To ask for opinions on ‘medicalised’vs ‘natural’ birth?

[birdonawire1]

Read so many stories of mismanaged births, CTG not read correctly, babies not monitored and damaged and then read romanticised stories all about the perfect ‘natural’ birth.

It seems very polarised so what do people think really?

NHS website says this “If after discussion and support you still feel that a vaginal birth isn't an acceptable option, you're entitled to have a planned caesarean.”

So I’ll just keep saying this on repeat until they give in. I can be very stubborn.

I don't know anyone who had an elective cesarean and regretted it.

I am not sure regretted would be the right word, because regret is useless. But my elcs was the worst of my 3 births and I still have nightmares about it now 8 years on.

Any birth can be awful. Any birth can be wonderful.

I was induced with both of mine due to medical conditions. My first was also because they thought the baby’s belly was bigger than his head, when in actual fact wasn’t the case at all, just sitting awkwardly.
I had both natural births, both had bad tears but all in all I was fine, baby was fine. One thing that did bug me was I was ready to push at 11.30 and the dr was too busy flirting with the nurses at the desk, when I couldn’t wait any longer the midwife said It was her first delivery so naturally go a bit nervous, an hour later I was at wits end and the baby started to come and she had to rush to get the doctor. She was nice lady though. With my first I wanted to go home as quick as possible as he was born at 00.56 so as soon as the dr gave me the all clear at 8am I was ready to go yet it took them 5 hours to discharge me because they were too busy trying to convince 2 other women to leave even though they weren’t ready. I was like I’m ready so you’ll free up a bed. No issues whatsoever ever with my second, 2 hour labour born at 7.35pm, 2nd midwife was a nutcase ( deal with nuts on a daily basis so no affect) dd had slightly raised sugar levels so decided to keep me over night else they were gonna let me go at about 10. Spoke to the dr next morning and they discharged me by 11 the next morning. 2 different hospitals and 2 to5ally different experiences. First one in West london the 2nd in Sussex 😊

My c section was fine, but my vaginal birth/recovery were much easier. I’d choose vaginal as long as there was no medical contraindication.

I had one of each - the “natural” one was amazing compared to the horror show of the first. However I don’t know if I would have viewed it as amazing if I hadn’t had such a bad experience to compare it to - it still hurt a LOT! Strangely enough I had a harder recovery the second time round.

hazeyjane obviously it was traumatic for you so please ignore my prying if it’s too upsetting to talk about... I’m really interested as to what happened during your elcs to make it go so wrong? I’m considering asking for a cs for my third after having two vaginal births as I assumed it would be more predictable and so there would be less chance of things going wrong?

Sorry you had a difficult birth, it’s a truly awful experience to go through

How the baby is born absolutely matters. It can impact the child and the mother (and the father) for many years afterwards. Anyone who understands birth trauma will know that.

That’s not to say any one method is better than another. For some women an ELCS will be the best option, for others birthing unassisted by a stream will be the right thing.

The most important factor IMO is informed consent. Many medical professionals seem to fail on this point. There is far too much talk about what the the mother is “allowed” to do.

I was very lucky with both. My first was born in West Africa where dh was working. It was quite a long labour but I needed minimal pain relief just pethidine early on to help me sleep. The pushing stage was short. I was chatting to the doctor and he said,” Stop talking and push, your baby is here!” About 4 pushes and there he was! Honestly it was embarrassingly easy. I used the favoured 70s breathing techniques throughout. That baby will be 49 this year.
My second, 4 years later was back in the Uk and again a simple vb. I hated gas and air so had nothing except local anaesthetic for an episiotomy.

The most important factor IMO is informed consent. Many medical professionals seem to fail on this point. There is far too much talk about what the the mother is “allowed” to do
I think this is tricky though. I do agree with it (obviously) but if the mother is not consenting and that will potentially harm the baby, then there’s a dilemma. I don’t believe all the ‘mama knows best’ because sometimes they don’t. It’s a balance though,m

I know someone with a law background working in health area she insisted she wanted an elcs and did thorough research on why.

When she had an appointment with the Reg to discuss she presented her statistics etc and the Reg insisted she show them to the Consultant who was SO impressed with the papers and studies they wanted a copy for their department

She went on to have two ELCs.

think this is tricky though. I do agree with it (obviously) but if the mother is not consenting and that will potentially harm the baby, then there’s a dilemma.

Pregnant women are entitled to choose or decline what they wish though, even if it could potentially harm their baby. If a pregnant woman is adamant she will not accept induction for example, even though drs feel strongly that it’s in her baby’s best interests, they can’t exactly force her into doing it. She still has the same autonomy and human rights as before she was pregnant.

I think during labour in emergency situations informed consent can be difficult (as in a lot of other medical emergencies not related to birth) but I think things can be done to improve this to a degree.

Women should be informed prior to going into labour what may happen so they understand their options.

Two births without intervention ( except a lot of coaching by the obstetrician as I progressed with the first) DS1 - private hospital in London specialising in natural birth, long labour, mostly in the pool,, very painful but I was so excited about meeting him it was all OK. He was born while I was in a squatting position so I was the first to really see him fully, I'll never forget the look on his face when he looked up at me (though I accept his vision might not have been able to really see me).

DS2 water birth at home, quick and comfortable. He arrived in the world with an astonished "WTF" sort of expression on his face.

I don't know anyone who had an elective cesarean and regretted it. The myth that cesareans are always awful is just that!

@Seline This is so true! Mumsnet was what convinced me to go for ELCS because 99% of all experiences sound overwhelmingly positive. I actually don't know a single person in real life who had a completely voluntary CS. Among friends and family, everyone went for vaginal birth, with a handful ending in emergency CS and the few ELCS were due to medical contraindictions. If I had only spoken to people I knew then I would have felt strongly drawn into a vaginal birth as well.

Birth is dangerous by nature. So long as there are competent medical professionals to hand if complications arrive then that’s what counts.

@presiacombatr there are a lot of negligence cases on this where doctors fail to properly inform their patients thinking that the patient will make the wrong decision. Obviously in these cases the doctor made the wrong call and the babies ended up dead or severely disabled. Most of the time it’s actually doctors failing to inform because they don’t think that their patient needs intervention despite there being a risk without it. They then decide not to inform the patient of the risk so that the patient does not ask for interventions. The view of the courts is very much that the patient has the right to choose regardless of whether it is best. The courts have recognised the significance of personal factors in thus decision making process and treat personal reasons with respect. I am inclined to agree. It is not a doctor’s place to make the right decision. Merely to ensure that patients are making informed decisions.

I actually don't know a single person in real life who had a completely voluntary CS. Among friends and family, everyone went for vaginal birth, with a handful ending in emergency CS and the few ELCS were due to medical contraindictions. If I had only spoken to people I knew then I would have felt strongly drawn into a vaginal birth as well.

They might not admit it. I usually tell people I had a cesarean because my consultant and I decided it was the safest delivery given the circumstances. The circumstances were that I wanted a cesarean but no one usually asks that and it stops the judgemental comments.

Very true Seline. My first was due to severe SPD - I could hardly walk, was massively immobile, had a pain free gap between my knees of about an inch. No way a baby was coming through without me exceeding it. I was physically and mentally exhausted after a shit pregnancy too. Still had to push for it though (kept hearing that SPD is "just a condition of pain, no risk of long term damage"...tell that to the women in wheelchairs cos of it!) although I am utterly convinced it was the right choice medically.

Second time round I asked for an ELCS at my first midwife appointment . As it was the SPD did reappear although I was able to retain mobility/flexibility second time round thanks to private physio although I had no way of knowing that would be the case. But if anyone asks, second section was due to SPD and having one before. Reality is that VBAC was never in the running for me, I would have asked for a second section regardless.

In real life people can be judgemental as hell about ELCS

It's true that a 'perfect' birth will be different for everyone - and that of course the main aim is to have mother and baby alive and well at the end.

But I was lucky enough to have the perfect birth for me (apart from the birthing pool being unavailable!).

Now, maybe I was just lucky, but I had a very easy pregnancy: no stretch marks, no morning sickness, nothing. Some, however, might say this was at least partly down to staying fit before and during pregnancy: swimming, cycling, walking, going to the gym, and taking yoga and Pilates classes throughout. My sister is also an anaesthetist and she says a significant proportion of those she needs to give epidurals to (NB not all!) are overweight/unfit.
I say all of this as someone with PCOS who finds it very difficult to maintain a constant weight.

I also read a lot about pregnancy and birth (and watched lots of episodes of One Born Every Minute!), so felt extremely well-informed. I feel this is important to mention as it’s my firm belief that fear is pain’s best friend! If you’re afraid, you panic and tense up more, and tension = more pain.

On top of that, as someone with a severe needle phobia, I was determined to cope with labour so that I would not need any intravenous intervention.

Again, maybe I was just lucky, but I truly think that all of this combined made my labour perfectly manageable without an epidural.

My contractions only ever felt like strong period pains, and I was able to just breathe through those (thanks, yoga and Pilates!). I moved around a lot during labour and think this helped a lot too. In fact, all I used was a yoga ball, hot water bottle, shower, and TENS machine.

Even the pushing did not hurt that much; I shouted a bit when I tore (understandably! 2nd degree tear), but screamed way more when I was being stitched up!

I really do think that we are conditioned to believe that labour is painful and so this actually does make it more painful for some women who believe this. (Self-fulfilling prophecy!) Equally, lying flat on your back apparently increases the pain (why would you not allow gravity to help you?), as, most likely, does fear of the unknown (in short, EDUCATE YOURSELF and learn all you can about labour and birth before the fact; if you are well-informed then you can relax much more and thus reduce pain).

I would therefore be sceptical of anyone who says you need an epidural and don't find the comments/banter in our society's conversations about birth all that helpful: "you just need one sentence: give me all the drugs" etc. You are you and you should just see when you get there (but I’m pretty sure that if you do as I describe above then your chances of needing an epidural or indeed any pain relief will be significantly reduced).

Ah, we don't have good births because we're in the wrong mindset and don't try hard enough to stay healthy. OK then.

I was a healthy weight and physically fit (going to the gym daily) before my first pregnancy. Within days of the positive pregnancy I was vomiting 20+ times a day with hyperemesis. Could not exercise, could barely get off the sofa. Hyperemesis fucked my metabolism. Hyperemesis left, SPD arrived 2 weeks later. By the end of my pregnancy I was fat and unfit and would have fitted in with your sisters stereotypes nicely - but I'd been made that way by the pregnancy.

Well done, Angelil. Here's your medal

My contractions only ever felt like strong period pains, and I was able to just breathe through those (thanks, yoga and Pilates!).

Lucky you, I contract in my back regardless of baby position and I've never known pain like it. I did manage to get to 10 cms on nothing but gas & air with my first (not through choice I add) but it wasn't fear which made it hurt like hell, but a giant head smashing into my spine/sciatic nerve and then to add extra "awesomeness" to the mix, making my leg muscles lock up with each contraction. I'd done my research, I wasn't afraid, I couldn't even get the midwives to believe I was in pain because apparently I'm so good at breathing through it but god it hurt.

It is just luck. Just as it's pure luck that I've had two pain free emergency section recoveries. I'm reasonably fit, I do pilates, I walk at least 20 miles a week, I don't drink but none of that explains why I can get out of bed as soon as the spinal wears off and carry on as if no one had just cut a baby out of me but I can. None of this stooped back staggering around, pressing the buzzer for a midwife every two minutes, unable to look after their own baby "nonsense". Would you tell all the women who have found their section recoveries hard that it's in their heads, or because they expected it to hurt Angelil?

Or maybe we are all different, we labour differently, we recover differently and luck plays a massive part. Also I get sick almost as soon as the egg meets sperm, constant nausea every single waking hour up until week 17-18 or so (it's getting longer each pregnancy), every smell, every taste...horrendous and I know plenty of women have it far worse. If you get to avoid that, you are lucky indeed.

@racecardriver Most of the time it’s actually doctors failing to inform because they don’t think that their patient needs intervention despite there being a risk without it.

Actually, in the UK, antenatal care and delivery is under the care of midwives, not doctors. The failure to inform lies primarily with midwives. Midwives have a vested interest to keep doctors out of the delivery room, and they are also severely under resourced, so they are drilled to encourage —force— women not to have analgesia that would require continuous monitoring. They achieve that goal by spreading misinformation, for instance on the supposed great dangers, and unavailability, of epidurals, and sadly often waiting too long to intervene.

It boils down to protectionism, money (or lack thereof) and sexism in the way resources are allocated.

@Angelik maybe I was just lucky.

Yes. That’s all there is to it. You were lucky. So please spare us the self-satisfied smugness.

Having spent 3 months on bed rest, lost one of my twins, and with debilitating SPD, to then break my waters at 33 weeks and having to be induced with a 25% chance of having a stillborn child, I don’t need any lessons on how I didn’t ‘need an epidural’ and should have just relaxed instead 🤨

And maybe the reason a ‘significant proportion ‘ of your sister’s epidural patients are overweight/unfit is because 62% of all adults in the UK are overweight? Just a thought...

I think the wording and language around birth needs to change a lot. As I mentioned before, a lot of information given includes a lot of ‘you will be/won’t be allowed, drs may decide to use forceps’ etc etc that completely ignores choice/consent. It’s everywhere. Even watching programmes likes the Emma Willis delivering babies a lot of the voiceover was things like ‘drs have decided to deliver Laura’s baby by planned c-section at 36 weeks’.

I read an article about new research titled ‘should all women be induced at 39 weeks?’ when really it should be ‘should all women be offered induction at 39 weeks?’ yet you rarely see that kind of language used.

Even on threads on mumsnet you see women writing things like ‘so baby is breech and the midwife says I have to go to an appt to try and turn him and has booked me in.’ then they are surprised when others tell them it’s not compulsory.

I get that in some situations there is a ‘need’ eg if you had a placenta completely blocking the birth canal it’s safe to say you pretty much need to have a section... but this kind of language is used all the time in situations where it absolutely doesn’t need to be.