The Care Factor


What is Care?

Is Care… love?

or is care providing basic needs?

Is Care a service?

Can you put a price on care?

Can care truly be outsourced?

Reports of abuse in dementia care, neglect in child care…nursing units understaffed, under paid…leave us concerned about the level of care we may actually receive.  We want, and expect, these care services to CARE.  We want them to love our loved ones as we would like to be able to, but work commitments or limited ability prevents us.  Culturally, we have come to assume an outsourcing of care.  Mothers are expected to return to work, as unpaid care work is not valued.  Our elderly are placed in ‘homes’, we try to visit as much as we can…

Are the highly dependent of our community pushed into these ‘care facilities’ so that we can get on with the busyness of life?  or because we believe they will be better cared for?

We know that care is essential, priceless even, and traditionally has been the unpaid (unvalued) responsibility of women.  Things have changed, with the move towards equality, and care is now outsourceable.  For a price.  We become very critical of every dollar spent.  We want the best for our loved one.  Can you even buy care?

From child care, to aged care…

what does it really mean?

Does paying more mean ‘better care’

or does this remain to be seen?

Weldon cartoon from The Big Issue 5-18 Oct 2018
Weldon cartoon from The Big Issue* 5-18 Oct 2018

There are many ‘care professions’.  One of these is the doula.

A doula offers support services, a continuity of care and carer, that fills a gap in our maternity system that was once filled by our female loved ones.  Before the medicalisation of birth, and the commodification of care, birth was a part of the everyday.  As females, we would have been around pregnancy, birth and newborns by default.  By the time we were having our own baby, we would be familiar with what to expect and surrounded by knowledgeable and caring loved ones.   But with the medicalisation of birth, we have a new default.  The knowledge was largely lost when birth was medicalised, and with knowledge lost so to was the ability to support loved ones.  In the current maternity climate, a loved one can be with you, but without knowledge or experience are limited in how they can care.  We rely on the medical system for ‘care’.

Can care without love, still be considered care?
Or is it something less, a kind of despair?

And love without the ability to care, leaves us stranded
The state of Society must be reprimanded!

In some ways, a doula is a ‘rent-a-friend’.  An outsourcing of care.  Very few women have a loved one who can provide the care of a doula.  The emotional, informational and physical support that a doula provides may be essential, and a human right, but it is elusive to most women. Traditionally, care is provided by a knowledgeable, and loving, experienced person.  With the state of society as it is, the doula has become an essential service.   The doula is trained and experienced. They have reclaimed knowledge on normal physiological birth.  They have studied to understand the maternity system, and how interventions can be avoided.  They can help us identify when they are necessary.  This is essential knowledge.  Birthing without doula care is like trying to breath under water.

The medical system is required to inform us, so that they can obtain consent.  This, also, is a sorry state of affairs.  The focus is not on decision making, but in ‘obtaining consent’.  Rarely are we privy to enough information to be able to provide ‘informed consent’, and yet, consent we do.  In the maternity system, we can plan ahead, with Advanced Care Directives.  Just as palliative care encourages us to do.  Birth is an area were an Advanced Care Directive is possible.  We can make Informed Decisions for various possibilities.  We can take the time, in advance, to understand the system, and the default care options, and communicate our decisions when they differ to the default.

Most people who write an Advance Care Directive for dying, do so because the default care is impersonal and focused on not dying.  This means many unnecessary interventions may be deployed in an attempt to prevent the inevitable happening naturally.  We still call death, death – no matter how it eventuates.  Whilst death is the outcome, the journey to death differs.  And leaves its mark on our loved ones.  And as the dying person, up until the point of death at least, the experience of a loving death, even if a medicalised one, is the absolute minimum we should receive.

It is the same with birthing.

Without an Advanced Care Directive, you get the default.  Impersonal, with the focus on not birthing.  This means unnecessary interventions may be deployed in an attempt to prevent the inevitable happening naturally.  We still call birth, birth – no matter how it eventuates.  Whilst birth is the outcome, the journey to birth differs.  And leaves a mark on our loved ones.  And as the birthing woman, the experience of a loving birth, even if a medicalised one, is the absolute minimum we should receive.  The way a woman felt during her birthing experience stays with her. It impacts her ability to care.

So why do we have Advanced Care Directives for dying, but treat women with ‘birth plans’ as if they are asking too much?


*The Big Issue is a wonderful magazine put out fortnightly, look out for a Vendor or subscribe and be a part of something awesome.

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