Is there a casual and callous attitude towards pregnancy and childbirth in society?

(385 Posts)
PeaceAndHope Tue 17-Jan-12 22:43:23

Hello everyonesmile

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?

PeaceAndHope Tue 17-Jan-12 22:51:39

Oh snapsad I just realised I should have posted this in the AIBU section.
My apologies.

Gigondas Wed 18-Jan-12 01:15:53

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 smile

ninjasquirrel Wed 18-Jan-12 06:04:39

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!

shagmundfreud Wed 18-Jan-12 09:46:14

"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.

shagmundfreud Wed 18-Jan-12 09:55:08

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. sad

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?

CailinDana Wed 18-Jan-12 10:43:33

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.

shagmundfreud Wed 18-Jan-12 11:31:31

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.

PeaceAndHope Wed 18-Jan-12 12:31:21

I got my maternal mortality statistics from here: http://en.wikipedia.org/wiki/Maternal_death

Shagmunfreud:

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 birthsmile 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.

Bramshott Wed 18-Jan-12 12:35:04

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.

WidowWadman Wed 18-Jan-12 12:41:10
QTPie Wed 18-Jan-12 13:20:53

Hi

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.

OrmIrian Wed 18-Jan-12 13:30:58

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?

Mackrelmint Wed 18-Jan-12 13:46:50

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?

cory Wed 18-Jan-12 13:56:48

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.

PeaceAndHope Wed 18-Jan-12 14:08:43

OrmIrian:

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.

Macrelmint:

I think you've understood exactly what I'm trying to saysmile 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 grin 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.

PeaceAndHope Wed 18-Jan-12 14:15:39

Cory:

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 thatsmile 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.

PeaceAndHope Wed 18-Jan-12 14:18:43

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.

SardineQueen Wed 18-Jan-12 14:28:23

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.

SardineQueen Wed 18-Jan-12 14:29:54

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.

QTPie Wed 18-Jan-12 14:36:32

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! ;)

SardineQueen Wed 18-Jan-12 14:37:45

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.

suzikettles Wed 18-Jan-12 14:44:37

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).

OrmIrian Wed 18-Jan-12 14:56:29

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.

CailinDana Wed 18-Jan-12 14:56:57

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.

QTPie Wed 18-Jan-12 15:01:38

SardineQueen, was it NCT? If so they do tend to er on the side of "VB good, CS bad", but it can vary quite a lot from instructor to instructor.

If you are going to tell people the full gory details, then antenatal classes (had mine at 26 weeks plus) is really a bit late and would probably really panic every pregnant woman there.... Unless people can truly have a choice of VB/CS.

I guess that there is a trade off between knowledge and being relaxed and calm. Really you want to know enough to be able to do everything practicable to reduce the risks of hazards happening to you without scaring yourself into a rigid ball of tension who them fights the whole process of birth....

QT

OrmIrian Wed 18-Jan-12 15:03:04

"people are often told that their experience of it doesn't matter because the baby is healthy"

I agree with that. When my babies were small i wanted to talk about my experience but felt that no-one would be interest (they probably wouldn't!). i was off the end of the production line and back to normality. I do think there is an argument for having an old-fashioned 'confinement' when the mother was allowed to do nothing, to truly rest and enjoy getting to know her baby. But that lack of space and time to just be is missing from our culture as a whole - not just after childbirth.

suzikettles Wed 18-Jan-12 15:08:44

Yes, I remember being quite overwhelmed (in shock in a way I suppose) in the immediate aftermath of ds's birth. I wanted to tell my birth story to everyone - I think telling it a few times helped me process it, and I had a pretty straighforward experience - successful induction, quick (5 hrs), g&a only, episiotomy.

Anyway, I remember my mum being very disapproving of me telling my childless friend about it. Like it was something you shouldn't talk about with people who hadn't been through it, in fact you should brush it off and be grateful that you had your baby.

I would say within a fairly short time though the memory had almost completely faded. I did forget about the pain, and I'm lucky to have no lasting sequelae (except for not bouncing on a trampoline tbh). I think talking about it was a good thing though.

shagmundfreud Wed 18-Jan-12 15:13:13

"If you feel that pregnancy is overmedicalised you can refuse scans, fetal monitoring etc. and opt for a duola and home birth"

The point I was trying to make was about the culture surrounding birth, which all of us are prey to. Women are very unlikely to opt for a homebirth, or to reject antenatal testing when the prevalent cultural climate around pregnancy and birth is one of fear, no matter what the actual medical evidence tells us about the efficacy of antenatal testing or the safety of out of hospital birth.

The simple fact that 98% of women opt to give birth in hospital in the UK despite the option of a safe home birth service suggests to me that most women do actually see birth as being a possible medical emergency, necessitating immediate access to doctors and operating theatres

"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. "

Where is your evidence that people are treating pregnancy and childbirth 'casually'?

I see the opposite: unprecedented levels of fear and anxiety about poor outcomes.

"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."

Are people who give birth out of hospital taking risks with their health and that of their baby? hmm

"I think you view the process as inherently safe, whereas I view it as inherently risky!"

No - not at all. There is no denying the 1 in 200 babies who die shortly before or during labour in the UK. Or the two or three dozen women who die in childbirth every year. Childbirth is not completely safe for mothers or for babies. I'm very keen that it should be made safer. I think we just differ in how this issue should be approached. I'm interested in the practical things we can do as a society to make birth safer. I'm not quite sure what would be the purpose of a campaign to tell women how dangerous birth can be.....

PeaceAndHope Wed 18-Jan-12 15:14:04

OrmIrian:

What is your definition of "minor damage" and "minor discomfort"? And how did you come to the conclusion that most women experience 'minor damage'?

What I expect wider society to do is to not dismiss the risks and complications that are associated with the process, or worse yet deny that they exist despite evidence to the contrary. I expect them to have a little more respect and sensitivity towards the women who go through it.

CailinDana:

exactly
If a woman has a fourth degree tear and incontinence but her baby is healthy nobody would care much about her condition.

TunipTheVegemal Wed 18-Jan-12 15:14:34

Another thing that might be relevant is when people who are suffering badly with horrible-but-not-dangerous pregnancy complications such as SPD or severe NVP are told 'You're not ill, you're just pregnant.' Not just by relatives/colleagues/bosses, but medical professionals too.

WidowWadman Wed 18-Jan-12 15:18:07

Lying to women and withholding information about the risks of vaginal birth as not to scare them away from homebirth is the opposite of enabling informed decision making. It's patronising and dishonest.

OrmIrian Wed 18-Jan-12 15:20:22

Minor damage is what I consider I had - an episiotomy first time round, tears second time around, weakened pelvic floor (9 years after my last baby), not to mention droopier boobs, flabbier tummy etc that took a while to get back under control. My evidence is purely anecdotal - ie all the women I know who have had at least one baby. And I know quite a few. But if you have evidence to say that that isn't the case I'm quite happy to beleieve you.

I still don't know exactly what you want society to do though. It sounds a bit vague TBH.

FWIW I am perimenopausal atm and to be honest i feel infinitely worse, emotionally and physically, and more disregarded now than i ever did when I was pregnant and bfing.

CailinDana Wed 18-Jan-12 15:23:04

In our NHS antenatal class the midwife wouldn't show us the forceps as she "didn't want to scare us." I think that about sums up the attitude of some people - the idea that keeping you ignorant is the best way to keep you calm.

I do think girls should be taught all the ins and outs of pregnancy in sex education, after all, it's all part of the experience and they should know about it beforehand. I think it's quite sad that women have to seek out information online about things that will be happening to their own body.

PeaceAndHope Wed 18-Jan-12 15:25:12

Shagmundfreud:

No, I didn't say people who give birth at home are taking risks with their health. I fully support home births.
However, you must understand that some women prefer to be in an environment where emergency help is available such as a paediatrician for the newborn if required. Others don't feel it's necessary. Neither approach is wrong. While birth is not necessarily a medical emergency, I'm sure you're aware of complications such as asphyxia, hypoxia, shoulder dystocia, post partum haemorrhage and cord prolapse which could very well result in an emergency situation. Sadly, there is no way of predicting who will experience these complications so one cannot be prepared in advance. Unless you can predict who will suffer these complications, you can't give anyone a 100% guarantee that they don't need to be in a hospital.

I think you're deliberately misunderstanding me. I'm not wanting to start a campaign telling women about the dangers of pregnancy, I am simply questioning the attitude of denial and casual dismissal which exists in society regarding pregnancy and birth related complications.

Yorky Wed 18-Jan-12 15:29:49

I think people like me are part of your problem - my 1st pregnancy was easier than easy, I had no morning sickness (major blessing as I was working in catering at the time!), no blood pressure problems, no SPD - I had a home water birth, the MW arrived 45mins before our son, the placenta arrived without injectino or difficulty, I had no tear that needed stitches, he fed easily and happily
And while people can do it like that, it always more comfortable to turn a blind eye to faecal incontinence, emcs, 4th degree tears, sore/blistered/cracked nipples, GD, PE, BP complications etc and say well, 'it may not happen to me'

For what its worth I am on pg#4 now and they have got progressively harder work (but no more medically complicated on my notes) - not sure if thats due to having toddlers to run round after as well as a bump, or my body feeling the cumulative effects of 4 pregnancies in 6yrs

I remember when I restarted my yoga classes after DS1s birth, when he was about 2months old, and my yoga teacher specifically told me not to try and stretch as I still had the hormone relaxin in my system and my body would be able to stretch further than was good for it, causing problems later. She said she would consider me a postnatal yoga student for 2yrs, but before those 2yrs were up I had a 2nd child (and we'd also moved so I didn't have the benefit of her advice sad ) My MW/HV had never mentioned this as a possibility, and I find being considered post natal for 2yrs quite extreme, but it does make me wonder about attitudes to new mums - not just the pressure to get back into your pre-pg jeans - would love to be part of those cuktures where mums are waited on, or kept to bedrest for a period after the birth (although I do think I'd go spare, the thought of a section and not being able to drive for 6wks terrifies me!)

Sorry this is so long and more about postnatal then preganancy, but I do think similar attitudes prevail

NeedlesCuties Wed 18-Jan-12 15:31:45

This is a really interesting OP and discussion.

Not sure what is 'right' or 'wrong' but from my own experience I feel that the shiny sunny happiness of adverts for baby items and pregnancy magazines really give a rose-tinted idea that isn't what happens in real life.

Either the magazines mainly focus on prams, maternity wear etc rather than health, issues, real experiences in order to sell more products or that is what sells because people want to see the sunny side of life.

The general ignorance in society about fertility rates and ages astounds me, never mind the ignorance about tears, pain relief, pregnancy issues etc.

PeaceAndHope Wed 18-Jan-12 15:34:42

OrmIrian:

What you consider minor damage might be more problematic for others. I know many women who would find their quality of life severely reduced by a weakened pelvic floor and self esteem a bit damaged by a body that changed for the worse.
However, these women are dismissed and told to get over it. That is the attitude I abhor.

I didn't understand what evidence you're asking for exactly?

FruitSaladIsNotPudding Wed 18-Jan-12 15:34:58

I agree with those who say there is a culture of fear surrounding childbirth, if anything.

Increased intervention in a double edged sword as well - it certainly isn't true that hospital and doctors = safer. Although that is the common perception, as the op is showing!

CailinDana Wed 18-Jan-12 15:36:02

From a feminist point of view I think some women downplay pregnancy and birth because they feel under pressure not to appear "weak" and "womanly" - they feel they should just get back on their feet and be ready to go as that is what successful go-getter women do. My greek friend assumed I would have 40 days in bed after the baby was born, as that's what they do in his home town. He was really surprised when I said I was in the pub three days after DS was born! (not drinking, just for a coffee, honest!). I didn't need the time in bed as I'd had a straightforward birth but I could see why a lot of women would.

The fact is, having a baby is a massive experience, whether you have an easy or difficult birth. Yet there seems to be very little acknowledgement of that fact. The media celebrates women who get back to "normal" (ie skinny) in double-quick time and PND is talked about very seldom. Even though DS is a year old and his birth was fine, I still sometimes have flashbacks to labour and I can't believe it all actually happened. I mean, I grew a person, and then he came out of me!! WTF!!

PeaceAndHope Wed 18-Jan-12 15:37:18

NeedlessCuties:

YES. I wish that these mommy magazines would focus a bit more on real issues instead of painty a romantic notion of motherhood.

I am like you in the sense that I'm constantly astounded by the ignorance regarding these issues and the insensitivity towards them.

PeaceAndHope Wed 18-Jan-12 15:41:58

FruitSalad:

Is it possible for you to clarify how my OP implies that hospitals=safer? That wasn't even really part of the actual discussion.

If you judge women who prefer hospital births, you're no better than those who judge home births. Perhaps if there were better information and more honest opinions available to women they would make decisions based on personal preference and not fear or alternatively an overly positive view of the outcomes.

shagmundfreud Wed 18-Jan-12 15:46:11

"However, these women are dismissed and told to get over it."

Who exactly is telling these women to 'get over it'?

Who exactly is dismissing women who have medical problems following childbirth?

PeaceAndHope Wed 18-Jan-12 15:47:06

CailinDana:

That's an interesting point. I think you can look at it the other way as well. Some women downplay the risks and complications because they feel like less of a woman if they have complicated pregnancies or deliveries. I think the common perception is that our bodies are meant to do this. Complications often result in women blaming themselves and feeling like failures.

PeaceAndHope Wed 18-Jan-12 15:49:30

Shagmundfreud:

Do you want names? Addresses? Phone numbers?

It's a general attitude I've noticed in my 31 years on the planet. I don't know why your attitude towards this discussion is so hostile, and I'm confused as to what point you're attempting to make.

shagmundfreud Wed 18-Jan-12 15:55:05

"If you judge women who prefer hospital births, you're no better than those who judge home births"

I don't think there is any moral judgement going on here.

I assume that women who choose a hospital birth do so because generally they believe it's the safest and most appropriate place for them to give birth.

Is it unreasonable or unpleasantly judgemental to assume this?

"YES. I wish that these mommy magazines would focus a bit more on real issues instead of painty a romantic notion of motherhood"

Have you got any of these magazines to hand, so we could discuss the actual content?

March's edition of Mother and Baby magazine carries an article on postnatal depression.

Other issues I've seen have had articles on special care babies, baby loss, pre-term labour, emergency caesareans, etc.

Although I will give you that primarily they seem a vehicle for flogging products, particularly formula milk, adverts for which (and for bottlefeeding equipment) seem to form the bulk of their advertising revenue.

NoWayNoHow Wed 18-Jan-12 15:59:32

This is a really interesting op, OP.

I tend to agree with you - I do feel that we downplay the potential complications with giving birth. 4 years down the line, I'm still traumatised by the whole thing, mainly because nothing that happened to me was even discussed in my NHS ante-natal classes.

In fact, the presiding messages were as follows: don't bother us until your baby is crowning; if you have an epidural, on your head be it, they cause delays, are only for sissies and will make your labour horrible and long if they don't stop it altogether; VB is textbook and standard and straightforward, this is what happens, and then you go home (unless you have an epidural, in which case meet my friend the forceps).

No mention of episiotomies, tears, ventouse, etc. I was just poorly informed, and being poorly informed left me badly prepared, and being badly prepared left me in a situation where I was having to make decisions on my labour without any in depth information whilst in a delirious sleep-exempt state.

The casual attitude to pregnancy and how it's just supposed to go swimmingly leaves me cross for all the above reasons. But it also leaves me cross because I truly believe there are women out there who are beating themselves up because their labour and birth WASN'T like they were told it would be, and in their minds it is their own fault - they feel they did something "wrong"

shagmundfreud Wed 18-Jan-12 16:07:34

"Do you want names? Addresses? Phone numbers?

It's a general attitude I've noticed in my 31 years on the planet."

I assumed you were talking about general social trends, rather than the particular attitudes of your friends and family.

shagmundfreud Wed 18-Jan-12 16:14:40

"because their labour and birth WASN'T like they were told it would be"

Don't most women know that over one in four births is by c-section in the UK, and that the majority of these are emergency c/s?

Who is telling women that their births WILL be straightforward?

thebody Wed 18-Jan-12 16:19:32

very interesting post and agree with Cailindala.

I once heard a male consultant on tv saying that the journey to 10cm is the most dangerous journey for mum and baby and thats right.

I nearly lost my first ds, in a hi tech hospital, hes fine now thank god and I had a good friend who lost her child in a home birth so pregnancy IS riskyand yes I get sick of the attitude of some that 'chinese women give birth in a field and then carry on' yes and lots die.

I have another friend who has a permanent illeostomy as she was cut during birth and the midwife caused her parmanent damage.

after 4 dcs I take for granted the bladder weakness, droopy tits, stretch marks and loose pelvic floor, feel got off quite free tbh

mummy magazines are ridiculous in the headlines, 'get the birth you want'. thats crap, you get the birth you get and theres very little you can do to alter this.

I hate the attitude of the types who say all births can be vaginal if you stay calm or go to the right classes, crap crap crap.

however I tend to think that its women doing this to women most of all.

NoWayNoHow Wed 18-Jan-12 16:22:51

Shagmund the midwives in the NHS classes are telling the women that their births will be straightforward, either by saying this directly (as was the case in my class) or by omitting to mention all the various complications and interventions that frequently happen that aren't straightforward.

And as a woman you went through an unbelievably traumatic VB, I take issue with your implication that unless it's an EMCS, then the birth must be how we imagined it would be.

You are being quite antagonistic on this thread - is there any particular reason for that?

CailinDana Wed 18-Jan-12 16:28:32

I agree with NoWay. The midwife at our NHS antenatal class honestly thought it would be "better" for us not to see the forceps. On what planet? How can anyone think it's better for someone to know nothing about an intervention that might happen to them in the not too distant future? It would be one thing if forceps were something used only in surgery while the patient was unconscious - then there would be no point in seeing them, but they're used on a fully conscious woman who can often feel what's being done - hiding them from her will only make her feel more unsure and afraid.

NoWayNoHow Wed 18-Jan-12 16:32:34

Sorry, that should read "as a woman who went through"

shagmundfreud Wed 18-Jan-12 16:34:42

"Shagmund the midwives in the NHS classes are telling the women that their births will be straightforward, either by saying this directly (as was the case in my class) or by omitting to mention all the various complications and interventions that frequently happen that aren't straightforward."

Which hospital did you do your antenatal classes at?

My NHS classes mentioned emergency c/s, forceps and ventouse.

If the midwife told women that they would have no complications in their births or spoke in such a way that women came away from the classes believing that the 27% c/s rate in the UK is actually a myth and that ventouse and forceps use are vanishingly rare, then I grant you there are grounds there for and official complaint.

Luckily for us we now have 'One Born Every Minute', which will reveal the truth of hospital birth the UK - that it usually seems to involve drips, continuous monitoring, lying on your back crying for long periods of time, instruments, surgery, and probably being left on your own a lot.

shagmundfreud Wed 18-Jan-12 16:39:03

"mummy magazines are ridiculous in the headlines, 'get the birth you want'. thats crap, you get the birth you get and theres very little you can do to alter this."

Given that there are some very basic things you can do that can signficantly improve the likelihood of getting through birth without needing surgery or other intervention I think it's very reasonable for magazines to discuss the issue of choices in childbirth. As long as women are clear that nothing can guarantee a straightforward birth, just increase a mothers chances of having one.

"I hate the attitude of the types who say all births can be vaginal if you stay calm or go to the right classes, crap crap crap."

I've never met anyone who's said that all births can be vaginal. Have you?

shagmundfreud Wed 18-Jan-12 16:40:31

Sorry - meant to add, that the articles about 'get the birth you want' would hopefully include a discussion of elective c/s and access to pain relief.

NoWayNoHow Wed 18-Jan-12 16:45:50

shagmund it was West Middlesex. I'd heard good things about it, but unfortunately the poor experience that began at ante natal simply continued...

Nobody believes that 27% is a myth (like I said, EMCS isn't the be all and end all of complications), however I didn't find out the national statistic from the class, but from my own research whilst pregnant. It's not even that they denied the facts of intervention or EMCS, it's that the facts weren't even mentioned (with the exception, as I mentioned above, of using forceps as a method of scaring us into staying away from evil epidurals).

Got to agree with you about OBEM - watched it for the first time and I do sense that there's not a lot that goes on in that programme besides waiting and wailing smile

PeaceAndHope Wed 18-Jan-12 16:56:09

Shagmundfreud:

Why all this hostility? Perhaps you might actually contribute to the discussion instead of poking holes in what others have to say.

I'm curious about something. Your last statement- 1 in 4 women have emergency cesarians and that to you indicates that a birth may not be straightforward? Why no mention of ventouse and forceps which are capable of as much, if not more damage? Why no mention of birth asphyxia, hypoxia, shoulder dystocia, and spontaneous third degree tears? Or is none of that important so as long as we avoid a cesarian?

PeaceAndHope Wed 18-Jan-12 16:59:14

I'm a bit concerned to think that some women form opinions on birthing and maternity care based on programs like OBEM. At the end of the day, even 'reality shows' are meant to grab attention and sensationalise.

NinkyNonker Wed 18-Jan-12 17:04:33

I see quite the opposite tbh. The expectation that something will go wrong, you will need intervention, pain relief, long recoveries etc is far more common than the expectation that everything will be fine.

shagmundfreud Wed 18-Jan-12 17:11:41

No hostility at all PeaceAndHope - sorry if my tone or my use of questions suggests this, because none is intended.

I'm simply questioning your repeated assertions that the 'general' attitude towards childbirth in the UK is that it's easy and straightforward. The questions are intended to get you to be specific about how you have arrived at your conclusion that this is the way people think.

"Your last statement- 1 in 4 women have emergency cesarians and that to you indicates that a birth may not be straightforward? Why no mention of ventouse and forceps which are capable of as much, if not more damage?"

Actually only 14% of births nationally are by emergency c/s. The rest are planned.

You are right that women could and should be told in antenatal classes and at midwife appointments about the problems sometimes associated with ventouse and forceps and the likelihood of their being used in birth. Because there is an argument that it's not possible for women to give truly informed consent if these things are mentioned when seeking consent at the time of use. Ditto with c/s or any other medical intervention in birth. Can you suggest a workable format for this? At my local hospital antenatal classes have been reduced to one 3 hour session on a Saturday morning. How much detail would midwives need to go into? What percentage of the time allocated for antenatal education would you apportion for the giving of this information? Or would it be acceptable for women to be given this information in written format for them to take home and digest in their own time?

"Why no mention of birth asphyxia, hypoxia, shoulder dystocia, and spontaneous third degree tears? Or is none of that important so as long as we avoid a cesarian?"

No - it's all important if it happens to you.

brandysoakedbitch Wed 18-Jan-12 17:11:57

Message deleted by Mumsnet.

SardineQueen Wed 18-Jan-12 17:14:17

Just got in and catching up, just wanted to anser QTpie's question - I did NHS and NCT ante-natal (PFB overkill grin which was just as well as I didn't get on with NCT and jacked them in) - they both gave the same info. The attitude about BF was similar - all about the benefits and very little about how to spot potential problems, what sort of things can happen, and what to do if they happen to you. All of my friends in RL had probs with BF and I was keen to find out how to avoid them but they simply would not talk about anything like that which I found peculiar and infuriating TBH.

shagmundfreud Wed 18-Jan-12 17:14:59

"I'm a bit concerned to think that some women form opinions on birthing and maternity care based on programs like OBEM. At the end of the day, even 'reality shows' are meant to grab attention and sensationalise."

Yes - this is true.

However, as childbirth no longer takes place in the home this is the only way for most parents/women to see what birth can look like. But yes - it's important to take on board that the picture which emerges has been 'shaped' with entertainment in mind.

SardineQueen Wed 18-Jan-12 17:21:33

forceps and ventouse were not mentioned at my NHS classes, or NCT (although I didn't go to the last 2 NCT ones).

Neither were tears or episiotomies or things like incontinence, loss of sexual function, loss of sensation and all the rest of it.

shagmundfreud Wed 18-Jan-12 17:22:15

Message deleted by Mumsnet.

SardineQueen Wed 18-Jan-12 17:24:29

Why has the OP brought out such aggressive responses here?

confused

SardineQueen Wed 18-Jan-12 17:26:34

With all other medical procedures people have it explained in great detail what will be done, how, when, what with, what the risks are and so on. So as to obtain informed consent.

It is not right if the first time a woman finds out about episiotomy is when she has one, or that a side effect of a really bad tear is severe incontinence.

I don't understand why the conspiracy of silence - which is exactly what the OP was talking about when she started the thread.

PeaceAndHope Wed 18-Jan-12 17:27:13

Brandysoaked:

Your screen name is apt because you sound a bit intoxicated to me;)
The opening line of my post clearly mentions that I'm new here. I don't know why you would imagine I'm someone else?

Since I can't make head or tail of your post, I don't know what else to say to you.

SardineQueen Wed 18-Jan-12 17:28:15

Message deleted by Mumsnet.

IWantMyHatBack Wed 18-Jan-12 17:31:10

"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."

Couldn't have put it better myself.

PeaceAndHope Wed 18-Jan-12 17:32:27

Shagmundfreud:

1. I'm not talking about attitudes specific to the UK. I'm a well travelled person and I've noticed a similar attitude almost everywhere.

2. In my opinion, women should be given written research papers and facts informing them about possible complications from all modes of delivery and intervention and the ways of avoiding them. There should be an opportunity to discuss individual concerns regarding the written matter in antenatal appointments.

3. Please point out where I have said vaginal birth is evil and all women should opt for elective cesarians. I'm talking about something entirely different but you are determined to make this thread about something it's not.

PeaceAndHope Wed 18-Jan-12 17:33:25

SardineQueen:

I'm very confused.

brandysoakedbitch Wed 18-Jan-12 17:35:33

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brandysoakedbitch Wed 18-Jan-12 17:36:57

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CailinDana Wed 18-Jan-12 17:38:11

I find it really odd that anyone would advocate hiding forceps from pregnant women, which is essentially what my MW did. How can you give informed consent if you don't even know what they're talking about? Keeping people ignorant does not help - and the idea that having the information will scare people doesn't make sense to me. Labour can be scary enough without having something new and unknown sprung on you in the middle of it.

brandysoakedbitch Wed 18-Jan-12 17:39:29

2. In my opinion, women should be given written research papers and facts informing them about possible complications from all modes of delivery and intervention and the ways of avoiding them. There should be an opportunity to discuss individual concerns regarding the written matter in antenatal appointments.

biscuit

brandysoakedbitch Wed 18-Jan-12 17:40:59

Have you had a baby Peace?

SardineQueen Wed 18-Jan-12 17:46:40

Message deleted by Mumsnet.

shagmundfreud Wed 18-Jan-12 17:46:46

I think women need to be aware of the frequency with which forceps and ventouse are used - they're very, very common in first births in particular.

And they need to know that serious complications following ventouse and forceps are rare, but if they do occur they can make you very unhappy.

Also know how to recognise if things aren't right after birth and to know what the best treatments are for these problems, and how to access them.

I'm not against giving out enough statistical information so that they can make sense of the likelihood of complications with c/s, ventouse, forceps etc, happening to them.

But actually a couple of paragraphs in Emma's Diary, and half an hour Q&A in a decent antenatal class with a knowledgeable and pragmatic midwife/antenatal teacher, would be information enough for most women.

OP - would that satisfy you?

PeaceAndHope Wed 18-Jan-12 17:48:11

Brandy:

Yes, I have children.

Question: what 'stats' have I posted and what exactly am I saying that is fucked up?

I'm happy to hear that you are in good health even after 4 children. I am however talking about women who aren't as fortunate. I'm talking about the general attitude of people towards pregnancy and childbirth. Comprende?

shagmundfreud Wed 18-Jan-12 17:49:09

"And what of the fact that many of them will not even have known that this was a possibility before it happened to them."

I don't think anyone would justify women going into birth with no idea of the possibility of postnatal complications. Or PND, for that matter.

I think we're all singing from the same song sheet on this one surely?

brandysoakedbitch Wed 18-Jan-12 17:49:41

General random strangeness - hurrah

is there a button for that?

Don't be daft I just know a few weeks ago there was a very very similar threa to this full of the same stats and I am concerned - I don't think what I am posting is strange I think it disagrees with you and the OP and that is allowed

SardineQueen Wed 18-Jan-12 17:51:02

What is emma's diary?

None of these things were mentioned on my antenatal classes, and others on here had the same experience. Also a conspiracy of silence surrounding BF problems.

So there is a problem.

SardineQueen Wed 18-Jan-12 17:51:42

Message deleted by Mumsnet.

brandysoakedbitch Wed 18-Jan-12 17:52:18

But it is a natural process, the problem with it is that it has been taken and medicalised (a lot of that is for the good of course) and taken out of the hands of women and made them feel like they cannot do it

I would also be the first to agree that TV has a lot to answer for: everyone screaming and laying on their backs and having emergencies - there is another side that is all I am saying and it is in the information you receive (well in my area anyway) but it is about measure and not scaring the shite out of people.

PeaceAndHope Wed 18-Jan-12 17:53:50

Shagmundfreud:

I don't believe that complications are uncommon following interventions such as induction, ventouse forceps or even cesarians done late in labour.
The level of severity can obviously vary but the morbidity associated with an operative vaginal birth is quite high.

What would satisfy me that's a tough question. A simple with a HCP or a few antenatal classes certainly wouldn't be enough. I've often found their opinions to be a bit biased and agenda driven. That is what makes the availability of evidence based, impartial information for first time mothers so important.

brandysoakedbitch Wed 18-Jan-12 17:53:53

No I asked if she was the same person, am I not allowed to do that? I do think researching these sorts of stats is a bit anal and fucked up (forgive the pun) that is just what I think. Asking someone if they are the same person is that troll hunting?

SardineQueen Wed 18-Jan-12 17:55:17

"But it is a natural process, the problem with it is that it has been taken and medicalised (a lot of that is for the good of course) and taken out of the hands of women and made them feel like they cannot do it"

Yes I would agree with that.

BUT at the same time, pregnancy and childbirth always have been terribly dangerous and are still usually the most dangerous thing a woman in the western world will do in her lifetime.

There is a place for medical intervention and there is a place for giving women, who are after all grown-up real people, the full information about what can happen.

PeaceAndHope Wed 18-Jan-12 17:55:25

That was a 'simple chat'... Missed a word there.

brandysoakedbitch Wed 18-Jan-12 17:56:39

I don't agree that is is 'terribly dangerous' sorry that is an overstatement

SardineQueen Wed 18-Jan-12 17:59:31

You don't think that pregnancy and childbirth have always been terribly dangerous for humans?

Dangerous, then. A bit dangerous? Dangerousy-wangerousy-woo. You might end up just a little bit dead. Slightly, like.

Better?

Should I stop worrying about countries around the world with high maternal mortality? Wahey!!!!

NoWayNoHow Wed 18-Jan-12 18:00:02

Wow, brandy aggressive much?

I don't know why there is so much aggression aimed at the OP. She raises a valid point that many women go into childbirth whithout knowing the risks and, more importantly, what they can do to avoid them.

Not everything is a conspiracy theory confused

shagmundfreud Wed 18-Jan-12 18:02:23

"I don't believe that complications are uncommon following interventions such as induction, ventouse forceps or even cesarians done late in labour.
The level of severity can obviously vary but the morbidity associated with an operative vaginal birth is quite high"

Most women will have an episiotomy or second degree tear after a forceps or ventouse delivery. The vast majority of these women will have uncomplicated healing.

Thankfully.

smile

"What is emma's diary?"

It's a health information booklet which the majority of women in the UK are given during pregnancy

"Also a conspiracy of silence surrounding BF problems"

Actually there's not much talk about feeding problems in general. I've never heard any sensible discussion (other than on these boards) or seen any health information which looks at some of the day to day challenges of bottle-feeding.

Not sure it's a conspiracy.

brandysoakedbitch Wed 18-Jan-12 18:04:20

No conspiracy theory mentioned or implied. So tell me how can one avoid forceps? or episiotomy? or tearing? or incontinence? they do happen yes but in reality they are not actually avoidable as such. Obviously keeping mobile etc improves things etc but any Midwife would tell you that and it is self evident I assume with gravity and all. I am not sure reams and reams of research pointing out the risks of everything would change the outcomes for women and babies.

'Dangerous, then. A bit dangerous? Dangerousy-wangerousy-woo. You might end up just a little bit dead. Slightly, like.

Better?'

hmm

NoWayNoHow Wed 18-Jan-12 18:05:02

brandy you don't agree that childbirth is "terribly dangerous"? Tell that to the ONE IN EIGHT women in Africa who die giving birth. And that doesn't even take into account infant mortality.

shagmundfreud Wed 18-Jan-12 18:05:30

"She raises a valid point that many women go into childbirth whithout knowing the risks and, more importantly, what they can do to avoid them."

No. It's also the case that most of us get in a car every day without having a clear idea of exactly how likely we are to die or be injured in an accident. We just know it's possible and we do what we can to avoid it.

Most women know that birth can go wrong. They know about instrumental births - that they happen and that they can be a difficult experience and leave women with perineal damage.

The OP has nothing to say about what women can do to reduce the likelihood of these risks other than to have a planned c/s, which is not acceptable for the majority of women in the UK (or in most other countries actually).

brandysoakedbitch Wed 18-Jan-12 18:05:43

Agree about lack of info and support re. breastfeeding - very very frustrating and absolutely avoidable too

SardineQueen Wed 18-Jan-12 18:06:53

Christ it's a figure of speech, not meant to be taken literally confused

I can rephrase - it also seems the case that ante-natal class leaders and others involved in ante-natal care are unwilling to bring up or answer questions on potential problems with BF and how to handle them. Based on my own experience and reading these boards I know other people have found this.

I had a baby in 2007 and another in 2009 and have never heard of this emma's diary. Does it have information about forceps and stuff? I wonder why they don't do it in our borough.

SardineQueen Wed 18-Jan-12 18:09:10

"Most women know that birth can go wrong. They know about instrumental births - that they happen and that they can be a difficult experience and leave women with perineal damage."

You see. I don't think they do. I didn't. Or at least I had a vague idea, that things could go wrong "down there", but no idea of just how bad it could be. People don't talk about it with people who haven't had children, generally, and the antenatal things don't cover it. I know that some of my friends and many women on here have been genuinely shocked at the aftermath of VB on their bodies, and that things might never get better etc.

brandysoakedbitch Wed 18-Jan-12 18:09:49

But we were not talking about women in Africa - we are talking about well informed and cared for women in the west. Globally of course it is dangerous -I had no idea one in eight dies but assume that malnourishment and lack of maternity care have a little to do with that stat if it is accurate.

If you are a poor black woman in America with no adequate health cover it is very dangerous - don't they have the highest infant or maternal death rate in the developed world????? have i made this up? rings a bell anyway so forgive me

Agree with Shagmund about the car analogy - good point and well raised

shagmundfreud Wed 18-Jan-12 18:09:53

"brandy you don't agree that childbirth is "terribly dangerous"? Tell that to the ONE IN EIGHT women in Africa who die giving birth. "

Yes - birth is very dangerous for malnourished women who have had no antenatal care, may be suffering from severe anaemia, have previous botched abortions, HIV, malaria, infibulation, and are giving birth without any access to medical care.

Luckily for healthy women in the UK who've had good antenatal care, the likelihood of dying in childbirth is very, very low and has been since the 1950's, when c/s rates were less than a 10th of what they are now.

PeaceAndHope Wed 18-Jan-12 18:10:52

OK now I'm very confused.

Shagmundfreud:

Where did I mention that women should opt for planned cesarians to avoid these complications? Are you aware that a planned cesarian comes with it's one little set of risks?

Is it possible for you to provide some evidence that most women who have operative births have second degree tears and heal easily? It would be derailing the thread completely but I'd be interested to see some evidence to prove that fact.

SardineQueen Wed 18-Jan-12 18:11:04

NoWay, well quite.

They are probably doing it wrong or something.

Rollersara Wed 18-Jan-12 18:12:35

I find this all a bit strange, possibly because I am considered high risk and so have seen more medics, with varying viewpoint, than a lower risk woman would. I'm also someone who likes to plan and have read books and Mumsnets and been to NCT classes and I feel I've had a good all round view of what can happen, good and bad. I don't think information is deliberately concealed, perhaps not everyone seeks it out to the extent that I did, but I've had a lot of discussions with midwives, consultants and friends and asked loads of questions and I don't think there is a conspiracy to be found...

SardineQueen Wed 18-Jan-12 18:14:14

Right people are arguing with my comment here:

""But it is a natural process, the problem with it is that it has been taken and medicalised (a lot of that is for the good of course) and taken out of the hands of women and made them feel like they cannot do it"

Yes I would agree with that.

BUT at the same time, pregnancy and childbirth always have been terribly dangerous and are still usually the most dangerous thing a woman in the western world will do in her lifetime."

I was not restricting it to UK 2012, I was talking across all time and all the globe. And pointing out that even with all the advances pregnancy and childbirth are still one of the most dangerous things that modern western women will do.

PeaceAndHope Wed 18-Jan-12 18:15:03

I think the point SardineQuuen is raising is that inherently the process is dangerous. We can make it safer with better diet, better medication (when required), better sanitation and better health care.

DilysPrice Wed 18-Jan-12 18:15:43

I think that we in the UK do talk an appropriate amount about maternal death risks and foetal deaths and brain damage. These things are rare, but when they happen they are unavoidably visible, and people (widowers, parents) make an understandably big fuss about them.

But I don't think we talk nearly enough about maternal birth injuries, because the women who have suffered horrific injuries in childbirth don't talk about it, because it's not the sort of thing you talk about. I totally agree with SQ - how can you possibly give informed consent to (say) forceps delivery rather than EMCS if nobody has ever told you that tears come in degrees, and they goes up to 4? At my ante-natal class we were given a long spiel about what it feels like to have an EMCS, and how important it is to avoid one, but the non-fatal downsides of VB were never mentioned.

I think the recent NICE report is hugely important for having taken these issues seriously rather than sweeping it under the carpet with "your baby's healthy, and you're not dead! Hurrah!"

I personally have no axe to grind on this one, but a horrified lurk on the ragged bits thread has left me shocked at how little we talk about these injuries in this country.

SardineQueen Wed 18-Jan-12 18:16:25

shagmundfreud those women are still dying though

Just as women in the UK 150 years ago were dying due to poor hygiene

And that's before you even look at all the other lifechanging things that can go wrong which are simply ignored. As long as the woman has survived then that will do. Not good enough IMO.

brandysoakedbitch Wed 18-Jan-12 18:17:45

Rollersara I agree - the info is there if you want it. When I went to have a look around the hospital when I was pregnant with my first we were shown the theatre all the equipment and the rooms. It did scare me actually (but i wanted a home birth but she was born too early for that) - but it was interesting. I have worked at the same unit since then and actually ime the majority of women are pretty well informed (sometimes a little too much and are very panicky about what can go wrong when in fat it is all going fine)

I thought Emmas Diary was a national thing and is in the initial bounty bag they give out (they have stopped giving them to me now as too many children so maybe sucking eggs) grin

SardineQueen Wed 18-Jan-12 18:18:18

x-post dilys and we make the same point smile

I agree with you that the NICE report on ELCS and costs finally touched on postnatal difficulties with VB

mumwithdice Wed 18-Jan-12 18:18:22

Rollersara, I'm with you. I was low risk, actually, but the first thing I did when I got my bfp was to pop along to the bookshop. But that's my solution to everything and I accept not everyone is like that.

The information is there; the problem seems to be that there are no signposts to it.

brandysoakedbitch Wed 18-Jan-12 18:22:21

Perhaps what needs to happen is that post natally the care needs to be more comprehensive and continence or the lack thereof needs to be properly followed up - the French give women sessions with a physio don't they - perhaps what would imporve outcomes for that type of injury in this country/

SardineQueen Wed 18-Jan-12 18:22:35

The information on anything is there if you look for it. I think the NHS should be providing this information in the same was that they give information on CS (bad), BF (good) and VB (good). And cover the fact that CS can be good, BF can be difficult, and VB can have adverse effects for mother and baby.

eg CS is safer for the baby. Is anyone told that? Course not.

NoWayNoHow Wed 18-Jan-12 18:23:50

"Most women know that birth can go wrong. They know about instrumental births - that they happen and that they can be a difficult experience and leave women with perineal damage."

I, like sardine had no idea about how damaging instrumental births could be. I had NO IDEA that I could tear my own bumhole, for example. I vaguely knew about episiotomy because a friend of mine had had one, but really had no idea that you could tear. I didn't know anything about ventouse at all (which was pretty terrifying when it got hauled out to use on me).

I had no idea how long the healing process was, and that I would be terrified to have a poo for virtually 6 months in case I ruined myself down there.

Maybe if I'd know, I would have gone in for perineal massage, ro done more pelvic floor exercises, etc, etc, and maybe that would have impacted my birth experience. Maybe not, but just maybe.

brandysoakedbitch Wed 18-Jan-12 18:23:56

Is a CS safer for the baby?

awingandaprayer Wed 18-Jan-12 18:25:18

Lots of things are natural - like dying of cancer. Natural and good are not the same thing.

Many people consider prior knowledge and a chance to think about a situation to be something that enables them to be in control not something that takes control away. Those that don't want information can always say they don't want to know - but when you go to an antenatal class, surely getting information about what might happen to you is the point?

I suspect a small part of the reason the full gory details and risks of interventions are discussed but not the risks of natural childbirth is to do with the legal necessity of infomed consent for an intervention. An anaesthetist would have to give you the risks, benefits and alternatives of an epidural and a midwife would have to talk about the risks, benefits and alternatives of an episiotomy for example. A VB without intervention legally requires no discussion. (Though perhaps morally should). I've certainly heard numerous anaesthetists complain that they feel in a very difficult position when called to see a woman who may have stated 'no epidural' on a birth plan now desperately asking for one - the problem being is it possible to get informed consent under such circumstances and what is the woman's 'true' wish: her birth plan or her request when in pain after hours of no sleep?

I don't think that's the whole reason though.

As for 'what is the point of dwelling on bad stuff':

How about the fact that not having full information about the risks, pain and reality of childbirth is likely to be a factor in developing PTSD after the birth and post natal depression. Incidence estimates of full clinical PTSD following childbirth vary from about 1.5% to over 5% - not insignificant in my view and many more have subclinical levels of post traumatic stress. Things like complications and interventions are factors but there are also many women who appear to have straightforward births but develop PTSD and it is thought that a mismatch of expectations and the reality is a factor. Another factor is feeling out of control and as I've said, for many (maybe most?) people knowing what to expect and what the options are helps people to feel in control.

brandysoakedbitch Wed 18-Jan-12 18:28:06

Is there any research saying that perineal massage changes outcomes for tearing? Has this actually been researched? If you are going to tear to your arse I am not sure a bit of massage makes a lot of difference tbh - I think position of the baby and Mother and how instrumental it is is more of a factor. Skin type is also a factor. I will be honest and say I cannot remember with my first if I knew about that but again not sure the outcomes change really. France have a good follow up system for women with the physio and all but they also love the stirrups etc and women laying on their backs - they also have an appalling bf rate

SardineQueen Wed 18-Jan-12 18:28:54

Yes CS is marginally safer for the baby, and marginally more dangerous for the woman. Talking risk of death.

I don't know how CS and VB compare for the woman when all complications are taken into account - and nor does anyone else in the UK unfortunately they can only guess.

I don't know about which is safer when it comes to other complications for the baby, don't remember having read that anywhere either.

NoWayNoHow Wed 18-Jan-12 18:32:46

brandy I do'nt have any research saying that it changes the outcome. However, FEELING like it might is surely a good thing? It gives the mother (a) a sense of control that she's doing something proactive, and (b) the view that the outcome might be more positive if she is better prepared.

NoWayNoHow Wed 18-Jan-12 18:38:38

Sorry, pressed post too soon.

I guess that's generally what I'm saying. If you know more and feel better prepared for something, there is a lot to be said for the sense of control that comes with that.

For example, nobody would suggest that we don't tell new parents about the fact that babies cry ALL the time, nurse ALL the time, wake in the night ALL the time, poo and wee ALL the time, just on the off chance that it will scare them and put them off and make it harder. Women are well prepared for post-birth by countless anecdotes and tricks from friends and family, and a plethora of books written on what to do in those first few months, including books actually given by the NHS.

I just wish that we were more open about birth - we shouldn't have to go hunting on the internet (and scaring ourselves half to death with the absolute worst case scenarios on there). It should be readily available to us in classes and through information handed out to us.

brandysoakedbitch Wed 18-Jan-12 18:41:07

Look NoWay I am all for being proactive - I have done a fair bit of 'massage' in my time (well Dh has) - it can do no harm that is for sure. I do think owmen should be encouraged to take control of these things and actually I do think it changes outcomes. I KNOW being positive and staying active and being in my own home have really helped my births have good outcomes. Having very positive input from my Midwife (and luckily I had the same Midwife for the first two and the same Midwife for the next two as the first retired! The Midwife who delivered the last two will be delivering this one too) - Having a chat with my Midwife who is encouraging and positive and excited about my baby's birth have really helped me too. I know it is a pipe dream but this sort of lovely relationship and input should be available to everyone - crazy crazy dream! It should not be about 'impartial' information given out in reams and 'discussed' - and who decides on the impartial nature of that information. Stats are very dodgy.

shagmundfreud Wed 18-Jan-12 18:41:18

"shagmundfreud those women are still dying though"

Yes. As I've acknowledged several times on this thread - some women die in childbirth.

Just for comparison, in the USA maternal deaths for 2005 were 548. Most of these deaths will have been from complications arising from c/s and from thrombosis, and be associated with obesity.

According to Dom Nozzi's listing of comparative risks, 14900 people a year in the US die from falls. And 3300 from choking.

I have yet to see any calls for obligatory training among the general population in how to perform the heimlich manouvre. wink

"CS is safer for the baby. Is anyone told that? Course not"

Marginally. For the first baby. And then for every baby after it increases the risk of serious complications like placenta accreta in pregnancy and during subsequent vaginal birth or surgery.

Oh - and I think EVERYONE sensible acknowledges that C/S is often a life-saving operation.

"Perhaps what needs to happen is that post natally the care needs to be more comprehensive and continence or the lack thereof needs to be properly followed up"

Yes, I agree. And just as important - women need to know what they can do to reduce the likelihood of perineal damage and assisted delivery, which is mainly to plan to give birth away (if possible) from those environments where these types of delivery are common.

shagmundfreud Wed 18-Jan-12 18:42:43

" I know it is a pipe dream but this sort of lovely relationship and input should be available to everyone - crazy crazy dream!"

Not so crazy. There are case-loading practices all over the UK.

Rollersara Wed 18-Jan-12 18:44:56

The impression I've got is some women simply don't want to know, and giving out more information might put them off or scare them. I like to know everything, I've got a good understanding of risks, not everyone is like that. If a woman is made more scared by being told about all the negatives after becoming pg, is it not more likely that she will be more tense during the birth and therefore more likely to have a bad experience and perhaps need more intervention?

brandysoakedbitch Wed 18-Jan-12 18:50:13

Shagmund - I am very fortunate that I am in this situation with my Midwifery care - I am even moving a little out of my Community Midwifes area (into a bigger house because of the many many children) and she is still up for it - she really values being part of our process as we value her role. We were exitedly discussing having a birth pool this time (as never had the room before) and she was so encouraging about it. I know case loading is done but I do wish that more women had access to this sort of genuine care. In Holland there is also very comprehensive post natal care and a high home birth rate which I feel can only be good for Mummies and Babies. I think it is post natally that the care should be focussed and not loading a woman up with stats.

shagmundfreud Wed 18-Jan-12 18:51:32

"I don't know how CS and VB compare for the woman when all complications are taken into account - and nor does anyone else in the UK unfortunately they can only guess."

No, and the comparisons are useless to women if they aren't aware that planning to give birth in a CLU appears to massively increase their risk of emergency c/s, and forceps delivery, to which almost all the serious health risks associated with planning a vaginal birth are attached.

The risks associated with elective c/s are pretty consistent across the board. The risks associated with planning a vaginal birth very WILDLY, according to standards and models of care in labour. All women are given to help make the comparison of the safety of vb and elcs are general stats - these are useless in individual cases.

brandysoakedbitch Wed 18-Jan-12 18:51:42

Rollersara makes a very good point at the end of the last page - very good indeed

shagmundfreud Wed 18-Jan-12 18:53:20

I wish it too brandy.

I had an independent midwife for my last two births.

Was fantastic!

exoticfruits Wed 18-Jan-12 18:54:16

I don't think that you want to scaremonger. You have no control over it and it is a perfectly natural process where most women are fine. If there are likely to be problems they will be monitored.
I get pregnant very easily and give birth very easily, it is nothing to do with anything I do, just sheer luck.
Getting in your car next time you want to do a journey is far more risky (and you also have no control over events)and yet people do it all the time.

brandysoakedbitch Wed 18-Jan-12 18:57:56

Mine acts like an independant - she is so lovely and is so pleased to be delivering a third child in our family. That is what is required for women: loving care but it is sometimes very hard to find in the NHS. A lot of people here talk about seeing a different Midwife every time they go and then when they turn up at hospital they are being helped by someone who has never met them before. I remember going to a talk by Mary Cronk and thought if I ever needed someone to help me she would be the woman: she really believes in women and their ability to manage themselves and their bodies and help positive outcomes happen. Don't get me wrong I am not a hippy sort who thinks one can wish oneself well but a positive attitude is vital and a bunch of stats without careful interpretation and careful delivery is terrifying for almost anyone

SardineQueen Wed 18-Jan-12 19:01:46

Are the figures for complications on CLU for all births or just the low risk ones?

I never know with those stats.

I am not sure what all this statistic flinging is for - I am trying to make the point that IME and in the experience of many other women, they receive incomplete information at antenatal classes. People only tend to go to antnatal classes for first babies - and at mine we were told (paraphrasing) CS are BAD and to be avoided at all costs. But not that CS are actually safer for babies (marginally and with the first one which is what people are usually having at an antenatal class). Problems like tears, incontinence, loss of sexual function were not mentioned, nor were things like forceps, ventouse. I I do not understand why that is. They certainly don't seem to mind giving all teh gory details about CS, even though loads of the women they are talking to will end up having them. So why not give the same info for VB. I don't get it.

brandysoakedbitch Wed 18-Jan-12 19:02:16

Exotic I agree about the car thing yes but I also do think that a major factor in birth going wrong is a lack of encouragement and support (for many reasons sometimes that Midwives do not have the time to actually stay with women). Being fearful and scared is a big problem particularly for for first timers and my Midwife reckons that most home to hospital transfers for first time mummies is about pain and fear and the management of that. I do also agree with you that it is about luck, pain thresholds, what sort of person you are etc etc and that cannot be accounted for in stats

SardineQueen Wed 18-Jan-12 19:04:36

Interesting that Holland is mentioned - I seem to remember that they have a very high infant mortality rate but IIRC no-one is quite sure why that is. Anyone here have any more info?

SardineQueen Wed 18-Jan-12 19:05:34

I know far more women with long term problems caused by VB than by car accidents TBH.

cory Wed 18-Jan-12 19:06:32

PeaceAndHope Wed 18-Jan-12 14:15:39
Cory:

"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."

But what with the books and ante-natal classes and television series and ante-natal check-ups and horror stories in women's magazines, surely women can't complain that they didn't know about the possibilities of pregnancy complications: I mean, you'd have to have been living in a cave somewhere. If you choose not to listen that is a different matter, but I really don't see how anyone can claim that the information is not out there.

Our ante-natal classes involved a visit to SCBU: I think you'd have had to be pretty dim not to conclude that there might be a risk of having a premature baby.

SardineQueen Wed 18-Jan-12 19:09:39

I didn't know. I don't watch those programs or read those magazines. Not being snotty, I have plenty of low-brow interests grin, but those are not amongst them.

I don't live in a cave but the first time I heard about degrees of tears and stuff was on MN after I had my first baby.

SardineQueen Wed 18-Jan-12 19:12:53

The real question for me on this thread though is:

Should all pregnant women be fully informed of the benefits and risks of different birth methods, and about common BF problems and how to avoid / spot / combat them

Or

As happens a lot of the time at the moment, Not.

Personally I think that full factual information about all possibilities is the way forward.

brandysoakedbitch Wed 18-Jan-12 19:14:49

But I fail to see how knowing about degrees of tears changes anything - obviously if you have a baby out of your fanjo things, bad things can happen. Look at baby and look at fango, essential mismatch in the sizes? I just think this info need to be delivered carefully and we do not have the comprehensive kind of care and continuity of care that women need for these stats to be delivered with any kind of meaning (and again it makes bugger all difference)

I do think incontinence full stop is a taboo for almost everyone and happens to almost everyone at some stage in their life - same as getting old and dying or going bonkers, we know it happens but no one really deals with it

brandysoakedbitch Wed 18-Jan-12 19:17:37

But the OP proposed that these stats should be printed out and given to women so they could ask questions - how can you possibly give all the information in a meaningful way?

brandysoakedbitch Wed 18-Jan-12 19:19:46

And all the info is available in something called books.... which you can ask questions about to your HCP if you need to. Surely women need to take responsibility to find this stuff out if they want to. I agree lots of people don't really want to know

EdlessAllenPoe Wed 18-Jan-12 19:25:37

"Interesting that Holland is mentioned - I seem to remember that they have a very high infant mortality rate but IIRC no-one is quite sure why that is. Anyone here have any more info?"

there was a study that over-reported the mortality stats because HCPs reported in deaths from outside the study area which caused that perception.
they were previously better than France's, yet slippage has been caused by an influx of immigrants from north Africa (think FGM, malnourishment, DV, very young mothers, who don't speak Dutch as 1st language)

see here it is still better than the UK at 4.7 vs 4.8 infant deaths per 1000 in the UK.

SardineQueen Wed 18-Jan-12 19:26:35

I think it is wrong that women be expected to seek out all this information for themselves when it can be perfectly well delivered by HCPs.

Risk of things like pain relief and CS are talked about in detail, things like ventouse and tears not mentioned at all. IME, obviously.

If something is a taboo in society then even more reason to tell women about it before they have babies so that they understand that it is a common problem after birth and help is available, rather than struggling on too embarrassed to tell anyone as happens so often at the moment.

SardineQueen Wed 18-Jan-12 19:27:26

Thank you edless that is very helpful. I knew that there was a high incidence and no-one knew why so that clears that one up!

SardineQueen Wed 18-Jan-12 19:28:31

Presumably if people can seek out information for themselves there is little point in HCPs giving factual information to anyone about anything really confused

SardineQueen Wed 18-Jan-12 19:33:47

brandy it's this you are referring to in many of your posts

"2. In my opinion, women should be given written research papers and facts informing them about possible complications from all modes of delivery and intervention and the ways of avoiding them. There should be an opportunity to discuss individual concerns regarding the written matter in antenatal appointments."

Why is this a bad idea? I think it sounds great.

brandysoakedbitch Wed 18-Jan-12 19:34:55

I think it is wrong that women be expected to seek out all this information for themselves when it can be perfectly well delivered by HCPs.

Yes but SQ my argument is that it cannot be delivered with any meaning in the system that currently prevails in this country - there is such a lack of continuity here in midwifery care that if would not help to have all the information dumped without interpretation.

Edless that is right, chatted about this to my Dutch friend who is a teacher and recently had a baby - her care was amazing, started off at home but ended in a CS for non progression and stress of her little one - she had the most amazing care particularly post natally with someone coming to her house several times to check on her and help out with whatever needed doing - also stellar BF support but of course as a non integrated immigrant this would be useless.

brandysoakedbitch Wed 18-Jan-12 19:37:25

Yes but I don't think it is a great idea - in reality it does not work. We are also assuming a high level of literacy and interpretation for those consumers. We already have the pregnancy book and Emmas Diary and full stats without careful interpretation are not helpful

Like I said research papers? by whom and who decides and who pays for the research - it is a process fraught with problems

SardineQueen Wed 18-Jan-12 19:37:54

But they manage to deliver stacks of information about how terribly risky epidurals and CS are

I'm simply saying there should be balance.

SardineQueen Wed 18-Jan-12 19:40:23

but brandy

"And all the info is available in something called books.... which you can ask questions about to your HCP if you need to. Surely women need to take responsibility to find this stuff out if they want to"

"We are also assuming a high level of literacy and interpretation for those consumers."

I think those things are contradictory. Either women can be expected to find out for themselves or they can't. I think the HCPs involved in caring for pregnant women should be giving this information.

brandysoakedbitch Wed 18-Jan-12 19:40:52

That is because it is a surgical procedure and you have to make informed consent because it is an intervention - VB as a natural process fall outside that remit - also there are pretty standard risks to those procedures and the range of issues associated with vb are so wide ranging and some very rare that it is almost an impossible task without scaring the shit out of people

SardineQueen Wed 18-Jan-12 19:41:49

I have given birth in a london borough twice in the last 5 years and have never heard of this emma's diary. The info in the "hello you're pregnant" pack was a big book that I had to take to all appts, and a few leaflets and adverts. I don't remember any comprehensive info or stats.

EdlessAllenPoe Wed 18-Jan-12 19:42:19

I think in actual fact the general perception is that childbirth is unbearably painful, likely to result in an emergency situation, likely to damage you, dangerous and will require a long period of recovery after the fact.

i think people are usually extremely surprised if it goes well, if you are fit immediately after the event, if you get to grips with baby straight away.

The general level of discussion of childbirth in my workplace is the swapping of horror stories.

so : i agree that people should know more about the real facts of childbirth. but i don't think the problem is that people think it is easy. I think the problem is people think it is difficult and dangerous but accept this as inevitable rather than looking at ways those dangers can be avoided.

SardineQueen Wed 18-Jan-12 19:42:46

Why are you so set against women being told what risks are associated with VB, in the same way as they are told about risks of CS, pain relief etc?

brandysoakedbitch Wed 18-Jan-12 19:44:11

But SQ that is my point - of people are readers and want to be informed then they can o and get books but lets face it most of out information is anecdotal anyway - a lot of people could be given the print outs of these stats and have no means of interpreting them. I think if you want to know about it all then you can find out for yourself but a lot of people choose not too and ramming it down their throat without that Midwife having a relationship with that person can very counter productive - rather like a tabloid with all the sensationalism and none of the subtlety.

SardineQueen Wed 18-Jan-12 19:44:25

That was to brandy.

SardineQueen Wed 18-Jan-12 19:46:35

What is sensationalist about simply informing women during the ante-natal process about things like tears, incontinence, forceps etc?

Why is it OK to reel off the risks of CS and "scare the shit" out of all the women booked for ELCS and the ones who will end up with EMCS, but not OK to mention teh risks associated with VB?

It seems terribly illogical to me and I simply do not understand it.

brandysoakedbitch Wed 18-Jan-12 19:47:03

Very very good point Edless I do think that people are scared and surprised when it goes well. It does frequently go well and have a great outcome.

brandysoakedbitch Wed 18-Jan-12 19:48:05

No no I am not set against it as such I was saying that is the reason that those interventions are explained - because of informed consent.

SardineQueen Wed 18-Jan-12 19:49:01

OP was mainly talking about pregnancy with that point I think - the old "you're pregnant not ill" thing. Certainly I was given no leeway when commuting or working during my pregnancy and I'm sure that's not uncommon either.

SardineQueen Wed 18-Jan-12 19:50:11

But surely forceps and things need informed consent as well? Yet they were not mentioned at any of my classes.

i also think women need to know about things like tears, incontinence, loss of sexual function and all the rest of it so that if these things happen to them they do not a. feel like they have failed and b. feel able to seek help.

brandysoakedbitch Wed 18-Jan-12 19:52:39

I don't think that women booked for an Elective CS have the shit scared out of them at all. When I had interventions with my first baby it was all explained calmly and in fact I had an epidural put in because there was someone free to do it who was just about to go into theatre for a long time so my Midwife said let's do it just in case the baby deteriorates anymore - I hated having it done but it was in place just in case - all turned out fine as it was but I have been through the process. No one ever tried to scare me with that sort of stuff - it is all explained by nice well meaning people but that is because it is an intervention and does not work in the same way as vaginal birth

brandysoakedbitch Wed 18-Jan-12 19:56:36

Forceps is a consent issue though - it cannot be done without it as generally it is done in theatre for a start. The post natal care is the issue here - if your midwife looks at your note and sees what you have gone through in your labour then the care should be altered to fit - with interventions you have a greater risk of continence probs etc and that should be followed up - how can knowing about this previously actually change anything. You cannot make informed consent about a natural process as such and again my point is that given the current climate how could this be delivered effectively and with care and meaning? stats do no good

SardineQueen Wed 18-Jan-12 19:57:25

You don't think that women sitting in ante natal classes listening to why you must avoid a CS at all costs and all the risks get "the shit scared out of them"

But you absolutely think that women in the same antenatal class would be shit scared to hear about tears and forceps and things.

That doesn't make sense, it really just doesn't.

personally I don't think many people will be "shit scared" of having the facts about pros and cons and risks explained to them, and I think it is a poor reason for not explaining these things.

shagmundfreud Wed 18-Jan-12 19:57:29

Peace -

Most women would have no interest in reading research papers on this issue - they want a basic idea of what they can realistically expect labour to be like, and information which will improve their experience of birth. They also need decent postnatal care. Money is limited in the NHS. If there's to be a massive injection of cash into the system I'd rather it be spent on improving outcomes as this is the only responsible thing to do. So more midwives, better care for at risk mothers, more effort to reduce emergency cs rates and instrumental birth rates.

By the way - are you a mother yourself? What is your specific interest in this issue?

SardineQueen Wed 18-Jan-12 19:59:13

First line should be "You don't think that women who know they are likely to have CS or have been booked sitting in ante natal classes listening to why you must avoid a CS at all costs and all the risks get "the shit scared out of them"

brandysoakedbitch Wed 18-Jan-12 20:00:04

And I don't agree with the OP that there is a callous or casual attitude to pregnancy - not at all. I think it is an over medicalised and commercialised thing now which makes me a but sad.

I do think people are assholes for not giving up their seats for pregnant ladies but that is just bad manners and a lack of care for others in our society and that extends to the elderly and disabled as well and is not exclusively a problem for pregnant women

SardineQueen Wed 18-Jan-12 20:01:22

shagmund what an od question. Peace has already said upthread that she has children.

I have no idea why OPs straightforward and interesting OP has caused such a kerfuffle in some quarters. I think it was an interesting OP which raised a good and valid point.

But on that note I am going to go and do something else as past experinece tells me this will go round and round in circles forever smile

CervixWithASmile Wed 18-Jan-12 20:03:03

This thread is seriously strange in how Shagmund is being called hostile, I'd say the opposite. Shagmund, you're the (almost singular) voice of reason as far as I can see.

My current experience is I've had it up to here with being told about the risks of pregnancy. Quite frankly if my first birth hadn't been treated so medically I wouldn't have suffered through the unnecessary cascade of interventions and the aftermath of a c-section.

Now I'm having my second I've had to hire an independent midwife to try to avoid the panicked, patronizing scaremongering of the NHS in relation to my wishes for a home birth. Heaven forbid I risk a 1 in 200 chance of rupture against the risks of the interventions and c-sections I likely will encounter in hospital.

Oh, and all the mention of shoulder dystocia, there are some extremely effective methods of dealing with that that more naturally inclined midwives tend to educate themselves on that the more medically 'risk averse' community tend to not do. So you might find outcomes are not necessarily worse for this in home birth (citing home birth as the opposite choice for most women considering pregnancy and childbirth as inherently risky).

So, my wish is that we do the opposite to scaremongering and support women in the belief of what their bodies can do. Provide choice in childbirth, yes, and the understanding of the trauma factor when things go wrong, but please not this litany of potential complications.

Belief in your own body and being as relaxed as possible can only help. When things go wrong we're lucky to have the medical system we do but a climate of fear helps no woman in pregnancy and labour.

brandysoakedbitch Wed 18-Jan-12 20:03:06

But it is desirable to avoid a surgical outcome, for everyone? the recovery rate is slower, the bf is lower for cs mummies - why would they try and promote it - it is generally done as a last ditch thing or if there is something indicating its necessity.

VB is seen as the norm and CS as the fall back position - I don't think that is abnormal

brandysoakedbitch Wed 18-Jan-12 20:04:47

Thank you Cervix, 'tis my belief also.

CervixWithASmile Wed 18-Jan-12 20:05:01

Im going to be really careful in how I say this but the responses on this thread are so odd towards Shagmund it's like they're almost the same people..

shagmundfreud Wed 18-Jan-12 20:06:20

Sardine queen I don't think anyone is making a case for us not discussing these issues with women antenatally.

But peace has a different agenda.

The same argument is used by breastfeeding advocates who think women should be given extensive and detailed information about the research into the risks of ff - you know, go through all the papers showing links between ff and diabetes, childhood cancers, SIDS etc. It's not about empowering women with information, it's about putting them off using formula.

It's pointless giving women massive amounts of detail about the risks associated with c/s OR v/b if they can do nothing with this information.

CervixWithASmile Wed 18-Jan-12 20:06:34

Another voice of reason, Brandy smile

oiwheresthecoffee Wed 18-Jan-12 20:06:54

"I, like sardine had no idea about how damaging instrumental births could be. I had NO IDEA that I could tear my own bumhole, for example. I vaguely knew about episiotomy because a friend of mine had had one, but really had no idea that you could tear. I didn't know anything about ventouse at all (which was pretty terrifying when it got hauled out to use on me).

I had no idea how long the healing process was, and that I would be terrified to have a poo for virtually 6 months in case I ruined myself down there."""

I just wanted to add my 2 cents i dont have children im one of those weird women who use mumsnet anyway wink and i had no idea before i came on here that any of these things happened at all let alone were common. I had no idea you could tear much less actucally be sliced open...Or any of the long lasting effects to be honest.
Im not sure as i even want to go through childbirth now after learning about it but i cant believe its just never talked about or mentioned at all !

brandysoakedbitch Wed 18-Jan-12 20:09:51

Cervix be careful SQ apparently reported me not only for troll hunting but also general random strangeness (polished weirdo badge)

Am still here though

CervixWithASmile Wed 18-Jan-12 20:15:48

You wear your Weirdo Badge beautifully smile

Look, I know I could tear from here to Darkest Peru. I know this because I've educated myself on it, but god, the last thing I need to think about in labour is the worst case scenario!

I also happen to think that the highly medicalised, birth is a dangerous process, regime actually perpetuates bad injuries through over zealous interventions.

NoWayNoHow Wed 18-Jan-12 20:19:53

"So, my wish is that we do the opposite to scaremongering and support women in the belief of what their bodies can do. Provide choice in childbirth, yes, and the understanding of the trauma factor when things go wrong, but please not this litany of potential complications."

I just wanted to draw attention as well to another post upthread that highlighted the incidences of PND and PTSD resulting from women who go into labour blissfully unaware, and then struggle with the dichotomy between what they thought would happen and actually what did end up happening.

There'a a very big difference between educating about potential outcomes and complications and scaremongering, IMO.

CervixWithASmile Wed 18-Jan-12 20:23:48

Well my problem was I went into labour 'blissfully unaware' of how childbirth was unnecessarily viewed as a medical emergency and therefore was traumatized and injured through unnecessary interventions. If I had been aware of how a natural process can be supported I may have had a far better outcome.

CervixWithASmile Wed 18-Jan-12 20:26:22

And to add to that PND developed as a result. I had no idea birth could proceed with dignity and minimal interventions and tried to rationalize, unsuccessfully, what happened to me as a result of believing all of the potential complications were actualy likely.

brandysoakedbitch Wed 18-Jan-12 20:30:39

The thing about having a baby like a lot of things in life is that people's perception of it and the reality to create a dichotomy - this would have been easier in 'ye olden days' when we had closer links with families and communities. Now most of us spend a lot of time dissatisfied with the reality of life full stop, we expect relationships to be better than they are that we can have everything we want materially from day one (and get in lots of debt and the like) and we wonder why we cannot just carry on our lives like before we had children. This is because these ideas are sold to us. I think a lot of the problems with getting bf established is that it takes time, you just need to be sat down and taught to do it and take as long as it takes but we all expect that it has to fit in with our lives. In the past we would have had support networks around us to support us whilst we found out feet. We have so much information nowadays I am not sure it is always a good thing - if you are the sort of person that seeks it out then all well and good but what if you are not and you need someone to mediate that information for you? what then? all the information and none of the wisdom to interpret it in its context. We are living in times when we have more information that ever available to us and honestly without kind and honest interpretation of the 'facts' it is tantamount to scaremongering

shagmundfreud Wed 18-Jan-12 20:33:43

"Im not sure as i even want to go through childbirth now after learning about it but i cant believe its just never talked about or mentioned at all"

So perhaps there's a rationale for telling people about the risks associated with birth in eye-watering detail - lower the birth rate. Maybe we should take the same approach to putting people off marriage, driving, eating and parenting in general.

How life enhancing that is. hmm

Oh, and it is talked about by the mothers I know in real life. And on parenting forums - at length. And is mentioned in some antenatal classes and in many books about childbirth. There's no 'conspiracy of silence' on this issue. Honestly.

brandysoakedbitch Wed 18-Jan-12 20:34:09

<sets up Earth Mother' Certificate next to weirdo badge> wink

PeaceAndHope Wed 18-Jan-12 23:01:18

Shagmundfreud:

I fail to see why you brought up the cost factor here. How much effort is it going to take for the NHS to hand out some pamphlets to every pregnant woman actually stating the real and unbiased risks of every intervention? And maybe some web adresses they might find useful? If I had a nickel for every brainless, stupid pamphlet they've handed me about influenza and whatnot I'd be BillGates.

Not every woman will make the effort to look up all this on her own. Most just go by the experiences of their mother or sister and assume that everything will work out. They need to know that forceps and ventouse are risky. They need to know that home births and elective cesarians are also options. How else will they make a truly informed choice?

There is most certainly a conspiracy of silence. Had I not researched it myself I never would have known about the real risks of an operative birth. When I first heard about fourth degree tears I thought "Ah well, they probably fix it"
I found out much later that fourth degree tears are hard to repair, often require more than one surgery and are associated with a high risk of incontinence.

I have children, but I was interested in this subject long before that. I think this is what I'm referring to- unless you have children you aren't really expected to know or care about childbirth and pregnancy. Maybe if more younger girls were enlightened on the subject we would have less first time mothers being taken advantage of.

I'm getting a bit tired with this 'agenda' you keep accusing me of having. What agenda do I have exactly?

PeaceAndHope Wed 18-Jan-12 23:06:13

"Look, I know I could tear from here to Darkest Peru. I know this because I've educated myself on it, but god, the last thing I need to think about in labour is the worst case scenario!"

I don't think anybody is saying we need to talk about it while in labour. But perhaps a bit more education on the subject prior to the d-day won't hurt?

I also want to say that the fact that seats are often vacated for pregnant women is hardly indicative of the real attitude towards pregnancy as a condition. You could vacate your seat for a pregnant lady and still not think much of the risks associated with birth.

PeaceAndHope Wed 18-Jan-12 23:12:42

You know what I find sad? The attitude of women towards other women.

Carrying a child and giving birth is the most selfless, courageous thing a human being can do. Instead of acknowledging our own bravery and sacrifices we constantly downplay the experience and judge other women for their choices. It's disappointing.

We call the process 'easy', we refer to life and body altering changes as 'minor' and thereby insult our own efforts and tolerance.

The reason that men have a lack of respect for the process is because we as women have no respect for it ourselves.

fruitybread Wed 18-Jan-12 23:15:34

Well, OP, this thread has certainly proved your point! - "I have noticed that whenever I point out the risks associated with pregnancy and birth the reactions are those of disbelief and annoyance".

Some contradictory reactions from the same people too - veering from 'why discuss it, it will scare women' to 'women DO discuss it and it is taught'. Despite other posters' experience to the contrary.

I just checked the RCOG site, which said that 'up to nine in 100' women suffer a third or fourth degree tear - and that it is not possible to predict or prevent the tears.

Now, some people here might argue that as you can't control that, why tell women? But that's also true of many other aspects of birth - if you'd want to be informed of the possible but uncontrollable risks of surgery, then why not the possible but uncontrollable risks of VB?

As others have said, it might at least give women something to contextualise their own experience, whatever degree of tearing (or not) they experience. I don't see how the argument of keeping women ignorant in case they get scared is anything other than infantilising and disempowering. SardineQueen, I agree, and it is surely blindingly obvious, that women are more likely to seek help for pain, continence issues, loss of sexual function etc if they aren't under the miserable illusion that everyone else manages just fine, and they are the only woman to have such problems. You only have to look at threads on MN where women are so relieved to find other mothers with similar post birth injuries, and who are encouraged enough to go and see their GP to see that happening.

I think that being dismissive of perineal damage and incontinence issues is actually related to assumptions about a woman's role in society/life. The more confined and home bound she is, the less issues like minor incontinence matter. For a woman who expects to be pretty physically active or who expects to be away from home, and be in work situations for example where they can't dash to a toilet quickly, then it's obviously more of an issue.

I think women sometimes don't help when they accuse each other of 'vanity' issues over post birth genital trauma and pelvic floor issues. I recall a recent thread here where posters accused each other of genital vanity, downplaying minor incontinence and basically saying with a healthy psychological attitude and a loving husband, such things didn't matter.

Another poster responded with admirable restraint, saying all she wanted was to manage the school run without shitting herself. Indeed.

CervixWithASmile Wed 18-Jan-12 23:17:07

I think you're being way too literal here. The reason I might think about it in labour would be if it was talked about too often or too much emphasis put on it.

Anyway I've made my point here and we can agree to disagree.

fruitybread Wed 18-Jan-12 23:19:39

Ah - cross post, peaceAndHope - yes, women's attitude towards other women re: birth depresses me too. Time and again you see here (and elsewhere, it's not just MN!) the attitude of 'oh, well, it didn't happen to ME, so it can't POSSIBLY be an issue for anyone else.' Extraordinary. And don't even get me started on that passive aggressive competitive birth nonsense...

brandysoakedbitch Wed 18-Jan-12 23:33:53

Yes agreed Cervix, way too literal. I got what you were saying when you made that point - so did the OP of course but there we are. I am agreeing to disagree too - I just think the OP is plain wrong

Despite my random strangeness I have never dismissed perineal damage/continence issues etc not for a second, and no one on this thread has done that if my memory serves me correctly. I just feel that there are better ways to handle it. My suggestions that post natally these issues should be properly followed up is a good one I think, then the information and help is aimed at those who need it rather than blinding everyone with scare stories that very often and most often in fact do not materialise.

I think Cervix was onto something with the similarities between the posts from certain people.

Heatherhills Wed 18-Jan-12 23:37:31

Is your mum an ob in the us by chance?

NonnoMum Wed 18-Jan-12 23:45:24

Message deleted by Mumsnet.

PeaceAndHope Thu 19-Jan-12 00:02:06

Apparently this place is a bit of a loony bin. I have no idea who the teenage boy from Arkansas is hmm, but why is it it freaky to talk about incontinence?

I think coming on to mumsnet was a mistake...

HeatherHills:

My mother is a professor of Geology. And my father is an alcoholic. Why do you ask?

PeaceAndHope Thu 19-Jan-12 00:11:23

Brandy:

I think your suggestion that post natal care should be a lot better is something I agree with. Physiotherapy is a good idea, and so is laser treatment.
But I think that we would be better off trying to avoid these issues from developing in the first place instead of getting to a point where we require extensive physiotherapy or surgery to correct the damage. Hence better care in labour, limited use of harmful interventions such as forceps and ventouse, offering cesarians to women who are carrying very large babies etc. are changes I would like to see.

CervixWithASmile:

I'm a bit unclear on what you are trying to say. Are you saying that women should not be told about the risks of childbirth? And that pregnancy is not risky in the first place?

BadDayAtTheOrifice Thu 19-Jan-12 00:12:24

Have to say, I completely agree with everything shagmund has said (and not for the first time). I think views on childbirth needs to start coming from a different perspective, and one that is not based on fear.

PeaceAndHope Thu 19-Jan-12 00:13:50

fruitybread:

Ah we agree on many accounts smile
I am being mistaken for someone who wants to scare women whereas I just wanted to start a discussion on the lack of appreciation and respect for what women go through.

PeaceAndHope Thu 19-Jan-12 00:16:44

BadDayAtTheOrifice:

Hi! The purpose of this thread was to discuss views on pregnancy and birth.
I encourage you to elaborate on what your views on the process and the women who go through it are.

I understand that you feel it isn't something to be feared. Noted.
But have you personally noticed a lack of appreciation for what we go through as women and mothers? Like we are expected to deal with it because it's what we were "meant to do"?

CervixWithASmile Thu 19-Jan-12 00:18:06

Peace, for gods sake, of course not. If you read my posts objectively I think that's clear.

PeaceAndHope Thu 19-Jan-12 00:23:20

I hope this won't be taken the wrong way but I am genuinely curious about something.
This is a question to all those who feel that pregnancy and childbirth are not to be feared.

Is it really possible to not even have the slightest bit of fear and apprehension in your mind about a process that-

1. Is painful no matter how you do it (yes cesarians are painful too)
2. Can cause a host of complications like pelvic floor disorders,incontinence, prolapse,PPH, diabetes, hypertension, paralysis etc.
3. Can change your appearance considerably and not always for the better
4. Can in very rare cases cause death

Surely a certain amount of fear and hesitancy is natural. I don't think over-medicalisation is the answer but I don't women should be made to feel guilty for feeling scared either.

PeaceAndHope Thu 19-Jan-12 00:25:33

Cervix:

I'm sorry for misunderstanding. If you feel women should be informed about childbirth and that the process is risky for some then we are on the same page. I got confused when you said that you disagreed with the OP completely when in effect we both seem to want the same thing- healthy, informed women who are respected for the brave journey they have embarked upon.

BadDayAtTheOrifice Thu 19-Jan-12 00:27:44

To some extent, yes, I do.
There is an element of 'well you've had children, so what did you expect, this is what happens'.
On the other hand, the biggest risk factors are mostly brought on by interventions that occur because of birth setting. Women still believe that hospitals are the safest places for them to give birth in and are oblivious to the fact they are very risky places to be in regarding injury to yourself. This is what we need to educate mothers on.

BadDayAtTheOrifice Thu 19-Jan-12 00:36:30

In answer to your questions.
1.It is only pain. It is causing me no damage. It is temporary, it won't last forever.
2.The other choice is to remain childless or adopt. 45% (ish) of pregnancies are unplanned. (my first was a 'happy accident')
3.I will not have the body of a 20 year old forever, even if I don't have kids.
4.So can crossing the road/ driving/smoking/ choking/ being hit by a sharp object in the wind and being decapitated. You've got to die of something.

I trusted my body. Its done me pretty well so far. Its never let me down. It did well giving birth. Twice.

PeaceAndHope Thu 19-Jan-12 00:37:01

BadDayAtTheOrifice:

I agree. Although I wouldn't categorically rule out hospital births. I think the hospital will be a safer place to birth when women know the real risks of interventions and are aware about the situations where those interventions would actually be required. If we have better informed women then they will be in a better position to assert themselves during labour and delivery and refuse what they aren't comfortable with.

As someone who lost a nephew during a homebirth gone horribly wrong I can say that there is certainly something to be said about having emergency facilities at hand during childbirth. The process can throw up some unexpected and less than pleasant surprises which we can't always be prepared for.
Nevertheless I still encourage homebirths. And hospital births and elective cesarians and anything else that women wish to make informed decisions regarding.

PeaceAndHope Thu 19-Jan-12 00:47:14

BadDay:

My body survived as well. That isn't really the point. Majority of female bodies do survive the process. Mere survival isn't really the goal though is it?

I find your attitude a bit casual as well. It is only pain, but would you say the same to someone who is having an amputation or surgery? "It is just pain, it's temporary, so get on with it"? I imagine not. Then why treat the very real pain of childbirth casually?

Most women desire children at some stage. Some really yearn to be mothers. The tradeoff for us is to risk the complications I mentioned. Most women do it without complaining but does that mean it doesn't bother them to have those complications? Does it mean we disregard those complications that can indeed alter the lifestyle of a person?

Of course nobody will have the body of a 20 year old forever! I just saw my 23 year old niece's post baby body. She could have easily avoided the stretch marks, sagging breasts, and cellulite for another 20 years if she hadn't had kids yet. Pregnancy does deteriorate the appearance faster and while it may not have been an issue for you some women struggle with self esteem issues regarding their post baby bodies.

PeaceAndHope Thu 19-Jan-12 00:48:36

BadDay:

What would you say to some at a high risk of cancer? That he/she has got to die of something? Anything potentially life threatening shouldn't be treated with this kind of disregard.

Doubledare Thu 19-Jan-12 00:50:27

I am 17 weeks pregnant and will have to have an induced birth due to developing blood clots on the brain at 11 weeks (caused by severe morning sickness) which led to me having a stroke. Not all the risks of pregnancy are "superficial".

I would have avoided having the stroke if I hadn't tried to "soldier on" as so many people (including my mother and husband) pointed out I was only pregnant not ill.

PeaceAndHope Thu 19-Jan-12 00:54:17

Doubledare:

Thank you for sharing your story. I am terribly sorry to hear about your experience.

I think the attitude of your mother and husband is the kind that I was referring to in my OP.

I hope they are more sensitive to your condition now.

Doubledare Thu 19-Jan-12 01:01:41

Thanks PeaceAndHope.

Yes, everyone around me is now on a mission to spread the word that if someone is suffering severe morning sickness they are to get straight to a doctor. Doctors take Hyperemesis Gravidarum very seriously as they are aware of how many problems it can cause.

PeaceAndHope Thu 19-Jan-12 01:10:55

Doubledare:

I am glad to hear that. I've learned something new today as I wasn't aware of this possible complication at all. I will be sure to spread the word as well.

What happens now? Do you still have symptoms? When will you be induced? How does this affect your post partum health and your baby?

BadDayAtTheOrifice Thu 19-Jan-12 01:15:31

I have not merely 'survived' childbirth. I have no long term issues from my pregnancies/births that affect me (not at the moment, anyway, I cannot forsee what the future has to hold for me).

I don't think my attitude to pain is 'casual'. Pain is something that is much feared in this society. It is something that must not be felt and must be 'relieved' and not 'suffered'.
I did not suffer. The example of 'you wouldn't have a tooth removed without anaesthetic' is often pulled out at this point.

Take, for example a marathon runner, or an ultra runner or a fell runner, they have to go through a lot of....pain, theres a barrier they have to break through (hitting the wall, transition?). Its hard work, just like labour. The feeling they get when they reach there goal is exstatic! Its the rush of endorphins and adrenaline! Its addictive, the people who do this do it again and again. The pain, feelings of accomplishment and the associated hormone release and has been compared to labour.

Suggesting women in labour avoid all the pain they can is like telling the marathon runners they should just get the bus.

Comparing that to the pain of someone suffering a life threatening illness does not compare IMO.

BadDayAtTheOrifice Thu 19-Jan-12 01:20:33

I should add, although I had good births, my pregnancies were shocking.
Awful sickness for the whole 9 months. I couldn't move/cook/ eat for all of it. I only put on 1/2 stone. Hyperemesis really is misunderstood and the suffering of that is severely down played. No understanding or sympathy of how it can severely impact your quality of life and relationships.

Doubledare Thu 19-Jan-12 01:22:44

I am on blood thinners and a whole list of medication. I will be induced either when I have to be (for medical reasons) or else when the doctors are comfortable that the baby will be ok (but no later than 37 weeks).

The baby is expected to survive but may have problems due to all the class C drugs I've had to take as well as the MRI's. I have a low chance of survival (due to the blood thinners and my previous haemorrhage with my first child). The doctors are going to do their best but I may not clot enough in time. They are going to try for a vaginal birth as there is less risk than caesarian but I had that the first time when I haemorrhaged so it's not a guarantee.

BadDayAtTheOrifice Thu 19-Jan-12 01:24:13

Also, just to mention, I'm 38, size 8, no stretchmarks or cellulitis, or sagging breasts (and I BF for a total of 3 years). Fuck, I would have the body of a 20 year old if I hadn't had kids. Damn!

BadDayAtTheOrifice Thu 19-Jan-12 01:27:10

Sorry to hear that doubledare, my boasty post had no place after that.
Hope everything works out for you.

PeaceAndHope Thu 19-Jan-12 01:28:12

BadDayAtTheOrifice:

I did suffer many complications but I was fortunate enough that I could afford to have them fixed. You should be grateful that you made it without lasting emotional and physical damage. Many are not as fortunate.
I suffered PTSD which took me a long time to get over.

Avoidance of pain is a personal decision. I am not suggesting that women avoid labour pains (not sure where you got that from) I am merely suggesting that we show a little compassion towards women who experience that pain.
Pain does involve suffering and most people don't exactly enjoy being in pain or discomfort, so I find it bizarre that you should oppose pain relief. It's fine to go without it if you so desire, but to patronise women who do ask for pain relief is a bit disgusting. If you did not suffer I am happy for you. I did.

I shall explain with an example. Not every woman experiences the same level of discomfort and pain during her periods. While I would be stuck moaning in bed during my period my sister could play basketball during her time of the month. She could well have patronised me for taking Ibuprofen and heating pads and said things like "Pain is not to be feared" and "I don't suffer, how come you do?'. But she understood that every female body is different.
The hormone that causes uterine contractions during the periods is the same one that causes labour pains. Just as menstrual cramps don't feel the same for everyone, labour pains don't impact all women the same way either. Given this disparity it is pointless to judge someone for accepting or refusing pain relief.

PeaceAndHope Thu 19-Jan-12 01:32:21

BadDay:

I am 31. I am a size 8 as well.I have some stretch marks, some cellulite (not cellulitis as you call it), my breasts do sag (not sure why you felt the need to mention breastfeeding because it doesn't cause the breasts to sag).

Instead of being humble and grateful that you managed without complications and that you are still able to look in the mirror and feel happy, you are boasting about it and ridiculing other women who have been less fortunate.
Shabby.

PeaceAndHope Thu 19-Jan-12 01:36:34

DoubleDare:

I am so terribly sorrysad I had no idea it was life threatening.I sincerely hope all this works out without a hitch.

I am curious as to why a vaginal birth is considered safer for you despite a previous cesarian and all the other complicationsconfused But then again, I am not a doctor.

Sending you e-hugs.

Doubledare Thu 19-Jan-12 01:38:21

That's ok BadDayAtTheOrifice.

The problem is so much of pregnancy is down to luck. I have no prior history of health problems, I'm youngish, my mother had five children with no problems, my sister had two with no problems, I don't smoke, drink or do drugs. I took my multivitamins and ate healthily. So how come I got sick when women who are obese and live on crisps and soft drink are fine?

Just remember, you are lucky, not superior to those of us who ran into complications or whose bodies didn't bounce back like yours did.

Doubledare Thu 19-Jan-12 01:44:13

Sorry PeaceAndHope, I had a vaginal birth the first time and still haemorrhaged badly, that's why even though it's less risky than a caesarian it's not a guarantee that I won't bleed to death.

I know there is probably people reading this thinking, "why didn't you terminate the pregnancy?" but because of the this risk of me haemorrhaging they doctors refused to consider this even though I was only 11 weeks.

Doubledare Thu 19-Jan-12 01:44:48

oops posted twice, not sure why.

Doubledare Thu 19-Jan-12 01:46:18

No I didn't, two different messages. Doh! I'll blame it on the stroke.

PeaceAndHope Thu 19-Jan-12 01:51:30

DoubleDare:

This is sounding more and more awful! You must feel trapped. Have you asked for a second opinion regarding the termination(assuming that is what you would prefer)? I'm sure it carries risks but surely the risks will be lesser than carrying the pregnancy to term and giving birth at 37 weeks?

BadDayAtTheOrifice Thu 19-Jan-12 01:52:44

Darn it, I just lost a big long post. I'm sorry I came across that way, its not quite what I meant, but I wish there weren't so many negative perceptions of how motherhood will 'ruin' you,

I'm not anti pain relief for anyone, its not right that some women suffer or don't get the pain relief they request, I'm just keen on approaching pain from a different perspective and reduce 'suffering'

I don't think I'm superior to anyone. Just lucky. I know that, and boy, do I appreciate all i have.

Doubledare Thu 19-Jan-12 02:31:28

PeaceAndHope, well my husband and I couldn't get our heads around it either. But I think the risk of me dying from the blood clots is so high they have to keep me on the blood thinners for four to six months until my body can disolve them. By the time it will be safe for me to have the termination my baby will be at full-term anyway.

Yes have had second and third opinions. Obstetrics won't touch me with a barge pole unless the head of neurology give the all clear.

RealLifeIsForWimps Thu 19-Jan-12 03:04:18

No-one can really comment on another woman's birth experience because no-one knows what pain feels like to another person. People have different levels of tolerance, and doctors also think that it's likely that people objectively experience pain differently. Therefore people who say "Oh you have to embrace the pain. It's bearable" should STFU as they have no idea how their pain compared to that of someone else.

I am a sub-3.30 marathon (bragging top trumps) and ultra-marathon runner, and I can say that for me, personally, pain of childbirth is on another level to running pain. Firstly, I think it's the fact that the marathon is finite. You know how much further there is to go. Secondly, you can stop, slow your pace any time you want. You control it. You don't control labour. Once you're on that train, there ain't no getting off and there ain't no timetable either. Lastly, you can actually train for a marathon and so spread the pain. You can't really train for labour in realistic circumstances.

Now, someone may well come on here and say "No way. Marathons are the worst thing ever"......which proves my first point.

SardineQueen Thu 19-Jan-12 07:52:03

Just catching up a little

Find it odd that the people who are saying there should be more info etc and that society has some funny ideas are being accused of sock puppetry (I mean, FGS, while the people who are apparently the "voice of reason" include someone who has had multiple posts deleted.

This is a very strange topic, I haven't posted on a discussion thread here and I'm not sure I will again. Is it yet another area of MN where there is a prevailing set of ideas which comes across as terribly hostile to anyone who wanders in and says something else?

NinkyNonker Thu 19-Jan-12 07:59:29

I thought 'excessive' pain relief was actually to blame for many of the interventions used in childbirth because it lessens the woman's control over what is happening? Makes her less in tune? Whereas an amputation carried out without pain relief would send the body into shock, and possible death. There is a huge difference, it would be ignorant in the extreme to suggest otherwise.

SardineQueen Thu 19-Jan-12 08:04:15

Still catching up.

Brandy your posts got deleted in case you hadn't noticed confused

So why you are warning people about me (?) when MNHQ decided that you were out of line is odd.

This is all odd, I don't understand it.

SardineQueen Thu 19-Jan-12 08:16:25

Phew got the the end!

Great post by fruitybread Wed 18-Jan-12 23:15:34, totally agree with all of it.

Doubledare your situation sounds horrific, I am so sorry, I don't know what to say.

What I won't be saying is "ooh look at me I'm a size 8" confused which is a strange post under any circumstances on this thread let alone when people are talking about their experiences.

SardineQueen Thu 19-Jan-12 08:17:16

Ninkynonker you seem to be saying that pain relief for women in labour is undesirable. Can you clarify your point?

CheerfulYank Thu 19-Jan-12 08:23:24

Oh Doubledare, oh goodness, I just don't know what to say.

Please let me know if you need anything, or just want to talk, or...I'm sorry, anything I can say sounds so inadequate. I will be thinking of you.

CailinDana Thu 19-Jan-12 09:05:04

Wow Doubledare, what a scary situation. How are you feeling about it?

I just remembered something vaguely relevant to this thread last night. The absolute numpty of a midwife who ran our antenatal classes told us that it was "very rare" to poo to during labour. Now, I know for a fact that that isn't true so I challenged her on it. She went bright red (making me feel very bad) and blustered something about "not wanting women to worry about it." It made me very angry. Labour is something you do, not something that passively happens to you. The idea that you don't need to know what's going on is just so incredibly weird - how can you feel in control and safe if things are happening and you don't understand them? Pushing is quite difficult and there is a feeling that you might poo. If you know that a lot of people poo and it's nothing to worry about then you're just going to say "fuck it, it happens to everyone." If, on the other hand you've been told by some idiot that it's "very rare" you're going to think "fuck it, I can't push, I'm going to poo, that's not supposed to happen!"

All I wish for is for the information given to be less sugar-coated and more matter-of-fact. Labour and childbirth are messy and unpleasant, there's no getting away from it. Injuries happen, things go wrong sometimes, but for most people it's fine. I'd like to see the whole "Oh it doesn't matter, your baby is healthy" attitude completely thrown out the window - if a woman is injured and traumatised by the birth she experienced then that's real and she needs to be listened to, not dismissed.

There was a thread recently written by a woman who had a truly horrendous birth, it made my stomach churn to read it. Her baby was healthy, thank god, but she was an absolute mess, physically and mentally. No one in her family asked her once how she was feeling, her midwife told her she would be "fine" and her husband wouldn't talk about it (as he was traumatised too). Had that been a car crash she'd experienced people would have been falling over themselves to help her, but because it was "only" childbirth she was supposed to just get on with looking after a tiny baby and forget about the huge upheaval she'd been through. Not acceptable in my opinion.

SardineQueen Thu 19-Jan-12 09:14:03

Another great post cailin, agree with all of that too.

One of my friends also had PTSD after a VBAC - if she had known how the birth was going to go she would have chosen another section. But the baby was fine, and her damage was the sort of damage that doesn't get talked about and women are expected to soldier on with, so to anyone except those very close to her the whole thing was a great success.

suzikettles Thu 19-Jan-12 09:19:06

My friend had a CS (due to failure to progress, so there wasn't any particular rush that might have led to a mistake). Unfortunately the anaesthetic didn't work on half of her body so she felt the whole procedure.

She had massive sympathy and support for as long as she needed it (obviously she was utterly traumatised) and her ds being fine was not the point, in anyone's mind - again, is it because VB damages the genitals and therefore the taboo is there about discussing it?

Anomaly Thu 19-Jan-12 09:32:31

I think the issue here is that people really struggle to get their head round other people's approaches to the same issue.

Having had an emergency section with my first when I was pregnant again I had to decide whether to VBAC or have an elective. One of the biggest factors for me in deciding was the continuous monitoring the doctors would have recommended had I tried for a VBAC. The statistics are actually pretty favourable that you can have intermittent monitoring and all will be well. So one woman would have been reassured to ignore this advice while I wasn't comfortable to do so and opted for an elective section. Neither approach is wrong as long as the mother is happy with her decision.

The key thing would be that either woman had the information available and made the decision that suits them. Information on things like forceps should be available especially as there is more than one kind.

I know some people would say that the information is there but in my experience it isn't easily accessible. My decision to have an elective relied a lot on research I carried out including reading articles in journals. I've got a science degree and am more able than many in the population to understand these.

CailinDana Thu 19-Jan-12 09:33:14

I think so suzi. People are very willing to talk about CS scars, even to show them to people and to talk about infections, numbness etc. I know the full details of my DH's cousin's CS, because her family talked endlessly about it. None of them know anything about my vaginal birth as no one ever asked me about it, and if I did mention anything it was glossed over, as though I was talking about my pooing habits or something. There is huge taboo around talking about your "bits." There are regular discussion from parents on MN asking what to call their daughters' vulva - and the responses are usually "I don't know, I call it {insert silly name}". Why not call it a vulva?? That's what it is for god's sake. All this silly secrecy eventually leads to women who are ashamed to discuss their birth because they just don't have the vocabulary to talk about it, and everyone is too embarrassed to listen. Therefore, a huge experience in a woman's life is shrouded in secrecy and shame. It's such a pity. My birth was a wonderful, scary experience and I don't want to feel like I can't mention it, it's a huge part of who I am now.

NinkyNonker Thu 19-Jan-12 09:48:33

No, far from it. I had everything known to man. But saying (as on page 9) that it is the same as pain relief for an amputation is misleading. We are talking about getting accurate information out aren't we? Isn't that the whole point of this thread? In which case it is important that the cons of lots of pain relief are put across too, as against just a blanket "pain relief good, pain bad." Sometimes pain is telling us something, for example that you are having a contraction, a whopping epidural (as I ended up with) removes that knowledge, u was reliant on a mw with her hand on my belly telling me when to push.

Likewise, when I was off my head on gas and air and pethidine I was barely aware of my surroundings and not in control of what was happening.

We need a balance.

This is why I think it is unreasonable to expect and embrace a little pain, it is totally different to the examples given over the page.

NinkyNonker Thu 19-Jan-12 09:49:52

not unreasonable...blush

shagmundfreud Thu 19-Jan-12 09:53:06

"There is huge taboo around talking about your "bits."

Not in my social circle or within my family there isn't.

Or on mumsnet.

Or on other forums like netmums.

Though I will admit that I've never heard anyone speaking at length about their c/s wound, unless it's infected or causing them difficulty.

Just goes to show - everyone is different.

NoWayNoHow Thu 19-Jan-12 09:55:36

Great post, Cailin

I wonder if the sympathy for CS vs VB ( in terms of finding out how the mother is and not just happy that the baby is here) is because CS is "unnatural" and VB is "natural"?

CS is an operation, therefore we should be checking how the patient is (whilst baby is just a by-product). VB is what you're supposed to do, so even if you are physically and emotionally traumatised, people don't really care because it happened as it was supposed to.

I know that's a simplistic view, but YKWIM.

Doubledare I'm so sorry for everything you're going through. Big hugs.

BadDay I appreciate your last post about how lucky you are and you that you know it. But all your previous posts simply prove the OP's original point:
- labours went fine
- no physical damage
- no emotional damage
- pain comparable to marathon running
- size 8, no stretch marks, no cellulite, no saggy boobs.

Let me outline mine in contrast:
- horrific 44hr labour
- intervention, 3rd degree tear and infection
- lasting emotional trauma, counselling no help, DS only child as result
- pain so severe and uncontrollable that even whilst unconscious after 2 pethidine doses, the contractions had me rearing up out of bed
- size 10, scarring from infected stretch marks from PUPPS, no cellulite, very saggy breasts

Just because it didn't happen to you doesn't mean that it's not an issue that doesn't need addressing, and that everyone else should just get on with it because it's not that bad.

CailinDana Thu 19-Jan-12 10:05:53

Never in all my life have I heard a bunch of women talking about their vaginas. Never. I don't think I'm unusual in that. I've seen discussions about it here on MN but that's partially due to the fact that people are anonymous. Look at poor Bupcakes - she wanted to talk about her "vagine" grin, but tried to namechange to do it and now has MN infamy fame possibly because people know it was her who started the thread. I don't see how anyone could deny that there is a taboo around discussing women's genitals. Shagmund, have you never seen the threads where there are long discussions about what to call children's gentials? There seems to be one every few weeks, and as far a I can see a lot of mums are opposed to calling their daughters' genitals by their actual anatomical names, does that not indicate a level of taboo?

shagmundfreud Thu 19-Jan-12 10:09:15

I think my problem with this thread is that people are giving examples of poor practice (bad teaching in an antenatal class, or poor listening from a midwife) and assuming it's a reflection of some sort of formal conspiracy to deliberately deny women access to important knowledge.

The truth is that hospital antenatal classes vary HUGELY. The ones delivered at my local hospital are often very poor. They're done in rotation by midwives, some of whom clearly hate doing it and have poor communication skills. The classes have been reduced from 10 hours to 3, which gives only enough time to cover the absolute basics. If I was teaching these classes I'd be incredibly concerned about using these sessions to tell women IN HUGE detail about all the things which can go wrong during childbirth. There are ways of giving this information that is more sensitive and more helpful to women.

Postnatal care is also very, very poor in many parts of the UK. Women in some areas are getting only one visit at home, and then waiting several weeks to see their health visitor. Midwives are so caught up with doing routine testing and paperwork, and so overwhelmed by the volume of their work that they don't have time to sit and properly listen. It's very worrying that women who've had difficult births are getting so little support or acknowledgement from their midwives, but I assure you, it's not a reflection of a lack of professional concern about this issue in the midwifery profession generally. Midwifery journals are bulging with articles on birth trauma and birth injuries, and on meeting women's emotional needs in pregnancy, birth and afterwards. It's on the ground that things are going wrong.

The problem is the system of healthcare we have in the UK, which neglects postnatal mental and physical health.

I also blame a system of maternity care which results in much larger women experiencing damage at birth than is necessary.

We should be focusing on what needs to change - in real life. Not polarising this issue by making vague accusatory comments about national conspiracies to cover the issue up. There is no conspiracy. There is just poor maternity care and poor antenatal education.

shagmundfreud Thu 19-Jan-12 10:11:57

"I also blame a system of maternity care which results in much larger women experiencing damage at birth than is necessary."

Sorry - that should read "which results in much larger numbers of women"

blush

shagmundfreud Thu 19-Jan-12 10:14:31

"does that not indicate a level of taboo?"

Yes there are taboos. Doesn't stop me and my friends discussing at length the state of our foo foo/lady garden/wanny/punani/ninky nanky noo/minnie etc

grin

Maybe I move in different social circles to you Cailin.

We're all a bit rough and ready round my way. wink

SardineQueen Thu 19-Jan-12 10:17:42

My antenatal classes were both very clear that pain relief = bad, so I think that message is thoroughly out there confused

CailinDana Thu 19-Jan-12 10:18:38

I think the word conspiracy was used in a rhetorical way and was then picked up too seriously by other posters. I'm not sure anyone on the thread does think there's a conspiracy going on.

What I think is that general attitudes need to change as this will have a knock-on effect on services. I agree with you shagmund that the care given is the problem, but I think that's partly due to the fact that women feel they can't complain, or if they do complain they're told "but your baby's healthy, that's the main thing," and are not listened to. Having damage from childbirth can be an incredibly lonely thing as society in general seems not to want to know about it and so women feel like they just have to shut up and put up. If we try to foster a more open attitude then I think women will become more bolshy about the whole thing and will be less likely to stay silent. I think the main aim is to have more of a general acknowledgement that childbirth is straightforward for many women, but for many others it's a horrendous ordeal that they have every right to feel upset about.

CailinDana Thu 19-Jan-12 10:19:23

Well I am an Irish Catholic Shagmund, so that might explain a lot smile

SardineQueen Thu 19-Jan-12 10:25:35

""There is huge taboo around talking about your "bits."

Not in my social circle or within my family there isn't.

Or on mumsnet.

Or on other forums like netmums."

But there is before you have had children.

Most of the time before I had my first child was spent at work, and with people who hadn't yet had children. People never spoke about their birth experiences - it wasn't something that came up. When I was pregnant I never had people talking to me about tears and things. And when my friends had children, they didn't really go into detail about what had happened with people who didn't have children.

Certainly after people have had children there is a period where this sort of thing is discussed a lot with eg people in postnatal group and friends who have had babies at a similar time, but for most people the need to talk about it has passed after a few months and they stop talking about it. I no longer feel the need to offload about my first birth experience as although it was not great, it was nearly 5 years ago now and is not so raw.

In my life, anyway, people just don't talk to each other about their genitals and incontinence and things, sometimes even when they are pretty close. We are still mainly UK people here aren't we? Have we morphed to a different culture and I somehow missed it? grin

NoWayNoHow Thu 19-Jan-12 10:26:53

shagmund I completely agree with you (bring out the bells and whistles!! grin )

Lack of resources and time in ante-natal care, plus more of the same post-natally, makes for a very confusing time, especially for first time mums.

I never saw the same midwife more than once in my entire ante-natal care. And the midwives that were there at my birth were all complete strangers to me.

This sentence especially: "I also blame a system of maternity care which results in much larger numbers of women experiencing damage at birth than is necessary." My hospital has freely admitted (and with no kind of apology) that they should have given me and EMCS after 27 hours labour when my contractions were 60secs apart yet I was only 1cm dilated. They didn't though, and weren't able to furnish me with any reasons, probably because their reasons were along the lines of not have the staff/anaesthetist/surgeon/operating room/post-natal recovery bed, etc, etc.

I know that an EMCS would have come with its own set of "what ifs" but I'd choose a "what if" over what ACTUALLY happened to me any day.

shagmundfreud Thu 19-Jan-12 10:41:34

"But there is before you have had children."

IMO there is no value in casual discussion of this issue for women prior to having their first baby. No more value than hearing old people talking about their piles or varicose veins. It's going to happen to us all, and when it does we'll deal with it. But talking about it at length to someone who can't do anything about it isn't helpful, it's just depressing.

However - there is a lot of value in a midwife explaining to a pregnant woman clearly and concisely the range of problems mothers can experience during and after birth, and giving women enough time afterwards to identify problems accurately and refer for help.

"probably because their reasons were along the lines of not have the staff/anaesthetist/surgeon/operating room/post-natal recovery bed, etc, etc."

About one third of c/s could be avoided apparently, without damage to mother or baby. The fact that there are so many avoidable c/s happening is putting huge strain on the system, which simply wasn't designed to accommodate these sorts of problems in such large numbers (remember - cs rate has almost doubled in the past 20 years). That means that some women will end up waiting for a c/s they and their baby desperately need. Not good.

NinkyNonker Thu 19-Jan-12 10:52:11

Well, mine weren't, at all. Regardless, there are attitudes on this thread that seem to be perpetuating the myth that indiscriminate pain relief is all good in childbirth, after all...we wouldn't have a tooth out or a leg amputated without it would we?!

brandysoakedbitch Thu 19-Jan-12 10:52:53

Still catching up.

Brandy your posts got deleted in case you hadn't noticed

Sardine Queen - Erm have they? How exciting but then again I can still see them so maybe I am only being randomly strange on occasion - thank you for noticing and pointing out, says a lot about you to be honest. Good to see that you focus on what is important eh? well done for bringing your own argument down to such a purile level

Some people disagree with your point of view, some people think you are voice of reason: that is the fun of it you see, we all have different views

SardineQueen Thu 19-Jan-12 11:07:00

"there are attitudes on this thread that seem to be perpetuating the myth that indiscriminate pain relief is all good in childbirth"

where?

shagmund your posts are confusing me. I have been saying throughout (and agree with the Op and others) that full factual information about different birth methods and different procedures and all the rest of it should be given as a matter of course to women who are pregnant for the first time as part of their ante-natal preparation.

This has been pushed back by brandy on the basis that people can look it up for themselves, and it will scare them shitless so it's the wrong thing to do

It has been pushed back by you on the basis that women know about this stuff already. But I don't think they do and on your latest post you seem to agree with that.

What is wrong with telling pregnant women the whole story, rather than the incomplete version that is all too often told at the moment? I think women deserve to know about things like forceps and tears and incontinence, so that if it happens to them they know it is a. normal and b. they won't get a terrible shock and c. they will feel able to seek help.

I do not understand that at all and it is exactly what the OP was talking about.

As for conspiracies - it was a figure of speech that I used - "conspiracy of silence" is quite a usual figure of speech to describe a situation where people are reluctant to talk about something and IME people were reluctant to talk about things like problems BF when I went to ante-natal classes.

OTOH OP has been accused of trying to persuade MNers on mass to elect for CS by scaring them which really is a loony suggestion.

SardineQueen Thu 19-Jan-12 11:08:47

?

Brandy

You were warning people on the thread that I was reporting people willy-nilly.
The fact that the posts of yours I reported were deleted is surely pertinent. ie I am not reporting people willy nilly - I reported 3 posts of yours which were trollhunting and personal attacks and they have now gone. What sort of person I am is one who thinks that you went too far and you pretending that you didn't is wrong when the evidence is there on the thread that you did.

brandysoakedbitch Thu 19-Jan-12 11:08:59

Ah yes it is the bit about me thinking that collating stats about perineal damage and incontinence and then posting them on the internet is a bit f....d up (perhaps removing the actual expletive will help) - what i meant to say is those people must really have an axe to grind and too much time on their hands - I think it is a horrible thing to do to just post stats because it scares people.

Would you like to report me now? is that moderated enough for you because I do stand by it I do think it is extremely odd and smacks of a lot of ishoos..

SardineQueen Thu 19-Jan-12 11:11:59

No that is not what those posts said and you know it.

There is no point in this, everyone knows that MN do not object to people using the word fuck (unless it is aimed at another ie a personal attack).

You overstepped the mark and pretending that you didn't is quite silly now.

SardineQueen Thu 19-Jan-12 11:13:55

I also don't understand that what could have been a really interesting debate, and has been in some parts, has attracted such an aggressive stance from some people, with accusations of trolling and sock-puppetry.

the OP has not said anything peculiar or outrageous and I simply do not understand why this has happened.

is this the reaction that women get when they post in this section for support?

shagmundfreud Thu 19-Jan-12 11:15:11

"I'm just talking about being better informed about what it actually entails and not living in denial about the true risks"

Maybe we should apply this type of reasoning to all aspects of life: marriage (domestic abuse, family breakdown); driving (show learner drivers pictures of horrific accidents and tell them about all the different types of death and injury caused by driving); sex (make people read research papers on sexually transmitted diseases) getting old - again, like pregnancy and natural life process and the 'default mode' unless you do something to opt out like committing suicide (so people could be informed about all the diseases old people are more likely to get, be shown pictures of bed sores etc).

Seriously - what's wrong with just having better antenatal education and better postnatal care, so that women have a clearer idea of what might happen during birth, and help with coping afterwards?

The alternative is .... GRIM. sad

And I think if you overwhelm people with information about the more challenging aspects of childbirth when they're not emotionally ready even to consider pregnancy - well, I think it would be very, very ineffectual. I suspect if someone had subjected me to a litany or horrors about pregnancy and birth as a teenager I'd either have mentally blocked the information out, deliberately forgotten it, or become phobic about childbirth.

brandysoakedbitch Thu 19-Jan-12 11:15:13

and agree with the OP and others... grin, yea whatever

Look it is not just me who has said that the information available if you want it - really I am not a lone voice in this. We just disagree is all, you don't have to get your knickers in a twist I just think you and the OP and others (haha) are wrong

I think post natally is how it should be handled - that this sort of care needs to be more comprehensive and not blowing people's minds with information when they are pregnant and have an imminent birth - general information is good of course (and actually with hindsight the info I got when I had my first was pretty comprehensive - had a look around scbu and theatre and they did talk about if it goes wrong stuff) but bunging a load of stats at people without sensible interpretation is dumb and cruel. It is tantamount to them being faced with a load of stats (from unmoderated sources) on an internet forum. The information needs to be moderated and delivered careful and ante natal care in this country as it stands not able to do this sensitively.

Like I said a lot of personal axes being ground and that does not necessarily translate into a national campaign does it.

brandysoakedbitch Thu 19-Jan-12 11:17:02

is this the reaction that women get when they post in this section for support?

No Dear it isn't, shall I tell you why? because this is not a support thread that is why. I have never seen anyone be anything but kind and helpful to those who have suffered injuries or trauma and are asking for support.

brandysoakedbitch Thu 19-Jan-12 11:18:25

Shagmund as ever you hit the nail on the head - yes absolutely - information overload does no good.

brandysoakedbitch Thu 19-Jan-12 11:26:51

and I will be honest with you SQ I have no idea what I posted in those particular entries but was honestly writing what I thought was missing - I would love to have the time to go all the way through and work it out but I can honestly assure you that I am not intending to deceive - I just cannot remember every word I have contributed (unlike you of course who may have even cut and paste)

And again thinking about it I have had a birth injury - my third came out with his hand about his head and I have some nerve damage. He was born at home, he and I were fine although I did suffer for a long time after with painful leg and fanjo (still do on occasion) but honestly I fail to see how this (very rare) outcome could be discussed with any meaning. Most people sustain damage from a hand by the face or above the head (usually tearing apparently) how could me knowing about this rare occurrence have changed anything at all? I would love to know how all these stats translate into useful and real help for women. This was third child, my second home birth, textbook birth and really quick and not awful at all - why would knowing that the baby could possibly have his hand in the wrong place help me or him in any way whatsoever??

SardineQueen Thu 19-Jan-12 11:31:14

Why is telling women factual information equated with exposing them to a "litany of horrors".

Isn't it possible that the idea that these things are so horrifying they must not be spoken about, part of the whole problem? Women are not pathetic feeble creatures who must have the truth kept from them. Someone posted a statistic upthread that I just checked the RCOG site, which said that 'up to nine in 100' women suffer a third or fourth degree tear. That is nearly 10%! So not rare, nto unusual, and something that women who are going to have a baby need to know about IMO.

I would far rather know what complications and risks are there, so that I can better face them if they happen. Rather than go into something unprepared and end up with terrible things happening that hadn't even crossed my mind as possibilities.

Maybe this is just a difference between people who like to know what is going on, and those who stick their heads in the sand.

SardineQueen Thu 19-Jan-12 11:33:34

"unlike you of course who may have even cut and paste"

What does that even mean?
I am surprised that you can't remember what you wrote as well, but there you go.

SardineQueen Thu 19-Jan-12 11:39:04

What good will it do?

If a woman is aware of the possibility of tearing she will

Know is it a possibility, and that it does happen
Know that if it does, what that will mean for her and the baby during the birth
Understand about stitching up, that anaesthetic will be used, that she will need to care for the wound, how long it will take to heal
Understand that this is something that happens to lots of women
Understand what side-effects of tears can be and which are not resolvable, which might take a long time to get better, and what needs attention from a HCP. ie what is normal and what is not

If she doesn't know about it, then that puts her in a horrible position. Is this normal, why did it happen, what happens now, will they use anaesthetic when they stitch me up, will I need a catheter, what is going on???

Incidentally I haven't had a tear myself so this is my best guess - about anaesthetic and healing and so on. Why do I have to give a best guess? Well because I still only have a sketchy idea of what happens when a woman tears during birth.

SardineQueen Thu 19-Jan-12 11:43:13

Can anyone explain as well why I am being accused of cavalier reporting, sock puppetry, and recording people's comments elsewhere (I assume this is what the cut and paste comment means?).

Why? I have never met with a reception like this on MN before and given that the thread is pretty evenly balanced in terms of those who think women should have more info and those who think they should not (or whatever the "sides" are) I don't understand the accusations. It's not as if I'm the only person with these views on the thread, and I know my views aren't wildly outrageous as I have had similar conversations before on MN, so why am I being accused of these things?

shagmundfreud Thu 19-Jan-12 11:44:12

Nobody is discouraging spontaneous discussion of this issue.

The question is whether prior to pregnancy even being on the horizon people should be formally taught about

Episiotomy
Labial tears
Fistula
Fecal and urinary incontinence
Perineal and pelvic floor damage
Colostomy
Adhesions
Abnormal placentation
Infection
Urinary infections and bladder damage
Piles
birth trauma
Pnd

Oh, and let's add on some pregnancy problems - pre eclampsia, OC, severe hyperemesis and antenatal depression. What about preterm birth and stillbirth?

What else should be delivered through a formal programme of antenatal education?

Seriously? When would you find time to discuss the emotional challenges of becoming a parent? Those which are about more than just the physical process?

OrmIrian Thu 19-Jan-12 11:46:43

Absolutely agree that all women who are contemplating getting pregnant should be made aware of as much information as they want. No problem with that. Every choice we make is better with more information. My second and third deliveries were much easier because I was forearmed.

However I do take issue with the change that the OP wants to see in society towards birth. I don't understand that TBH. It's a bit vague really. Like it or not, pregnancy is only really important to those closely involved. The rest of society isn't that bothered generally. I would have found it quite disturbing if total strangers started treating me like some kind of plaster saint or recounting the risks of VB at tbe bus stop hmm

SardineQueen Thu 19-Jan-12 11:51:56

"When would you find time to discuss the emotional challenges of becoming a parent"

My classes didn't cover this either. It was all about birth. I asked both classes if it would be possible to talk more about what would happen once the baby was actually there - looking after it and so on - and was told no, the classes focis on birth as that is what people want to know about.

And your list

Episiotomy
Labial tears
Fistula
Fecal and urinary incontinence
Perineal and pelvic floor damage
Colostomy
Adhesions
Abnormal placentation
Infection
Urinary infections and bladder damage
Piles
birth trauma
Pnd

Yes. Even if were just a couple of minutes on each, just so that people are aware that they can happen and what they should do if they have them, what help is available etc.

SardineQueen Thu 19-Jan-12 11:53:05

Orm I would have appreciated a bit more leeway at my place of work and on my commute - the view in society is that pregnancy is not an illness which is of course true, but this seems to have been interpreted as women who are pregnant must carry on as usual which is sometimes hard.

SardineQueen Thu 19-Jan-12 11:55:02

Hard if they are feeling unwell or have something wrong with them etc.

brandysoakedbitch Thu 19-Jan-12 11:58:20

recounting the risks of VB at tbe bus stop

Bloody Hell OrmIrian you have been lucky then. I do find people love to tell horror stories (particularly to first time mummies) and the competitive horror birth stories too... when i was pregnant with my first a woman in a waiting room told me all about her stitches and incontinence, yea, thanks for that love! I was of course sorry for her but clearly she didn't give a toss how it made me feel.

I don't think that the title of the Op is really what this is about of course, I think this is someone all these horrible things have happened to me (and genuinely for that I am sorry because it sounds dreadful) and everyone has to know everything about everything that can happened so they can make and 'informed choice'- whatever the fuck that is anyway

I don't think we have a casual or callous attitude at all.

CervixWithASmile Thu 19-Jan-12 12:03:35

OrmIrian has hit the nail on the head. None of us disagreeing with the OP are saying there should not be support, advice and information during pregnancy and childbirth on the common complications (and the less common when they occur).

I think what we are disputing, and what is being ignored about our posts, is the validity of perpetuating more fear and worry regarding the process of childbirth.

As I've already said, I have experienced medical birth trauma, and I believe it was directly as a result of society's attitude to, and the resulting over medicalisation, of birth. Having an attitude that birth is a normal thing and giving women back power, choice and dignity in the process would be an almost unthinkable step forward for society at this time.

Almost worse than my physical trauma was the lack of power and dignity afforded to me and again I believe this is due to society's, and the medical professions, attitude towards birth as a dangerous undertaking.

NinkyNonker Thu 19-Jan-12 12:18:39

"I find your attitude a bit casual as well. It is only pain, but would you say the same to someone who is having an amputation or surgery? "It is just pain, it's temporary, so get on with it"? I imagine not. Then why treat the very real pain of childbirth casually?"

"Avoidance of pain is a personal decision. I am not suggesting that women avoid labour pains (not sure where you got that from) I am merely suggesting that we show a little compassion towards women who experience that pain.
Pain does involve suffering and most people don't exactly enjoy being in pain or discomfort, so I find it bizarre that you should oppose pain relief."

I read these comments as saying that avoidance of all pain is just fine, maybe I was wrong. Similarly likening it to tooth removal or an amputation is disingenous. I just think that given that this thread is all about 'telling the truth about childbirth' the modern idea that you don't have to be a martyr to pain, men wouldn't go through it, it is your choice, pain relief is all good, in the modern day we don't have to suffer etc (not on this thread specifically, on many others) is an equally valid one-sided argument to challenge.

As I said, I ended up with every form of pain relief going, but I can pinpoint the exact moment my labour started going awry. As a result of the labour I had, I have to have the next on the surgical ward to mitigate the risk of the PPH I suffered post episiotomy when I needed forceps to deliver DD. I am not anti-intervention, or medicalisation, or pain relief at all...

CrunchyFrog Thu 19-Jan-12 12:31:36

The NHS classes I attended were terrifying. The MW assumed we all wanted pain relief and laughed in my face at my perceived naivete when I said I didn't. I had an induction WITHOUT informed consent, was given drugs I didn't want or need, a litany of abuse. That my baby and I survived the CLU was down to luck.

I don't want or need shroud waving, or dire warnings of fistulas etc. With my two other births (at home) I got nothing but horror stories from HCP. Including outright lies, statistical nonsense and anecdotal exaggeration. Hospital HCP, especially on CLU, are terrified of birth.

The CS rate is too high. I do not doubt for a second that the women given EmCS need them at that point in time - but if they were not abandoned/ drugged/ forced into labour etc, then many could be avoided.

It is no coincidence that the only birth injuries in 3 births were sustained in a hospital setting. And that the only one of my babies to experience foetal distress was the one in the "safe" hospital. Or that the only birth which was followed with severe PND was the hospital one.

I will not trust anything said to me regarding pregnancy and birth by any person who works on a CLU. They have a fearful, negative view of both.

Going into birth 2, I was terrifed - but not of birth. Terrified of what the HCP might do to me this time. Thankfully, despite it being a bit of a tricky birth, we stayed at home and all was well. Had I been in hospital, I would have certainly been on a drip, and therefore epidural, and probably a CS for failure to progress.

With number 3, I had the best MW in the universe (NHS) who supported me totally, researched with me etc. Had I not had them, I would almost certainly have caved into the pressure to induce (DS2 was 42+3) and ended up with intervention again.

I believe it is our responsibility to weigh up our own individual risks. NHS policy is totally one size fits all, and that, IMO, leads to massive problems. For example, I knew the numbers for CS, but also knew that my individual profile made me less likely to need one if I stayed at home without drugs.

The simple fact that so many women are still birthing on their backs is one that could be causing so many difficulties - you are far, far less likely to tear kneeling or on all fours!

Weird thread.

OrmIrian Thu 19-Jan-12 12:39:01

sardine - I think that courtesy should be extended to anyone who is in discomfort. I would always offer to give up my seat for an obviously pregnant woman, as I would for someone elderly or ill. If a woman is suffering during pregnancy - ie extreme sickess or tiredness any workplace is required to make allowances by law aren't they?

brandysoakedbitch Thu 19-Jan-12 12:52:41

yes they are risk assessed now in the workplace, one of the girls who worked for my DH has just gone off on Mat Leave and he was lovely to her. She has SPD a bit at the end so he arranged for her to work from home etc and let her come in later and leave earlier so avoiding rush hour. I these small concessions are given to a lot of women.

Pregnancy has not been devalued in any way by society - many many (poor) wwomen in past times have been forced to carry on and on working until they almost drop. This country has good maternity care and benefits which enable women to make choices, which is what it should all be about.

Not giving up seats etc is nothing to do with societies view of pregnancy and everything to do with peoples general lack of care for others and just plain bad manners. The amount of times I have been barged out of the way whilst holding the hand of a very small child because we are being too slow or in the way is countless - just bad manners and impatience.

shagmundfreud Thu 19-Jan-12 13:06:33

"and was told no, the classes focis on birth as that is what people want to know about"

How long was the class?

"Even if were just a couple of minutes on each, just so that people are aware that they can happen and what they should do if they have them, what help is available etc."

You can't talk about PND/PTSD/stillbirth/serious pregnancy health problems/serious problems with health after birth in a couple of minutes each. You can't. And you shouldn't. And if you did people wouldn't remember anything useful about it if at a later stage they did experience these problems.

CailinDana Thu 19-Jan-12 13:07:35

CrunchyFrog your first experience sounds horrific, but to me (and I'm aware I could be wrong) it sounds like a lot of it happened because of the very reason we're talking about here - you weren't given correct and honest information. It surprises me how many women don't realise the negative effects induction and an epidural can have. I've spoken to women who were horrified and amused that I'd spent practically my entire labour on my knees - in fact the second midwife I had wanted me on a bed right away, and it was only due to the support of the first midwife that I didn't give in. There does seem to be an agenda among hospitals to make labour as "smooth" as possible, not for the woman but for the midwife.

Women should be told honestly that a homebirth for first time mums is slightly riskier than having a hospital birth. They should be told that at hospital they will be offered pain relief, but that all pain relief has a down side - pethidine can make you sick and disoriented, epidural can slow things down and increase the risk of intervention, etc. They should be shown in antenatal classes how to keep active during labour, and told that if they do lie down this could make contractions harder to bear and less effective. All we were given on active labour was a single badly drawn leaflet. It wasn't even mentioned in antenatal classes. Detailed information should be given on tears, what is done to repair them, and what to do to keep them clean and help them heal and what help is available if things go wrong. Overall the message should be that yes, labour is difficult and can be dangerous, but that all women should try to trust their bodies and take control of their labour. Instead the message I got was that forceps would be used on me if the midwife said so, but I wasn't allowed to see them as I was a silly little woman who might be frightened. Not exactly empowering.

We were given a lot of detail on c-sections, complete with little duplo figures playing the parts of the theatre staff but there was very little detail on the intricacies of a vaginal birth, which I think is not a good state of affairs.

brandysoakedbitch Thu 19-Jan-12 13:09:49

Also with childbirth classes a lot of Fathers are also present and I think a factor might be for women that they would not wish to discuss ( and by this i mean the tearing and incontinence and piles stuff) in front of their men - you can take an opinion on whether that is right or wrong but i do think it would be a factor

CrunchyFrog Thu 19-Jan-12 13:20:16

cailin I had lots of information. But I was lied to.

I got the impression that the OP wanted the (statistically less likely) damaging stuff to be taught about, but without the many, many things that can be done to avoid going down the CS/ instrumental route, as in the OP's view, these things are unavoidable and hospital birth the default.

I don't have the information at my fingertips, but something like 40-odd % of mothers have a CS or instrumental delivery. That is way, way, WAY too high. But when women are terrified, and therefore malleable, and HCP are risk-averse in a statistically invalid way (ie, they will follow protocol to arse cover, even when protocol may not be the most effective treatment) then more interventions will happen.

If women are to be given accurate information about everything that can/ may/ vanishingly rarely does happen, they would need to commit serious time and resources to it. I know that because in my 3rd pregnancy I spent upwards of 25 hours a week learning about everything I needed. And in my case, I only learned about things relevant to me - so induction, GD, big babies, OFP, anaemia etc, and treatments for SD. Plus also techniques for birth. I actually did know more than the SHO I saw at 42 weeks - I had more up to date research, more knowledge etc. That doctor made an utter fool of herself with her shroud waving bare faced lies.

Gosh, what convoluted sentence structure. <fires self from English language.>

SardineQueen Thu 19-Jan-12 13:20:33

shagmund the NCT classes were 3 hours each once a week for about 6 or weeks, I didn't attend the last one or 2 though as the woman taking it was really horrible.

Once class involved sitting watching videos of adverts for DVDs about pregnancy yoga and baby stuff and hypnobirthing CDs and stuff, one was a BF session which was crap, there was a lot of sitting in pairs and breathing and stuff. I remember one bit as well we had to label a cross-section through a woman's reproductive system.

The NHS classes were a lot better - 4 weeks I think and again about 2 hours each. We covered all the different types of drugs in (negative) detail, went round the birthing suite, there was some info on BF.

SardineQueen Thu 19-Jan-12 13:20:56

6 or 7 weeks that should say, my 7 is sticking!

SardineQueen Thu 19-Jan-12 13:21:55

"I just think that given that this thread is all about 'telling the truth about childbirth' the modern idea that you don't have to be a martyr to pain, men wouldn't go through it, it is your choice, pain relief is all good, in the modern day we don't have to suffer etc (not on this thread specifically, on many others) is an equally valid one-sided argument to challenge. "

If no-one on the thread has said it then why are you challenging it?

This thread gets stranger and stranger confused

SardineQueen Thu 19-Jan-12 13:25:11

"I will not trust anything said to me regarding pregnancy and birth by any person who works on a CLU. They have a fearful, negative view of both. "

shock

Isn't it dangerous to do this?

I was advised to have anti-D injections, as I am rhesus negative. With my second child I had placenta praevia and was recommended a section.

I can understand that HCPs don't always do a great job, and sometimes they do a terrible one, but to ignore / mistrust everything they say, to turn your back on modern medicine and diagnostic procedures and all the rest of it - now that I think really is a dangerous message to propagate.

SardineQueen Thu 19-Jan-12 13:27:44

Orm grin no workplaces are not required to make allowances for women who are eg knackered to the core in first trimester!

Obviously if the woman is signed off sick that is a different matter.

The risk assessment they are supposed to make is to do with things like lifting, climbing ladders, manual work, and in offices whether seating is appropriate, that sort of thing. Not that I have ever had one hmm I have read that many employers don't really bother with this piece of H&S at work.

Sorry for multiple posts, I keep going out to do things and coming back again!

awingandaprayer Thu 19-Jan-12 13:27:49

There really is a difference between giving accurate information including realistic risks and scaremongering. There is no reason why the message still can't be positive and aimed at minimising and reducing risks and interventions.

You can't compare the risks of childbirth to the risks of driving or the list of things you mention shagmund I can't think of another planned, expected one off event where the risk you might be so psychologically traumatised you develop PTSD is so high. I certainly don't expect to take that risk on my drive home tonight and I wouldn't be recommending just detailed risk assessment and preparation if that were the case I'd expect someone to ban me from driving.

And that is why statistics are important brandy though I accept that it is very difficult to interpret and understand stats and scientific research accurately and accept that it is a persons right to choose what info they want.

However it angers me that sometimes women are not given the sort of information that might have helped them prepare and perhaps reduce the risk of serious and unnecessary psychological damage.

sherbetpips Thu 19-Jan-12 13:30:48

I think for me pregnancy is one of the few times in your life (other than elective surgery) that you know that making a decision to do it, will put you in hospital.
To deny that you will be injured, torn, bruised is silly of course you will, you are expelling another human being from your fanjo - do pregnant ladies want you to point it out to them? no thank you.

SardineQueen Thu 19-Jan-12 13:31:07

"Pregnancy has not been devalued in any way by society - many many (poor) wwomen in past times have been forced to carry on and on working until they almost drop. This country has good maternity care and benefits which enable women to make choices, which is what it should all be about. "

Seriously?

See here 30,000 women sacked annually for being pregnant

And individual case that came up on google from last month

brandysoakedbitch Thu 19-Jan-12 13:32:10

They cover different types of drugs quite negatively because from a Midwives point of view they often lead to a cascade of intervention. Epidurals in particular as it immobilises the Mummy, opiates make the mummy sick and the baby dopey and it can have problems after - how the hell can you put a positive spin on these? Yes you can have pain relief but it can lead to other stuff, that is the message surely? Quite sensible and absolutely in keeping with the 'telling the truth' thing you apparently want. You cannot have it both ways. This is not a strange thread at all just that people are disagreeing.

I think the over riding thing here is that a lot of people think the battering with the truth approach is unhelpful to them. Better general care and information ante natally and certainly better care and follow up post natally is what is required not lots of stats

SardineQueen Thu 19-Jan-12 13:36:40

cailin another great post. Agree with you entirely again.

I was induced with my first child. I was not warned of any of the possible side effects, or about what I think are called "prostin pains", nor told that it was my choice whether to be induced or not and that actually if I didn't want to be it wouldn't mean automatic disaster for my baby.

If they had told me the statistics about placenta degradation or whatever it's called, and that I could be monitored, and that induction came with all these possible risks, I would probably have opted to hold on for longer and see if nature took its course.

But I didn't have the full information, and that was bad.

"There really is a difference between giving accurate information including realistic risks and scaremongering. There is no reason why the message still can't be positive and aimed at minimising and reducing risks and interventions.
"

Yes exactly.

SardineQueen Thu 19-Jan-12 13:39:36

But there is a positive of pain relief. It helps the pain.
The negative is that it can lead to cascade of intervention.
But what are the stats? How often does eg gas and air or pethadine lead to cascade? How much of this cascade is due to the fact that a woman who is asking for pain relief may not be having a great labour?

Drugs = bad is an incomplete message. And sets a lot of women up to feel that if they have drugs then they have failed - a message which comes through in the way the message is delivered.

SardineQueen Thu 19-Jan-12 13:41:31

I posted this earlier:

"What good will it do?

If a woman is aware of the possibility of tearing she will

Know is it a possibility, and that it does happen
Know that if it does, what that will mean for her and the baby during the birth
Understand about stitching up, that anaesthetic will be used, that she will need to care for the wound, how long it will take to heal
Understand that this is something that happens to lots of women
Understand what side-effects of tears can be and which are not resolvable, which might take a long time to get better, and what needs attention from a HCP. ie what is normal and what is not

If she doesn't know about it, then that puts her in a horrible position. Is this normal, why did it happen, what happens now, will they use anaesthetic when they stitch me up, will I need a catheter, what is going on???"

People think the second option is better? I just find that really difficult to understand.

brandysoakedbitch Thu 19-Jan-12 13:42:08

But stats are not important to the Mother at point of contact ante natally - they are important to form policy etc but really without careful interpretation and communication they are confusing and can be damaging. And for the record I do think people are well informed by Midwives about the risks of homesbirth (lots of people on this forum talk about Midwives and Doctors trying to scare them into hospital) also they use them again when trying to get women in to be induced for going over term (even though term is not really until 42 weeks) - On the occasion you meet a sensitive HCP who puts these stats in context it is an amazing thing. Which is why printing it all out, giving it out and leaving it with the parents to come back with questions is dangerous. Lots of people on MN come for support to even raise subjects with their Midwives due to a lack of confidence or familiarity of the HCP they are dealing with. A lady here a couple of days ago wanted to change her hospital for instance and felt difficult about raising it with her Midwife because the last two times she saw different people. Until you sort that out you cannot just dump this sort of information in peoples laps and expect them to be able to cope with it.

SardineQueen Thu 19-Jan-12 13:46:21

I have not said that stats should be handed out confused

I have said that common problems with VB and procedures and common postnatal problems should be at least broached as part of the antenatal preparation that women get when they are having their first child.

Incidentally the idea that these things not be mentioned because there are men present is ridiculous.

brandysoakedbitch Thu 19-Jan-12 13:46:37

So, if this is all so necessary and improves outcomes for women, why do they not do it then? Do you not think that they may have thought this through (and by 'they' I mean HCPs and trusts etc) and thought better of it?

brandysoakedbitch Thu 19-Jan-12 13:47:13

NO the OP said stats should be handed out and then people allowed to come back and ask questions

SardineQueen Thu 19-Jan-12 13:47:41

You really think it was unnecessary to have the risks of induction explained to me before I had one, and all the options laid out?

That gets a biscuit

brandysoakedbitch Thu 19-Jan-12 13:48:05

Incidentally the idea that these things not be mentioned because there are men present is ridiculous.

As I made clear that may be so but I do think this would be a factor for some women

shagmundfreud Thu 19-Jan-12 13:48:06

Sardine - if you are being offered a medical procedure or drug, then you need to give informed consent. I agree that this often doesn't happen with induction in particular. I think this is very poor.

But a large part of this thread has been about women being given extensive and detailed information about possible poor outcomes associated with a normal physiological process, possibly before they're even thinking about having a baby. For the purpose of increasing general understanding of birth trauma and birth injuries.

Big difference.

"Drugs = bad is an incomplete message"

And one which is almost never given. Midwives acknowledge that sometimes pain relief is necessary and that it helps many women.

SardineQueen Thu 19-Jan-12 13:48:28

But you're not talking to the OP, she hasn't posted for yonks.

brandysoakedbitch Thu 19-Jan-12 13:48:53

You really think it was unnecessary to have the risks of induction explained to me before I had one, and all the options laid out?

Who has said that?

SardineQueen Thu 19-Jan-12 13:50:40

shagmund I am posting about my personal experiences having a first baby in the UK in 2007.

I have never heard of emmas diary
BF people would not answer questions about downsides
Ante-natal classes were not even-handed at all
Message was drugs = bad

Just because other people may have had different experiences does not mean that these things did not happen to me, in the NHS, recently. And judging by other threads, I am not the only person who has had this type of experience.

SardineQueen Thu 19-Jan-12 13:52:18

You just did Brandy.

"So, if this is all so necessary and improves outcomes for women, why do they not do it then? Do you not think that they may have thought this through (and by 'they' I mean HCPs and trusts etc) and thought better of it?"

BTW in our area they run ante-natal classes for women only for those who do not like to discuss personal matters with men around. I think that reason you have given is a non-reason TBH and if women are beign denied information because it will upset the fathers then whoever decided that needs a good kick.

CrunchyFrog Thu 19-Jan-12 13:52:42

Yes, at the point of you making your decision whether or not to be induced, a full and frank discussion is important.

You damn well will not get one at the current time.

You'll get" hmm why WOULDN'T you want to be induced? Cascade of intervention? <tinkling laugh> why, that is SO RARE."

If you do do your own research (and I will regret forever not having done so for DC1) you will find accurate and unbiased information. I can't imagine being induced, had I had that information.

Less concentration on the due "date" would help - telling women they are probably going to have the bay some time in a 5 week window would be more accurate and useful.

CrunchyFrog Thu 19-Jan-12 13:54:33

Sardine - my classes in 2003 were drugs = necessary and good. And BF is nice if you feel like doing it. Oh, and the cracker - you musn't have ANY fizzy drinks if you BF, because it will make the BM fizzy. hmm

Possibly some standardised training for delivery of these classes would help.

SardineQueen Thu 19-Jan-12 13:55:56

Crunchy yes exactly. I would not have had an induction either. When I see threads on here I do tend to tell women about my experience and that I would do it differently if I was doing it again.

Information for women re pregnancy and childbirth is vital and should not be edited to suit the hospital budgets, the HCPs personal ideas and preferences, anyone's timetable, or an assumption that women are feeble and stupid and will have a nervous confloption if they are told some pretty important facts about birth risks for all types of birth, and common postnatal problems.

SardineQueen Thu 19-Jan-12 13:57:45

xposts!

I found that the NHS classes were much better than NCT - I think with NCT it's a bit hit and miss what sort of instructor you get. The NHS ones were very good but as I say I felt they were not even handed and did not cover some of the things that people were likely to face during the birth and postnatally.

Certainly there should be consistency in the messages that are given.

brandysoakedbitch Thu 19-Jan-12 14:00:30

NO one is saying that it did not happen to you but clearly as other people have posted on this thread it does not warrant giving information about all the possible outcomes all the time. Your experience does not necessarily translate into a national experience. I have been very well informed about everything all the way along, every thing that has been done to me or my baby has been explained and I have been able to make a decision about that. Having all the information early on does not necessarily make a difference to the outcomes for women. Some women have expressed the opinion here that they do not need to know all about fistulas etc from the beginning but that has been ignored too.

There are also lots of us who have had repeated (in my case) very very positive experiences, I am actually well informed and I have worked in a Labour Ward too (but after my first two babies) and that has helped. I am not talking about giving women nothing and being in a state of ignorance I am suggesting that the implementation of that information needs to be carefully thought through. Whether you like it or not some women would not like to discuss the more embarrassing parts of what could happen in front of their husbands. I am one of them as it happens - I have no wish to discuss piles and tears and incontinence in from of my DH, nothing wrong with my relationship with him, we are very open but I would not feel comfy with that and nor would he. But I never pee, break wind or burp in front of him either so perhaps it is just me. However he has been at all the births of our children, been amazing and supportive and an excellent Father so it is not to our detriment I feel.

I call for sensitive implementation of information tailored to the particular woman (again pipe dream) and not making the assumption that they want to know everything all the time because they don;t you know, whether you like it or not some people don't want to know about it

brandysoakedbitch Thu 19-Jan-12 14:01:20

you musn't have ANY fizzy drinks if you BF, because it will make the BM fizzy.

Classic Crunchy - my poor babies!

brandysoakedbitch Thu 19-Jan-12 14:09:48

Certainly there should be consistency in the messages that are given.

Yes in an ideal world that would be true but of course when information is given out by different people their prejudices and experiences come into play. That is how come so many people have so many different experiences with their HCPs because they are human beings and bring their own shit to the table each time. Depends on who you speak to and who is caring for you so sadly there is not a uninformed way of delivering this sort of stuff.

That is why one Midwife will suggest you go on your knees and another will ask you to get one the bed and that is why the produce generic The Pregnancy Book and Emmas Diary stuff for the masses with the basics outlined.

brandysoakedbitch Thu 19-Jan-12 14:10:47

and of course it should be nothing to do with budgets either but again the real world dictates otherwise.

Message withdrawn at poster's request.

herethereandeverywhere Thu 19-Jan-12 14:21:19

I do agree with the OP and do agree that there is a tendency to skim over/avoid reference to the risks of natural childbirth. At my NCT class I asked for stats on likelihood of tearing (she didn't have any) and had to ask for advice on how to look after stitches post-birth. There was no mention at all of likelihood of incontinence (a significant % experience this for a temporary time after birth) and what do to improve this. The horror of an open episiotomy and pooing myself as I walked down the road was a huge shock and one which had me on a watch list for PND.

I would have FAR preferred to be told that there is a small/x% risk of these things happening, a risk which increases with instrumental delivery, or whatever. Ignorance is only bliss when you're one of those fortunate enough to have a straightforward birth and recovery. Giving FACTS (including the actual likelihood of experiencing these complications) is assisting women in preparing for what to expect and to help them make decisions about their care (eg: whether to refuse induction, try to avoid epidural or whatever).

Another related point is the disconnect between the NHS advice given antenatally in relation to risk of complications and the facts you're presented with on the consent form which you have to sign moments before the procedure, eg:
"Forceps can leave small marks on your baby's face but these will disappear quite quickly" is the only reference to damage to mother or baby in the forceps section of the NHS childbirth section on their website. The risks I signed up to whilst racked with the labour pain of a malpositioned baby not to mention being frightened and exhausted included "lacerations, paralysis, (baby) and lacerations, incontinence (me)" - I suffered fecal incontinence and DD is facially scarred. I really don't think that was a fair presentation of the facts. It (NHS website/leaflet) also says the Obs will "gently pull" so I was beyond quite shocked at being pinned to the table whilst the obs dragged with all his strength.

Keeping me under the veil of ignorance did nothing to reduce the stress on me or - in my case - the likelihood of having to have any such intervention, all it did was compound the fear and anxiety when the worst happened.

SardineQueen Thu 19-Jan-12 14:30:43

herethereandeverywhere yes that is the sort of edited / incomplete information I'm talking about.

brandysoakedbitch I can't believe that you are saying that women in antenatal classes should not be given information on piles and incontinence and tears and things in case they / their partners are embarrassed by it.

This sort of approach is why women struggle on with all sorts of problems and don't feel they can tell anyone. Appalling.

SardineQueen Thu 19-Jan-12 14:32:16

lunaticfringe who on this thread has suggested that pregnant women be told about dead babies?

I have suggested that they be told of a nearly 1 in 10 chance of a 3rd or 4th degree tear and what that means.

Not quite the same confused

TopazMortmain Thu 19-Jan-12 14:32:54

Interesting thread. 38 weeks and having a private birth outside the UK. I have a doula and have had twice monthly appointments throughout. My approach to the birth is as a medical, biological event with no spiritual undertones. I've researched the possible complications, written a birth plan which includes rising levels of pain relief and believe I have mentally prepared myself for all eventualities. For me an informed and cautious birth plan is a priority, as is a scientific approach to the process with as little 'woo' as possible.

I am lucky to be in a position to have more options than most and firmly believe that birth is potential painful and possibly life threatening and should be managed as such.

SardineQueen Thu 19-Jan-12 14:35:28

The words are interesting.

Some people are talking about stats, facts, probabilities, risks

Others are talking about scare-mongering, shroud-waving, dead babies

How can these responses be about the same thing? There is a total and utter lack of agreement here isn't there. I don't understand how giving full information about common risks to pregnant women can be interpreted in this way but obviously it can, and so I don't see that accord can be reached.

fruitybread Thu 19-Jan-12 14:39:13

The trollhunting on this thread is extraordinary.

A poster upstream said that ANY thread that started with a post discussing fecal incontinence would be a troll.

No. There are threads here every week started by women with severe tears who have ongoing problems, including pain and incontinence, and who are (usually) humanely directed towards the Ragged Bits Thread elsewhere on MN.

shagmundfreud Thu 19-Jan-12 14:51:45

"I found that the NHS classes were much better than NCT - I think with NCT it's a bit hit and miss what sort of instructor you get."

No - this is true with the NHS too.

My NHS midwife's response to me that I'd heard that having an epidural would make a forceps delivery more likely was to say 'You can read too much you know!'

Which made me feel like an utter, utter twonk.

After my forceps delivery (following on from my epidural) I felt like seeking her out and telling her how she'd made me feel.

In a professional capacity I've also observed some DREADFUL NHS classes, as well as some excellent ones. Ditto NCT.

BTW - just been putting a table together for birth outcomes for healthy low risk first time mums. From the recent 'Place of Birth' study. Does not include outcomes for first time mums being induced. These would be worse I suspect - much worse......

Thought it would be a useful contribution to this thread, and info worth sharing.

smile

Forceps Delivery
OU 9.8%
Home 6.3%
FMU 5.3%
AMU 7.8%
Total 9.3%
Unplanned caesarean section
OU 13.0
Home 7.7%
FMU 6.1%
AMU 7.1%
Total 11.9%
Normal Birth
OU 46.4%
Home 69.3%
FMU 71.1%
AMU 62.9%
Total 49.7%
3rd or 4th degree perineal trauma
OU 4.6%
Home 4.4%%
FMU 4.1%
AMU 4.9%
Total 4.6%
Epidural
OU 37.9%
Home 21.1%
FMU 18.1%
AMU 23.6%
Total 35.2%
Admission to a higher level of care
OU 0.8%
Home 0.5%
FMU 0.2%
AMU 1.0%
Total 0.8%

OU: obstetric Unit
FMU: free standing midwifery led unit
Home: home birth
AMU: alongside midwife led unit

shagmundfreud Thu 19-Jan-12 14:54:50

Hang on, let's format this a bit

Forceps delivery

OU 9.8%
Home 6.3%
FMU 5.3%
AMU 7.8%
Total 9.3%

Unplanned caesarean section

OU 13.0%
Home 7.7%
FMU 6.1%
AMU 7.1%
Total 11.9%

Normal Birth

OU 46.4%
Home 69.3%
FMU 71.1%
AMU 62.9%
Total 49.7%

3rd or 4th degree perineal trauma

OU 4.6%
Home 4.4%%
FMU 4.1%
AMU 4.9%
Total 4.6%

Epidural

OU 37.9%
Home 21.1%
FMU 18.1%
AMU 23.6%
Total 35.2%

Admission to a higher level of care

OU 0.8%
Home 0.5%
FMU 0.2%
AMU 1.0%
Total 0.8%

OU: obstetric Unit
FMU: free standing midwifery led unit
Home: home birth
AMU: alongside midwife led unit

SardineQueen Thu 19-Jan-12 15:01:51

Those figures are very different on the tearing than the RCOG figures earlier.

I think it would be useful for pregnant women to have those stats as part of their antenatal preparation. Why not?

fruitybread Thu 19-Jan-12 15:12:34

I think it's worth adding to this info that the same study (the Birthplace Study) found homebirth carried a higher risk to the babies of first time mothers -

www.bbc.co.uk/news/health-15861280 and www.midirs.org/development/midwiferyweb.nsf/z45/B70C83EAA441387C80257953003CD2C2?opendocument

Worth adding too because it's important to contextualise that the risk (including risk of death/serious problems) is still very low at less than 1%.

This actually illustrates how I feel about keeping women informed. A choice is only a choice if it is informed. Someone looking at a holistic picture of birth will want to take into account every aspect of the outcome, from the likelihood of intervention/injury to the mother to the risks to their baby. Different women will place different values on the same set of risks, of course, and it's human nature to try and ignore those risks which we don't want to accept. But that's not an argument for keeping women in the dark.

fruitybread Thu 19-Jan-12 15:16:11

Ps yes, I agree that those stats on different kinds of delivery/intervention/injury should be part of antenatal info - I can't think of a good reason why not?

Message withdrawn at poster's request.

Message withdrawn at poster's request.

CrunchyFrog Thu 19-Jan-12 15:42:21

I'm assuming those stats include planned HB that result in hospital transfer at any stage? (routinely people transferred pre-labour are still included in the HB stats. Happy to be corrected!)

I'd be interested to see the stats for the births that actually take place at home.

WRT the language - I found that I was presenting the evidence as I saw it, in a calm, reasoned way, and was confronted by HCP using emotive language and bare faced lies. For example, the SHO who told me my baby WOULD die if I went over 43 weeks, and that I was risking his life by refusing induction. Or the MW who chose to tell me that placentas "fail" at 42 weeks. Anecdotal, yes, but my experience. All I did in response was smile, thank them for the input, and explain that I would be having a HB. Had they used less emotive, more sensible and actual evidence-based language, I would have been far more likely to listen.

There are so many things that can happen in labour and birth, it would take an awful lot of time to explain them fully - especially to women who aren't used to reading science, or who don't speak English. Explaining them in a half assed way (as happens now in many cases) leads to more fear - and fear leads to more pain, a need for pain relief, and often intervention.

There is a need for better education - in part so women can reduce their risks (nothing guarantees a simple labour, but you can increase your chances) of intervention. I don't know how it can possibly done in the current system.

NinkyNonker Thu 19-Jan-12 15:44:28

SQ, because it was and is a relevant point. There is the attitude that I noted displayed in many arenas that discuss childbirth, much like many of the assumptions made on this thread. If it is relevant then it is a perfectly viable part of the discussion...the OP was doing the same thing. She made a point, people discuss it. I make a point, people discuss it. Ad infinitum.

However my point should obviously just be dismissed because you say so and it disagrees with your general premise.

helsinkihelen Thu 19-Jan-12 15:52:33

SQ although i have agreed with almost all that you have said, i think your callousness towards the poster whose baby died and she almost died is astounding. Miscarriage and still birth are are as part of pregnancy and childbirth as stitches, tears and incontinence. Indeed i would also say that babies dying should be part of the education process because if it sadly happens to you, unless you have been through it before or those close to you have - it is something that most people are totally unprepared for or have a complete lack of understanding about. It's not about scaring people - it's about being realistic- like being open about SIDS. I'd rather be told about it and have some tools in the kit to help reduce the chances of things going wrong.

Anyhow, i have found this thread to be fascinating and even the posters that i wildly disagree with i feel have put forward some really valid points.

helsinkihelen Thu 19-Jan-12 16:04:07

Yes,LunaticFringe sorry, you were the poster, i am not surprised you found the response offensive. Such an awful thing to go through.

DilysPrice Thu 19-Jan-12 16:07:34

SQ you need to apologise to Lunatic Fringe - I think you must have misread her post, but you were completely out of order.

Lots to chew over in that data. Mostly as expected, but interesting that FMU has generally better outcomes than home birth. What stood out for me in the context of this thread is the 3/4 degree tear figures, which are terrifying because 1 in 20 / 1 in 25 are big numbers (even bigger as a % of VBs) and the fact that they're near constant across units suggests there's sod all you can do about the risk short of ELCS.

NoWayNoHow Thu 19-Jan-12 16:11:10

"Ignorance is only bliss when you're one of those fortunate enough to have a straightforward birth and recovery. Giving FACTS (including the actual likelihood of experiencing these complications) is assisting women in preparing for what to expect and to help them make decisions about their care (eg: whether to refuse induction, try to avoid epidural or whatever)."

This is the most sensible thing I've read so far.

shagmund those stats are very interesting, but it makes me shudder to think what they would be if inductions had been included...

I think the tendency to induce at the levels they do at the moment is ludicrous. And I also agree with the poster who said that having such a focus on a due dute doesn't help either.

A 5 weeks window is surely for more realistic and also reduces the stress and general "fed-up"ness of the mother. Only 3% of women give birth on their due dates.

fruitybread Thu 19-Jan-12 16:14:02

Hang on -

I'm sure she can correct me if I'm wrong, but I think SardineQueen misread LunaticFringe's post.

The problem is, there have been so many OTT responses on this thread, it makes a climate of misunderstanding more likely. The OP, and SardineQueen (and others like me) have said that they think there needs to be more info about VBs and that the risks are sometimes downplayer/ignored/glossed over.

Some other posters have decided this can only mean we want to indulge in scaremongering - so there have been lots of posts along the lines of 'yes, why not make people look at pictures of gonorrheoea for six hours before having sex!' (I kid you not, it's on this thread...)

So when LunaticFringe posted what read to me as a sad and honest post about the loss of her baby - and then commented that 'people don't want to hear about dead babies' - I'm afraid to say it was possible to read it very quickly and think it was another one of those accusatory and exaggerated responses.

I hope this isn't callous, but it illustrates a point. I feel personally that pregnant women should be given info about illnesses and situations that arise where sadly infant death is a possibility. That doesn't mean I think, before I am accused of it, that I think pregnant women should be forced to look at pictures of dead babies, or any such insane and OTT nonsense.

Surely anyone can see there is a difference.

LF, I hear what you are saying about being part of a whole subculture because of your experience - I think your post was open and honest and I am sorry you have experienced such a loss.