Free Birth

[Weathergames]

Am watching the programme on the BBC about Childbirth All or Nothing.

I had two of my kids at home which everyone at the time thought was a bit "out there".

AIBU to think "Free Birth" with planned no medical intervention or medical professional present is maybe a risk too far and possibly not fair on the baby should it need medical intervention?

I am prepared to be told IABU.

"What worries me is that certainly from what I've heard, some unassisted birthers don't go so much for the proper antenatal care either"

Some women avoid all contact with hospitals and medical professionals because of mental health issues. This group tend to have really poor outcomes for their pregnancies. :-(

It's good antenatal care that has had the biggest impact on maternal deaths and pregnancy outcomes over the past century. The biggest fall in maternal deaths in the 20th century came with the introduction of antibiotics, but also with the introduction of the NHS, so that poor women could have antenatal care. Amazing that something so cheap and low tech - access to midwives with a pinards, a tape-measure, and a device to measure blood pressure could have had such a huge historical impact on maternal health.

America is just so loony about maternity care. It's such a polarised system. There is craziness at both ends of the spectrum....

leedy, I think that's the bigger issue for me.

Its one thing to hurtle into a free-birth being assessed as low risk. Its another to go into it either being high risk and ignoring that or simply having no idea of whether you are high or low risk.

I think that encouraging women to at least have ante-natal care is hugely important. That care needs to be none judgemental and the woman needs to feel like she is not pressured and can change her mind if she chooses.

I went down the other route because of extreme anxiety, but I had a massive distrust of my wishes being disrespected and had a massive distrust of medic (which sounds ironic if you want an ELCS, but its about being as in control as you can be).

There are actually a lot of parallels between the two and lots of similarities in how you should treat women in both situations. Basically it comes down to opening channels of communication, rebuilding trust and disproving the woman's negative expectations. I don't think its always possible to do that through counselling since actions speak louder than words and its very difficult to do within the timeframe of pregnancy.

Done well, I think you can change how women feel, but if the attitude is 'your choice is wrong and dangerous' you don't even start that engagement so the opportunity to do that is lost.

leedy - were you referring to the-toast.net/2014/11/04/unassisted-childbirth/

"But who is saying there is only one 'right' way to give birth?"

Quite a lot of people, either explicitly or implied. Pro-"natural birth" people do talk about how it is "empowering" (ie other ways are "disempowering"), "pro-woman", the gold standard to aim for, and women do feel like they've "failed" if they end up having interventions.

And of course on the other side, you get a lot of talk about how a hospital based model is "safe", "responsible", anything else is "how could you live with yourself if something happened", etc.

"I'm really not sure who you're addressing this comment to or why you're making this analogy. Are you assuming that because I found my homebirth empowering I also think people shouldn't take medication when they're ill? I don't get it?"

I think it's a reasonably apposite analogy, actually - obviously I'm not saying that you personally have those feelings about medication, but telling someone who had a medicalized birth about how empowered you felt by having a non-medicalized birth can sound awfully similar to telling someone who had medicalized depression treatment about how amazingly empowered you felt about having dealt with it without medication. Not saying you shouldn't feel this way but it can suggest to people who did otherwise that they did it "wrong".

"And?"

I planned a non-medicalized birth, I didn't get one, I got over it. But I'm not sure how I'd have felt if I'd been dead set on having a particular "birth experience".

hyperspacebug, yup, that was the one. Terrifying.

i think the empowered disempowered thing is personal opinion. I think the woman who had the portland caesar did everything in a way I couldnt bear. She seemed fine with it, and i do think elective caesarians are fine and valid. I just cant understand why anyone would.
The freebirth was also valid to me, and idyllic. I remember how much I craved one. I really had to be strict with myself

I have now seen this programme and like everyone I come with my own preconceptions based on my own experiences.

I agree that they set out to pander to stereotypes, but in the end I didn't think C-section woman was that bad. She seemed much more able to say 'this is what I want but I completely understand that others want a different experience' than the others.

Generally I'm quite sandal wearing, but I do find that whole 'yes because I worked really hard at reading my mantras, I had a great birth' thing gets so on my wick. C-section at least had some sort of understanding of others.

Like Leedy, I wanted a non-medicalised birth but didn't get one. It's a bit shrugs until someone suggests that maybe I just didn't try hard enough.

"Quite a lot of people, either explicitly or implied. Pro-"natural birth" people do talk about how it is "empowering" (ie other ways are "disempowering"), "pro-woman", the gold standard to aim for, and women do feel like they've "failed" if they end up having interventions."

Who are the 'natural birth people'? Are you referring to a specific book? Blog entry?

"but I do find that whole 'yes because I worked really hard at reading my mantras, I had a great birth' thing gets so on my wick"

So you don't think that there is anything any of us can do to improve our experience of childbirth? There's no sort of preparation, or mind-set or anything really that will make us feel better about labour during or after we experience it?

it wasnt the caesarian itself that i thought made her seem disempowered. She just seemed like a complete add on to her husbands life, and everything had to fit in. The section just seemed to fit in with that. Asking if shed be fit to fly to america 10 days post section etc. She obviously gets something out of it, but it all seemed very oppressive to me.

The whole lotus birth thing seemed much more "out there" than the freebirth, yet she didnt seem to have a particularly hippy appearance or lifestyle, so less easy to stereotype i guess

Interesting study: here

"A prospective study of 825 women booked for delivery in six hospitals in southeastern England was conducted to determine their expectations of childbirth. Women completed three questionnaires, two before the birth and one six weeks after. Questions covered both objective and subjective aspects of birth, and gave particular attention to control, its importance and its relevance to psychological outcomes. Four different indices of psychological outcome were considered: fulfilment, satisfaction, emotional well-being, and the words that women used to describe their babies, which were shown to be related to different patterns of independent variables and of intra-partum events. Our results did not support popular stereotypes: high expectations were not found to be bad for women, although low expectations often were. Information and feeling in control were consistently associated with positive psychological outcomes."

Who are the 'natural birth people'? Are you referring to a specific book? Blog entry?
I.e. People like you, minifingers, who do a good line in denigrating other women's choices and experiences whilst simultaneously bigging themselves up for being merely LUCKY and having a great birth (or a great breastfeeding experience, or whichever other "gold standard" of mothering happens to be under discussion). This sort of insidious behaviour is all over MN and I can't stand it.

"So you don't think that there is anything any of us can do to improve our experience of childbirth? There's no sort of preparation, or mind-set or anything really that will make us feel better about labour during or after we experience it?"

Of course you can prepare as much as you want for labour, and yes, of course it's helpful to, eg, do yoga exercises or guided meditation or whatever you think will get you in physically/mentally great shape for labour, but NONE OF THEM GUARANTEE A PERFECT BIRTH EXPERIENCE. If you have exactly the birth experience you wanted, that's great, but you can't put it down entirely to your great preparation and mind-set, nor can you put a high intervention birth down to poor preparation and mind-set. You don't get the perfect birth you deserve if you just try hard enough, that's just not how it works.

Personally last time I did a fantastic active birth workshop, a brilliant prenatal yoga class, I was really strong, flexible, relaxed, etc. and none of the above stopped my kidneys starting to shut down at 38 weeks and an emergency C-section while the anaesthetist marvelled at my frankly hilarious blood pressure. DS1 featured a less spectacular level of intervention, but still more than I'd planned because he was enormous, OP, and got his head wedged in my pelvis.

"Information and feeling in control were consistently associated with positive psychological outcomes."

Well, exactly, that makes perfect sense - and it could apply to any sort of birth. I was happy with my emergency section because the medical staff were informative, not patronizing, friendly, etc. and explained everything to me in as much detail as I wanted.

If you have exactly the birth experience you wanted, that's great, but you can't put it down entirely to your great preparation and mind-set, nor can you put a high intervention birth down to poor preparation and mind-set. You don't get the perfect birth you deserve if you just try hard enough, that's just not how it works.

Of course not. Especially when everything you've just said is about the woman and none about the preparation, mind-set and attitude of those attending to you.

I've seen plenty that suggests that a 'traumatic' birth can be much easier to cope with and deal with good communication and understanding of what is important to the woman concerned by those looking after her, and 'textbook' births can be terrifying and feel out of control when a woman is not kept informed and treated with respect.

It does seem that events can spiral out of control and make an experience worse because of the way mind and body are connected.

And I've seen a few studies where women who are more anxious and afraid before had are more likely to end up with more intervention.

But I don't think this is for ONE SECOND a women's fault and they could have done more. That would massively over simply it. Some women are naturally more anxious and no number of whale music cds would help and some women have bodies with questionable mechanics. But I do think that we should look a lot more at psychology - but this burden shouldn't be put on the door of the woman alone.

Planners, managers, midwives, doctors, media, politicians, friends, family and partners also need to step up and take their share of responsibility.

And I personally think the reason we have women who consider freebirthing, is because one or more of the above have failed that woman somewhere.

" who do a good line in denigrating other women's choices and experiences whilst simultaneously bigging themselves up for being merely LUCKY and having a great birth"

Seaoflove - with respect, do you have to personalise this? What do you know about my births? Or how I approached them? I did no preparation at all. I have never done hypnobirthing, or had a waterbirth, or done yoga, or done anything. And actually I had one long, difficult forceps delivery resulting in a huge, infected episiotomy and readmission to hospital, one shoulder dystocia with an 11lb baby, and a 36 hour home to hospital transfer ending up with me on a syntocinon drip and with a pph.

I have never had a straightforward birth.

I don't denigrate other people's 'experiences'.

Please don't personalise this argument. Having strong opinions that the rising tide of c-sections and other interventions in birth is not categorically a good thing and needs addressing is not a controversial opinion, or an unusual one, and has nothing whatsoever to do with anyone else's 'choices' - it's to do with the way maternity care is delivered at the moment in the UK.

leedy
"NONE OF THEM GUARANTEE A PERFECT BIRTH EXPERIENCE. If you have exactly the birth experience you wanted, that's great, but you can't put it down entirely to your great preparation and mind-set,"

Do you know the term 'straw man argument'? From Wikipedia: "The so-called typical "attacking a straw man" argument creates the illusion of having completely refuted or defeated an opponent's proposition by covertly replacing it with a different proposition (i.e., "stand up a straw man") and then to refute or defeat that false argument ("knock down a straw man") instead of the original proposition.[2][3]?"

The straw man argument you are putting up is that there are people out there who actually believe and are making a case, that women can guarantee themselves a 'perfect birth experience' by doing yoga or hypnobirthing etc'. Actually nobody espouses this view and therefore your assertion that it's false is meaningless and pointless, and designed to make people who support this type of preparation for birth look idiotic and naive.

"It does seem that events can spiral out of control and make an experience worse because of the way mind and body are connected. "

^^ and this.

I'm not personalising anything. I'm just confused as to why you backtrack and essentially change your story every time someone pulls you up on something you say. Most bizarre.

My view,
Everyone is entitled to their own choice.
Personally I think home delivery of any kind is best reserved for pizzas.
There's no reason not to have a detailed birth plan, and a non-medicalised normal birth in a hospital setting, where you have pain relief options available and back up for emergencies.
Only my personal view though.

Having strong opinions that the rising tide of c-sections and other interventions in birth is not categorically a good thing and needs addressing is not a controversial opinion, or an unusual one, and has nothing whatsoever to do with anyone else's 'choices' - it's to do with the way maternity care is delivered at the moment in the UK.

The thing is you are doing one thing here. You are saying that medicalised births are a bad thing. They are neither good nor bad in themselves. A woman who chooses a medicalised birth does so because she feels happier with that - and if you apply the mind and body connection and research you pointed to yourself earlier - then this ISN'T a bad thing.

For a woman who is either forced, persuaded or otherwise ends up with a medicalised birth then this is a different matter. The medicalization is STILL not the bad thing though; its the way its imposed or communicated to a woman that makes the difference. If its medicalised because doctors are being defensive or are projecting their own ideology on others then that's bad.

And for women who want a more medicalised birth, but are being pushed down a route where intervention is limited this can also be a bad thing, as they may feel like they have been denied pain relief, their wishes and fears not listened to or respected and this in itself creates anxiety and indeed trauma.

So yes it is about how maternity care is delivered in the UK. And its not about other people's choices. Its still about how policy is affecting women and expectations and wishes are not being matched up. There is no point in promoting 'normal births' and home births in the way that is currently happening if women ultimately don't want that and are feeling like they are being pushed down a route they don't want as it'll be counter productive.

Over time you might be able to reverse our belief that medicalization is good, but if you try and do that too quickly you'll end up doing just as much damage because of the link between the mind and body. And that's why, as such, medicalization is not a 'good' nor a 'bad' thing, but something that different women respond to in different ways.

Until we get our heads around that then we risk harming women one way or another.

I guess it is the unneccessarily medicalised births that are the problem, RedToothBrush.

How do you define that though SDTG? That's the problem really.

The guidelines on CS changed to stop disparity and acknowledge that mental health was an important consideration what was 'need' and what wasn't because its so subjective and different doctors were coming to different conclusions of what was necessary and what wasn't. and despite the intent the new guidelines haven't really resolved the problem either

I feel lucky because someone recognised my 'need', but when I read other stories on MN about women hysterical at being denied the same thing, I do really think about it.

Of course its even more difficult in circumstances which may be becoming worrying during the course of labour. I think instrumental and unplanned CS are an even harder call in many cases.

Dont doubt I'll be Flamed chewed up and spat out for this comment but I care not
Anyone wanting a free birth with out any medical intervention or pain relief must need their bumps feeling....
You get no prizes for bring brave!!!!

I just want to say the ELCS husband didn't come across to me as controlling or cold at all.

His wife was clearly distressed about birth and I think the point the doctor made about the link between IVF and ELCS was the main explanation for her choices. She wanted control, but I think control over the birth was less the point than control over her BODY - hence all the hair and makeup palaver. Having suffered antenatal depression myself where I felt repulsed by having my bodily autonomy invaded by this alien foetus (now beautiful pfb) I wondered if there was a touch of that going on too and she was desperate to have control and regain herself.

In those circumstances she may have convinced herself she could have herself back and bounce back soon after the ELCS - to the point where she considered travel 10 days after.

My DH was often 'the bad guy' at antenatal/postnatal appointments - asking how much I could do, asking about sex etc. Some of it would have looked borderline abusive if heard without context of my mental health and our relationship. But actually he was doing it to ensure a professional laid out, aloud, in black and white, boundaries/symptoms/treatment options etc so that I could be sure of the limits of my body and regain what felt like a little control and understanding of the crazy process of birth and pregnancy.

Just my twopennies worth but I think some of the judgement of him on this thread is super harsh. He seemed much more caring to me than the partner of the freebirthing woman who had the arrogance to think he was an appropriate person to be the only attendant at the birth.

"You are saying that medicalised births are a bad thing. They are neither good nor bad in themselves."

I'm saying nothing of the sort.

Medicalised births are sometimes necessary - everyone knows that. If they are necessary then why would anyone say they are bad?

But if they are not desired by a mother and are avoidable then in what sense can they be good? For example - how can cutting a woman's perineum ever be 'good' or even 'neutral' if she hasn't requested it and if it is unnecessary for a successful birth and for the integrity of her pelvic floor? How can doing surgery on a woman who hasn't requested it and would rather give birth vaginally ever be anything other than bad if the same woman could (and wants to) give birth without it and is capable of having a normal vaginal birth?

"The medicalization is STILL not the bad thing though"

Medics have a commitment to 'first do no harm'. If an intervention carries risk (they all do) and is avoidable (ie, the mother is capable of having a normal, healthy birth without them, and it is her wish to do this) then the use of that intervention is harmful.