New guidance to reduce epidurals and a target rate of 20% for C-Sections

HmmThinkingAboutIt Christ, I'm not surprised considering what women put up with now in hospitals I'd hate to think what it was like in 1858. My point was "modern times" since women have given over their births to the medical community. Which would include your French doctor.

I agree that more should be done to help pregnant women feel more confident about the process of giving birth and there are lots of measures that can be taken to help reduce the fear of what's involved - not to mention changes in attitude among HCPs and alterations to hospital policies and environment to make the whole thing more pleasant for the families involved.

But ultimately, a pregnant woman needs to feel empowered to take ownership of her body and birthing process - and if that includes the certainty that she can have an epidural or section if she so requests, then so be it. Setting targets will simply erode choices and disempower women further.

Actually I would prefer not to have an epidural - i am a running marathons, climbing everest type person and i would rather have pain with control than lack of pain and feel out of control of my own body, just my personal preference. But i don't see the nhs rushing to help pay for my hypnobirthing classes to give me the tools to attempt birth without an epidural... and i am not entirely confident the nhs has the resources to help me attempt a fully active birth either. You can't just set targets and convince women to do things the way you want without providing resources and support.

[and before anybody says anything, i am fully aware that i might need/want an epidural and a cs when the time comes, but that doesn't change how i feel now or the strategy i want to start out with].

BOF But isn't the issue we all see this differently?

You see it as a social problem. I don't. I see it as a practical problem. Babies are getting larger, women are giving birth later, there are lots of reasons.

Birth has always been problematical and always killed women in droves.

I don't see my atttitude to birth as being a social problem.

I have no problem, however, on you holding your views and I am not trying to persuade you round to my way of thinking. I don't think there's anything wrong with you believing what you do.

I just don't agree with you.

We're all entitled to our own views to be respected for our own birth and a duty to respect others views when they are giving birth.

I should say "in labor animals don't seem stressed" I obviously haven't discussed my theory with many cats.

The way births happen in hospitals (being forced to lay on your back etc) can cause pain in women, it's a horrible cycle.

I did a hypnotbirthing class with my first dc and it discussed the beginnings of fear in child birth, I dont think it really is something that has always been a problem. You don't see animals shitting themselves about giving birth.. even though they have a healthy fear of other animals, threats, etc.

I took it to mean, she wants to know why women feel that birth is a big bad scary thing that isn't a personal attack on you. It is a social problem that we have gotten to the point that women are scared shitless to give birth, how is it a problem to want to redress that? Of course it should be discussed on a wider scale or it will snowball.

Treats "Let women decide for themselves how to manage their own births without arbitrary targets."

That is exactly how I feel. The medicalisation zealots are no better or worse than the natural birth zealots. Neither respect that women are different, have different needs, opinions and different ways of seeing risk.

It is appalling to subject women to interventions without consent.

It is equally bad to say that caesareans and epidurals would not be needed if women 'had confidence in their bodies.' So if you have a traumatic birth, it's your fault for is it?

Read treats comment - that's what equality is. Crediting women with the intelligence to make their own (and often different) decisions about how they give birth.

Buggy said "I don't understand how it's got to the point of women having such little faith in their ability to give birth.
surely this needs addressing socially not through kpi's in hospital."

Buggy, I apologise in advance if I have misread your post.
But it sounds as if you are employing exactly the paternalistic and patronising attitude which this thread is challenging. Why are you angry that some women wish to have epidurals and c-sections? You seem to be assuming that "natural" (which includes forceps according to the RCM/NCT document) is best for everyone.

Thanks for the messages of support. If I'm going to get involved inthis thread I didn't want to drip-feed information.......

leftwing - I read that book too and felt dismayed by the disempowerment inherent in the US system. I put it down thinking that natural birth following the woman's own instincts would be better.

But who's to say what level of pain women should be able to put up with in delivering their babies. And who's to know that one woman isn't suffering a lot more than another in the same situation? Let women decide for themselves how to manage their own births without arbitrary targets.

Bigoldfanny I'm glad you raised those points. After I read Naomi Woolf's Misconceptions it left me horrified at the over medicalisation of birth in the States and the pressure on women to birth on the hospitals' schedules. You hear a lot about doctors overriding women's choices and midwives laughing at birth plans. From that perspective guidelines which encourage medical professionals to prioritise natural birth make a lot of sense.

I looked into engaging a private midwife to advocate for me - but I found that her birth philosophy was just as rigid but in the opposite direction, completely opposed to epidurals and really pushing home birth. I'm not opposed to having an epidural or a C section, I just want to be able make my own informed decisions and not have things taken out of my hands. I don't know how you legislate for that.

buggyrunner Um, I'm not sure what faith's got to do with anything. Most women expect to have a vaginal birth. Some of them still end up needing c sections. Which is hardly surprising since bodily functions aren't exactly under the control of faith... Apart from which, some of us couldn't give a crap about our ability to give birth. Like I couldn't give a crap about my ability to run a marathon or climb Everest. I wanted a caesarean. I don't need my choices to be addressed socially thank you. My reasons are my business. Don't make such daft assumptions about what motivates other women's choices.

I don't understand how it's got to the point of women having such little faith in their ability to give birth.
surely this needs addressing socially not through kpi's in hospital.

treats sorry I didn't see your post, I'm so sorry for your loss. I also can't imagine a doctor denying your very reasonable request

Treats, I'm so sorry for your loss

I really hope you get whatever birth you wish for this time.

NO, I don't want women's choice to ever be put to the side. But I worry that when doctors are allowed to medcalise birth you are more likely to lose your choice. Assigning a time for delivery via a csec or a shot of pitossin is easy for doctors and allows them to avoid the night shift 20% seems like it would more than cover women who need a csec for medical reasons or just because they are too scared to go through a vaginal birth. But it might out an emphasis on doctors helping to educate women who think csecs are "easy" labor.

BigOldFanny - that sounds awful . I think it's the same problem but the other way round. Targets or standards are set for deliveries and the focus becomes meeting those targets or standards and not on what's best for the individual woman and her particular circumstances.

Also I was held down when I tried to walk around, and was asked about an epidural every 5 minutes for the entirety of my labor. My labor in the UK where it was assumed I would give birth naturally and not have a csec went way smoother.

I live in the states I could not find a hospital in my area that had a csec rate of under 40% some MUCH higher. When it becomes the standrd t is very difficult for women who dont want a csec to avoid them.

I was GOING to say that the NCT IS a predominantly male organisation, because when I was a member (2-3 years ago) and received the bumpf for its AGM, I was appalled to find that the majority of its board members were male.

I thought I'd best check my facts though and note that the current 15 trustees are 8:7 female:male. So its leadership is marginally more female than male at the moment.

I'm not sure if I think that a charity that strives so hard to represent all parents of both genders (which is, overall a GOOD thing) is also the right body to be so influential on the subject of childbirth - especially pain relief. These are exclusively women's issues and should be represented by bodies that are exclusively focussed on the needs of women in childbirth.

Incidentally, I'm pregnant with DC3 at the moment and will likely be offered a non-medically necessary C-Section thanks to the very traumatic delivery I had with DC2 (which sadly ended in my baby's death at 7 hours old). So, I'm a classic example of the kind of C-Section that could be witheld under these guidelines.

This is a very important subject - thanks for posting it here.

Great posts ushy and PMhull.