A voice in birth.

By Catherine Greenwood
Nov 2016

When I became pregnant in early 2014, I had no ideas of the challenges I’d face. I don’t mean the general parenting challenges that we all typically face; I mean the ones I’d face because I am a Deaf woman, and a NZ Sign Language (NZSL) user.

During the early pregnancy, for the typical check-up with my GP, the ultrasound appointment, and the appointments with my midwife, there were no issues with booking an NZSL interpreter for those because there’s funding in place for that, from the Government given to the sole national NZSL interpreting agency. This funding is generally for any health-related matters. Deaf individuals can also have access to funding for workplace use. There are also interpreters available at most tertiary institutes in NZ (though, to be fair, it depends on where in NZ you live!). So, in short, I had not really experienced any barriers when needing the services of a NZSL interpreter.

However, once I started to enquire about interpreters for ante-natal classes, and La Leche League (LLL) meetings, I encountered problems.

The hospital providing the antenatal classes wanted to only provide one interpreter for the 6-week 2-hour classes. Typically, an interpreter would work in segments of 20-30 minutes at a time, with at least a 5-minute break in between, as the job of interpreting is both physically and mentally demanding. Physically because they are using their upper body/arms to sign as well as doing facial expressions for grammatical features, and mentally because they are translating between two languages simultaneously – English and NZSL.

This is probably a good time to clarify that NZSL is not just a visual form of English. They both have their own structure, grammar, and vocabulary. E.g., I like ice cream (a VERY basic example of an English phrase) would be signed as ice cream, I like.

In addition to the above challenge, signed interpreting is quite different from spoken interpreting, in which the translation is consecutive – a few phrases in the first language would be spoken, then it would be translated verbally into the second language. Signed interpreting is done simultaneously. (Incidentally, a great resource is this website which covers many NZSL signs)

So, in practicality, this would have meant that the ante-natal class would have to stop every 20-30 minutes, for 5-10 minutes at a time, which is impractical for the CBE and the participants including myself – we wouldn’t be getting our full 2 hours’ worth of education at each week’s class. Also, the risk of just one interpreter is they cannot discreetly clarify with their teamer if they’ve missed something (which does happen, especially when technical terminology is used); they’d have to interrupt the class to clarify with the teacher.

To avoid this, where possible, two interpreters are booked for jobs longer than an hour. I asked the hospital why only one interpreter would be booked; their reply was that previous expectant Deaf parents who’d attended those classes were okay with just one interpreter. I think this was more of a case of them just accepting what was on offer, and not knowing how to advocate for their rights. After quite a few discussions in the end they agreed to provide two interpreters for all the classes. I felt this was a battle that was unnecessary.

I was interested in attending LLL meetings because I had heard of them through my sister and friends who were involved with LLL; because I was intending to breastfeed my baby, I felt it would be beneficial to attend some meetings before the birth to get information and tips on breastfeeding as I understood that it can have its challenges.

Unfortunately, when I enquired about booking interpreters for those meetings, it was considered a “want” (i.e., personal choices of education) versus a “must have” (doctors, midwives, and Plunket(!) appointments) in which case interpreters would have been provided for using the funding. That didn’t sit right with me as the funding is from the Ministry of Health, the very ministry that advocates for breastfeeding, so I felt that funding for attending LLL would fit their criteria!

Additionally, when I read the criteria, “mental wellbeing” was one – LLL would certainly fall under that category as it is not about the baby only, but it is also about the mother’s wellbeing.

After many emails, the manager at the interpreting agency then spoke with someone involved with LLL and found out more of what LLL was all about. They then got back to me and said that considering the new information they had, they felt it did indeed fit the criteria, and would be happy to use the funding to pay for interpreters at any LLL meeting I wished to attend. Hallelujah!

There are many active NZSL interpreters in NZ (about 70, for a Deaf community of around 10,000 – not that many in that respect), but few that I would have felt comfortable with letting into such a private and special occasion that the labour/birth would be. Also, because both my husband Daniel and I are Deaf, we had to agree on potential interpreters that we both liked and felt comfortable with! Fortunately, we soon agreed on two that we both liked, and after checking with them on their availability – especially their flexibility as we all know a natural birth cannot be predicted/planned – we were good to go, so to say. [Two interpreters were chosen, so in case one was unavailable at the time, the other would be able to come; and to work in shifts if needed – such as a long labour.]

The labour – funnily enough – was during Labour Weekend, and both interpreters were on standby; one of them would come when my midwife visited me for a check-up, either through the midwife contacting them directly or through Daniel texting them.

Then, when the midwife arrived at my house to stay with me for the duration of the active labour, the interpreter stayed too. The first one arrived on the Monday morning when the midwife arrived, then they swapped in the early afternoon. For a few reasons, I agreed to transfer to the hospital to continue labouring and have the birth. Later on, in the evening the interpreters swapped one more time, just before my son Magnus was born. The interpreter who had just gone off duty knew I was going to give birth soon and hung around outside. Shortly after my son emerged earthside, she came back in and joined the celebrations – through the pregnancy our relationship with both interpreters had developed into something special, and they were more than an interpreter at times – another support person essentially.

An excellent support crew! My sister, Dad, Mum, and the two interpreters, chilling after Magnus was born

It was vital that we had access to an interpreter at the birth, because obviously the ability to communicate effectively and smoothly two-way with the midwife was important. For example, Magnus had two episodes of duskiness where after breastfeeding, his skin tone went pale and he was floppy – I was able to quickly alert the midwife to this change in him, and he was immediately taken to the resuscitation area and checked (where thankfully each time his skin tone went back to normal and he was once again alert), and when the paediatrician had been called in to check him, both Daniel and I were able to fully follow what everyone (the paediatrician, nurse, midwife) around us were saying about our son and his health and we could give our fully-informed consent to the plan of action for monitoring him due to those episodes. It’s moments like that when timing and clear/effective communication is crucial to a good and safe birth for both baby and mother.

I feel I must also say it is important that an interpreter is present and that it’s not a family member (including a hearing partner!) or friend doing the interpreting. They haven’t had the training to interpret in high-pressure situations that a birth can be, and it is blurring their role: I feel a family member should be able to stay in the role of a family member and be able to offer that support that only a family member can and an interpreter can’t (as they’re bound by work ethics, such as staying in role while on a job). Especially when there needs to be medical intervention and it can be an emotional time for a family member/partner.

The access to interpreters during pregnancy and – especially – the labouring/birthing is crucial, and the access needs to be improved. I see this being achieved by more education for Deaf people themselves that they have the right to an interpreter if they wish to have one, and education for midwives (and medical staff at the hospital should the birth happen there). Some naively assume that Deaf people can lipread just fine – which may be the case for some, but then how would the Deaf person communicate back if they use NZSL? And quickly too? One-way communication is not good enough. My own experience with Magnus’ birth has reinforced the importance of being able to communicate effectively two-way and being able to make fully informed decisions which will only ever be able to be achieved by having an interpreter there.

A new family at home with a 5-day old Magnus.