Do you agree with this statement regarding pain and child birth

[user6767]

Chatting to a few friends tonight about child birth. One of them made a statement that I had never really thought about before but I can definitely see her argument.

She basically said it's wrong that women have to bear the pain of childbirth. When for nearly all other invasive/painful procedures we would be given pain relief as standard. She pointed out whilst we do have options like epidural these are not standard and in the UK in particular a 'natural birth' is seen as ideal. Also that she thinks if men had to give birth there would already be many more pain relief options available by now.

I thought it was a really interesting view point. Wondering what others think?

No, I don’t agree.
Of course, all women should be offered whatever pain relief they want but every women should be fully aware of the implications of whichever intervention they want.
However, I strongly believe Far far FAR more work needs to be done around non medicalising births. Birthing is still seen as a truly frightening concept- this has come from male doctors and physicians in decades gone by telling women how they must give birth and how they must feel. Horrific practices such as forcing women on their backs and in stirups, to being in a medicalised environment with no privacy, medical equipment everywhere, brusk frightening midwives and consultants and women feeeling like they are not being heard. All these things (and way way more) lead to birth being more painful than it should be. If more support and education were in place, far more women would manage without major pain relief such as epidurals (which frequently do come at a price)
Lack of Education, and support + too much unnecessary medicalised input = Greater pain during labour leading to requesting more pain relief

One of my best friends has a csf leak as they punctured the bag of fluid surrounding the spine during her epidural.

This is a well documented complication of epidural. She was in agony with a headache, unable to get up or care for her baby at all.

She had to go back to hospital and have a procedure in theater to take blood and use it to seal the leak and form a clot.

If she could do it again she would have refused an epidural as it was worse than the pain.

Epidural does carry a risk of permanent loss of feeling or movement in, for example, 1 or both legs.

Someone puts a needle in your fucking spine it is not risk free.

Giving birth isn’t a medical procedure unless something goes wrong. So no, I don’t think pain relief should be standard because every interruption of the natural process increases the odds of something going wrong and turning something natural into a medical event. We should instead be pushing to make monitoring and exams as non-invasive and as hands off as possible and to increase women’s comfort and sense of peace, in a perfect world, she wouldn’t even feel like she was in a hospital or see a member of the medical staff unless something was going wrong. We don’t have the tech for that yet, but hopefully someday women can give birth solo or with just their most trusted people for support, but with an invisible medical safety net that doesn’t impede the process.

My friend wasn’t able to have an epidural mr and gave birth with just gas and air. My dad went in for a lumbar puncture and was given a spinal pain block…

@WineInTheBlood

Yeah, even before I went through childbirth myself I always said the same thing. Then I went through a horrendous induction (during covid so on my own) and they wouldn't believe me when I wasn't coping with the pain - they wouldn't even give me gas and air because I wasn't in active labour apparently . By the time they finally checked me hours later and realised I was nearly fully dilated it was too late for an epidural and so the first time I was offered even a sniff of gas and air was when they were pulling the forceps out (because my baby was in distress surprise surprise). I was so angry afterwards. Nobody should be made to endure that without pain relief - they don't even pull a tooth out without anaesthetic. And having spoken to a lot of friends with pretty similar stories it's obviously a huge problem.

What a horrible experience! Induced labour generally takes longer, it's a shame you had to be induced. Inductions seem to be happening more and more nowadays.

I was shouted at during labour by an anesthetist for refusing an epidural, I was coping quite well on diamorphine and my sister had quite severe complications from an epidural there was no way I was having one.
First birth I was drugged up to the eyeballs, fainted in the shower and took quite a few weeks to recover. Second birth no pain relief, was fine a couple of hours later.
It should be your choice to make not the health boards.

@AnneLovesGilbert

She’s right. If men had periods, got endo, fibroids, had to be pregnant, had miscarriages and give birth it would all be better managed, diagnosed earlier and much less painful.

We can put people on the moon but it takes 10 years to get an endo diagnosis.

Utter bullshit.

I’m derailing but it’s all part of the picture.

Completely agree with this. If you haven't already read it, I can highly recommend Invisible Women by Caroline Criado Perez - great book that's eye opening on this & many other levels.

When I look at the 10 years of therapy (on and off) I’ve had to have to undo the damage of a traumatic birth, I put a lot of it down to these ‘unwritten policies’ that the staff (from top to bottom) employed on me.

I was a strong, sensible woman, wildly educated about birth and with a proven high pain threshold. After 2 days in horrible pain (all the interventions, short of a section) the flashbacks I suffered after were all actually about not being addressed directly, whispered decisions being made without me, not being believed about serious symptoms, being ignored (seems like this is their actual prime directive in pain management), being lied to, being patronised constantly (somehow even worse when it’s woman after woman doing it). A lot of what I can only call Gaslighting.

My body was going through excruciating and varied horrible experiences (some natural, some as a result of their ‘care’). But it was my mind that lived the real nightmare. Tell me how I was supposed to feel? Strapped down, having multiple procedures performed on me by detached strangers, horrible pain with no control, no voice, no agency. Tell me how that is a different scenario to torture scenes we see in the movies (or in real life). It’s exactly the same, but with white coats.

It’s almost the last area left in modern life where women (not all, i grant you) can find themselves thrust back to medieval times and attitudes.

I still can’t look at pics taken the morning before I was induced. I look so happy, so happy and brave. Ready to face a life-changing and painful experience with a full tank of gumption. It’s taken a decade to refill that tank, drop by drop.

And all that guff about ‘but you should be so grateful you got a healthy baby out of it’ as if one cancels the other out. I said to my GP ‘Would you say that if another patient was in an horrific car accident on Monday, but coincidentally won the lottery on Tuesday? Or would you deal with the medical and psychological issues of the accident?’

I disagree. It's too simplistic a solution to a chronic lack of research into women's health issues.

What we need is proper, long-term, high-quality research into women's health.

That's the only real way women's health services from that first painful period to childbirth can be managed better to serve women.

Because for every women who has an awful experience of childbirth, there's one who had the opposite experience. We need information on WHY.

What are the genetic, physical, environmental, etc factors that impact the experience and outcome? Can we predict who absolutely needs an epidural and who will not need anything at all? Does it vary per pregnancy? Why? What are the factors that help us prepare.

If only I was a medical researcher or rich philanthropist...

@Hariboqueen1

I actually disagree. The thing is its not a invasive/painful procedure, its not an operation. Its something our bodies have been designed to do, nearly all species have to go through it and I think we are actually geared heavily towards pain relief in the UK. On the other hand I do wonder why giving birth is so painful, humans have pain as a warning that something is wrong ie infection or injury. But with periods and babies I dont get why whoever designed us made it painful for us!

One big difference between women giving birth and other female mammals giving birth is that being intelligent means having disproportionately larger brains and therefore heads compared to most mammals, and therefore it's more or a struggle for the baby to fit through the birth canal. This is widely accepted, I think.

The other reasons vs why human births are far more dangerous and painful than for most other mammals are very interesting and continue to be studied.

www.bbc.com/earth/story/20161221-the-real-reasons-why-childbirth-is-so-painful-and-dangerous

It's also fascinating that human babies are born so helpless, by comparison. A horse or giraffe etc will stand up and walk minutes after birth, be fairly self-sufficient almost immediately in comparison to a human baby. They would be the equivalent in human terms of what, a 2.5 year old? But for a woman to carry a human baby to that stage of development is physiologically impossible, so we have the trade-offs.

What is fascinating is that how we have designed society around these necessary trade-offs then try to present our norms as objective values or facts. Our whole society is a function of biology: that we are a species that lives in groups, that our young require prolonged care etc.

Imagine if crocodiles were the ones that got smart! The society they designed would look much different, I am certain. We should never underestimate how central our biology is to what we do, as individuals or a society.

It should be up to the woman what pain relief she wants during labor.
If she wants an epidural that's her own choice no one should be telling her she can't if that's what she wants.
I was offered an epidural and other pain relief but has it's my body I opted for a drug-free birth and will do it again this time around too.
I've had 2 really quick labours hoping the 3rd is just has fast.

@MotionActivatedDog

On the other hand I do wonder why giving birth is so painful, humans have pain as a warning that something is wrong ie infection or injury. But with periods and babies I dont get why whoever designed us made it painful for us!

I’ve always wondered this. It doesn’t make sense that childbirth is so painful. It’s not necessary to the outcome. What other natural processes where nothing is wrong are painful? Other than periods.

Hope I've helped to answer this a bit, from a biological perspective. ^^

This is an interesting point of discussion that I’ve never really thought about however my only birth experience was an induced labour. Like a pp I was never given an option of an epidural and had only gas and air for hours. When I eventually couldn’t take any more and asked for diamorphine it took at least another half hour (after DH pressing them) for that to arrive by which time I was climbing the walls. I ended up with a EMCS which I didn’t really appreciate how incapacitated and sore I’d be after it. Although the drs etc explained that it’s a major procedure I think society in general sees it as a fairly routine thing where people just ‘get on with it’ afterwards. You are still expected to get up and deal with the newborn not long after it, regardless of the stitches/bleeding/painful whatever else. I also think when you say you have ended up with a section folk think your bits are tickety boo...but that 12 hours of initial groundwork doesn’t come without a toll on your body!

Yes I have always said this.I'm not a wimp and and usually very independent. My last pregnancy was very difficult. I had twins by planned caesaran . Had them in afternoon. Brought onto ward at 8pm. Private room( quite isolating because you didn't see anyone). DH asked to leave at 10pm. Still had catather in which restricted movement. Couldn't walk yet anyway and shunts in backs of hands. Still frozen from epidural and unable to sit up/straighten myself upwithout help. Hospital bed with rails up and a baby either side in wee plastic cribs. Unable to reach out and pick up babies when they cried to breastfeed. Left completely alone and midwifes only came briefly when I rang the bell throughout the night which I was very hesitant to do too much.

Longest night of my life. I begged to go home the next day. Imagine if a man went in for hernia or abdominal surgery. Can you imagine him being expected to look after newborn twins alone immediately after? The next day the sister in charge told me to ask the night staff on dutyto take the babies for a couple of hours to let me get some sleep. I rang after feeding them about 11pm to ask if I could have a couple of hours and she looked at me as if I'd horns on my head and said no we're busy. 😂

@CrouchEndTiger12

One of my best friends has a csf leak as they punctured the bag of fluid surrounding the spine during her epidural.

This is a well documented complication of epidural. She was in agony with a headache, unable to get up or care for her baby at all.

She had to go back to hospital and have a procedure in theater to take blood and use it to seal the leak and form a clot.

If she could do it again she would have refused an epidural as it was worse than the pain.

Epidural does carry a risk of permanent loss of feeling or movement in, for example, 1 or both legs.

Someone puts a needle in your fucking spine it is not risk free.

The risk of dying in childbirth due to fatigue (and thus putting baby at distress and raising the risk of bleeding) is far greater than all of the epidural symptoms you mentioned. And even then you only get them in the UK where nurses and midwives are allowed to put in spinal taps. In places where epidurals are managed by anesthesists and standard eg the USA and India these side effects are almost unheard of.

We need to stop pushing this dialogue that epidurals carry greater side effects than natural ‘painfree’ birth.

Most of the women who die in childbirth in the world die because of a ‘natural’ labour - it is ‘natural’ for human women to die in childbirth. But it’s also natural for human men to die from shock due to the pain from kidney stones and we never let that happen due to lack of pain relief.

@Timeisavirtue

I’m not sure if it’s true or not but when I was in labour with ds13, the nurse told me epidurals slow the labour down. Now I’m not sure if it’s true or she was trying to defer me for whatever reason. If it is true they probably don’t endorse it because the nhs is apparently always overstretched so they want to discharge people ASAP. I didn’t even get offered one with my dd, mind you the labour was only 2 hours, I did have gas and air and picotin which to be honest actually was okay.

It is true. And that does pose more risks, to prolong the labour. However, should people asking for pain relief be left in agony? That's often the case and wouldn't be acceptable in any other field of healthcare. Here it is dismissed as "oh well, of course it hurts".

It's clear from this thread and actual data that experiences vary wildly and we also ave laws that consent is needed for medical treatment so doctors and midwives need to listen to women and let them choose for themselves. The way they are treated in the UK currently is absolutely disgusting. And then you go to the postnantal ward, which is the seventh circle of hell.

@WeeM

This is an interesting point of discussion that I’ve never really thought about however my only birth experience was an induced labour. Like a pp I was never given an option of an epidural and had only gas and air for hours. When I eventually couldn’t take any more and asked for diamorphine it took at least another half hour (after DH pressing them) for that to arrive by which time I was climbing the walls. I ended up with a EMCS which I didn’t really appreciate how incapacitated and sore I’d be after it. Although the drs etc explained that it’s a major procedure I think society in general sees it as a fairly routine thing where people just ‘get on with it’ afterwards. You are still expected to get up and deal with the newborn not long after it, regardless of the stitches/bleeding/painful whatever else. I also think when you say you have ended up with a section folk think your bits are tickety boo...but that 12 hours of initial groundwork doesn’t come without a toll on your body!

I was told I needed an epidural during my induction, but it was me who tried to see if I could go without. All at the advice of my Mum whose births were much, much slower than mine.

@MagentaSunset very interesting thanks

[quote WeeM]@MagentaSunset very interesting thanks[/quote]
Welcome! Glad it was interesting.

Because for every women who has an awful experience of childbirth, there's one who had the opposite experience. We need information on WHY.

Of course I agree. And we DO largely know why. Births complications and physiological traits that are likely to make childbirth easier/ more difficult, plus position or orientation of babies, underlying health conditions of baby or mother, etc etc.

The complicated thing is working out a risk framework to weigh up all of these factors in proportion to make tailored care plans with the best statistical success for mothers and babies in each situation. Then discussing these with the mothers and explaining the tailored risks in their specific situation accurately, then letting them make an informed decision.

Childbirth is such a dangerous thing that tragedies and pain will never be eliminated, but with proper data collection and research and tailored, personal care the risks can be reduced, massively. We've proved that already over the last 100 years but, to our shame, the risks to both mothers and babies in the UK remains unacceptably high compared to those in other developed countries.

More stillbirths, more disabilities caused by mistakes during labour, more trauma to mothers caused by substandard or barbaric "care". More pain as often pain relief is denied when requested. Trauma of having to jump through hoops to get a C section when it's in the best interests of mother and child - women not being allowed to make choices about their own care.

Then postnatal care. Traumatised women who've had difficult births shoved on communal postnatal wards with nobody responding to buzzers for hours. Women who've had c sections who can't sit up to pick up their crying newborn to change their nappy or hug or feed them because nobody comes when they ring the bell. For hours. I was given no food or water, nobody answered. Nobody changed the colostomy bag. It was like being treated in a war hospital. Women who'd lost babies put on the same ward as the newborns?! Barbaric.

All of this is possible to make much better, with our current knowledge. And much more money needs to go to research too. There is no excuse. Women in France all have postnatal physio as standard to reduce the risk of prolapse and check pelvic floor. Nonexistent in the UK leading to many debilitating sometimes lifelong conditions. Many women experience post traumatic stress and then postnatal depression because of how awful postnatal care is. All a massively false economy and it should not be swept under the carpet. As several PP have said, men would never out up with this.

I even saw that new hospitals beint built now in some places have single rooms with ensuites only in all wards except postnatal wards. Fucking hell. As if there's ever a situation when more patients would need privacy. That shows you exactly how much women's rights are prioritised. And then they'll all say "oh yeah, we'd love to give you privacy but have no private rooms..."

I totally agree and have said it on here that childbirth is a medical procedure, no one has their appendix removed with gas and air..
I e also seen and heard women being very rude towards each other about birthing procedures particularly the nasty ‘too posh to push’ comments …..

I treated birth as a medical procedure had an epidural, episiotomy and ventouse. I refused to have anyone other than medical staff in with me. I think we as women allow ourselves to be emotionally blackmailed, cajoled and told by men how things should be, that’s without the woman on woman nasty judging that occurs.

All women should be allowed to choose what they want and need, it is a very painful process and this needs to be talked about a lot more. The whole issue around childbirth is exactly the same as women having iuds fitted or removed with no pain relief. Women’s reproductive welfare is of secondary importance in the medical sphere and we need to remember this and go in fighting.

It is not humane, normal or a badge of honour for anyone to be in significant pain for hours…. We also need to tell our young women the truth about childbirth.

I had no idea some people were not offered pain relief. Why not?? That's awful. I did get offered it (I chose not to take it both times but that was my choice totally). If you want if and can't have it that's just horrendous.

This country is barbaric when it comes to women’s health.

This pretty much sums it up!

I had dd overseas, when I came back to Uk and heard how childbirth was treated I was horrified! And grateful I didn't have her in the Uk.

Epidural is not the only pain medication safe for use in childbirth there are several, yet here in Uk there's basically only 2 offered - epidural and gas & air - and patients are heavily discouraged from even using those!

I don't believe it's truly due to higher risk outcomes - if that were true they wouldn't be widely in use in other countries

We can put people on the moon but it takes 10 years to get an endo diagnosis.

14 in my case despite textbook symptoms reported and observed

Op google "medical misogyny" "sexism in medicine"

It's a huge issue and not just in obs & gynae

Women and girls are literally dying because of:

Medical research based on the male body as "typical"

Medicine doses are calculated based on male bodies - which have different muscle mass, water content, hormones etc to female bodies

Medical textbooks all take the male patient as "typical" even though we KNOW that many medical issues present very differently in women and girls

Medical training of course follows the influence of the textbooks and research. Gps no longer even have to have obs & gynae training as a matter of course. So all hcps (and I was one) are trained on the premise that how a male body reacts to illness and injury is what we base our training on

Then there's the more overt sexism - eg I have it on my medical records that I am
"Hysterical" and "neurotic" in relation to me begging for referrals for the endo - I have been unable to get these removed

It's endemic in the medical profession, not just in Uk but pretty bad in the Uk.

Don't even get me started on the pushing of mirena coils on patients who don't want it, don't need it, and in my case for whom it's medically contraindicated (supported by letters from TWO specialist gynaecologists)

I've actually had hcps getting angry with me for refusing the mirena coil. I wasn't even sexually actively at this time. It's outrageous!

It IS barbaric!

@gogohm - you were lucky childbirth wasn't that painful for you. That's not true for everyone. It depends on so many different factors. I had an induced labour due to pre eclampsia and like you barely noticed any pain, in comparison to my endo periods it barely touched the sides! But I'm
not arrogant enough to assume that my experience extends to that of others. I had a long Labour ending in an emcs when dd got stuck in the birth canal. They had to kinda push her back in! Everyone responds differently to pain - not just psychologically but in terms of hormone and chemical response, nerve receptors etc. I have a dangerously high pain threshold which means I often don't realise I'm injured/ill until quite late on. Seems a good problem to have it really isn't! I have a chronic disability now that affects my nerves and muscles and while I'm in constant pain I am very wary of taking loads of pain meds as I fear I wouldn't notice an injury - eg a sprained wrist - and would do more harm by continuing to use eg the wrist causing more injury. I've actually had this happen in the past when I've carried on using an injured body part without realising or not noticed when I was sick because the pain I was aware of wasn't that bad. This has included serious hospitalising conditions.

I had no pain relief by choice through an almost 30 hour Labour. I hadn't intended to be a "hero" I simply wanted to "save" the pain relief until I really needed it so I'd get the best benefit. As it turned out until the section was almost definitely decided on I had nothing and then was swiftly given an epidural, very quickly after that was administered things took a very dodgy turn (baby in distress and I started crashing too) so they whipped us into surgery to get baby out ASAP so that they could appropriately treat us both for our separate conditions (turns out I have a rare condition that only presents during late labour and cannot be screened for prior)

Friends and family have had precipitous labours (when the birth is extremely fast so the body doesn't have time to adjust/prepare and often results in major tearing and bleeding), back to back labours etc which can be extremely painful - we know this not only from the reports of the women involved but from empirical data too.

Women who are very nervous/anxious, naturally tense up and that can increase pain - just as it does in other times when we are experiencing a pain.

@Hariboqueen1 some think we aren't designed as well as some claim for giving birth. It's to do with the fact that we're not really designed to be bipeds, our physiology hasn't caught up with our cognitive evolution.

Maternal mortality is still I believe higher in humans than it is in most other species

@Fifthtimelucky coils are routinely inserted without pain relief which is completely unnecessary and indeed again barbaric!

I have trouble with smear tests, every single time I tell them it starts me bleeding - a lot! And they need to go careful AND that they need to use a smaller speculum cos I have narrow hips (despite my large dress size! They seem to think the 2 are mutually exclusive!) and my cervix is angled weird. They NEVER listen and look at me as if I'm an idiotic wimp! The whole "not getting a smear cos you're embarrassed is pathetic" spiel drives me nuts! Many many women experience serious pain and bleeding with smears, then there are the many many women who are dealing with trauma associated with such a personal procedure. I went with a friend for her first smear and the nurse was an arse about it! I then took the nurse to one side and explains the REASON why I was with my friend was because she had been a rape victim less than a year prior and was extremely anxious. Then the nurse was "well she should have said something" no sympathy, no empathy or compassion. Disgusting!

@PinkPlantCase meds have come on a great deal in recent times. It's entirely possible to have pain meds that don't prevent a mother from feeling or participating in labour

@PTW1234 I had 7 emergency admittances due to endo, 4 I was unconscious - still didn't get a referral, diagnosis or correct treatment

I was told I needed an epidural during my induction, but it was me who tried to see if I could go without. All at the advice of my Mum whose births were much, much slower than mine.

But what people are trying to say is that because personal experiences vary so wildly anecdotes are essentially useless, we need detailed data to look at this. Which factors cause the complications, in isolated or combined, statistically? Which women are more likely to suffer extreme pain because of biological markers that have been identified in pain research, or their particular physiology, or the orientation of their baby etc etc. So that tailored care plans can be suggested by qualified people looking at individual risks prior to birth and a mother's informed consent can be obtained. Obviously some may choose not to follow sucj tailored plans, but most would feel much more comfortable with it I expect, if it was based on a trusted relationship with a doctor who'd made informed recommendations based on their own particular medical history and circumstances. Rather than some blanket ideological policy primarily aimed at keeping the costs of births as low as possible.