I'm fairly convinced that the care I received during the birth of my daughter was not quality care. I will concede I got a healthy baby out of the deal...but I was damaged in the process. I still experience a level of stress when I think of her birth or for that matter read about other people's births...and don't even get me started on the idea of the next birth. I'm still angry - it's been more than a year and I'm right pissed off, in part (in large part) because I know nothing has changed in the year since I gave birth and that things are unlikely to change before I next give birth (more than a year from now - quite possibly in another province if I have any say in the matter). It's 2011. I live in Canada. I live in a major city in Canada - and access to medically neccessary services during labour and delivery are questionable at best.
So what would quality care look like...here's a few ideas:
1. The childbirth approach decided upon by women and their care providers is respected and access is provided in a timely way. That means that if a woman and her care provider decide that a csection is the way to go then the woman gets her csection as planned. That means that if an induction is needed, the woman gets the induction - as planned. That means if a woman asks for an f*n epidural - she gets it without undue delay (within an hour).
2. Adequate resources are provided - this means that if its a level three hospital there should be dedicated obstetric anaesthesiology. If every other province can somehow manage to meet this standard why can't BC?
3. Outcomes would be measured - not just the broad measures (like infant and maternal mortality) but some of the other stuff that also matters like maternal satisfaction, rates of post-natal PTSD and post-natal depression, wait times for access to service, etc. Problems would be identified and solved...there would be a continual process of making things better.
Still angry though - don't know when or if it will pass.