to think that birth is about having a baby rather than some transcendental spiritual experience?

[upsylazy]

The main reason I'm posting this is that a good friend of mine had her first DC 4 months ago. She went to NCT classes and I know that there are some very good NCT classes which don't overdo the natural birth thing but this one definitely DID. She listened to the class teacher and endless other women who came in to describe their labours as the most amazing experience of their life and talked a lot about the spiritual side of birth etc.The walls were all adorned of women in birthing pools at home, holding their baby with a spaced out spiritual look.

My friend was completely hooked and signed up for hypnobirthing and planned a home birth in water.

The reality, for all sorts of reasons completely beyond her control was that she ended up being blue lighted to hospital, needed a crash section under GA. The baby had to go to SCBU due to breathing problems and a suspected infection and friend had a massive PPH which required 2 blood transfusions.

Obviously, she was left traumatised by the whole experience. However, 4 months later, she still can't seem to move on at all from the experience and seems to see herself as a terrible failure which is impacting on her ability to bond with her DD as she sometimes feels that she has let her down.

Her DH is a diamond and is trying to be supportive but is starting to get frustrated as he really doesn't "get" why she is so devastated as, for him as a bystander, being told that he might lose one or both of them, in his mind (understandably) he thinks surely the fact that they;re both fine is what matters.

This isn't the first case I've seen like this and I think that these women are often given unrealistic information about birth. Of course, for some women, labour and birth are almost spiritual experiences but I think they;re quite a small minority. I'm not talking about the actual moment when you meet your baby which is fairly universally wonderful but labour itself also being wonderful.

I spoke to my nan when I was expecting DS1 about the classes I was going to and she simply couldn't believe what I was saying as, when she gave birth, the only hope women had was that they'd both come out alive - her mum died giving birth and so did one of her cousins.

I know I'm rambling here but I suppose I'm saying that maybe we should go back to seeing birth as a means to an end and having a positive birth experience as a bonus rather than an entitlement. Of course it's better to have a good birth than an awful one and I'm not saying that women shouldn't try to prepare or plan if it makes them feel empowered.

My first birth was horrendous beyond my worst nightmares but it didn't leave any great mark on me as my only hope going into it was to come out with a baby. had I psyched myself up to think that I was going to get a beautiful mystical experience, I may have found it much harder to have got over my feelings of disappointment.

For me, the reason I was traumatised after DD1's birth was nothing to do with the fact that the plan changed (planned home birth, got prem baby who was transferred to children's hospital due to infection caught on maternity wards) but the fact that I felt ignored during the birth.

There was nothing emergency about her birth, she wasn't very prem (35 weeks), the birth was actually totally normal, it was the lack of answers when I asked questions, being given diamorphine without my consent (I yelled help, the mw gave me drugs...I wasn't asking for drugs and was fine, just in transition), being flipped on to my back by two midwives when I was yelling at them not to do it etc.

I had the next two at home (yep, idealised hippy home water births, no G&A, hypnotic thing, the whole lentil weavery lot!) because I knew I would find it easier to make sure I was listened to. It worked.

"shagmundfreud, yes, it has an impact, but it doesn't guarantee it"

I have NEVER met anyone who's come anywhere near suggesting that booking a homebirth or birth at an MLU guarantees a straightforward birth.

The NCT certainly don't suggest this to be the case!

"So thanks for that"

thanks for what Snetter? You are reading something into my posts which is simply not there.

Actually I have NO IDEA what choices you made about your birth.

You definitely didn't read my posts then. Bye.
Hope your pedestal gives you a good view from up there, so you can keep on seeing only what you want to see, and ignoring things that you don't like so much.

Snetter, I've read your posts.

I still can't see what you're in a froth about.

You chose to give birth in hospital. Did you have a crash c-section with your ds? I can understand that if you only have minutes to get to theatre it is preferable to be in hospital rather than having to transfer in from home or an MLU, so it was lucky for you and your ds that you made the choices you did.

There is nothing you have said that I 'don't like', other than the sneery stuff about me being 'on a pedestal', which I only don't like because it's silly and a bit childish. Moral issues don't come into this subject. It's about doing the best we can to get through with our physical and mental health and our baby's health intact.

This is a very interesting thread OP.

My best friend and I both developed the same rare complications giving birth which resulted luckily in live babies but pretty horrific birth injuries and hospitalisation for both of us.

My friend also loved the idea of a very natural birth (so did I). She did several hypnobirthing courses and came back saying things like "our bodies are designed for this - it's an amazing experience" and "we in the West need to get back to giving birth like women in Africa".

Anyway, I didn't disagree with the idea - I too wanted a natural birth. But having wanted a baby very badly and needed intervention to get and stay pregnant, my birth plan was along the lines of "as natural as possible but what happens, happens".

I wasn't happy with my birth but my expectation was that something might well go wrong. I didn't feel a failure - I felt I did a brilliant job for both of us to survive. My friend told me afterwards that she hadn't felt that way; she didn't understand why her body had failed her and sunk into a depression for months. She missed every medical appointment for five years rather than go to a hospital again.

Luckily, my friend is now ok. She was diagnosed with PND depression linked to her birth. She herself now says that she thinks part of the issue was that she genuinely believed she would have this amazing experience and she was shocked to the core when it didn't happen. From there, everything felt "wrong".

I'm not saying the same is true or will be true of your friend, OP. I'm just saying that I recognise some of what you say. Giving birth can be amazing for some people, I've heard, but it does help to emphasise the baby being the most important thing.

(Not that I would ever say that to your friend. She just needs to know you will support her no matter what. Perhaps her feelings are nothing to do with her pre-birth expectations.) Hope she feels better soon.

" but it does help to emphasise the baby being the most important thing"

Oh for goodness sake, even those people who teach and practice hypnobirthing believe this to the very core of their being.

If having an expectation that most women can give birth without interventions, and that there are things you can do which can improve your experience of the birth contributes to a poor psychological outcome, then you'd find more PTSD and PND overall among mothers who practice hypnobirthing and among those who opt for births in a low tech setting.

Actually the opposite is true.

Whatever sort of birth you plan you need to be aware that sometimes birth goes badly wrong.

Certain hypnobirthing techniques place a great emphasis on the mother believing in her natural ability to give birth, and for the majority of women who decide to follow this practice it's a very good strategy, resulting in shorter and less complicated labours.

And all women who have difficult births resulting in PTSD or PND need sensitive care afterwards, whatever their expectations prior to the birth. So sad that many don't get it.

shagmund - I agree that hypnobirthers do believe like everybody that the baby is the most important. I was just explaining that my friend personally felt that she was going to have this incredible experience that would be beautiful and was horrifically shocked when it wasn't. Which made her feel like she had failed. I'm sure that isn't the vast majority of people's experience but the OP's story just sounded very familiar in this particular case.

Sorry but i don't agree that believing in your natural ability to give birth helps you avoid complications in any way. I agree with quite a few of the things you have said but not that.

Cansu - women who have confidence in their ability to birth their baby probably experience less fear in labour. Anxiety causes women to produce adrenalin which slows the labour down by diminishing the effect of oxytocin. A very significant number of caesarean sections are for 'failure to progress'. It's not hocus pocus - there is a clear physiological rational for encouraging women to feel confident in their ability to birth their baby. And there is a growing body of evidence that hypnotherapy techniques are linked to better clinical outcomes in labour.

I think NCT classes are very variable. My NCT teacher I had ten years ago was excellent, although the people in the class were a bit off the wall. With ds I had an epidural after 28 hours in labour (total length 33 hours). My labour experience was OK, but not magical. I had an intervention free birth and I believe that I owe this to the NCT as well as good midwives. The NCT classes helped me be active in the decision making process.

At the time I was the youngest at the age of 25. Only one person out of 8 had a completely natural birth. Only two of us (including me!) managed to breastfeed.

I think the problem many people have with the NCT is the type of women the NCT attracts rather than the NCT itself. A lot of the women are high achievers and have never experienced "failure". Many of the women I met were convinced that their high level of sucess in life was down to their hard work. Unfortunately childbirth isn't like passing a degree course. There is a random element of luck.

Tireness makes many women over senitive. For example I remember feeling livid because she told me that having no pain relief made her feel like a REAL woman. I don't believe she meant to be as tactless as a ten ton lorry.

@ShagmundFreud: I'd be happy to hear where your conclusion are based on that "the expectation that most women can give birth without interventions" is related to less PTSD and PND.

I actually did research on this topic, and we found that women who experienced childbirth as "worse than expected" have more PTSD symptoms....

From what I know, potentially empowering measures such as a birth plan, and definitely also preparation including realistic expectations, and empathetic caregivers contribute to the experience of birth. Unfortunately, in some cases, the sequence of events, complications and interventions are beyond what anyone can prepare for.
In many cases though, women who develop PTSD did not have a delivery that others (friends, family, doctors) would consider traumatic, but it IS the way they have experienced it. And that is what counts..

For those with a traumatic birth experience (incl. upsylazy's friend, so it seems) who have not tried antidepressants, counselling etc. (or with little result), or who are afraid of another pregnancy or never ever want anything else than a planned c-section -- many women have experienced very positive results with EMDR therapy. Even years after the trauma. It's a quite unconventional treatment, involving talking combined with handtapping/handwaving/clicks, but in so many cases it works! It also works quick - usually 2,3,4 sessions are enough, and therefore even doable during a next pregnancy (as for many women, that's when the memories and fear increase..). Your brain basically reprograms, so the memories don't cause such disturbing thoughts/sensations anymore. Send me a msg if anyone would like to know more :)

I think that expecting a spiritual experience during birth is fine, as long as you accept that it could be heaven, or hell!

DrMe - women who use hypnosis are encouraged to believe in the body's natural ability to give birth. And women who choose to birth outside of medical settings (at home and in free-standing MLU's) have a higher degree of confidence in their ability to birth their baby than similar women who deliberately choose to birth in a CLU in order to quickly access medical treatment, should it be needed.

There is reasonable evidence that women who give birth in non-medicalised settings have better physical and psychological outcomes. Also that women who use hypnobirthing techniques are more likely to express satisfaction with their births afterwards. I admit that this may be related to issues other than their own confidence in the likelihood of a good outcome, but I think that these things are all tied up together and are hard to separate. When it comes to psychological outcomes after birth, It's hard to know what we can attribute to one to one care (which women are more likely to get in a low tech setting), what we can attribute to the sense of empowerment that women who have birthed at home, or without pain relief (if this is their choice) may feel, and what we can attribute to the better clinical outcomes associated with out of hospital births.

Just to say, in case I've been misunderstood, I am not in any way criticising my friend or telling her that she needs to pull her self together - I'm actually really worried about her. Like I said, she seems stuck in this kind of mental block of knowing that she's lucky to be alive but still feeling awful and guilty and a failure about how things turned out. She did see a counsellor at her GP practice who basically told her that she needs to put this behind her and that she's lucky to be alive - she knows that FFS but that doesn't change the way she feels. I just don't know how to help her.

YABU. I had a very different NCT experience which helped me massively. I had the water birth/hypno music/doula all planned and it went mostly to plan. However luckily my NCT teacher had told us there is a time and a place for drugs and intervention, and when I had reached that point I knew without doubt I was doing the right thing. My body let me down (no pushing ability) and I needed forceps and pethidine. Without the NCT teacher I would have felt a massive failure.

So I don't think it's anything to do with the NCT, more to do with unrealistic TV programmes which show women on their backs screaming for 30 seconds and out pops a baby.

The length of labour for a first baby was quite an eye opener for me (71 hours from waters breaking to baby arriving).

My NCT classes were mostly fab, and we weren't told to expect a spiritual experience or anything! It was pretty realistic and there was lots of discussion of different options. In the group there were 3 'hippie' type births planned (home/water/hypno-including mine!), one epidural planned and the others were going to go with the flow on the day. What I've found interesting is that all 8 of us had something go quite dramatically wrong, and nobody's plans were stuck to. I was thankful we'd discussed birth plans changing and the necessary flexibility! I think the OP's friend's birth sounds very traumatic and would guess she'd be feeling as she does no matter what she'd planned.

Isn't it partly the case that all women (people) are different: that expectations is part of what makes an experience but not the whole of it? The degree of the experience is another factor, but again just one factor among several.

Like some people can be in scary accidents and come through without severe emotional scars and others end up traumatised? My dad is still scarred from bullying at school: from his stories, what happened to him is not at all dissimilar to what happened to me at the same age, and I can't seem to work up any emotion about it at all. Doesn't mean his feelings aren't valid, they're just different.

I think we need to be tolerant of each other and give ourselves time.

But at the same time not project what others should be feeling: I did get annoyed when my friend kept telling me I must feel so disappointed about my caesarian and should look into counselling to get over my feelings of inadequacy. I took a hard serious look inside myself and couldn't find those feelings anyway.

tbh I think she was just projecting what she would have felt if she had missed out on her lovely midwife-led unit birth with special handmade biscuits (apparently); her being an NCT teacher probably had nothing to do with it.

What she failed to take into account was that I had always known that I wouldn't have that kind of birth (health reasons) so disappointment wasn't part of the equation. Also that we are simply different people. And perhaps that I was not at a very vulnerable time of my life.

Assuming that I must be feeling traumatised was silly. But assuming that I must not, or that I must snap out of it by a certain time would be equally silly. Like telling a car crash survivor that it was silly of them to break a leg when somebody else in the same circumstances last year only sprained their big toe.

@Upsylazy As many have said already, so kind of the obvious, best you can do is be there for your friend, and same goes for hubby - but I understand it's difficult sometimes, as you might find it difficult to find a way to help considering your different expectations, and the husband just has a totally different outlook (more focussed on the outcome). The counsellor at the GP practice obviously didnt help....

As for practical and professional help: I think the first question to answer would be if your friend has serious signs of a postpartum mental disorder. From the information you provide, she may suffer from PTSD or PND. But it could just as well be that this is not the case, and it's mainly her 'broken expectations' that are causing the problems she has. In that case some so-called psychoeducation with a or her midwife, i.e. reviewing birth notes, going over the sequence of events that occurred, caregivers acknowledging that she's not a failure and that her expectations weren't realistic or at least not the way things usually go (based on statistics) may be enough..

As for PTSD and PND, there's some "home tests" she can do, based on which she can decide to seek further professional help or not (and find the right professional for that).
** For PND, the easiest thing to do is to complete the EPDS (Edinburgh Postnatal Depression Scale), which is available here: fcmc.weebly.com/uploads/3/4/8/9/3489838/edinburghscale.pdf (including scoring instructions). A combination of anti-depressions and therapy (from someone with PND experience - the GP counsellor obviously didnt get it) is most effective.
** For PTSD, I don't have a link to a questionnaire, but much info can be found here: www.birthtraumaassociation.org.uk/what_is_trauma.htm . The full list of PTSD symptoms can be found here: www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp
For PTSD, I would recommend EMDR therapy. It's a quite unconventional treatment, involving talking combined with handtapping/handwaving/clicks, but in so many cases it works! It also works quick - usually 2,3,4 sessions are enough. There's ample evidence of the positive effects in people with trauma other then after birth, and research is ongoing with postpartum women. A list of therapists in the UK can be found here: www.emdrassociation.org.uk/home/index.htm . If you think some personal stories rather than "research" or "statistics" could help your friend in deciding is this is her think, I could send you can article I published with some personal birth stories of women, who then tried EMDR and have seem most symptoms disappear...
Take care and good luck!

upsy I can understand that you're baffled by your friend's response to her birth.

Honestly, you need to educate yourself about PTSD. The thoughts she's having, about how her birth wasn't the way it was meant to be and that's why she feels bad, are probably a justification she's created for the intense physical response she's having right now. Trauma does crazy things to one's body and neurochemistry.

She might be telling herself "i'm feeling this way because I'm so disappointed", but in fact, her body is just processing the trauma of the experience in and of itself.

Support her. Don't tell her she should feel different. She can't control her body's response, which means she can't talk herself out of her thoughts right now... it's not about reason/logic/realising she is actually lucky, it's about getting through the sensations atm. Give her a lot of time and lots of hugs.

Hmm. I think that yes, the whale music whatever stuff is overhyped and that actually 'natural birth' is not as great as people make out unless they are very, very lucky, but otoh, you know, we can put men on the moon and fix men who can't get an erection, so actually coming out of birth without huge genital trauma is really not that much to expect in this day and age if only research was done rather than dismissing womens' birth and post-birth experiences. So I don't think it's just about getting a baby- a baby is the main point of it, sure, but also not ending up permanently disabled by SPD or nerve damage or huge perineal scarring is something which is an entitlement and should be given far more attention by the medical profession (who are dismissive of such things as psychological or 'female problems').

Very few women want transcendental spiritual experiences, but plan for natural births where their hormones work optimally to give them the safest birth for both them and baby with least interference that can affect bonding and bfing.

The disappointment in not getting that is perfectly rational imo, although not being disappointed is perfectly valid too.

If there was no natural birth movement that questioned medical practice that was based on convenience rather than the woman or baby's best interests then we'd still all be shaved, strapped to a bed and drugged to the eyeballs with the doctors controlling our bowels.

Knew I wanted a HB but "wasn't allowed" as I have asthma. I believed the lying cunt that told me that, because I was incredibly naive and believed that HCP would provide the best, evidence based option. I now know that is not the case

Yes, I felt like this too. When pregnant with my first child my suggestion I may want to try a home birth was basically laughed out of the room my my midwife at the doctors surgery, even though there were no complications and both me and baby were in perfect health. I was terrified of hospitals due to a childhood trauma. She wasn't even very happy with me saying I'd like a water birth - she just replied "well you can go in the bath on the ward but not have the baby in it!" ggggggrrrrr.

I had two wonderful births, lovely healthy babies and very quick pain free recoveries for me. Absolutely perfect for me. They were both ELCS on maternal request and I couldn't be happier with my experiences.
However

Antental classes both NCT & NHS concentrated far too much on a perfect VB (but then again thats what most people want) and neglected to mention the complications that can arise (my NCT teacher thought you couldn't move without a pillow clutched to your tummy or walk upstairs afte CS (scare tactics) ) - plus she didn't think any of us needed to know about CS as it wasn't likely to hapen (3 out of 8 had one -admittedly mine was elective but the others weren't) and the possibe trauma a mother can face hich I think is totally irresponsible.