... 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.

I'd also like to point out that it's not that easy to find unbiased, straightforwardly factual information on birth. A lot of things tend either towards the natural birth stuff that apparently women are idiots for believing, or towards a 'you're an absolute moron for not having an elective C-section like all the doctors do' (MN tends a bit towards the second, in my experience). I actually read quite a few scientific papers, but that was only possible because I'm a university researcher (in a completely different field) who could therefore read journal articles behind paywalls, and I'm not actually sure it was that great an idea, since I'm not actually qualified to evaluate medical papers and so to read them in context. But I ended up reading them because I found it so hard to find concrete answers to really basic questions, like what percentage of women have serious tears, etc.

I had sepsis, forceps, a brow first baby and subsequent birth injury.
I was well informed and aware prior to birth about possibilities. I was aware of the likelihood pain relief would lead to intervention, and considered low risk strategies to see if I could minimise that risk. I chose to birth in a hospital because in spite of being low risk, I was aware my anxiety about something going wrong would mean I was happier in hospital. I wrote in my birth plan I would try to use low level pain relief but would make my own decision in labour about when to move on from that. I said I wanted to birth in the obstetric unit as I would be more comfortable there.
Long story short, I felt pressured into remaining on MW unit when I didn't want to be, was repeatedly denied my choice of pain relief contrary to guidelines, and heavily pushed to remain there even when I was showing signs of sepsis. I have no guilt or disappointment about not having a 'natural' birth. I am, however, still livid that a mw pushed her ideology on me when I was in too much pain to effectively resist (I definitely did resist, just not enough apparently) I complained afterwards, was effectively told I was a wimp, re complained, and my complaint was upheld because that mw did push her ideology on me against my wishes, and she absolutely did fail to follow guidelines about pain relief. So, it does happen. And I highly doubt I was unique. Perhaps, I was more vocal about it afterwards, and perhaps a few people got pushed into 'natural' birth and we're glad afterwards, and I was unlucky to have other complications.

mini, why not direct your scorn at the societal narratives that make women think they've done birth 'wrong' if they require intervention rather than women themselves? Sure, we should all take responsibility in educating ourselves about the realities of childbirth and I'd say most of us do.

But when we have friends or people on social media telling us how happy they are to have delivered without intervention or pain relief, colleagues saying they'll do anything to avoid a section or induction because they want to do it 'naturally,' should we not be asking why these ideas are so pervasive? Why is my immediate thought after my induction, forceps delivery and episiotomy not 'thank God for modern medicine,' but 'fuck, I wish it could have been different'? I don't think it's because I'm stupid (the exam board who awarded my doctorate would hopefully concur) but that none of us are totally immune to the norms and standards which surround childbirth in our society. All of these messages, however they reach us, can burrow down pretty deeply into our subconscious.

YANBU.

My antenatal classes with DS1 were a farce. I still remember the midwife saying “as you are all low risk you’ll have your baby in the birth centre, be home within a couple of hours then have your next baby at home”

I had the easiest pregnancy and went into spontaneous labour but it progressed quicker than expected yet I still ended up pushing for FIVE hours. Because i was low risk, I was left with an unsupervised student midwife who didn’t act when she should have. Had to have an episiotomy in the end (which my body also couldn’t handle, stitches broke down and took months to heal!) Ds was back to back and in distress due to the prolonged second stage and came out all purple and needed resuscitating/working on for what seemed like ages before I could even give him a cuddle. Also lost quite a bit of blood.

I developed cholestasis with DS2 so was offered monitoring and induction. But before I was diagnosed with cholestasis, I called the midwife office one morning after being up all night unable to sleep because of the insane itching. I was told that “it was probably nothing” because I’d had a low risk pregnancy both times (until that point) and i didn’t have cholestasis the first time so there was no reason why I should get it this time. At my last midwife appointment at 38 weeks, she said that despite having cholestasis I “could always decline induction if you wanted and see if you go naturally”. Erm... No i think i’ll follow the advice I’ve been given by the consultant thanks.

Why are they so obsessed with the idea that everyone must have a “natural” birth???

My actual induction was painful, but very quick - I think my “active labour” was noted as 35 minutes! And only a first degree tear. Couldn’t have been less natural - but it was a million times better than my first labour. Also felt fully recovered after 2 weeks.

But when we have friends or people on social media telling us how happy they are to have delivered without intervention or pain relief, colleagues saying they'll do anything to avoid a section or induction because they want to do it 'naturally,'

Or midwives coming around to the house after your 2nd emcs and saying "You must be so disappointed"...Er no, I was meant to be having an elective section only I went into labour early and refused their "kind" offer of attempting a vbac whilst lying on my back strapped to a monitor whilst my back, pelvis and thighs contracted extremely painfully.

It's not only what other people say and think but our own personal experiences outside childbirth. I have a massive issue with failure for a couple of reasons and in the midst of my postnatal breakdown with ds, seeing failure all over my notes was very nearly the final straw. Rationally I know that "failure to descend", "failed forceps", "failed vaginal birth" etc are matter of fact assessments of the situation not a reflection on what I did/didn't do but I still find myself questioning if I failed in some fashion and can't help concluding I probably did.

It wasn't disappointment because after all I got the outcome I desired more a sense of not deserving it because I hadn't earned it.

@lightonthewater
Oh, your experience sounds awful. Makes me so sad and angry(!) you were treated so carelessly. Im pleased to read that it didn’t scar you enough to prevent you having another though and that that experience was more positive.

@DuggeeHugs
I had a baby last week.
All the stats are out there if you want them.
You can look them up nationally. Which.com let’s you look up stats for every hospital, percentage of women who had EMCs’ etc.

I feel like the information is all there now online - if your midwife won’t tell you.

The 'highly medicalised' environment I had my DD in (via EMCS due to distress after being back to back and 10lbs and pushing for what felt like forever) was the best thing for me and I felt completely reassured by and trusted in the medical team supporting me. Although I had that overwhelming feeling (that a lot of others describe) of my body knowing what to do, it couldn't manage to see it all the way through. I was so grateful for the assistance, and delivery of a healthy baby. And my recovery after the CS was really quick (conscious this was just luck and not everyone has a straightforward recovery). Remember laughing when I saw my NCT teacher a few weeks later and said my csection was due to failure to progress and her response was ' oh charming, they told you you failed'. Well no actually, I hadn't ever even considered it like that until she put that twist on it! To me failure to progress was a perfectly logical way to describe it- I felt in no way inferior while in the hospital, but, in that moment, very patronised by her! Couldn't care less if someone wants to describe their birth as natural, they also do have to accept factually that it is a vaginal birth as opposed to a caesarean! Get the blimmin baby out, hopefully in a way that doesn't traumatise you too much and in which you hopefully felt as comfortable as you could. Then crack on with bringing it up!

Thanks @Bumblealong1 I've got it all now

Three years ago I didn't, because I naively believed that my HCPs were giving me the best advice. By the time I realised what a paternalistic, unbothered by fact, experience-led nonsense passes for the treatment of pregnant women, it was too late.

When I had DC2 last year I made damn sure I found every scrap of research and data I could access to prevent the same situation arising again. And I still had to fight for them to acknowledge the facts not the woo. It's exhausting and I'm pretty sure that if I'd presented requiring assistance with a neurological condition I would've been given the relevant information upfront and informed consent would've been sought.

LollyLollington medically it's a vaginal birth. In reality, to me, it was a natural birth. I chose a mlu where pain relief wasn't an option. I chose this because my baby was due near Christmas and I didn't want to be heading towards a very busy city in December! I'm so glad my further children were born in the same unit. My recovery was fast. All of that would have meant zero without 3 healthy dc. Stop caring about other people's take on your labour.

Also, congratulations on your new arrival @Bumblealong1

It really shouldn't be up to women to research this stuff. Does that include fifteen-year-old? Or women who can't speak English? or women with ropey internet access, or dyslexia?

It really shouldn't be up to women to research this stuff. Does that include fifteen-year-old? Or women who can't speak English? or women with ropey internet access, or dyslexia?

I think it’s a good skill to have and you should research everything.

However. Doctors should do more to inform women as there are women who will not be able to do so.

But are statistics actually helpful to women preparing for labour? Does it mean anything to you if a midwife gives you percentages and figures? It’s the same with breastfeeding. How many times did we all here ‘2% of women are unable to physically breastfeed’, doesn’t mean that the other 98% will be able too. It’s pretty meaningless on an individual level. Each labour/woman and baby is so different I can see why midwives/ante natal classes for low risk women don’t feel it necessary to bombard people with stats. Consultants are obviously better at calculating clinical risks and relaying that to a patient. That’s their job.

But are statistics actually helpful to women preparing for labour? Does it mean anything to you if a midwife gives you percentages and figures? It’s the same with breastfeeding. How many times did we all here ‘2% of women are unable to physically breastfeed’, doesn’t mean that the other 98% will be able too. It’s pretty meaningless on an individual level.

I like to know statistics. I can rationalise things that way. “There’s a 1 in 10,000 chance of this happening. Imagine school. There were two thousand people there. Now imagine five schools. This would happen to one person from those five.”

That way I can decide whether I’m comfortable with that risk, or not comfortable with it.

I don’t want someone else deciding for me what I am or am not happy to do.

But are statistics actually helpful to women preparing for labour?

I found them helpful. Statistics are what drove my absolute refusal to be induced. As it was DS came along himself at 40+9.

I attempted labour in a standalone midwife led-unit but had to be transferred (in an ambulance, which was two hours coming as labouring women are not high priority).
On the tour of the unit when I was pregnant they said one in four women got transferred. I thought it was worth taking the risk. Turns out the stat they should actually have given was two in three first time mums got transferred. If I'd known it was so likely I'd have to transfer I would have gone straight to the big hospital.
As it was, the wait and the bumpy ambulance made me stressed and I think might have played a role in the drugs and interventions that followed.
So stats do matter.

Turns out the stat they should actually have given was two in three first time mums got transferred.

That's very high. When I gave birth there was a 40% chance for first time home births to end in transfer.

I would be with you by the way - if it was a 66% chance of transfer and transfer being a bumpy ambulance (as opposed to just moving units within a hospital) then I would also have just gone for the big hospital.

I agree the stats are very important. The stats about waiting times for an ambulance should also have been given.

YANBU whilst I don't think we should be telling women horror stories I do think there is too much emphasis on birth plans etc. Sure have some ideas of what, in an ideal world, you would like to happen but know that childbirth is rarely the ideal. It doesn't make you a failure if it doesn't go the way you planned.

From my own experience though I do think you know what your body is telling you and you should trust your instincts. For example I knew when I needed to push even though the midwife was adamant I couldn't possibly be that far along. Took ages to persuade them to give me an exam but I was right. I also knew that DS was not coming out by himself during the pushing phase, again I was told to just keep trying. Before eventually ending up with an emergency spinal block and forceps because I was right and his head was in totally the wrong position he was stuck and in distress! Thankfully we are both all fine now.

So whilst I don't think our bodies or our babies always know what to do. I do think that we often do know what our bodies are doing (even if it's wrong) and we should be listened to more during the process!

Having given birth once, I find the statistics useful. My own personal preference will be to avoid a caesarean for my next child (unless its an absolute medical necessity, of course) and I have several local hospitals so would be more inclined to choose one with a lower CS rate, for example.

I'm also not bothered about breastfeeding my second so that wouldn't really factor into my decision. There are various other things I would take into account too.

It's all hugely influenced by my experience of having my first DC though. It's impossible to know what it's like until you've been through it. I thought I was someone who'd prefer a medicalised environment, was very open to getting an epidural etc. It came as a great surprise when I found it wasn't actually what I wanted at all when I went into labour.

Before my first birth I did have a brief look at the stats and didn't find them that helpful. It was just so hard to contextualise.

I think the best way to prepare first time mums is to make it very clear that labour and birth is unpredictable and to give them the techniques to cope with whatever ends up happening as effectively as possible, whether that's a water birth or a c section. The better hypnobirthing courses will do that, IMO. The bad ones set women up to feel that if things don't go "right" it was their fault which is incredibly unhelpful!

Yanbu

I hate this , it's just after way to make women feel guilty if everything isn't sunshine and roses

I knew fairly early that ds1 was unlikely to be a natural birth , frankly after the drama around nearly losing him 5 weeks in I didn't bloody care I just wanted him in the world safely , I'd had lots if discussions with my medical team about risk if stillbirth so I knew I was facing a rough ride

I went to an antenatal course , run by an annoyingly smug woman. She asked in the prep info around the pregnancy circumstances you were in so she fully knew there were women there who were facing defunate c sections....she then promptly spent 20 minutes giving every possible worse case scenario around c sections , how awful they were , how they prevented bonding and how traumatizing they were

Even including a stand up skit using us as doctors and nurses showing how awful to was to have so many people in the room

One young mum burst into tears

I am older and a lot more bolshy so afterwards I made a huge complaint and she actually told me she believes most c sections are unneeded and the mother being lazy and advised me to reconsider

Had I done so ds1 would not have made it

I made a big complaint (ds1 was born then and I lost track of 2hay happens)

My body knows what to do...it basically tries to off me and my offspring ....and certainly with DS2 and horrendous hellp syndrome I'm very glad that the doctors overruled my body's knowledge

The most outstandingly arrogant example of this though (granted this has to be an outlier and she must have been disciplined for it) was a HCA who opened the ward door , of the ward containing four of us mum's whose babies were in NICU (bear in mind there was a sign to keep the door closed ) so that we could hear the other babies cry to stimulate our milk production ....and I quote "because nature knows best"

Vile woman....four women whose babies were fighting for their lives in NICU being forced to listen to babies who were with their mothers

Granted after a giant uproar where frankly I'm impressed she made it out alive a senior midwife shut the door apologised profusely and we never saw that HCA again

I also don't think it's the case that women don't know that childbirth can be painful and dangerous. They don't make TV programs about it because it's never without drama! But I think there is a lot of woo woo around that makes women believe they can control which experience they have if only they can get themselves into the correct hypnotic state. The idea that there is a right and a wrong way of doing it that you can control is where it all goes wrong for women. In my opinion.

“Consultants are obviously better at calculating clinical risks and relaying that to a patient. That’s their job.”

I’m afraid they aren’t in my experience (and my parents are both doctors - I have no problem holding my own with medics)

My experience with doctors is that they are not usually very adept at interpreting statistics, though this may just be my personal experience. And may be because that is part of my professional expertise, so I ame to spot that I usually better at it than they are.