to think the natural birth at all costs ideology is fucking crackers?

[burnagirl]

We have a scandal on our hands. Shrewsbury Maternity Unit.

I couldn't believe what I was reading, but to be honest, I wasn't all that surprised, having had many a run in with the natural birthers/earth mothers in the past.

There is a toxic and insidious ideology permeating the 'birth culture' in the UK. This culture that tells women that our bodies were 'made' to give birth, that our bodies KNOWWWW what to do, that any intervention means failure on our part. That childbirth pain is something to be endured with happiness and joy - I mean, really? Is it some sort of a more 'noble' pain? Something transcendental and sacred and good?

Nah, fuck off with that. You wouldn't have a root canal with no pain relief, so WHY do we fetishise female suffering in childbirth? To me, there's this mile-wide misogynistic miasma around this narrative, probably rooted in religion.

Then there's this totally daft idea of intervention/c-section being a failure. Such bollocks. We don't seem to realise that, from an evolutionary perspective, it isn't even necessary for MOST mothers to survive childbirth. All we need is ENOUGH mothers and babies to survive, so no, our bodies are not sacred temples that somehow magically Know Best.

Can we please do away with the woo around childbirth and just do what needs to be done to ensure that mothers and babies come out of the (let's face it, fucking painful and dangerous) process alive and well, however the hell it happens?

I wanted a natural birth as many have already stated, for me it was short term pain over longer term pain/recovery issues.

I do however feel that too much pressure was put on me even though I had made my decision. A new mum on the same ward as me said she repeatedly asked for an epidural and was repeatedly told she would need to wait a little longer until she was then told it was too late.

I often wonder if it is a cost saving thing?

I think a woman should be able to deliver her baby however she wants. Pain relief free vaginal birth, elcs or anywhere in between, whatever, it’s her body.

I had a surprise elcs with my DTs. I spent weeks being talked out of it by some consultants, told by one he’d allow it only because I was carrying twins, and had to argue and provide evidence as to why I had chosen that. I’ve been told afterwards by some that I’d ‘cheated’ and ‘gone for the easy option’ errrr, fuck off, I had major abdominal surgery, my dd wasn’t breathing properly when she was born (dt2, delivered 4 minutes after ds) and I thank my lucky stars and the incredible medical army we had that I had a section and she was ok. I shudder to think what would’ve happened if I hadn’t had a section.

I felt like a failure afterwards in many ways, because I couldn’t fall pregnant naturally (ivf babies), couldn’t birth them naturally, and then couldn’t feed them which definitely contributed to my pnd. Now 21 months on, I think I’m a superhero and 100% believe I made the best choice to get the three of us through birth and out alive the other side.

So many typos in my post it doesn't make much sense..

I know many women who have felt like failures due to needing interventions / sections.

I've had x3 "SVD" (3 children)

Statistics don't lie? OK, so statistically, more than 50% of women in Sweden 'need' an epidural, 60% in the US and 77% in France. Either French women are all wimps, or is the case rather that epidurals are available at maternal requests and you are not told that there there, you're doing so well, you don't need one?

If Debbie or Brenda choose to go the vaginal route and are happy with it, then more power to them. Let's not shame Mary who decided that she doesn't want to labour and chose an elective section though. She's done JUST AS WELL as Debbie and Brenda.

I agree with you. But who is it that's shaming Mary? Nobody here, and the massive problems at Shrewsbury and Telford were way beyond 'shaming'.

I've had two c-sections, I've never felt shamed for it. I have had a lot of people suggest that the only reason people like me would still be upset or traumatised by our births is because we're naive lunatics who'd been conned into wanting whale music and candles for pain relief, though.

“ Agreed- giving birth without intervention is not an achievement.”

Of course it isn’t. Neither is it a reason for insult and mockery.

@MuchTooTired - you've suffered like hell, you went through all this, and you ARE an absolute superhero. Chapeau bas!

YABU, but only because what you've said is not quite the correct interpretation IMO.

It's definitely what some woo people think, but is way ott to my idea of reality.

I didn't have a choice for my first birth, DC1 was back to back and it all went a bit wrong so I had an EMCS.

For my next DC I did a bit of natal hypnotherapy with CDs at home and some reading around birth. (Active Birth book and Ina May Gaskin).

What I got from it is that automatically intervening/medicalising can lead to more interventions, e.g. unwanted instrumental or c section births.

Same goes for making mothers lie down to labour/give birth instead of letting them stay active and upright.

There definitely needs to be a middle ground where women who want to can try to birth in peace and quiet, without some fucker rummaging in their fanjo every fucking hour. (Can you tell my DC1 experience was a bit traumatic).

While those who need pain relief can be given it without feeling like they're begging for it. Same goes for those wanting a CS for personal reasons.

Fwiw for dc2 I arrived at hospital 9cm dilated (uncomfortable fanjo rummage on arrival despite me having intense contractions 🙄) then made to lie down with band on for baby check because of previous CS. I then laboured for a further 2 hours, had electrode up fanjo for DC2 scalp, doctor came in and was also up there getting scalp blood samples and eventually episiotomy and forceps. I just wonder what would have happened if I'd been allowed to wander around for another half hour as I'd been doing at home?

Which is kind of what happened with DC3 who was about 5 minutes away from arriving in the hospital lift before I got to the room

So I don't think there's any need to glorify natural birth as amazing, but neither to say it must be medicalised and controlled.

I didn't even think with DC1 that I could have refused any of the many, many, many internal examinations (by several different midwives and doctors) and random other things that were done (enema was great 🙄). I was a scared first time mother so I thought the experts knew best.

No one should feel ashamed at any intervention they need (I was that close to punching an idiot colleague who used the phrase "too posh to push"), but neither should there be eye rolls at those who'd like to try to avoid intervening where possible.

My first midwife was obsessed with the birthing centre, not by choice I ended up on labour ward and very grateful for that, and that's what I will be considering for my next one. My midwife already questioned why, and I am so fed up excusing myself why I want labour ward and not birthing centre!

Bertrand I always find myself nodding along to most of what you write but I don't see where you're coming from on this thread. Where is all the shaming and mockery? Nothing has been said personally about you, or any woman. It's an opinion on an institution.

The fact that 'too posh to push' is even a thing tells me all I need to know re. attitudes to intervention.

I had two quite difficult births, the second really very difficult. I had gas and air only as was my wish and I don’t regret that at all. I’d probably be an ideal candidate for an elective next time but I don’t want that and the fact that I narrowly avoided it second time round is something I’m very thankful for.

I’m not mad or “woo”. I’m not begrudging anyone a planned c section. If people want all the pain relief it should be there. Equally however, I don’t want people to begrudge me what I want which is a birth managed by women and one which is as close to its natural state as possible as safely as possible.

@Zebraantelopegiraffe
its wasnt a definitive statement. There are lots of ifs and buts
But your sentiment was that vaginal birth is generally safer in the absence of identified risk factors. This just isn't definitively the case! Adding "ifs" and "buts" doesn't change the fact that the premise is wrong, because there is no safest method of delivery

Yes, there are all kinds of risks associated with c-sections including the ones noted in your post. There are also a whole host of risks associated with vaginal birth. How you reconcile and prioritise these risks is largely subjective and hence it is vital that every woman has objective information presented to them in an unbiased manner so that they are in the best position to make an informed decision.

But while everyone is squabbling about natural birth v intervention and how midwives are evil pain relief with holding pain relief the REAL problem of a dysfunctional system from board to the coal face is not being talked about
Women being denied pain relief, objective information and ultimately autonomy over their bodies through being denied c-sections are not distractions. I'm not "squabbling" with you about which method of birth is safest to be facetious. It is absolutely of fundamental importance that this drive to promote vaginal births and reduce c-sections is stopped. We must let women make truly informed decisions that aren't predicated on the idea that vaginal birth is optimal in most cases and therefore should be the default. This is an approach that simply isn't supported by the available evidence and therefore needs to be abolished. Funding issues etc should also be tackled, but it is really unfair and dangerous to imply that the "natural birth" issue is a distraction from bigger things.

YANBU. Ideally yes a natural childbirth with no intervention would be wonderful. However, lots of women and their babies would die if they had no intervention. Pain relief is also there for a reason!
I think natural childbirth classes and some NCT classes need to change. My NHS one was very informative on both a straightforward birth and a one requiring various intervention discussing pain relief with pros and cons and no judgement.
I like midwife led units sitting is less clinical but they need to be in the same hospital as consultant led in case anything changes during labour. They are a floor apart where I gave birth. I opted for midwife led but as my waters went and I had to go on the drip it was the labour ward for me.
Women need to be able to make the right choice for them and that particular pregnancy. Obviously in a high risk pregnancy the midwife or doctor needs to step in to make the birth safer.

More staff pare needed. That and a continuity of care. Imagine having your child delivered by someone who you’ve built a relationship with and knows you.

The best birth experience I had was when the midwives listened to me. I was able to explain what I wanted and they took me seriously. I feel midwives only listen to a mothers wishes when she’s had a baby or two. It’s like oh she’s had a baby so she knows what she’s talking about.

As a side note, the antenatal classes I attended did not mention c sections at all. It took a very nice doctor, who I spoke to prior to being induced, to explain what happens. A short conversation allayed a lot of fears.

more than 50% of women in Sweden 'need' an epidural, 60% in the US and 77% in France. Either French women are all wimps, or is the case rather that epidurals are available at maternal requests and you are not told that there there, you're doing so well, you don't need one?

the statistic conveniently forget to mention the %age of injuries and medium to long-term effect of the vaginal births - despite calls or needs for a c-section that wasn't available.

Basically you can turn around all the statistics but without the full info, they are pretty meaningless.

It's not just about the survival of baby and mother (important as they may!), but also the quality of life and traumas and so on.

The flaw to this post is that intervention actually causes a lot of risk and issues also, over medicalising birth brings risks. I'm not fetishising birth, I wish every woman got the birth she wanted however that looks, but pain relief and surgery does not always guarantee a safe, healthy delivery, or we'd all do it. Every woman has to make an informed choice, be aware of the pros and risks and there will always be an element of see what happens. Birth is unpredictable, I do believe natural as the default is the safest option until other risks arise, and yes a woman's MH is part of that, if she doesn't want to that automatically moves it from the default if that makes sense.

Why are people mentioning home birth and unassisted birth? From the Independent report:

Clinical malpractice was allowed to continue unchecked over a period of 40 years, with repeated failings by doctors, midwives and hospital bosses, according to a leaked internal report.

This is a badly run hospital service, badly run right across the board if the above statement is true. This is what needs to be improved. Just shouting that hospital is safer, doesn't make it so, as this case demonstrates.

Personally I think I’ll be the least stressed in hospital knowing I’m surrounded by people who know what they’re doing and minutes away from intervention if it’s needed!

How many women went into the Shrewsbury Hospital believing this to be the case? How many women then believed that something going wrong was 'just one of those things' and not evidence of a badly run maternity service?

It's convenient and easy to blame advocates of physiological birth as it obscures the real scandal in maternity care which is too few midwives, not enough funding, and pouring money into processes like routine induction while not having the resources to support women adequately through the process.

I fully agree, and this makes me one of the 12% of YABUs.

And just to add I think it's men over managing birth which has added to birth intervention risks, having women on their backs legs up for example as it makes it easier for the professionals to see and manage but is one of the worst things you can do to a woman in labour.

I've met quite a few women who were seriously unhappy about their birth experience because they needed intervention.

I have met quite a few women who were seriously unappy about their birth experience because they felt intervention was FORCED upon them

they felt bullied
they felt pushed into a corner
they felt they were being treated without respect

WHY is that still allowed?

My son is 17 years old it took me many years to digest process and accept what was his overmanaged birthing process. (I btw gave birth naturally)

MY 19 and 16 year olds birth were natural homebirths I felt on top of the world during them and after the birth.

My oldest a hospital managed epidural was done so effectively sensitively and with my feeling that they listened to me and wanted me to have a positive birthing experience .

What it comes down to is us needing to SUPPORT women to get an experience that is " right for that woman" and if that is a epidural or a c cestion for that to happen with the woman feeling she was consulted supported and at no point made to feel belittled.

IF what is right for the woman is a home water birth with candles and music and them singing along to anything they wish

they should be made to feel supported consulted and at no point being made to feel belittled

Frankly OP your opinion is in my view as wrong as what you are trying to say that the ones YOU dont want is.

IF we want to move forward in birth we need to focus on what the woman wishes and needs and wants and HOW can we support her to achieve that.. IF what she wishes is not ideal then we need to work out how to support her to make further choices in how she wishes to proceed.

ALL of that is possible and would be such a step forward. There are fantastic hcp out there who already delivers this. However for me when my daughters gets to give birth and my sons partner gets to that stage.. I would like for them to be able to do so feeling supported, listened too and left feeling like they have had a positive experience no matter if they had a homebirth or a c section.

I just find it so hugely frustrating when women's wishes are ignored or belittled and frankly I feel you are belittling them when you use phrases like " woo" IF that is what helps that woman birth her child and that birth becomes a good experience for her then WHY would you wish to take that away from her?

On the other hand If she needs a c section and has a good hcp team who supports this and talks to her it is also possible for her to walk out feeling empowered and good about this experience

Surely THAT is the aim? For the woman to feel her birthing experience where possible was supportive.. She was listened too and her wishes were taken into account?

I had an emergency CS after failing to progress 48hrs after waters broke. I knew labour would be painful but didn't know how badly I'd cope, DC was back-to-back and when I did eventually get an epidural it failed twice and only covered part if the contraction pain. Gas and air did nothing, and pethidine gave me enough relief to sleep for 45 minutes before becoming ineffective. The recovery from the CS was straightforward.

But I'd still say a vaginal birth is best. This doesn't mean best for everyone, but it is best outcome-wise for most women. The best case scenario for a birth is a vaginal delivery with no complications. I knew this before giving birth, but I also knew birth is a lottery.

I'd say we need a better attitude towards providing pain relief. The worst bit of my labour was when I was contracting but being kept on a maternity ward with only co-codomol and a TENS machine.

I have a real issue with your 'shame' argument as well. I was neither validated or shamed for the way my kids arrived, we were all just relieved that they and I were ok. Nobody made any judgement on how that happened, and I accept that that is only my experience but we need to be really careful about talking about who is shaming who here.

Sorry what do the hideous events at Shrewsbury have to do with natural birth?

@GrumpyHoonMain
And while yes an elective c-section is better than an emergency c-section and an assisted birth in terms of long term damage, all three cause more long term pelvic floor damage than uncomplicated vaginal births. Those are the facts
And yet you can't elect for an uncomplicated vaginal birth so a fair proportion of women hoping for this will actually end up with some intervention or an EMCS. It therefore follows that when assessing risks around pelvic floor damage you should be really comparing ELCS statistics to those for attempted vaginal birth which would include uncomplicated vaginal births AND EMCSs and assisted births.

peregrina I’m not familiar with the hospital being discussed, my post was in reply to the OP not related to this report that’s since been mentioned.

More staff pare needed. That and a continuity of care. Imagine having your child delivered by someone who you’ve built a relationship with and knows you.

I never understand how people think this might work in reality, as lovely an idea as it sounds. You’d have to have a single full time midwife working shifts both in the community and in the hospital labour ward, they wouldn’t be in the hospital full time therefore and taking into account shift patterns, leave, sickness etc. the chances of having the same midwife you’ve already ‘built a relationship with’ would be pretty small. How do you think it would work in practice?

I don’t expect to have met the people who help me deliver before, it just isn’t practicable. I’m not bothered whether we’ve had weeks or months to build a rapport and relationship as long as they’re competent and professional. I don’t know anyone who would expect to show up at hospital whenever the baby decides to come and have a midwife they already knew on hand to deliver!