... about "natural birth" and "your body knows what to do"?

[ParsnipsAreTheDevil]

I keep seeing the whole "don't worry your body knows what to do" thing thrown at pregnant women and it was a massive part of the hypnobirthing course I did before
DS was born (he's 2 now). When it came to it it turned out my body didn't have a bloody clue what to do. In labour for 3 days, wasn't dilating, emergency c section and we both got sepsis. Felt like a massive failure afterwards thanks to the massive emphasis on natural birth and my body categorically NOT knowing what to do?

Aibu that what we should be saying to pregnant women is to keep an open mind about birth? I've met a few women since who had very similar experiences to me. Breathe the fecking baby out my arse.

It does really depend on the individual, doesn't it? And to that end, a relaxed mother (because she is getting what she wants, as far as is possible) is more likely to end in a positive birth outcome for her and the baby

I was terrified of having an epidural because I have a thing about needles - I have a high pain threshold except for that very specific pain. My birth plan only said "No epidural". If I have to have dental treatment, I take paracetamol beforehand and avoid having any anesthetic injections at all, because to me the pain of a needle going into my gum is worse than the pain of the drill in my tooth. I gave birth having only had two paracetamols, and it was honestly not the most painful experience of my life

But would I judge someone who wanted an epidural from the outset? Hell no - that would be ridiculous, surely? Everyone is different, everyone needs something different to get through this wonderful but potentially traumatic experience. Thankfully we live in a time where there are a plethora of options at our disposal, and no-one should be made to feel bad for using them

Oh :( I didn't know that about induction rates. It was my perception that things were moving more towards how to facilitate more non-medical births and assist the natural physiological processes in order to reduce the likelihood of complications - which is (paraphrased) what you've said later. Certainly that's the change I've noticed with two pregnancies 10 years apart. However, I'm obviously less involved in the field than somebody who works there - I'm just a bit confused about which it is. Or is it that the midwives and doctors you personally know are more supportive of this approach whereas general policy is becoming more defensive? That wouldn't especially surprise me, TBH.

Personally for me (I am not saying this is right for all women!) medical procedures and needles and being restricted and monitored and such frightens me and makes me feel uncomfortable, I would much rather deal with a pain which is muscular in nature than anything which involves piercing the skin even if it's very minor, that's just a personal preference I think, and I'm not overly worried about the pain of labour because it's functional in a way, it's like the kind of pain you get during a workout (just much much much more intense). Ultimately I'd prefer to see how I go with managing it and take labour one contraction at a time. I don't want to have all kinds of "just in case" measures taken, I specifically chose a hospital where the policy is not to utilise stuff like that, but OTOH I'm definitely open to going with other options if it came up in the middle of labour that there was a problem - in an emergency/urgent situation, I tend to just get on with it because I don't have the time to get anxious and worry about it quite the same. Also, if I get to a point where the pain is so bad that the thought of the epidural needle no longer scares me in comparison, then I'm all for it. I just don't like the thought of going in expecting that. For me it's very very much if I don't absolutely need it, then I don't want it, and I would like quite a high justification for something particularly if it's going to involve discomfort or restriction for me - but if I do need it then just do whatever you need to do, and I'll deal with it. But I do like to know what they want to do and why, if there's time of course.

Somebody else might find the thought of the pain and lack of control or "what if" much more scary and be much more comfortable with medical procedures and monitoring because feeling in the hands of experts is more important to them, especially when certain interventions are low risk, and I think it's really important to recognise that too - that people are different and have totally different anxieties and preferences.

Today 23:38 ShovingLeopard

Isn't it more anger towards HCPs denying adequate pain relief/fobbing women off and deciding for them that it will be natural, that people are railing against, Momo? Not so much women who choose to forego pain relief?

• maybe to an extent. But you do get the sneery comments ‘I wouldn’t have my appendix out without pain relief so why give birth without it’ which actually is directed towards women who don’t use pain relief.

And some are very quick to assume your birth must have been easy or less painful if you forego pain relief- err, no, if hurt like hell actually!

It’s all very misdirected of course .. people should live and let live and not feel threatened by people who do things differently

To choose a pregnancy then demand all the drugs because you simply don’t want to feel anything is ridiculous imo.

Why do you think this is ridiculous, Notasgreenas?

No idea if my body would’ve known what to do, because I got pre eclampsia and had an elcs. Given I couldn’t get pregnant naturally, and my milk didn’t come in, I’m pretty confident mine wouldn’t have had a fucking clue 😂

I have never given birth vaginally,my body,my placenta didn’t know what to do
Without skilled medical intervention me and my babies would have died
Childbirth can be a high risk activity I’m afraid bodies don’t intuitively know

I remember reading that Queen Caroline died of birth injuries 11 years after the birth of her 8th child.

You should have seen what happened to Princess Charlotte, George IV's only (legitimate) daughter. Now that was tragic, and an object lesson to every natural birth fan. Nowadays of course she'd have been whipped into theatre at the first whiff of meconium.

Momo I've said stuff like that, but never directed at other people's choices. I have been bloody angry at the idea a midwife or doctor could decide for me that I don't need pain relief. I'll be the judge of that, thank-you very fucking much.

It makes my blood boil that women are denied adequate pain relief just because it's related to birth. No way would men put up with that. But personal choice of another woman? Absolutely up to her. I can see why some might prefer to minimise the risk of instrumental birth, for example. I'm not saying other women aren't judging you, but I haven't personally noticed it, and just thought it was a backlash at the way pain relief is withheld in and after childbirth.

That said, I might be a bit thick-skinned. I chose ELCS, and got a few nosey/judgey fuckers being rude enough to ask me why. "I'm just too posh to push", delivered gaily never failed to shut them right up

Times have changed I suppose, I can't imagine what information women are given now but when I had mine I was pretty well prepared; went to classes, read quite a lot and when the time came it did all happen naturally. I was in hospital so had anything gone wrong, I was in the right place to receive help. Childbirth seems more complicated now and some of the awful stories I've heard about difficult births and midwives thinking they know best, are quite awful.

YANBU just as with breastfeeding, it's different for everyone.

I was lucky that I had a midwife who did our antenatal classes was a sensible honest type.

Yes 'natural, vaginal birth around due date was most likely but she also went through the other possible scenarios.

I still felt like a failure for needing an emcs (following 28 hours of labour following induction where I didn't progress past 4cms and dd ended up in scbu).

I also experienced an oddity as in I didn't notice my contractions - I have endo and frankly my periods are a lot more painful than any point of my labour was - and I had no pain relief until they decided a Caesarian was necessary. I just didn't need it.

I was visited the day after by my community midwife and said something like 'I failed, I haven't given birth, I don't feel like a real mum' she said something like 'I've read your notes BELIEVE me you failed nothing! As you've been told you and baby we're lucky to survive! You are definitely a real mum' Which was true.

I was also advised another pregnancy would be life threatening for me, and possibly baby. I'd have loved more (and to try for a vaginal birth) but it would have been irresponsible.

Yes back in the 'olden days' a lot of women popped them out like peas (my mum had no problems giving birth but miserable pregnancies for various reasons) but a lot DIDN'T (why do people think caesarians and instruments were invented in the first bloody place?!) and babies and mothers died (sadly some still do, even now & in this and other developed countries - dd and I were lucky but I have friends who weren't so lucky) or were/are left with long term consequences.

My sister had almost the opposite problem - precipitous labour - by the time she was due her third they decided best she be in hospital before due, rightly so as with no 3 she was less than an hour from onset to baby clean and wrapped in a blanket! But that in itself is problematic as it's quite a shock for baby and mum!

It's the way women are fucking insulted by it somehow being decided STILL that we're somehow too emotionally fragile to be told the truth!

I believe it's possible to be honest without 'scaring women shitless'

Lisasimpsonsbff - you say "why?" I say

Because better to know before you're mid childbirth, potentially in a great deal of pain and already scared only to be frightened more at the worst possible time. Fear makes us tense.

Because why should women be patronised and condescended to? Most of us are perfectly capable of taking the information on board and processing sensibly.

I WAS very calm, wasn't in any real pain, just was getting fed up & tired as it was taking so long. Still needed an emcs (baby wasn't so calm and my body did its own weird freak out unbidden by me)

"I think that pregnancy is totally natural but not giving birth!" Again not for everyone. Dd was my 3rd pregnancy. I lost 2 previous pregnancies to mc/ectopic. Dds pregnancy was fraught with worry as I had bleeding, fainting, very bad morning sickness (not hg but bad), early onset SPD, GD and pre-eclampsia. I was on crutches wearing a very not attractive pelvic belt, pricking my finger however many times a day, extra scans (was considered a high risk pregnancy for several reasons inc I was pregnant less than a year after last mc), carefully controlled diet, limited 'exertion' ordered culminating in total bed rest for the last 3 weeks before dd was born.

I love kids, I'm the eldest of 3 and the eldest cousin of a big family, been babysitting since I was 14, been a guiding and scouting leader and nanny before having dd.

My close friendship group when having conversations about growing up, getting married and having kids used to (good naturedly) tease me I'd have my first before I was 20 (they were almost right) and go on to have a big brood. A few who lost touch with the group, when we got back in touch, commented they were surprised I was late 20's before having my first and that I'd had no more, which unfortunately meant they felt awful once I explained why.

Life can work in strange ways sometimes.

In terms of popular culture I LOVE when characters in films or tv are portrayed as having birth complications or, not having a 'normal' tv/film experience of pregnancy/birth.

Friends I felt was particularly good at this.

Carol:

going "I'm not doing that!" At the birthing class, arriving at the hospital NOT screaming, panting etc, the birth portrayed as taking a while (other stuff happening with other characters), getting impatient "not helping!", being shown as a bf mother and happy to discuss it, answering questions honestly.

Then Rachel - getting fed up at being overdue, getting frankly pissed off at other mums giving birth more quickly and her own labour progressing very slowly, then regretting it once in full blown pushing stage, getting tired. Struggling to bf initially. Worrying about that. And the bit I LOVED was the writers/costume department portraying her as still having a bit of a bump and larger breasts for a few episodes AFTER giving birth. (I've come across a good few particularly younger mums being dismayed that the tummy/bump doesn't just miraculously disappear the day or 2 after birth), commenting on being desperate for a shower and sleep!

I really felt those episodes were well written.

I also love the celebrities promoting bf as a natural non-sexual process. I've just seen on Facebook today, apparently public bf is now legal in all 50 USA states.

We need MORE of that in popular culture. For pregnancy, birth, bf, post birth women's bodies to be acknowledged honestly & celebrated.

Mn existed when I had dd, but only just and we didn't get a computer at home until after I had her. The Internet and how we use it has grown & changed a lot in that time (almost 18 years).

My now ex has said of that time, he went home but couldn't sleep as he fully expected a phone call to say he'd lost either me or baby in the night, that he dreaded arriving at the hospital the next day for the same reason, took him a few days to relax and he's one of the most chilled people I know! He'd faced the possibility of losing me twice in one year. He also said he felt powerless and the most scared he'd ever been in his life, and he was a serving soldier at the time!!

The being refused pain relief - can you imagine the uproar if men were refused pain relief for anything? Yet it happens regularly to women, not just in relation to 'women's issues' either, women are routinely expected to tolerate higher levels of pain without complaint. It's outrageous!

BertieBotts - I get what you're saying but certain breathing techniques can help with pain relief to a degree - related to oxygen levels, endorphins and relaxing of muscles. I've found them effective at least partially for migraine, period pain, spinal pain (chronic condition), and during labour. But they're not a replacement for meds for severe pain and women shouldn't be denied pain relief if requested.

I agree with BertieBotts and also with Terriersandtea - my experience of hypnobirthing techniques was not “woo bollocks” but another tool in the arsenal for getting through labour and birth - however they panned out. I did not expect it to be the only thing I needed, but learning the breathing and visualisation techniques helped me through SOME (not all) stages of my 26-hour labour and helped to conserve my energy. I was fully aware of the various interventions that may be offered under various circumstances, so I knew the risks and benefits in advance. However, I was on a high-risk pathway despite all monitoring showing that everything was within normal limits so I had to argue for the option of a less medicalised birth - I had weighed up the evidence and felt that IF (note IF) everything progressed “normally” then less intervention was better for me and my baby, but I was prepared for things not to go smoothly

As it was, I was another who was thought to be in early labour after 24 hours of contractions (they were never regular or frequent enough) only to arrive at hospital in agony prepared to be sent home but finding I was 9cm dilated. Those later contractions, before I was examined and given gas and air, were agonising, scary and I felt alone in a world of pain. Had I not been so far along I would have needed pain relief. Baby born in the water on gas and air a couple of hours later - very calmly, I was euphoric. Hypnobirthing got me so far and meant I still had some energy reserves for the later stages. But it was never sold to me as anything other than a tool amongst a range of others

I should say - I am fully aware that the way my labour panned out was luck, as most labours are. I agree with BertieBotts about seeing interventions as tools, and hypnobirthing techniques can be one of those tools

Yanbu.
My body didn't know what it was doing. I ended up having a c section. I've had two lentil weavers since basically tell me it was my fault; one for not doing hypnobirthing and one for taking pain relief.

My cesarean costs a massive £87 more than a vaginal.

Where does this cost come from?? I've seen it used a few times. With the best will in the world how can surgery cost so little compared to a natural birth. You're looking at a couple of extra thousand pounds.

It does really depend on the individual, doesn't it? And to that end, a relaxed mother (because she is getting what she wants, as far as is possible) is more likely to end in a positive birth outcome for her and the baby

I agree with this, it's such a personal and individual thing.

I did hypnobirthing and asked for minimal intervention from the midwives, including saying I didn't want them to tell me when to push etc as I wanted to just.go with what my body was telling me. My body did know what to do and baby was born safely. BUT that is just me and just that birth, who is to say my next birth will be the same.

Throughout my course however we were made fully aware that things don't always go to plan and a lot of the hypnobirthing concept was aimed at allowing us to try to stay as calm as possible in a variety of situations that could arise (including c section), it's a huge shame your course didn't appear to support you like mine did.

YANBU.
My body doesn't know how to go into labour and takes a lot of coaxing in the form of induction!

Birth plans shouldn't even be a thing other than "get baby out safely"

And don't get me started on home births.

“And don't get me started on home births“

Why?

The evidence shows that for healthy women having their second or subsequent baby they’re just as safe for the baby as a hospital birth.

And safer for the mother.

What’s you’re problem with that?

Married

The cost is a lifetime cost. What’s happened previously is that only the cost ‘on the day’ for a successful VBAC vs ELCS has been used. And that is higher for ELCS.

But that’s not the true cost. Let’s say we have a hundred women refused CS and forced to VBAC. The true cost needs to take into account things like:

How many of those women needed an emcs?
How many needed instrumental delivery in theatre?
How many will need prolapse repair in a couple of years, which isn’t counted under the obstetrics budget but under general surgery/gynaecology
How many will need other surgical interventions/therapy etc?

That’s when the costs start to close the gap.

I was on another thread about this and someone posted the link to the costing - we also had someone who does costing for the NHS on who confirmed that they don’t look at downstream costs, and agreed that was not a good thing to do.

Home birth or cs - the issue I have is that women are not being listened to. At the same time as I was fighting for my cs, someone I know was fighting for a homebirth. We both wanted different things but both of us were justified. She was a second timer, no risk factors and was having a hell of a time getting one. That should be her choice. Obviously if she had risk factors she’d be a fool to ignore them but she didn’t.

Home birth can be a safe and viable option too. It’s womens choice that’s key.

“Where does this cost come from?? I've seen it used a few times. With the best will in the world how can surgery cost so little compared to a natural birth“

Because they factor in the costs involved with problematic vaginal births which end in surgery and instrumental births.

However they don’t factor in the costs for either c/s or v/b that may occur in later life or in subsequent pregnancies and births.

For me the figure is a bit meaningless because it doesn’t take into account that rates of emergency c/s will vary hugely according to hospital and birth setting (labour ward/birth centre) and parity.

Eg, a low risk first time mum of 38 having her baby in an OU in a big teaching hospital with a high rate of emergency C/S only has about a 30% chance of having a straightforward vaginal birth with no complications. A low risk mum of 25 having her second baby at home/free standing MLU has about a 95% chance of a spontaneous vaginal birth. Comparative costs would be hugely different for each mother.

Also worth taking into account that some hospitals MUCH higher rates of unplanned c/s than others.

On another note - this thread shows how the government gets away with under financing maternity care.

Because many women need to believe that birth can’t be made better, regardless of good evidence showing that appropriate settings for birth and proper staffing actually can increase the rate of straightforward birth significantly.

“Home birth or cs - the issue I have is that women are not being listened to.“

^^. This

Absolutely not helped by the chorus of ‘doctor knows best’ voices that tend to chime in on discussions on this subject.

Women should be able to choose how they have their babies.

YANBU my body didn't have a clue what to do - anterior placenta, back to back labour despite managing to turn him the day before. Failed contractions, drugs, epidural, finally managed to escape with a 3rd degree tear. Lucky me. Then I got sepsis. Awful experience, and no my body didn't know what to do.

Second time around I pushed for an elcs but I was refused by the consultant who was a bullying cow. I ended up with a really straightforward labour with only gas and air, 8 hours altogether with a tear but not as bad this time. My body did seem to know what to do and during it I felt calm and more together than the previous time.

I know that my mindset did help the second time, because things had gone so badly the first time and we survived I think I convinced myself that even if things went wrong it'd be fine because we were fine last time. When things straight forward I felt more in control and was able to cope but it definitely didn't have a bearing on stopping it from going wrong.

The part about the whole process is the way that HCP push the idea of choices and being in control on parents when in reality, they're absolutely not in control and the choices are made by the HCP at the time. The ploy about birthing plans and the endless 'no drugs' spiel make first time parents believe things are going to be a certain way. My friend spent ages planning her birth, she also announced to be in a rather proud way that 'we've decided not to have an epidural' right after I'd had to have one for DS1 - why the hell would anyone believe that they had such a choice?

The implications of all of this is the MH of the parents afterwards when their plan and choices have all gone to shit. They're the ones left with the guilt that they 'failed' in labour and their baby ended up exposed to drugs which they'd scared the lives out of themselves with beforehand. There's a thread on here at the moment where the OP is 'fully informed' and asking for advice about choices. I had gently tried to point out that it's whatever the HCP decide at the time, and of course the mum has the right to refuse, but if you're only faced with one option that you've terrified yourself with beforehand, then that doesn't lead to a very nice experience for anyone.

It's all because natural labour is shoved at women from the very beginning, in reality very few get through it without some sort of intervention. It's irresponsible of the HCPs.

Lots - you may have felt powerless in labour but not everyone does.

I didn't feel powerless in my labour. Or at least not in my second and third labours where I had a midwife who listened to me, gave me choices, and let me make the choices.

Again - people seem to need to believe that there can only ever be one way their labour could have gone. One outcome. This is rarely true. Health professionals know this. The course of a labour will often be affected by the way it's managed, and how it's managed may depend on many things - the practitioner caring for the mother, their level of expertise, confidence and experience; the protocols of the hospital, and national guidelines.

The RCOG acknowledge this. They've produced research showing hugely, hugely varying rates of the following between hospitals, differences which still exist every after demographic factors and hospital characteristics are controlled for:

• episiotomy
• assisted birth
• unplanned caesarean
• induction

In other words, how a labour goes will often be shaped by other forces than the mum's own body. The evidence proves that this is the case.

No stats or research, just a personal opinion, but I reckon medical intervention plays a massive part in inhibiting the bodies natural processes. Even small stuff like examinations. My second labour - I had nothing, no drugs, no gas and air and yes, my body did know what to do. I kind of stood on one side and let it - not that I had any choice, it was overwhelming.