean section, roughly grabbing a woman’s breast and forcibly manipulating it into the baby’s mouth without consent, and sexually based comments are all examples of obstetric violence. One less common but particularly disgusting type of obstetric violence, coined the ‘husband stitch’, occurs when a woman’s vagina is deliberately stitched up more tightly than necessary. This is done due to the myth that a tight vagina equates to a more pleasurable sexual experience for the husband/partner, but it does no such thing and actually causes the woman excruciating pain when she is having sex. In fact, it could be considered a form of female genital mutilation. Such types of abuse are hard to reconcile, particularly as the status health professionals have long enjoyed is founded on a high degree of trust and respect by the general public.

It is clearly a double strike for women, and perhaps their partners also, when on top of the physical outplay, they feel they have been blindsided by disrespectful behaviour coming from those they had previously placed on a pedestal. It is this breach of faith in the ‘goodness’ of such professions and the professionals themselves that is hard to psychologically reconcile as much as any of the physical consequences of what has occurred. The violation of their rights can leave a long-lasting imprint and for several women, it reactivates memories of any previous trauma/s they have experienced, especially if they have a history of sexual abuse.

The impacts of a difficult, traumatic pregnancy, birth and or post birth complications are clearly very real for many women and their partners, and while birth trauma is now more commonly recognised, it is still treated as an individual issue rather than taking a broad lens to the subject. Medical systems and health professionals in general have been slow to acknowledge and respond to this problem in an organised, systemic kind of way. A birthing debrief can be organised for the woman and her partner with medical professionals, but from my observations, results are mixed with some finding the process very helpful in terms of healing, while others become even more distressed.

They feel that those they spoke with were more interested in mitigating any chance of blame and or risk of litigation than in genuinely working in partnership with them to help resolve the ongoing impacts of the trauma and review workplace practices to minimise the risk of similar occurrences happening to other women.

However, what is presented here is not aimed at criticising the medical system and those that work within it, per se. There is no doubt that thanks to the marvels of Western medicine childbirth is much safer these days than in centuries past.

Having access to a reliable health service and the development of a strong relationship between women and the health professionals involved plays an enormously important role in how women travel through pregnancy and feel about the birth and their post birth experiences. Yet globally, the state of our health systems are clearly not at a standard that they need to be.

What we don’t want to see however, is that the strength and integrity of these services are a reflection of where humanity is at, rather than being something separate to the people who work within them and the general population they serve. Hence, workers within such facilities are only one aspect of the equation when it comes to the standard of care and attention we receive when we seek support with health matters. We, the public, must also look at the part we play in terms of our responsibility for our health and wellbeing that in turn creates a demand which is placed back onto the workers and the system itself. It is cyclic in its demand and supply nature and while we are prepared to tinker around the edges, we are not yet willing to look more closely at what is going on.

What is obvious when we start to dig below the surface is the way that ideals, beliefs and expectations have all heavily contributed to every aspect of our lives. They reflect the level of worth we hold ourselves in, which in turn impacts how we care for ourselves and subsequently is then reflected in our state of health – as a health professional and or as a patient/client.

Using maternal health services as an example, the pregnancy experience obviously has an impact on women’s expectations regarding the impending birth. Some pregnancies flow smoothly and others can be very challenging with lots of nausea and other concerns such as gestational diabetes, hypertension, severe pain from symphysis pubis dysfunction and or a decline in mental health. There may also be worries about the growth and development of the baby and potential risk of miscarriage or premature birth. All these problems are real and there is a high reliance on the medical system to provide some type of treatment to minimise risk and relieve ill health symptoms, such as pain levels. Everyone is looking towards the end goal point where the baby is safely born and both mother and child are healthy.

However, there are a lot of interlocking parts involving the mother, the baby and the health professionals that contribute to the pregnancy and childbirth experience, yet women tend to only skim the surface and see childbirth as solely being the end point of a nine-month journey that started with conception and ends with the birth. The woman may see herself as being very responsible in the way she looks after herself, e.g., ceases alcohol and drug use, eats a healthier diet etc., and plans for the birth and caring for an infant. She may even feel a closer relationship than usual with her body as it changes shape with the growing baby and it’s highly likely that this is the most intimate she has felt with herself in eons. Appearance wise, it seems like the woman is doing a great job and ticking all the boxes for how she is expected to behave in such circumstances.

What is less obvious is the underlay of the ideals and beliefs women have collected along the way through avenues such as the media, interactions with friends, family and work colleagues, cultural traditions etc. It all sets them up for pictures around what needs to happen in order to have the perfect birth. Of course, some degree of preparation at a major time like this makes common sense, and many women can flexibly adapt their plans if needs be. Others, however, struggle hugely yet when asked to let go of dearly held ideals and beliefs and listen to and accept any advice provided that is contrary to the images they hold around childbirth and their perception of the role of any health professionals involved. It’s a resounding ‘no’ from these women to anything that they consider might spoil their plans as the grips of their belief systems, based on all the external implicit and explicit messages they have accumulated to that point, are so strong that what is being communicated to them is not given any credence.

Repeated attempts to explain what is going on and why certain procedures are recommended or necessary fall on deaf ears as women dismiss any medical advice and insist on doing things the way they have pictured it in their mind. Sometimes the consequences are dire for both mother and baby and the very thing/s women have been warned about, come to pass. It can be hard for women in these situations to acknowledge and accept responsibility for their part in what has occurred.

Even when some can realise the magnitude of how caught in ideals and beliefs they may have been in pursuing a certain birthing pathway, it is nonetheless still a major challenge to not then sink into guilt, regret and despair.

Others find the only way they can bear the pain is to blame those around them, including the health professionals. Either way, the result is traumatising for not just the woman, but also for others involved whether that is by personal or professional association.

The above shows that we can’t say that it is all the fault of the health system and its workers, and neither can we say that service users are innocent recipients – there is a dual responsibility here. While we aren’t responsible for the running of the entire health service on our own, we can look closely at the part we play. How we are personally living is extremely important and powerful in terms of its influence on the model and standard of healthcare available for us – and the behaviour of professionals delivering those services. Similarly, healthcare workers themselves have a responsibility for the quality of how they are living because the body they bring to work will reflect not just the state of their own physical and mental health but also their sense of purpose and their relationship with work, the quality of their interactions with others as they undertake their job, and their connection with humanity as a whole.

Every single person involved contributes to the standard of care and culture of the health service environment, whether that be through acts of service or through utilising the services offered.

Delving further into this subject, from the perinatal patient side of things it can appear that a woman has done her ‘homework’ and rigorously prepared for the pregnancy and childbirth, had regular antenatal appointments and followed medical advice. However, one aspect women often don’t stop to consider is the quality of their relationship with their body. It is taken for granted as being a functional tool to incubate and birth the baby and it is expected to then heal quickly so that it doesn’t impede women from physically getting on with their life as a mother. Usually, their body is treated as secondary to what they mentally want to do or have happen and then there is massive frustration and anger when their body draws the line and brings everything to a stop, e.g., through mastitis or migraines. The level of vulnerability women feel is then through the roof and difficult to bear and hence, the situation women find themselves caught in can physically and mentally feel very exhausting and traumatising.

But in these types of situations, do we really ‘stop’ and do a stocktake on how we have been living and the quality with which we have been treating our body – or do we keep pushing ourselves to the absolute limit, all the while loathing our body for not keeping up and performing the way we want it to? As women, we are notorious for disregarding our body, whether that be through the relentless ‘doing’ and ‘busyness’ as we turn ourselves into a slave to meet the needs and wants of others, or through taking on a hard and tough exterior ‘women can do anything’ type of ‘warrior’ mantle, or simply through neglecting the basics such as diet, exercise and a solid sleep routine. We are so programmed to rely on our thoughts as the supreme form of intelligence that we completely miss the early warning signs that our body is communicating to us.

It doesn’t occur to us to stop and question the source of our thoughts – yet we take it for granted that our thoughts are an indisputable authority, telling us what and how something, such as birthing, needs to be managed. There is no connection with the delicacy and sensitivity of our body and without the bodily connection, we are in separation from our inner stillness and Sacredness and our actions are definitely not tender, loving and nurturing. When we are living in anti-Sacredness, our bodies and minds pay the price because we have lost touch with our essence, yet this is the part of us that contains a wealth of wisdom and intelligence that can guide and support us with how to best care for our health and build our wellbeing bank.

As amazing as our bodies are for the way they keep going and going, the dismissiveness and overriding do take a toll and eventually the fuel tank runs dry and we experience some type of health complication and or disease.

This is the point where we then rely on a health professional to find the means to cure, or at least minimise our discomfort, and we get hurt or angry when the type of treatment we want is not forthcoming. But still we find it hard to acknowledge the part we have played in this whole chain of events, even if we are a health professional ourselves and have a wealth of temporal medical knowledge running in the background. So, are we really a victim of a floundering health system and at times it’s disrespectful and burnt-out staff or do we need to take more responsibility for the state of our healththe state of our health in the first place? This is not to say that illness and disease could be completely eradicated, but it would make a huge difference to the quality of people’s lives and their health overall if we lived in harmony with our body rather than treating it as a functional necessity that is expected to meekly go along with whatever and however our mind dictates something ‘should’ happen.

"In-truth, there cannot be an ‘unexpected’ medical diagnosis, simply because you and your body are involved in all that you do. You know all of its associations and involvements simply because you cannot live without your body and in turn, your body cannot but experience all of your choices."

Serge Benhayon Teachings & Revelations for The Livingness Volume III, ed 1, p 530

Our bodies deserve gold star status and treatment, for when we honour our bodies we find we have the gateway to our essence and when our body, mind and essence are working harmoniously together, we have access to the richness of love, wisdom and intelligence that reside within us all. Should we then need to present to a health service of some description, we come with a quality that lets those we are in contact with recognise that our body is revered as something very precious and accordingly, needs to be treated with immense dignity and care. When we respect ourselves, we find that that the impact on others draws them to respond likewise. Anything that does not meet this standard quickly reveals itself and we are able to call it out because we are no longer willing to pay the price for allowing harm via giving our power away and allowing others to treat us poorly.

Our job is simply to bring focus to and practically live what our body and the innermost aspect of our being are communicating to us, even when that requires us to have the courage to not override or dismiss ourselves or meekly capitulate to fit in.

We live it because it is what we are and the rest will be whatever it needs to be which means letting go of any pictures or expectations that people will change or that the healthcare system will miraculously improve. To some, it may seem uncaring or selfish to live this way, but it is actually the opposite because when we are true to ourselves, the love we hold within naturally flows outwardly and enriches everyone and everything around us. It is a truly loving gift that can be felt by all.

"Health is not the absence of ill-health.
‘Health’ is a joyous vitality that embraces life and its purpose with no reservations. "

Serge Benhayon Teachings & Revelations for The Livingness Volume III, ed 1, p 529


Reference:

  • [1]

    van Dael, J., Reader, T. W., Gillespie, A., Neves, A. L., Darzi, A., & Mayer, E. K. , Learning From complaints in Healthcare: a Realist Review of Academic Literature, Policy Evidence and Front-line Insights. MJ quality & safety, 2020. 29(8): p. 684-695.

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  • By Helen Giles

    I love that life is never static and is always presenting new opportunities for myself and others to grow and evolve.

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