To not get why a vaginal birth is so important to some people?

[Liketochat1]

Some mothers talk of the trauma and disappointment of not giving birth vaginally. Some say they don't feel like a proper woman or that their body failed them. For many this sounds very traumatic, for others moaning.
AIBU to not 'get' why this is so important to them? I've had 2 c sections and was only intensely grateful that I live in a country and in an age where there are gifted surgeons and resources available to perform these life saving operations. In other parts of the world women are dying in childbirth as they don't have access to these.
Am I so unreasonable to think this?

Shag, best practice is NOT getting through. Evidence-coat it all you want, but I do not want to risk a natural birth under NHS conditions. And I don't want to have a home birth either.

Even the best hospital with the 'best' (low in your terms) rates of cs can have a day where it is so busy there isn't enough staff to provide the care you want.

THe NHS does medicalised births relatively well compared to natural birth. For an elective, they have to have a fully staffed theatre. My midwife for the elective was fantastic too. Much better than the one I got when trying to labour under natural birth conditions.

CS is the best outcome for me on the hierarchy in that it achieved the best physical and emotional outcome for me and my dcs. I am thinking logically and based on the current state of the maternity units in the UK.

'Waterbirth is linked to high rates of maternal satisfaction and lower rates of complications.

As is homebirth.

As is doula care.

As are hypnosis techniques.

You can be as cynical as you like, but the evidence is there. In fact some of it has been incorporated into the NICE guidance on best practice in maternity care!'

Which is exactly why many women, myself included, feel disappointed and/or inadequate if, for whatever reason, we end up having a CS. Because we get this kind of thing quoted at us, continually before we give birth and on threads like this afterwards!

Like someone upthread, it was the horrible and lengthy recovery period after DD1's emergency cs that made me feel less of a mother initially. I was on my own and it was painful and difficult to do a lot of things, especially getting in and out of bed. I had a rope on the back of the door to help me sit up in bed and I remember crying profusely one night in huge pain as I attempted to sit up to attend to my howling baby, absolutely convinced that it was not like this for most women.

I still suspect it isn't like that for many women, but I can now see we were both healthy and that was by far the main thing,. However, I desperately didn't want the same with DD2 and was incredibly happy when she was a quick and easy vaginal birth. I couldn't believe it when the midwife invited me to get up and have a shower afterwards and it didn't hurt to move.

i wish people wouldn't say the first days with a baby aren't important.
maybe not important to them.

they can be incredibly joyful or intensely miserable for some.

saying 'it doesn't matter' doesn't help those who found it miserable, it is dismissive of their experience too.

YANBU and I sort of think like you op. However, after my second emcs, I felt slightly inadequate as a woman (I was feeling a bit low a the time).
I feel that there is a fair amount of "what is natural is best" and "the body was designed for childbirth" and if, for some reason, you didn't follow this natural ideal, I can understand you might feel like a bit of a failure, especially if you were desperate to give birth naturally or/and ff.

so missM do you want people not to advocate for better perinatal care?

i don't see how that helps anyone.

OP, I can see your point of view that c-sections are often life-saving, so in that respect YANBU.

However, if you can't understand why they are so important to some people, then YAB a little U.

Vaginal birth is, literally, a rite of passage. The original rite of passage.

'Which is exactly why many women, myself included, feel disappointed and/or inadequate if, for whatever reason, we end up having a CS. Because we get this kind of thing quoted at us, continually before we give birth and on threads like this afterwards! '

So we shouldn't promote natural births now, just in case people are disappointed? How silly.

'so missM do you want people not to advocate for better perinatal care?'

Eh? That's not what I was saying at all! The OP asked why some people feel disappointed in not having a vaginal birth, and I was suggesting why. If you're told all these (correct) things before you have your baby (and especially your first, when lots of people are convinced that it will all go exactly as they plan it), then when it doesn't happen you can feel inadequate. Obviously women should give birth vaginally if they can, that's not what the OP was about!

"Which is exactly why many women, myself included, feel disappointed and/or inadequate if, for whatever reason, we end up having a CS. Because we get this kind of thing quoted at us, continually before we give birth and on threads like this afterwards!"

In what way to these facts make you feel inadequate?

I had an epidural followed by a forceps birth following my very long first labour with a posterior baby. If I'd been offered the same care as at my homebirth with my third baby (also back to back, very long labour) I think I would have stood a very good chance of an unassisted birth. I don't feel inadequate that I didn't get it. I feel cross that I wasn't offered the help that I got (paid for - private midwife) that enabled me to have a normal birth with my third baby, despite all the things working against me (diabetes, suspected high birth weight, malpositioned baby, maternal age, previous shoulder dystocia, cerclage).

Why do you insist on judging yourself, instead of judging the system in which you gave birth?

And if you made the best choices you could at the time, and the care you got was great, then why does hearing that waterbirth or homebirth is linked to lower rates of c/s a problem?

"THe NHS does medicalised births relatively well compared to natural birth. For an elective, they have to have a fully staffed theatre. My midwife for the elective was fantastic too. Much better than the one I got when trying to labour under natural birth conditions."

I think you have a good argument here. Why risk an under-resourced natural birth that may end in theatre in an emergency c/s when you can have a fully resourced planned c/s?

Yup - I have sympathy with this argument. And I paid for my own midwifery care with my second and third baby to circumvent the problem of poor staffing on maternity units.

"CS is the best outcome for me on the hierarchy in that it achieved the best physical and emotional outcome for me and my dcs. I am thinking logically and based on the current state of the maternity units in the UK."

With respect, you will never actually know this for sure. Some women do go through labour and emerge in absolutely brilliant physical condition, with no or minimal scarring or damage to the perineum. I know a good number of people who have experienced these types of birth. No antibiotics. No scars. There is no doubt that a straightforward vaginal birth resulting in minimal tearing is, in retrospect, a safer option than submitting to major surgery. However, it's reasonable to take a gamble on this, particularly if the other option is birth in a CLU where large numbers of women are having emergency surgery.

MissM - would you prefer then that no one was told about things that can help during labour? Just so other people don't feel bad when they don't work for them.

I didn't get the homebirth planned with DC1 - I was dehydrated and ketotic and tired due to long labour as he was B2B so we went into hospital. I was disappointed, I'm sure it impacted on bonding and I had a real fight to 'allowed' birth upright. We were healthy, yes, but I was still disappointed not to have a homebirth. DC1&2 were born at home and it was a far better experience for me - calm (despite crazy quick labours)and peaceful no bonding problems and no unwanted visitors the next day.
I feel disappointed that I didn't get a homebirth, I wish we'd bonded more quickly but I don't feel guilty about going to hospital as it was medically the safest option at that point likewise if I'd had to have a cs I wouldn't have felt guilty or inadequate because it would have been the best option at the time.

Hmm - think my figures were a bit off. Hard to research during night feed. I shall check my source (DH) later. My point was really that we are doing ourselves a disservice as women with all this competitiveness about births. That's what it is at the end of the day. Shagmund you are right we need excellent maternity services to support all births and everyone should get a chance at the birth they want. No one should really (as was said up thread) be planning on a medicalised birth as they don't feel the nhs can provide the natural birth they want. The state of some units is a scandal.

But I do feel we need to question the myth that if you have a c section you are stupid, lazy, less of a mother, didn't try. Sounds extreme but it's there explicitly and implicitly in the discourse about birth. This is my concern and it's a criticism levelled at women by women which is worst of all.

Birth is hard, it can get complicated, let's be kinder to ourselves. Perhaps the reason people with doulas and homebirths have better psychological outcomes is because they are meeting these percived 'standards.' so we can either all have a home birth (not safe or wanted by all) or challenge the thinking around this so that we are not holding up an unattainable standard.

I'm not surprised those who have emergency life or death surgery during birth later rate thier experience less favourably than those who don't. But please let's not add insult to injury in perpetuating the idea that these births are not good enough.

But I do feel we need to question the myth that if you have a c section you are stupid, lazy, less of a mother, didn't try. Sounds extreme but it's there explicitly and implicitly in the discourse about birth. This is my concern and it's a criticism levelled at women by women which is worst of all.

I'm interested in where this comes from - it's not something I've ever heard expressed by anyone and it was never something that was even implied in the ante-natal classes I went to (although the MWs running it told to always always question 'why?' something was necessary and were very into upright active birth if possible )

I think perhaps we picture in our heads what birth will be like, then when it doesn't happen that way there is room for disappointment. I have had one natural delivery and three c/sections, but have been at lots of births as I work as a doula. The main thing to remember is that if you feel traumatised by what has happened during childbirth, it will and does affect you and gets repeated time and again as that 'birth story' is told. Acceptance is great, letting it out if you are traumatised is also great, and hopefully having a warm healthy baby to love and look after is fantastic.

Me too librarians

'MissM - would you prefer then that no one was told about things that can help during labour? Just so other people don't feel bad when they don't work for them. '

Nope, not saying that at all. Thought I was answering the OP's question but clearly it's being interpreted as me asking for no advice or guidance on giving birth whatsoever.

'Why do you insist on judging yourself, instead of judging the system in which you gave birth?'

Perhaps that's just the kinda gal I am, Shagmund, whatever, but you don't actually know me, so making that kind of comment which to me sounds fairly aggressive, isn't really helpful.

i won't be coming back to this thread so you can say what you like now. Blimey, I thought I'd made a fairly innocuous comment! What must it be like when people say something inflammatory on here?

"I'm interested in where this comes from - it's not something I've ever heard expressed by anyone and it was never something that was even implied in the ante-natal classes I went to"

I agree. I have never heard anyone express these views either in real life.

I think you see in the discourse what you want to see.

For me there overwhelming consensus seems to be that birth is very dangerous, labour pretty much unbearable without drugs for all but the lucky few and that women are lucky to get through with their lives intact, let alone their perineum.

"Birth is hard, it can get complicated, let's be kinder to ourselves".

Or maybe we could switch our attention to our system of maternity care, and start criticizing that for failing to support so many women to have an optimally healthy birth, rather than focusing on the choices and behaviour of individual mothers.

"Perhaps the reason people with doulas and homebirths have better psychological outcomes is because they are meeting these percived 'standards.' so we can either all have a home birth (not safe or wanted by all) or challenge the thinking around this so that we are not holding up an unattainable standard."

I don't get this thinking. Women having homebirths and doula led births are less likely to need emergency surgery and more likely to come out of the birth in good physical health than similar women birthing in CLU's. I would suggest that the reason these women feel happier about their births is because they experience less stress and better care in labour, not because they're striving for any sort of 'ideal'. And actually women who have doula care or opt for a homebirth who don't get one (myself included - I had to transfer in to hospital after my second labour at home failed to progress) are often STILL very happy with the outcome because they feel that everything was done to maximise their chance of a normal birth (even if in the end it didn't happen).

Personally I think we need to be very straight with women. To say - if having a normal birth is important to you, then it's a good idea to do as many of the following as you can as this will maximise your chances of achieving this.

And then go through the list of evidence based choices associated with lowest rates of intervention in labour.

And of course tell them what the intervention rates are for women of their age/health status.

I think it's wicked to encourage women to want a natural birth, tell them it's achievable, and then throw them to the wolves by packing them off to a massive, understaffed CLU especially if they're going to be induced when they get there

Really cruel.

I think 70 years ago when maternal mortality was still around 5% women giving birth wouldn't be angsting over how they gave birth as long as they and the baby were fine. It shows how far removed we are from this that birth is seen for some as 'an experience' and people get upset if they don't get the 'experience' they want. Personally I think every safe birth is something to be appreciated in it's own right no matter how it happened.
I ended up with an emergency forceps as DS got into trouble very quickly and it could easily have been a cs- I didn't care as long as he was out in the 10 minutes time limit. However as I was being stitched up the doctor kept telling me that I could've pushed him out myself. I said I didn't give a toss as long as he was safe and she agreed. When I thought about it afterwards what I felt she was saying was he'd come out my fanny but maybe I might have thought I'd failed as I hadn't pushed him out myself. Mad really. Maybe some people might think that but to me birth is still risky and I was relieved we'd got through it when it could've gone really badly wrong.
It's the same with epidurals- I know 3 people who didn't tell me they'd had an epidural because somehow having one means you didn't do 'it' properly. I can see how people are made to feel like they are somehow a failure but it's a load of old bollocks.

I've seen women scared and left alone, not told what is happening and freaking out because of it. In fact I've experienced this myself. Research suggests that a woman who feels informed and supported during labour will progress quicker and have much more chance of a normal vaginal delivery. Having said that things can change in the blink of an eye and intervention has to be swift quite often. This again leaves mums scared and anxious, which is a feeling that can persist into the post natal period. No two births are the same, and nothing is predictable as I'm sure everybody on here knows. I agree that knowledge is power, and support in labour is vital. Get a good birth partner, one who can run fast if need be, to run to theatre if that's where you end up. Post traumatic stress is common after a bad experience in childbirth and should be attended to via talking, perhaps to a counsellor or good friend. There is no room for beating yourself with the guilty stick if it doesn't go to plan and many c/sections that I've witnessed have been a close call for mum or baby and that's why it's been done. Hospitals aren't quite as keen to give surgery as people may think, so unless you are paying privately for a planned c/section by choice, there will be a damn good reason that you have had one.

I did everything I was 'supposed' to. It did not stop me becoming pre-eclamptic and having to be watched constantly in case I started fitting.

Now THERE'S a condition completely belittled by others.

YANBU I don't get it either. The same with the whole breastfeeding malarky, I just don't get why it is such a tragedy to some people to have to use the dreaded rat poison formula.

People are obsessed with the word "natural" because apparently everything natural is pure and untainted. I hated being lectured about breastfeeding by midwives and earth mothers. My philosophy is do whatever feels best but don't go on about it and don't tell other people what to do. Each to their own.

I actually think that everyone on this thread is basically agreeing on the big stuff, ie women should be able to make the choice that's right for them without feeling judged for it (whatever choice that is).

I am pretty surprised at the people who say they've never come across the "birth fascist" attitude before. Not that I disbelieve you, just surprised.

The embedded attitudes have flavoured posts on this very thread! People have talked about VB being "a rite of passage", "the way your body's meant to work", "better for the baby" (questionable), "better for establishing breastfeeding" (particularly difficult to hear for those who had an EMCS and also struggled with breastfeeding!) among many other things.

All this means people who had CS, especially an unplanned one, can very easily read "you are not a real woman as you missed the rite of passage", "your body doesn't work as it's meant to", therefore "you've jeopardised your baby's health, and your chances of successful breastfeeding."

I don't think it's seeing what you want to see.

For what it's worth, after my 72hour drug free labour and EMCS (failure to progress, back to back, head thrown back), one of DH's mates thought it was funny to say "too posh to push" and another friend, after having her first DC in 2 hours, told me rather smugly that it was because she'd done Pilates during pregnancy. (So if she can take credit for her good birth, that must mean I have to take the blame for my horrible birth!) Even my dear sister in law said "I knew you would struggle to give birth!" (Thanks for that!)

Felt like shit for ages, but nearly 3 years on, I sooooo don't care anymore! Even considering elective for DC2 in April.

Shagmund: "Personally I think we need to be very straight with women. To say - if having a normal birth is important to you, then it's a good idea to do as many of the following as you can as this will maximise your chances of achieving this."

I have no problems with this provided that the risks to mother and baby and the likelihood of a vaginal birth going wrong are also disclosed to women so they can make an informed choice in the light of shockingly low level of maternity provision on the NHS curently.

We all know the risks of cs too well, but somehow as women we are supposed to know and take on the risk of a vaginal birth going wrong as if it were our lot in life. Medical and birth professionals are notably cavalier about informing women of the risk of a botched vb. In many instances, they don't say anything at all. I have to rely on anecdotal accounts from other people and the horrific things I read on mn to inform myself. Not the best way to find out but then again, where else am I supposed to find out if medical professionals don't tell us?

Before I was allowed to opt for a cs, I had to see senior midwives who were there to present to me the risks of choosing an elective section. They had the stats and risks for cs, but funnily enough did not say anything about the risks of vb. Even on questioning, they made up some laughably low statistic on vb that proceeded to instrumental deliveries to 3rd/4th degree tears 'from their experience' which made me lose all respect for them immediately. I smiled and told them it was cs for me.

"It shows how far removed we are from this that birth is seen for some as 'an experience' and people get upset if they don't get the 'experience' they want."

But poozlepants this makes it sound like some kind of foot-stamping spoiled brat "I didn't get what I wanted" "It's all about me having a great 'experience" type of thing.

Whereas birth trauma, and the psychology surrounding birth, are nowhere near as trivial as that...

THAT demeans women's feelings and belittles the impact of an event which is hugely important to all women, however it happens.

I, for example, feel massively judged by comments like that. Because my first birth experience did lead to severe trauma and depression. Which I don't think was due to me being a spoiled brat and throwing my toys because I didn't "get the experience I wanted*...

db
xx

I don't think I actually disagree with a lot of your points shagmund (re maternity staffing, right to choose). I am simply suggesting we beware of perpetuating an unquestioning myth that natural birth = good interventionist birth and think about the impact this has on new mothers. If you haven't been exposed to this narrative may I suggest you re read this thread.