Why does it seem everyone has a bad birth these days?

[Littleigloo]

Just doing my research (but I have a while to inform myself as we are only trying, at the moment). Out of all my friends and family who have had babies in the last 5-10 years, I would say all bar one or two of them had difficult births to the extent. Two needed debriefs and counselling. Inductions that fail and needed forceps, baby was injured as a result. I don’t know if this is just an unfortunate group of people or indicative of a larger sample. All different ages, some first and some second pregnancy, most of them were low risk.

This coupled with hearing that maternity services are struggling with poor staff and low ratings. How do you mitigate any risk to yourself? I understand it’s very much a how long is a piece of string situation and highly dependent on lots of variables but is it as bad as it seems or do the people with bad experiences just talk about it more?

Thanks

You can probably Google it but I think the stats are something like a 0.1% risk at 37 weeks that rises to a 5% risk of stillbirth by two weeks overdue.

I spoke to a pregnant women at a postnatal appt in the queue who very proudly told me how she refused induction for weeks with her last DC after going overdue.

Her baby had to be monitored every single day and the consultant met with her every day to try and convince her to induce. In the end the hospital forced her to induce as they said it was too risky for the baby to wait any longer. She was absolutely furious.

I just watched her open mouthed after knowing someone who had done something similar and their baby died.

It's mad to me that women would willingly up the stillbirth risks to their baby in order to not have an induction. I guess people just think it won't happen to them

@fourlambbhunas Most definitely. I've suffered with chronic anxiety my entire adult life. When I was in hospital with my first I was induced, and my anxiety due to all of the monitoring because so heightened there was major concerns because my heart rate was through the roof, and in turn that caused my baby's heart rate to become dangerously high. With my second my anxiety was marginally better as I went into labour naturally, but it was still very much a part of the whole process and again caused issues with both myself and baby.
Home birth was just a totally different experience. Of course my anxiety was still there, but definitely nowhere near as much as with my previous labours. Even 10 years on from previous labour and almost 40! I felt listened to, not pressured into checks or medical procedures, and incredibly well supported by two 1-1 midwives. Labour was my longest one yet, but it was by far the most positive experience. Both for myself and for my husband (his first and only baby!) It's had a huge positive impact on my life in general terns, too.

It's 3 in 3000 at 42 weeks (0.1%) so nowhere near 5% (vs 1 in 3000 at 37 weeks). Both tiny numbers, of course it would be huge not tiny if it happened to anyone.

Let's not derail the thread here though, this is a different discussion of benefits vs risks of IOL. Much could be said here either way

It’s approx 0.1% at 37-38 weeks, rising to 0.2% at 39-40 weeks and 0.4% at 42-43 weeks.

So less than a 10th of the 5% you mentioned..

I'm not having any more, but I would refuse to be induced if I was to go over again (induced at 42 weeks with my first). Even after two weeks. I'd opt for additional scans and make my decision from there.

I agree.

I accepted an induction the minute it was offered to me though so I'm the very opposite of those women.

Personally, because the expectations to have a smooth experience is so high, that anything that doesn't follow the script makes it a bad experience. Childbirth is messy, and bloody and stressful. Having strict birth plans of whale music, no interventions and choirs singing whilst you quietly push is unlikely to happen. I think that the expectations and demands women put on themselves and the process have a lot to answer for. My plan was to have a baby, however that happened, I wanted her (and me) to be safe and come home. That was as far as a 'plan' developed.

I had an elective c section for this reason

Most people I know who had straightforward births had their first child in their mid to late 20s. In my circle that's fairly unusual and most were in their early thirties to early 40s and most had some kind of problems - lots of emergency c sections, significant bleeding, severe tears. People are also generally unfit, many people drive everywhere instead of walking for example.
Also it used to be a taboo subject and now people talk about it. I think that's the main reasons

The average UK woman now has her first baby in her thirties. That’s historically unprecedented. (My mother’s generation average new mother was age 24.) We’re physically built to do this around age 20. Doing it at age 35 instead has pretty serious medical implications for both the mother and child. But it’s convenient for society that women work for a decade or two before having children so we don’t talk about that…

Also, babies are getting bigger, because of better nutrition and also the fact that the large-headed babies who would previously have died during the birth instead are saved by caesarean and grow up to have more large-headed babies of their own.

Plus there is now so much widespread ignorance about how to prevent problems arising during labour. To give birth naturally the mother needs to feel safe and relaxed and ideally in a dimly lit private place, but hospitals rarely create that atmosphere. The difference between a calm safe delivery and a hideous life-threatening situation can begin with very small things going wrong like harsh lighting, loud shouty background noises and constantly changing staff coming to check on the “lack of progress”.

There’s also pressure on the midwife to deliver the baby asap or get the mother into surgery. I chose to have my baby at home. Active labour took three hours because my baby was big. In a hospital they’d have referred me for an emergency caesarean after the first hour. But I got DD out eventually, no drugs or intervention needed and we were both fine. In hospital my peaceful ‘good birth’ would have swiftly been managed into a ‘bad birth’ and then I’d have been traumatised and have found it harder to bond, etc etc.

Perhaps some of these babies and mothers would have died 30 years ago? Or conversely maybe standards of maternity care now being abysmal causes a lot of problems..I'm sure it does, and it causes the perception of a bad experience even if the outcome was the same, with good care the mother would feel more positive about the experience

@Naptrappedmummy but if the inductions aren’t actually improving the stats at scale then what is the benefit? Unnecessary inductions are being handed out and it is impacting women’s birth experiences negatively and introducing other risks.

One wonders whether the good outcomes from home births are partly due to having the undivided attention of 2 midwives. In hospital you're lucky to have one and even then it will probably change to a different one during labour

I do think a birth plan is important - there is a middle ground between a strict unwavering birth plan and no plan at all.
I had non negotiables on mine, e.g. no matter the birth I had I wanted immediate skin to skin. I listed the types of pain relief I would consider (for me epidural but not pethidine). I said I wanted to be able to be mobile, so for example if monitoring was required it should use a longer wire.

I had no plans to have a c section but written in my birth plan was what I wanted to happen if I had to have one.

Writing the birth plan educates you about what is available to you, pros and cons of various options and also allows you to think about your preferences. It's good to discuss with your partner too. It means that if you are offered something in Labour you have already done your research on if you think it's right for you, and your birth partner also understands your reasoning. It doesn't mean you have to religiously stick to it nor that you have failed if you don't, but the act of writing a birth plan educates you.

Birth is a huge huge event and it's best to arm yourself with as much information as possible.

Yep same here for me, except my active labours were 3 hours and 16 minutes/36 minutes.

I think a third child will just zoom out like on Mario cart 😂

Avoiding stillborn babies is the main risk they are wanting to avoid. That does mean that for every baby death averted a lot of women have unfavourable birth experiences. Is it worth it? I don't know. I had an induction and it ended in a severe tear that affects me every day, years later. But I would 100000000 times rather that than my baby have died or been left disabled. I also don't know if I might have had the tear anyway.

I think it helps to just accept that childbirth comes with risk and for a good proportion of women your body will not be the same again. It;s the unrealistic expectation that makes it psychologically more difficult to deal with

I think it's only important if you have strong preferences. My only strong preferences were an epidural ASAP and that I wouldn't be breastfeeding and didn't want to be asked about it again at birth, other than that I was happy to go with the flow and largely follow the advice of medical professionals.

I agree. I wasn’t the slightest bit interested in a birthing plan.

It may have suited me that I had my DC during the covid period as I really wasn’t wanting any fuss.

I literally got sent a letter with the date for my C-section and turned up at the hospital the same as you would for a dental appointment. No discussions about what would happen or anything. I watched a YouTube video of a C-section out of interest but that was about it.

The only crap part about my pregnancy being during Covid was that my partner wasn’t allowed to attend any of my appointments. We did book some private scans so he could feel a bit more involved but the NHS wouldn’t even let him in the building when I had appointments with them.

He wasn’t there when I was told I was having a boy which was a shame as we had both hoped for a boy so would have been nice to share the moment together.

@ShoePalaver I think the dedicated care of two midwives to just the one person is definitely a huge advantage of home birth, you're right.
I also got full continuity of care both ante-and post-natally which was great. It meant that I really got to know my midwife and vice versa. I felt confident to put my trust in her when I was in labour because I'd got to know her.
It was even more significant for me also I think because this was at the height of Covid, May 2020.

I'm having an elective c-section this time and I'm looking forward to the fact that we'll know the date and I'll be going in knowing roughly what to expect.

It feels similar to my induction, it made me feel calm and relaxed having a date and just having to turn up at the time I was asked.

This. I also had a wonderful home-birth, much thanks to my skilled midwife!

I had 'good' births, a number of my friends had 'good' births, inc some twins. Common factors: for the most part these births were in women who were fit, healthy, not very overweight, and between the ages of 18 and 30 or sometimes a bit older if a 2nd or subsequent baby. High levels of antenatal and general education in both the women and birth partners meaning they were more likely to speak up and to be truly heard (it shouldn't be this way). And most of the births were between during the 90s and 00s when practices had been getting better for a while, and staffing levels and moral were quite good. That's not to say there have been no traumatic experiences amongst us, nor can everything be explained by the above, sometimes things just go wrong even in young women with low risk pregnancies. But all the higher risks in increasing numbers, plus stretched services, plus this problem of not listening to women, which seems to be going backwards(!!), has a lot to answer for, plus what others have said.

I was lucky, I had 3 easy births out of 4. Number 3 was my difficult one, but it was still straight forward with no intervention. He was a big baby and it was a painful induction but I got there. The others were lovely births 🙏

Had one easy no intervention birth (not in this country) and one traumatic (U.K.). Latter due to no continuity of care and bullying incompetent midwife. Perinatal maternal deaths are rising in this country. It is not just people are more aware. Women are treated appallingly

My sister has 5 kids. 4 births, as one was twins.

First was difficult. Second was extremely fast and she had him 20 minutes after arriving at hospital. Third was so fast they examined her and said she was in early stages and would be 12 hours plus. 30 minutes later she wanted to push. Was told no. She looked at her husband, he decided to check and found baby crowning.

Twins were elective caesarean and she bled loads and needed a transfusion.

All in all she thinks all were positive as she was very well cared for.