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

Just to clarify my last post - because I think that the reference to 'finger-wagging' might be seen as derogatory. I think that the natural birth movement has become a rival orthodoxy (led by men, as demonstrated by my initial post), which leads to women feeling that they have to have a birth which is either/or. And chances are that the HCPs looking after you will be on one 'side' or the other, leaving you feeling disempowered if you want something different.

I think the issue is that there are two conflicting paths for feminism to take on this issue. Firstly, I think it's absolutely true that male obstetricians took over from female MWs and imposed medicalised delivery to suit themselves - stirrups, lying on our backs, etc. and women absolutely should be reclaiming childbirth as their own individual experience and be able to dictate how they want it to proceed.

But, unfortunately, there are too many finger-waggers telling us what we SHOULD want, to the extent that there is almost as much orthodoxy in the other direction - pain-free home births etc. Genuine clear sightedness about the kind of birth you want is almost impossible, certainly for a first delivery when you really don't know what to expect.

So we should be advocating for pain relief in labour to be taken seriously, but unfortunately, this can often be see to conflict with the movement to de-medicalise childbirth.

Balaskas did a great job in fighting for women to be allowed to birth in positions not on their back and this does happen now but in reality, I suspect most women do.

The bed dominates the room, women are encouraged to push lying on their back and holding their thighs. If I know that this position is shit for pushing out a baby then so do trained MW & obstetricians. But a woman birthing on the floor on all fours is harder to observe than a woman on her back on a bed. Sod how much extra pain she feels in this position and the complications which can come with it.

I had a friend who wanted to birth on her knees, leaning over the head of the bed and was told she wasn't allowed by a MW at a hospital in Yorkshire. She'd arrived fully dilated, ready for the second stage and was still denied a choice in birth position for no good reason.

Katie my sister had a similar experience. Was told she wasn't allowed pain relief because she was coping well without it. She told them she really wasn't but they insisted she was fine. Horrific to go through that experience and feel like your feelings aren't being validated and that someone knows your body better than you do. She has refused to consider having more children because she found birth so traumatic.

Where does Balaskas and the Active Birth movement fit into this?

Dirgeinvegas - some of those MWs from OBEM must surely cringe watching back how they speak to and treat women!! One poor woman was begging for pain relief, told it was too early then soon after she was at 10 cms.

Recent family experience of someone totally denied any pain relief (not even gas and air), uncomplicated, not too long labour, forced to labour on her back in stirrups for FS!!! I was so angry for her and she didn't twig that was 1970's shit practice.

Oooh - this thread moved on while I was typing out my last post.

I found my first labour traumatically painful (although mercifully brief) and I get a bit teary when I think about the prospect of my second (due in late November). I don't think I could have been better prepared for labour (see my reading list, above ) but I was still unprepared for the amount and type of pain that I experienced. And I really do think that it's IMPOSSIBLE to theorise about pain management in childbirth if you haven't experienced it.

You can doubtless do a lot of interesting research and make detailed observations, and become more experienced at the practice of delivery, but you CANNOT make pronouncements about appropriate pain relief in childbirth if you haven't experienced it. You simply don't know.

And - also - everyone's experience is personal. I don't know if it's possible to measure pain (I don;t think so ) but even if two people experience the same level of pain, their response to it will still be different. Therefore, blanket pronouncements on appropriate amounts of pain relief in childbirth are completely misplaced.

There should be appropriate pain relief available at every stage of labour, administerable at the woman's request, without judgement or pressure.

And I agree with whoever said that the lack of research and progress into childbirth pain relief is indicative of general attitudes towards it.

Katiebeau This>> That is showing hatred to women, not devising a way of eleviating the pain if a woman chooses it

I think you're right and also the way women are spoken to in labour. If you watch OBEM you can see how disrespectfully some of the women are spoken to, like they are children.

When I had DD I had pethidine which I found dreadful, made me spaced out but still in pain but unable to move to soothe myself. My waters broke and I slurred at the midwife to tell her. She told me to go to the toilet to check. I tried to get out of the bed to check but couldn't move. She snapped at me "can you not just put one foot in front of the other?".

I would never speak to someone like that, never in my professional life and especially not to someone as vulnerable as a woman in labour.

Possibly only rivalled by the way some HCPs speak to the elderly.

Hmm, I believe in personnal choice. If you don't want pain relief fine... if you do fine. I was taught that pain relief was administered by women to help women (Willow Bark tea) donkeys years ago - until the Catholic Church decided pain in childbirth was punishment for the original sin committed by Eve and murdered all the wise women and Midwives of the day.

I agree most medics (male and female) and also a lot of MWs are not aware of the trauma of a birth overmedicalised for the sake of it (and avoiding be sued).

Women who want pain relief are routinely denied it (how inhumane is that) and forced to labour on their backs in stirrups in the UK today - horrific unnecessary pain for the woman. That is showing hatred to women, not devising a way of eleviating the pain if a woman chooses it.

Pain relief with drugs will always have side effects, so long as these are clearly communicated with an educated decision by the woman going through the labour why does anyone comment.

By the way I have never ever seen a man sneer at a woman who used pain relief or needed a CS - but I have seen plently of women do so.

... exactly, the blame is terrible - as PH says everyone's experience is different (in fact my two birth experiences were wildly different).

It has to be about supporting choices and the process of labouring and not making women feel guilty about their choices. ... better painrelief is always welcome as an addition to my menu of choices though!

Certainly most of the advocates of drug-free birth have been men. Grantly Dick-Read wrote 'Childbirth Without Fear' and was the founder of the Natural Childbirth Trust (as it was originally called). Frederick LeBoyer wrote 'Birth Without Violence' - advocating water birth. Dr Fernand Lamaze developed the Lamaze technique, advocating breathing techniques to aid labour. Michel Odent is probably the most prominent current obstetrician advocating natural childbirth - he regularly pops up complaining that having fathers at the birth doesn't help women. (Interestingly, those last three are all French, and France - I think - has a much higher rate of intervention than the UK).

But there are also strong women advocates - Ina May Gaskin in the States for example.

Another fascinating book I read was 'Birth' by Tina Cassidy, which described how our evolution as human beings (bigger brains, standing upright) had led to a childbirth process which was difficult and painful, unlike less evolved animals who were still suited to it.

There was quite an upsetting thread on MN recently (can't remember the title or even what forum it was on) where women shared their experiences of painful births and being denied pain relief and there was a palpable sense of anger from some women that the experience of pain during childbirth was somehow downgraded and treated as less deserving of treatment than other kinds of pain - the relief of pain is a priority in operations and other procedures but treated as a natural part of the process in childbirth - and women just have to suck it up.

This is an interesting topic for me. I'm just getting down some stuff I know, but will probably return later with a bit more about how I feel........

Great birth? I'll take the credit.

Bad birth? You didn't try hard enough.

Nothing empowering about either of those messages.

SOH I agree, I have spoken to someone who holds the same belief - you didn't visualise hard enough for a positive outcome. It baffles me. There is only so much influence anyone has over their labour, to an extent we have to deal with the hand we're dealt and it may not always be what we wanted.

Blaming women for how their birth turned out, I often think, is just part of trying to make money out of selling your own technique for great birth and then when it doesn't work - blame the woman for not trying hard enough.

Women tend to blame themselves enough after having a EMCS or forceps etc without having it piled on by experts. It affects them greatly and is also one of my huge bugbears.

Hope your experience was better.

Agree with so many posts here. Yes, sakura also like men becoming experts on childcare and infant feeding in the Victorian era. Heartbreaking the advice they gave out to women on how to raise their babies. Newborns deprived of food and cuddles in order to build character.

I think we're still feeling the repercussions of that now with so many of us turning to experts to tell us how to raise our children, we no longer rely on our instincts or advice from others who have been through it. 200 year old guidance from male doctors is handed down from generation to generation.

Agree that women are reclaiming childbirth and that medicine doesn't like it. Look at the BMJ article on the safety of homebirth which was proved to be flawed and yet they still wouldn't retract it. Then on the basis of the article, it started a discussion that some women should be forced to birth in hospitals for the good of their baby.

I don't know a single mother, whether giving birth at home, hospital or unassisted who isn't trying to do the best for her baby. To talk about taking away that choice makes my blood boil.

I've been re-reading Naomi Wolf's Misconceptions recently along with all my baby books, and just wondering if anyone knows of anything similar/more recent?

The Marie Mongan hypnobirthing book is an interesting read. It claims to empower women to harness the power of their minds (bravo thus far).

It has a section on breech babies/malpositioning and explains quite clearly that babies become malpositioned because a woman is unable to let go or is negative about the upcoming birth in some way. Absolutely no acknowledgment of any other factors, certainly nothing medical or outside a woman's control.

Horrific, accusatory nonsense. Behind the veneer of 'support' is this nasty message that a woman can somehow fail birth or deserve a medicalised or complicated delivery due to her own flawed approach to birth.

Just a thought, if you were interested in how we are set up to feel like failures sometimes even from the corners that purport to champion a woman's inherent 'power'...

I am not great with feminist theory but I am a childbirth educator with feminist leanings. I can only tell you my personal thoughts on this but it might help put your feelings into context.

I teach a lot of women, normal, everyday women who want to experience childbirth. They want to know what a contraction is and to feel the labour. The mums-to-be I see with breech babies often feels devastated at the suggestion of ELCS and not giving birth vaginally. This might sound odd - it's a chance not to experience the pain and physical challenge of labour (not that CS is a breeze) but yet I don't know many women who chose not feel anything.

Yes, some choose gas & air, pethidine, epidurals etc but the idea of feeling nothing at all makes them feel cheated of a right of passage.

My own view is that childbirth has become very medicalised and medicine is male dominated, obstretrics is suspicious and distrustful of womens bodies and what they're capable of and, at the risk of sounding extreme, I believe the medicalisation of pregnancy and birth is just another way to control women.

We know that interferring with birth increases risks to mothers and their babies, research is everywhere. Medicalised birth should be available to those who need it but on the whole, most women would do better with the support of another woman and an environment that was more conducive with good birth than a bright, sterile delivery suite, (usually) a male observer and lack of privacy and control.

Incidentally I also don't believe too strongly in the theory that we have evolved to have worse births than other mammals. I think evolution compensates for that in other ways (human babies born prematurely, we can give birth on all fours changing the shape of the pelvis and our joints are designed to move to allow baby to pass through and babies head moulds to allow the same). I truly think our culture of managing birth, taking away womens control over their own births and how we're surrounded by stories of terrible births has more to do with it.

I also saw the photo gallery on Manila in the Guardian and felt sick at the way those women are treated. No privacy, dignity, birthing on their back. Its just not how women would chose to do it if left to their own devices, I don't believe anyway.

Oh Karen that sound like a horrible experience....poor you.

The whole way that maternity 'care' is set up causes women pain and problems in labour, which then requires men to invent things to relieve and improve this. A few examples:

• Making women travel to a hospital in labour, then move them between various rooms depending on what equipment is where
• Making labouring women lie down on beds so that they can be monitored, despite the fact that this has been proven time and time again to make no improvement whatsoever to the number of healthy babies delivered - but it does slow down progress of labour and often causes a lot more pain
• Filling the room with a succession of people, none of whom the woman knows - causes anxiety and slows down labour
• Making the availability of care and access to drugs dependent on a set of hospital rules, rather than believing what the woman is saying. "Go home, you're not in labour yet" (tough shit that you feel in labour, that you are in labour in fact - you've got to prove it by being dilated enough to be worthy of interest) and the fact that epidurals aren't available for women who want them, sometimes for hours and often by the time they are it is too late
• Maternity and postnatal wards operate at though babies arrive 9-5, Monday to Friday. They don't.
• The prevailing attitiude of HCPs is that labour is something we will let you do on our terms. Not that women are intelligent, capable of making their own informed decisions and taking the consequences when things go wrong.

The whole thing is fundamentally misogynist and it makes me really, really angry.

I think unassisted childbirth is dangerous, supported at home by a midwife cool though ( though I was still too nervous to contemplate it ...)

Agreed, snowmama!