Is there a casual and callous attitude towards pregnancy and childbirth in society?(385 Posts)
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I'm sorry if I have posted my question in the wrong section but since I am a newbie I hope you'll all overlook it.
I have spent a lot of time recently wondering about the varied attitudes to childbirth and pregnancy and the lack of proper information regarding the process amongst most people.
I do believe that with the advancement of technology and better care we have been able to make the process a lot safer than it was in say the 1700s when the maternal mortality rate was 35%. However, it is my observation that people tend to take the whole thing for granted and assume all will be well because "women have been doing this for millenia".
I have keenly researched this subject and I have noticed that whenever I point out the risks associated with pregnancy and birth the reactions are those of disbelief and annoyance. I once brought up the possibility of fecal incontinence post childbirth and was admonished (by a man) to stop 'scaring people'.
I recently read a comment on a men's website that said "Pregnancy is the safest thing ever. It's not dangerous-to say that it is dangerous is misleading".
I certainly agree that the mortality rates in the developed world are rather low, but death is not the only thing that makes a process risky.
Pregnancy comes with superficial risks like permanent body changes to more serious ones such as permanent incontinence, diabetes, hypertension, uterine prolapse, obstetric fistulas (although these are rare), and even a permanent colostomy. Even in the developed world women still die of haemorrhage and aneurysms while giving birth.
Why is it that bringing this up tends to anger most people? Why do most people deny that these complications exist despite clear cut medical evidence that they do?
Is it traditionalism by virtue of which women are "meant" to bear children and therefore how can the process not be safe? Or is it just a paternalistic refusal to acknowledge that women do put themselves at risk for a series of complications (irrespective of whether they occur) when they have children?
I am not trying to imply that pregnancy and childbirth are horrible, evil things but I do believe that the attitude towards them is a bit casual and ignorant.
Your thoughts please?
Oh snap I just realised I should have posted this in the AIBU section.
I would get this moved to Aibu or even feminism as there is a feminist angle in what you are saying.
All interesting but as am up with insomnia fretting about elcs on Thursday , I am not really in best mental space to think about this
I remember being pregnant and getting a bit upset about a bloke (trying to be reassuring I think) saying "you'll be fine, women have been giving birth for thousands of years...". Yes, and quite a high proportion died of it. Thank God for modern medicine but it is still a big deal, so YANBU. Agree you should get this moved to AIBU or Feminism!
"we have been able to make the process a lot safer than it was in say the 1700s when the maternal mortality rate was 35%"
Are you talking about a lifetime risk or a per baby risk? Where do you get your figures from?
The research I've seen here has the rate in Sweden in the 1890's (before the advent of antibiotics and safe caesarean section) at just over 3 in a 1000.
And of course the massive drop in maternal mortality in the UK happened in the 1940's and 1950's, with the introduction of the NHS and the welfare state, at a time when almost all births were managed by midwives.
But no - I think we should sit up and take notice of the 40 or 50 women who die every year in childbirth in the UK. Particularly as these women are disproportionately from ethnic minorities, and from poverty stricken backgrounds. We need to address the issue of inequality in childbirth in the UK.
Sorry - wanted to add, that one thing we do have in the UK is a yearly report which examines the surroundings of EVERY individual maternal death. I think this is very important.
We also have very high levels of intervention in pregnancy and birth, which put the fear of god into most women, many of whom now spend the entire 40 weeks in a state of extreme angst about things going wrong. The saddest thing about this is that the huge increase in intervention rates and prenatal testing hasn't resulted in a drop in the stillbirth rate in the UK in the last 10 years.
Of course flagging up how dangerous birth is, and how many things can go wrong isn't going to improve the experience or the outcomes. If anything it'll make it worse for women.
One simple thing which is proven to make a difference when it comes to the safety of childbirth is to have better staffing levels in hospitals. There are campaigns running in the UK to promote one to one care across maternity units in the UK. OP - maybe this is something you'd be interested in supporting?
I have to say, when I was pregnant I did find some very odd attitudes towards pregnancy among men. One male friend of mine was very interested in my pregnancy, weirdly so, but when I told him that I was worried about getting having a tear during the birth and needing stitches he claimed that very rarely happened and I shouldn't worry about it at all. That of course isn't true, but when I told him that he just flat refused to believe me. I have no idea why. After I had my DS he wanted to know all about the birth so I told him I'd had a small tear and a few stitches. He was really shocked, properly shocked. It was very weird indeed. I thought about it for a while afterwards and reckoned that he was worried about me and couldn't get his head around the fact that I might be injured. He wanted to convince himself that nothing at all bad could happen.
In a lot of ways pregnancy and childbirth are very mysterious for men, it's something they're totally excluded from on a personal level. I found some men worked very hard to downplay pregnancy, to make fun of it, even to insult me (one in particular kept saying I was "fat") which I suppose could be a normal reaction to something unknown, or could be interpreted as a way of taking away the idea the women are special and can do something amazing that men can't (which would be my feminist take on it).
What dismays me is that women seem to collude in this playing down charade, particularly when they expect pregnant women to carry on as if nothing is happening to them (the whole "you're not ill, you're pregnant!" thing). The fact of the matter is, pregnancy and childbirth are way outside the normal experience of most people - they're a unique thing that most women only go through a few times in their lives. It's a dangerous process, and one that should be cherished, and recognised for the life-changing event that it is. It seems that women nowadays are expected to sail through their pregnancies, working till the last minute, pop the baby out with no pain relief, and be back in their pre-pregnancy clothes out walking with their perfect baby in a few days.
It's no wonder so many women end up feeling like failures.
I think you have to strike a balance between acknowledging that pregnancy is a special state and that pregnant women have additional needs (which it is, and which they have), and treating pregnancy like an illness, which of course it's not!
But as for pregnancy and childbirth being 'way outside' the normal experience of 'most people' - err, they're not. They're normal life events, albeit ones which aren't happening every week.
"women nowadays are expected to sail through their pregnancies, working till the last minute, pop the baby out with no pain relief"
Actually I'd say the opposite is true. Pregnant women these days experience a great deal of medical monitoring and testing, which yearly grows greater and greater. One fifth will have their labours induced. Over one in four will have their baby born surgically. One in three will have epidural analgesia. Almost all will have their baby in a high tech medical environment, despite the fact that for a large minority there is no medical need for this, and no benefit for them or their baby.
So yes - I'd say we're the opposite of cavalier about pregnancy and birth. In fact, as a society I'd say we love to meddle in both in ways which are both invasive and controlling, sometimes to the benefit, but mainly to the detriment of women and babies.
I got my maternal mortality statistics from here: http://en.wikipedia.org/wiki/Maternal_death
I am not really talking about the illness v/s normal state scenario. If you feel that pregnancy is overmedicalised you can refuse scans, fetal monitoring etc. and opt for a duola and home birth I'm one of those women who would prefer to have as many scans as possible, regular fetal monitoring, and consultant led care. To each her own and thankfully we can make these choices. That isn't what I'm talking about.
I'm talking about the denial amongst people and a failure to acknowledge that while being a perfectly natural process pregnancy and childbirth does come with a set of risks and possible complications. Treating it like an illness isn't right but then treating it casually is not the answer either.
I don't think it's right to force inductions and surgical births on women but think about this- some women may actually WANT to have their labours induced after a stage. Some may actually WANT an epidural or cesarian.
As for why they have their babies in hospitals, well some people just like to be on the safer side. And remember that a low risk pregnancy doesn't always imply uncomplicated birth. Some prefer not to take risks and I respect that.
I think you view the process as inherently safe, whereas I view it as inherently risky! No problem, just a different way of looking at things I suppose.
I think it's a very difficult balance for society to strike TBH - yes, many people may have a callous attitude, but set against that there's the increasing number of "pregnancy rules" about what you can't eat, and can't do, which smacks to me of society trying to control pregnant women and make them into walking incubators, doing what's best for the fetus at all costs.
I think that it is just something "not talked about" - very much like "old age". I always thought that people grew older, they got some help, they were looked after and they died peacefully in their sleep. Since visiting a few nursing homes, I have a very different picture (adult nappies, old people poo-ing themselves, old people swearing and shouting at the nurses, people generally waiting to die in a fairly miserable state - and that is in a good home!).
Many people have good/acceptable births (like many people die comfortably in their own beds, with their mental and physical faculties about them). So there is perhaps not a lot of point thinking about the worst when it hopefully won't happen.
Also there is a lot of research that suggests that being relaxed and calm during birth really aids a quick, easy, intervention-less birth. If you are scared, then your muscles are tense and you fight your own body's efforts to give birth.
I would actually say that society's attitude is the reverse of callous - it is trying to be protective (whether it is childbirth or old age etc). There is too much fear in the world as it is.
A different perspective on things anyway.
What do you want to acheive though? The majority of pregnancies do end safely and successfully with no lasting damage to the mother. It would be great if we can increase that majority but I am not sure that making society as a whole fret about it will help.
And I don't think people get annoyed when you bring up the subject of risk in pregnancy and birth. A bit taken aback maybe. But I think it's an irrelevance to most people unless they happen to be pregnant, newly delivered or know someone who is either of those things, or they are HPs who work with pregnant women. It's just not a big deal to most people - or is that the problem?
Is part of it a tendency to mistake 'natural' for safe? I feel a lot of people have told me that as pregnancy is 'perfectly natural' it is nothing to worry about. Which is a complete non-sequitur but it does seem to be a prevalent cultural belief to link natural and safe.
The sensitive nature of much of the damage pregnancy and birth can inflict probably helps keep it hidden to some extent as well. I knew people tore before I gave birth, but I had not heard the stories of faecal incontinence, infected stitches, tears not healing etc, that I heard after I gave birth - these were shared only amongst women who had all given birth, and I would imagine that most people who experience problems like these would not want to discuss these kinds of things with most people.
Then there is the huge array of pregnancy and birth experiences. Because some women can coast through with little problem at all (and possibly even some benefits?) it is not something that is universally damaging, and there is of course a large interest in letting women know that they don't have to be scared by it and that everything may well go swimmingly, for example to help women feel comfortable having homebirths if they want.
I do definitely agree with your general premise though, that the risks and suffering that can result is downplayed.
One question it would be interesting (but impossible) to answer is how differently pregnancy and childbirth would be portrayed and treated if it were exclusively men that went through them?
I don't think society is casual about giving birth any more than they are casual about any other action that might potentially cause death or injury but usually doesn't (taking a job on a building site for instance or driving to work).
The fact is that there is no evidence that worrying about these things beforehand- beyond taking necessary safety precautions- is actually likely to achieve any good, and it may even do harm. There is plenty of evidence to suggest that relaxed and confident women are less at risk from complications, just as a nervous roofer might actually not be the safest one.
I had a complicated pregnancy where things nearly went wrong. I am confident that all medical precautions were taken. Once I had decided to take the risks of falling pregnant (and I knew from the start there were risks) I would not have thanked anyone to go on about the inherent dangers; I just couldn't see the advantage to me in that.
I would be open to anyone else who needed to talk about their fears, but would not welcome a climate where there were constant hand-wringings about the dangers of having babies. Any more than I thank my mother for going on about the dangers about us going for a ride in the car; as a non-driver I am sure she has a point and we are taking a risk that she is avoiding by staying at home, but I still don't want to hear about it.
Please don't take offence to what I'm about to say but yours is the actually the attitude I was referring to. Truthfully not all pregnancies end without complications. Prolonged morning sickness, diabetes, RH incompatibility, hypertension etc during pregnancy and incontinence, prolapse and pelvic floor trouble post pregnancy are not as uncommon as you'd like to think.
I think you are right about what my issue is. The fact that it's not a big deal to most people.
I think you've understood exactly what I'm trying to say It's an assumption that natural s always linked to safe. To be clear, I'm all for encouraging women to swim and stay active through pregnancy and I don't view it as a disease at all. However, I don't think a lot of people understand and accept the real risks associated with the process and tend to treat it like a piece of cake!
I can easily answer what it would be like if men were the ones having babies Firstly, paternity leave would be a minimum of two years(paid of course). Cesarians under GA would be the norm and all natural childbirth would be considered "too cruel". Oh, and there would be a global one-child policy because no man will go through that twice.
I respect what you're trying to say. Some people know they're taking risks by doing certain things but they don't want to hear about it.
I'm concerned about the vast majority of first time mothers who have no idea about the full extent of the possible complications. I believe they deserve to be informed.
I'm being a bit picky here but bear with me. You said that it's a condition that can cause death or injury but usually doesn't. I'd like to correct that It usually doesn't cause death, but it almost always causes some kind of injury. I count tears, episiotomies and cesarian scars as injuries. I also include morning sickness, fainting spells, a lowered immune system etc. in my list of things that cause discomfort.
To be clear I'm not talking about a climate where people harp on about the dangers of pregnancy because that would be bizarre and tiresome!
I'm just talking about being better informed about what it actually entails and not living in denial about the true risks.
Good OP, OP, and now that they have rearranged the way MN is displayed in the topics you will probably get a wider variety of answers than you would have last week!
CailinDala I really enjoyed your post and agree with it.
I do think there is something a bit odd about the attitude of society to pregnancy, giving birth, breastfeeding, pregnant women and even children to a certain extent. Almost as if children are a necessary evil and when women are having them (note not couples - women) the least they can do is be all jolly hockey sticks and bounce through it....
Something anyway, I've not quite clarified it in my head. But yes there is something odd about it.
I did think it strange that when I did my antenatal classes the possible complications / problems with CS were covered in detail, but none of the possible complications / problems with VB were. I didn't even know about really bad tears and serious incontinence and stuff until I read it on here. I think women should be aware of these things.
Ok, bearing in mind this is a thread about the hazards of both pregnancy and childbirth (so it would be "too late" to tell people about them in ante-natal classes), when would people be educated in these matters?
Since I think that all of this information is out there for people who are truly interested (through various websites and through places like this), then I can only think that it would be part of sex education at secondary school (since you want to get the message to pre-16 year old girls? Might reduce the teenage pregnancy statistic a bit! ;)
I think they should have told us the possible complications of VB, as they told us the possible complications of CS. It did not feel even handed.
Do you think it's partly to do with society's slightly prudish squeamishness about "down there"?
By all means talk about the cut the surgeon made on your abdomen to get your baby out. By all means talk about your infected stitches, the permanent numbness and annoying overhang.
Don't ever talk about your episiotomy, grazed labia, your weak pelvic floor, the 4th degree tear. That's just not nice for polite society.
(Mind you, I didn't know about the numbing and the overhang until I read people discussing it on here either).
OK, no offence taken. I happen to think that is the right attitude to take.
If you think that pregnant (or intending to be) pregnant women need to be more aware of the potential risks, then more power to your elbow. Forewarned is forearmed as they say. Although I can't help thinking that if you are going to worry about the sort of minor damage that pregnancy does to most women you might never get pregnant in the first places!
Pregnancy is a normal (for want of a better word) thing for the female body. We were made for it. Undoubtedly it can go wrong and even when it doesn't can leave a body in a different state to the way it was before - so does ageing, illness, accident, we have to accept that as part and parcel of simply being alive.
But apart from wanting to see women better prepared, and to see the outcomes improve year on year (which everyone wants to see surely?), I don't understand what you expect wider society to do.
I think there is a certain prudishness about birth and I think it can feel quite lonely when you've been through a big, mind-bending experience but you feel you can't talk about it. I do think there's a certain dismissiveness about childbirth - people are often told that their experience of it doesn't matter because the baby is healthy.