Pain in childbirth - can anyone help me with my thinking around this?

Although it has been briefly mentioned my view is very swayed by my experience of hypnobirthing. I was anxious about giving birth to my first which is why I went on a course. The theory is that women often have a subconcious, ingrained fear of pain in childbirth through cultural conditioning and if you are afraid you will realease adrenaline which directly interferes with oxytocin and other birth hormones, so your body works against itself. That ingrained fear of birth comes from the message that is culturally all around us. Think about how birth is described - labour, contactions, dilation all very medicalised terms. Think about how birth is presented on TV - screaming and dramatics. Think about the language used to describe birth - pain is always present. I think us women do not do ourselves any favours, when I was pregnant other women took great delight in telling me how painful and long thier labours were. We are conditioned to believe labour is painful and that builds fear. The medicalisation of birth has perpetuated this adding the fear, vulnerability and apprehension a women experiences. Choices are taken away. Women are dictated how they should position themselves, what they should be feeling and what should happen when. THey are made to feel they aren't doing it right. 'oh you are only x cm dilated' , 'stop making such a fuss'. The idea behind hypnobirthing is that it replaces that negative subconcious fear of giving birth and gives you confidence in your own body and what it was designed for - we have evolved to give birth. The idea that birth should be painful was as someone already mentioned borne out of religious dogma that birth was punishment for original sin.
My mother didn't understand why I needed to do hypnobirthing classes. For her the fear of childbirth was removed by her asking an aunt when she was a child what it was like to give birth. Her aunt's reply was 'its just like doing a big poo!' for my mother that was good enough!
I believe a women should have pain relief if she needs it. Only the individual experiencing their labour knows what pain they are in and how much they can cope. I do however think that the medicalisation of birth and the interventionist nature of birth is producing a viscious cycle of fear and therefore pain.

good book

WOTMania I think you hit the nail on the head, you can't win either way!

Purpoisefull Yes, empowerment in birth should be about a woman having any of her choices respected. I think it depends on where she gives birth. The woman who had the hypnobirth on OBEM was mocked and even laughed at afterwards for not serenely giving birth. I think they showed her in transition (begging for pain relief but her mum refused on her behalf? I didn't see it all) which is not usually a calm time anyway. A lot of people I spoke to were pleased that she asked for pain relief, in a smug "ha! That'll teach her" kind of way.

I wish pregnant women were credited with having brains and people didn't judge them for their birth/PR choices. In fact, slightly off topic but when I was pg with DD I was in a meeting with my very senior manager and about 5 men who are my equivalents. I made a comment and the senior man said "ignore her, she's pregnant. It's all just rubbish that comes out of her mouth now". I sat shocked, the men laughed and then they continued their conversation as though I had never spoken. V humiliating.

Snowmama -

I think its sadly too much to expect for MWs to play the coach and advocate role for women in hospital -- I think they do in home births, but that is not for everyone.

So I think it's more realistic to seperate out the female friend/supporter role from the HCP - whether it's your mum, sister, friend or a doula. Dads can be at the birth, but even if they are your complete soul mate they just don't fulfil this role.

I know doulas can be expensive, your trainee idea sounds good (sorry OP, we have strayed so far from theory ... ;-) ). For lots of women who can afford, or whose family/friends want to give them a ridiculously expensive travel system etc... I think there is a 'because I'm worth' it aspect to saying the baby will be ok in a second-hand pram and umbrella fold buggy, but that it is worth saving up for a doula. It is a practical expression of the much more theoretical discussion on the other thread about valuing what women do in giving birth.

I also know people who have been tricked into an epidural and have completely lost confidence in their bodies negatively impacting on subsequent births.

For myself I've had one in hospital (planned HB) and two at home. The one in hospital I had to really fight to give birth upright and was told that I didn't neeed to push when I did (she examined me and the head was out of the cervix) tried to cover me up for 'modesty' when I was so hot my PJs were soaked in sweat. When I went in they tried to get me on drips to speed up labour etc and this was all female MWs.
My homebirths were great. I wandered around naked, they were quick, no one told me I didn't need to push or to lie on my back or suggested extra PR (didn't have time with DC3 - MW arrived 7 mins before she did).

I don't think I would have had a problem with a male MW it depends for me on whether they listen to me and respect my choices and don't judge me by the fact that I look a lot younger than I am.

I'm finding this thread fascinating. wrondecade -

'I think there definetly is a culture of 'your a real woman' doing it as natural as posssible' (This isn't your quote?)
My experience is thta people think I'm crazy and don't use PR to 'prove' something . and am making it harder on myself. I guess you just can't win can you.

I think there definetly is a culture of 'your a real woman' doing it as natural as posssible

when I told realtives I had barely any PR they were like youre part of the womans club now, I think its probably harks from an earlier time when women did have much PF so had to make the best of that situation?

Completely agree Himalaya. I had a really bad birth experience and a very good one, the reason I did not suffer trauma with the bad one wasbecause my mum was there and represented and supported me so I always felt respected. For the good birth experience, my mum could not be there so a doula performed that role which again made me feel safe. During I had good and bad female and male HCPs but I saw them as performing a different, safety related role. I guess the question is should we be expecting some of the (female?) midwives to have a 'doula' aspect/ responsibility within their job role?

Off topic but because doulas are super expensive, I got a respected doula to recommend a trainee, and hired them in the last six weeks of pregnancy. Was not the full experience but was enough and a lot more affordable.

Nothing can prepare you for giving birth. For me (and I think for many) there was the pain of course, but also the unfamiliarity of being part of the medical/hospital system for the first tine. although I'd read the books been to antenatal class I think I had an unrealistic idea of the role of the MW. On telly (I know this sounds stupid..) they are always there holding the woman's hand going ' you can do this' buy in real life they are popping in and out, checking your monitor, bring all procedural and not very sympathetic. Which came as a bit of a shock.

I do think women are stuck between a rock and a hard place - between the natural child birth chearleaders and the hospital bureaucracy that is nrcrssary with anethesthesia, risk management and accountability.

I've no problem with male obstetricians and MWs - male or female they are all strangers who see you in a vulnerable position - same as your kidney Dr or whatever. I just want them to respect me and listen to me and i had HCPs of both sexes who were good and bad at this.

I had a terrible first birth, so for the second birth I had a doula. Which was the best money I've ever, ever spent. Having someone there who had done it herself, who knew what I wanted who most importantly worked for me was brilliant. It was just a different role from the HCPs who in the end work for the hospital.

x-posted with sprogger - 'in control' is probably a better and less cheesy way of saying 'empowered'!

But what about a female midwife who had no children, or who had only had c sections? I feel like Lisianthus - that empathy and respect is more important.

I think empowering women in childbirth is a cliche but is what the goal should be - I don't understand why this is talked about as if it's synonymous with a drug-free birth though. I agree with those who have said that there is potential for much better designed pain relief and medical interventions, if only it weren't set up as either/or.

I feel exactly the same way tortilla. I think that many if not most women would prefer female caregivers whilst giving birth, for the same reason that my 93 year old grandma prefers a woman to help her to get into her nightclothes and give her a bath. It is easier to feel more comfortable when your genitalia (and probably your breasts too) are on display, if there are only women in the room. The comfort and safe feelings of a woman in labour are important to the woman as a person and to the progress of her labour. They are more important than a man's right to choose to be a midwife IMO. I was SA as a child so I accept my views on this may be skewed.

lisianthus - I completely agree that sensitivity and caring are not exclusively female traits. However, I don't think your comparison of obs/gyn to female HCPs treating testicular cancer patients or prostate patients quite holds up - these HCPs will be treating both men and women in the course of their work, either as urology specialists or oncology specialists. I think there is only obs/gyn where you are exclusively treating one gender - and it seems odd to specialise in something where you are only treating the opposite gender, and treating them in situations where it all about their femaleness and when they are at their most vulnerable/exposed. It's not that I don't think men can't be caring and sensitive (and as I said, I had good care from male midwives and doctors) - it's just that I don't understand why they are motivated to be in this field of medicine of all the ones they could choose from (plenty of other opportunities to be caring and sensitive).

I don't know why I feel like this. It unsettles me that I feel like this (you use the word odd - i feel that too). I have no issues with male nurses/doctors in general, male nursery workers, male teachers, male carers. But something deep down makes me feel that being male and an obstetrician or midwife is just somehow wrong... I guess because childbirth was not a medical condition historically (although it is now) and because it is where a woman is at her most vulnerable and most primal it seems wrong for a man who is not closely involved with the woman (i.e. the child's father) to be present, let alone directing her / making decisions for her / taking the credit for the delivery etc.

I'm a lot less worried about male gynecologists actually - it's purely something about the birthing experience that makes me think the male involvement should be nil (apart from potentially as birthing partner)

I see where you are coming from, but I don't think the "you're not ill" part is relevant, because I think that they key point is that however your pregnancy went and whether you are ill or not, childbirth is a time of vulnerability. It isthevulnerability that makes it important that the MW be sensitive and respectful. I don't think caring for other vulnerable humans is a sex-specific trait.

This part of this thread just made me feel a little odd, as it seems to be the opposite of what I believe as per threads about raising and children in this section. Sensitivity and caring are not innately female traits.

Lisiathus I understand your analogy but I dot agree. You're not patient when you're giving birth, you're not ill. Yes, I would rather have a man who could empathise than a woman who couldn't but the most important thing for me would be having someone who understood, who done it. Someone who'd been pregnant etc.

I realise I don't speak for all women.

This is the thread I referred to above, where women discuss their experiences of being denied pain relief in labour. I found it quite a harrowing read.

Mumsnet followed it up with a webchat with the president of the Obstetric Anaesthetists Association, which was informative inasmuch as it dispelled some of the (to me) myths about the impact of epidurals in labour.

Incidentally the President of theObstetric Anaesthetists Association is a man - and I share tortilla and sakura's question - why are men in this field?

I think the problem re midwives and ob/gyns is not one of sex, setting aside the situations where the woman giving birth is a survivor of assault. IMHO, the issue is whether the person, male or female is able to empathize and treat the labouring woman respectfully, respecting her feelings. Of course a man is capable of doing this sensitively. Not all men are though, and not all women. The most insensitive MW at the birth of my DD was female.

To me, saying a man cannot be a sensitive, respectful MW because he can never give birth is like saying a female doctor or nurse is incapable of treating a man with prostate or testicular problems sensitively, because she can never experience those. By definition, most medical professionals are never going to experience every issue faced by each of their patients.

And all births are different, so just because a MW has given birth, doesn't mean that she will be any more sensitive to a woman giving birth if she is not that kind of person. I'd rather have a sensitive respectful male MW than a female midwife who has given birth five times, each time with minimal pain and is insensitive enough to think that any woman who is experiencing extreme pain is exaggerating.

All this is NOT to say however that there is no sexism in the birth process around the issue of pain.

I don't think its off topic TPL I wonder if control is some of the appeal? Control and rescue. One my pet hates is phrases like "we'll deliver your baby here/then". Actually, the mother does the hard work in most cases and the ob/MW just catches (and even that isn't always necessary - would be less so if women could labour freely). It gives the credit to the wrong person. Also disempowering and I think a lot of our birth practices are structured around the idea that women can't do it themselves, they need saving.

Yes it is a very good question. Especially given the number of women who state that they would hate to be cared for by a male midwife - the same feelings presumbly apply to obsteticians, only the numbers of men involved make it very unlikely you would get a choice. Women who say they would not like a male MW are regularly laughed at on MN, but I think it is entirely understandable that someone would not want a male stranger in the same room as them during labour and delivery. For women who have been sexually abused or assaulted, it can be very uncomfortable.

I experienced both extremes of childbirth with my boys, super medical and a home birth with no pain relief. The second was so much more empowering. I had done a hypnobirthing course and felt no fear. Most importantly, as I was on my own turf I felt much less compunction to do what the HCPs told me I had to do (routine examinations etc, not actual advice about my safety or the baby's). A few days afterwards the community midwife tried to tell me off about it, as if I had not the right to refuse to let a stranger into my fanny within 2 minutes of meeting her!

With DS1 the anaethetist who botched my epidural came to see me afterwards and sneered at me that next time I should get an epidural earlier as I clearly wasn't the sort of person to cope with pain. Luckily there was a case review and he was made to apologise to me face to face. He was a junior doctor, about 25 at most and with absolutely no respect for the women he was supposed to be helping. Actually I think a lot of his contempt came from his own fears about not being able to control the siituation (and about having caused me some serious damage due to his inexperience and incompetence). Sorry that was a bit off topic.

I feel uneasy about men at birth. I had a male midwife, felt incredible uncomfortable about it and yet felt it wasn't politically correct to ask to change (probably wouldn't have happened anyway).

Its not just men, I want my birth support person (a MW for this baby) to be someone who has given birth themselves. Someone who understands the emotional aspects and not just the physical. I think that's my issue with male obs/mws. They can't possibly understand the complexity of the experience. It's not a medical event (usually anyway) it's birth and it changed me as a woman. A man will never understand that. Sorry if that sounds horribly sexist but that's how I feel.

'But childbirth has always been led by and seen as a female thing? I think the pressure on women to have "natural births" comes from other women - not from men??'

Not read all the thread but this struck me - I think the pressure to have a 'natural birth' comes from women but the main problem is the interventionalist stick you on your back on a bed and tell you what to do is a male thing.
IME women will let you labour how you like unless very influenced by men (male DRs, obs etc)

This is really interesting reading for me.

I actually wanted to go back to a pointy sakura made about male ob/gyn and midwives: why do men want to get involved in this field? There are so many men who are ob/gyn consultants. Why? Why are they so interested in spending their working life treating women at their most vulnerable, when they can't possibly empathise in any way? What do they get out of it? I have never been able to understand it. It's not that I didn't had good care from male consultants during my first pregnancy (saw exclusively women with the second), it's just that I didn't know what they got out of it and what their motives were for being there.

It makes me feel a little uncomfortable even saying it - I'm all for equality of opportunity :) - but it just seems weird that men want to muscle in on something (the potential to get pregnant and give birth) that is pretty much the key difference between us and them.

What do you all think? Do you care? Do you think it is part of the problem?