2 very interesting articles in Guardian today

[pupuce]

Found this !

Strapped to a machine, deprived of control ... the miracle of birth for British women. Survey shows that mothers' dreams of holistic experience end in hospital shock

and How to cope

[Angeliz]

I heard about the first one on GMTV this morning. Just read that article, it's so sad.

I was over the moon with my midwife and care that my only worry with this one is it won't be as nice as the first. It seems i was very lucky.

[JoD]

After reading these, even more convinced that a home birth is for me.

[Marina]

There was coverage of this in the Independent as well. Isn't there a forthcoming half-hour programme on Channel 4 on the reality of birth in the UK? Saturday 29th Jan, possibly?
The Indy noted that Scotland, with its higher national ratio of midwives to clients, fared much better in terms of satisfied mothers, well done to Mears and colleagues.
The Indy also had a comment piece from Rowan Pelling, a journalist whose first delivery ended in an emergency c-section at Addenbrookes. She found out later that a friend with similar complications lost her baby boy at a different hospital

[puddle]

It's interesting isn't it? I had a bad first birth just as described here ending in a ventouse (on the operating table - a whisker fron emergency c-section) and a fantastic second birth - also in hospital but with just gas and air. So I have seen both sides of the British experience!

From another angle, I have a friend in Holland due to give birth soon and they are very pro-home birth and anti pain relief. It's her first baby and she is absolutely terrified - she feels she is being forced into it and would much prefer to do it all in hospital (apparantly all her friends have ended up going into hospital during the births of their babies due to complications. This is heresay obviously and I have no idea of the stats. But does anyone get it right - would be interested to know from which are the 'beacon' countries in terms of birth and how they do it.

[Prettybird]

My Junior Chamber was "twinned" with one in Holldand and when we went across for a "Twinning" weekend I stayed with couple where the wife was a speech therapist. She had chosen - unusaully for Holland - to have her ds in hospital as "too many of her clients had suffered from oxygen deprivation at birth".

I beleive that she did most of her labouring at home though, as she was in and out of hospital in under 2 hours. And she also said that she made sure it was as "unmedical" as possible - she just wanted the back-up of the hospital resources if needed.

Come to think of it, my best friend's dd1 needed a full scale resuscitation, as she was "hanged" on the way through the birth canal (cord around her neck). Scored zero at birth - but was home wthin the day. Had bloodshot eyes though, as all the blood vessels burst when she was hanged. She's now a bright and inteliigent 12 year old.

[tribpot]

My sister was born at home in Holland 24 years ago - my step-mum says it was just what 'everyone' did. I'm actually waiting for an email reply from a friend of mine in Holland whose ds is a year old, I asked her if she'd had a home birth (previously I had no interest in such matters hence why I'm asking her now and not when he was born!).

A friend of mine had a baby in Sweden just before Christmas, hers was a fairly horrific experience but not through any particular failing in the health system I don't think (two days without food in case she would need a c-section?).

The articles have really confirmed my fears that we may be left flailing around in a panic because of a lack of staff, back to thoughts about doulas I think.

[Piffle]

I had my 1st (DS now 10) in NZ and at GP first appt was offered choice of GP led, midwife led or hospital led care.
I wanted a natural as birth as possible so I chose midwife led care, it was all free whatever I chose.
My midwife was affiliated to the hospital and the GP, she liaised with everyone, she was FANTASTIC all visits were done at home, she encouraged me to decide on whatever birth I wanted -homebirth or delivery suite or the new natural birthing suite that was being built and would be completed when I was due.
I chose the NBU and it was my first and I thought it was a good compromise as the NBU was above the delivery suite incase of emergency
I was 11 days over and my midwife was there twice a day checking me and the baby, calling the GP and letting her know I was fine
I went into labour naturally, forgot to call midwife, she turned up for monitoring and found me in transition!
Anyway had very quick natural delivery in awesome environment, GP just missed the birth, we all had tea and toast afterwards and I was home with 2 hrs.
Gp lived across the road and was always popping in, she was great too!
Never saw one hospital staff member!
Perfect IMHO
I do hope it is still like that!

[michmash]

Very interesting article. We chose a Midwife run birth centre (birth pool and gas only pain relief offered) that was attached to a maternity ward so that medical intervention could be requested if needed. I was terrified that if left completely to doctors then my chances of a natural birth would diminish. DS was delivered by 2 midwives and knowing that if something went wrong, there was a ward full of doctors down the corridor made it a worry free experience. I think that there needs to be more facilities like this where you can have the best of both worlds. If you want a natural birth and everything is going OK, then the midwives will help you achieve this and sometimes even defend your right to it. If you want or need stronger pain relief or intervention then it should also be available and easily accessable at the time of birth. But we should have the right to chose and not feel that there are no other options.

Sorry to rant, but feel very strongly about this.

[morningpaper]

"dreams of holistic experience"

Frankly I think this is where the problem lies.

What other societies tell women this is something to aspire to?! We have become such consumers that we've lost sight of the fact that in the 'good old days' when women laboured at home vast numbers of women and children died.

I'd rather all women had shit birth 'experiences' and live babies.

[weightwatchingwaterwitch]

4% of births being not in hospital is a slight improvement from 10 years ago isn't it? It was 2% IIRC. Haven't read the whole article but this doesn't surprise me, v depressing.

[Uwila]

I think medicalised births and caesareans are soooooooo undervalued. The thought of a home birth terrifies me. Slice me open and take that baby out safely is what I say.

Now I realise not everyone agrees with me. And, I think that people who want to have it without medical assistance and pain relief have a right to do so.

But, I also think that being strapped into a hospital bed with an obstetrician/surgeon watching over me is the most comforting and reassuring way to safely deliver my child. Medical technology was deloped and exists to save lives. The condition of the baby when it is born is to me far more important than how it gets there.

[Lua]

Uwila, I see your point.
But what it hasn't been discussed here is the effect of a medicalized birth on the babies. I will try to find the actual papers, but I remember seeing research that there is a high number of babies that are born less than healthy due to anesthesics given to the mother during labour. Also, a number of babies are born before their term, due to higher than necessary C-section rates, and those also can have health complications.
I think all would agree that technology is fantastic to save lives when needed. What should be debated, is when it is used more to cover hospital liabilities and doctors schedules than to insure the health of the baby and the mother.

[wordsmith]

Morningpaper, agree totally

[Uwila]

Point taken Lua, but I think (if I had time to dig up the evidence) we would also see that there are a lot of complications that result from a resistance to go to c-section. My first was born by emergency c. She was born at Epsom General. They have a high rate of caesareans, and are criticised for it. BUT, they also have a very low rate of complications in new borns that result from difficult delivery. I translate to mean that their willingness to go to c-section has resulted in healthier babies (like mine).

I do however take your point that cutting them out too early without any reason to do so is perhaps a bit rash. But, I think that most hospitals todat wait until week 39, whereas some used to do it at 37.

[weightwatchingwaterwitch]

I don't think that's a fair translation Uwila.

[Marina]

Neither do I www. I had a healthy term baby spend two days in SCBU because she suffered elective-section related respiratory distress at birth. I respect and respected my consultant's view on why I ended up with a second elective instead of the VBAC I preferred but my baby had a bad start to life outside the womb because of it. And I was bloody ill with a massive clostridium difficile infection for a MONTH after she was born.

[Uwila]

Oh, Marina, can you explain that more? Genuinely interested to know. I am pregnant now and planning an elective. But, if someone could tell me why that is potentially damaging to the baby, I would have a rethink. No one yet has been able to convince me of a single risk. I'm not worried about the born too soon risk because I'm certain of the age of the baby, and the hospital has already indicated they will plan for week 39. So I have no concern that they will accidentally deliver it prematurely.

But, seriously, I've not heard of a a caesarean induced respiratory distress. What is that? And what causes it?

[mears]

Caesrean induced respiratory distress is actually pretty common and is one of the greatest reasons a baby is transferred to SCBU. Babies born by elective C/S do not have the stimulation of contractions to prepare them for the birth. The passage through the birth canal and contractions cause fluid to shift from the lungs in preparation for breathing. With elective C/S baby does not get this preparation and can end up with respiratory distress until the fluid is absorbed in the lungs over time. Another name for it is TTN - transient tachypnoea of the newborn.

[highlander]

there is apparently very little risk of this once you've hit 38 weeks (so my OB told me), but I still opted to wait until 39 weeks.

DS, however, had quite mucousy posset for the first 48 hours and I was told this is common in CS babies as the fluid hasn't been squeezed out.

Still have a CS anyday! (but mine was beautifully planned, control freak that I am )

[Marina]

Mears has done a good job explaining there as one might expect Uwila! It was such a shock as she was a bonny term baby of nine pounds, but we had also had a stillbirth the previous year, so dh and I were distraught, and I don't use the word lightly. She was out after 48 hours and clearly not in serious danger after only about four hours.
My elective was because dd had not engaged at 39 weeks, I had a larger than average amount of amniotic fluid, and they were concerned about cord prolapse if I went into labour spontaneously. So there was an element of "discretion" there, I could still have begged for a VBAC. But I trusted my consultant and Mears agreed with their view when I posted about it glumly and that clinched it for me.
I definitely fall into the category of three deeply crap birth experiences, two gorgeous healthy children to show for it. C'est la vie I guess.

[pupuce]

I too see (as a doula) section babies taking "longer" than vaginal babies to get going... I read about a week ago (need top look where now....) that a recent study had shown that caesarean babies take longer to get back to their original birth weight.
I have to say that I see many section babies sleeping so much (IMO because they weren't born when they felt ready) and having great trouble being woken up for a feed!

Aloha and Jimjams have read (and liked I believe) "The Caesarean" by Michel Odent... maybe you would find the boolk of interest too...

[motherinferior]

Hmmm. I've done birth both ways - first time round I was absolutely clear that I'm crap with pain and would be wanting an epidural. Second time round, I had a home birth with just gas and air.

Now, I rave regularly about how fabulous my second birth was and what an improvement on a vile emergency ventouse, like Puddle a whisker from C-section, the first time. But the thing is, my whole second labour was fundamentally different - it took seven hours, whereas I'd been in pain for around 24 the first time round when I got my epidural. And I'm quite sure I would have felt much much worse first time round (unimaginable though that seems) if I'd gone in convinced that birth was a natural event I should just breathe through.

If it's unacceptable that we're not getting the home births we want, it's also unacceptable that women are waiting an hour, in lots of pain, to get the pain relief they want.

[morningpaper]

Motherinferior: very true.

It's also absolutely UNBELIEVABLE that in this day and age there is no totally safe pain-relief for childbirth.

(I had an epidural that didn't work - and the same thing happened to my best friend who gave birth 2 weeks ago! Jeez, how common is it for an epidural NOT TO WORK?)

[motherinferior]

Quite a lot, I think. Mine only worked on one side. Which also had me wondering if in fact it had worked quite a bit on that side and the pain I felt was only a fraction of the total agony.

Also, gas and air is so utterly fab that personally I think anyone who opts for a totally drug free birth is missing a great opportunity.

[hoxtonchick]

i need advice on a kind-of related topic. i'm 14 weeks pregnant with my second. i have diabetes & therefore will be induced before term. last time it was 39 weeks, this time they are muttering 37 but will probably let me go to 39 weeks. i know that this induction is necessary. however, ds just wasn't ready to be born at 39 weeks. it took a dose of prostin, having my waters broken & a synotocin (sp?) drip, 24 hours of labour, ventouse AND forceps to get him out. and i was lying down, continuously monitored for all this time. i had an epidural which worked well (specially as they kept topping it up ), but it wasn't a very pleasant experience. my obstetrician assures me that it wasn't that unusual for a first labour & this one is much more likely to just pop out. but surely if i'm induced early, this baby won't be cooked either. so i have been thinking that maybe an elective section would be less traumatic & i would feel more in control. though of course the main objective is a healthy baby. so help, please, some words of wisdom from mumsnet's finest!