To be concerned at the number of people on MN second guessing doctors?

[Wolfgirrl]

Every day I read a new thread where the poster is canvassing opinion on whether to reject medical advice.

The most common seem to be wanting to refuse a caesarean/induction and not wanting to top up fail to thrive babies with formula.

I totally agree that everyone has the right to refuse medical treatment etc, but when it relates to a baby you're not just putting yourself at risk. It just seems selfish to me? Interested to hear other's opinions.

@Gumbo omg that is so sad when people talk about the risk of stillbirth being 'tiny' with an overdue baby, they forget somebody has to be that statistic, and it is the worst outcome imaginable. Surely any amount of inductions is worth reducing that risk?

Again, I'm really not talking about human error or GPs, or misdiagnoses etc. Here is an example of the sort of threads I mean:

www.mumsnet.com/Talk/breast_and_bottle_feeding/2403408-Why-dont-my-big-ebf-babies-thrive?pg=3

www.mumsnet.com/Talk/childbirth/2158928-vaginal-breech-delivery-at-home-any-positive-stories?pg=1

www.mumsnet.com/Talk/childbirth/2652722-VBAC-home-birth-40yrs-Is-there-a-chance-with-NHS

Women have never had so many sources of help as they do now - midwives, health visitors, breastfeeding peer support workers, lactation consultants, breastfeeding groups, La Leche League, the Breastfeeding Foundation, websites such as Kellymom (and thousands more), books, forum websites such as MN and others, youtube tutorials.

I've experienced support from midwives and health visitors and the problem I got is that they all contradict each other. As did many of the websites and online tutorials. And when you've spent your entire life being taught that breastfeeding is really hard, you've never seen anyone do it, you know the stats on it and you don't know anyone in real life that's actually done it, all the contradictory support doesn't add up to much.

Women used to have access to family members who had breastfed, knew it was possible, had learnt about it from their mothers and had grown up seeing it done. That's support. We have more support now than in the last few decades when formula was so pushed that breastfeeding knowledge in communities was all but lost due to formula pushing by business and by medical professionals. But one good source of support is better than twenty mediocre/poor ones.

Also I suggest you read, 'This is going to hurt'. A great book written from the diaries of an NHS obstetrician/gynaecologist.

@fourplasticrings

I have no idea why everyone seems to think watching family members breastfeed is the answer.

Even women in the same family have different boobs and different babies. One woman could find it very easy but her daughter could find it a lot more difficult.

Blind faith in doctors is incredibly unwise, they are not the fountain of all knowledge, however dismissing them out of hand is also pretty stupid.
They are giving you their educated opinion, nothing more or less. It's up to every individual what they do with that information.

Inductions have their risks too.
It is not always a clear call and could be intervening leads to a unnecessary complications and emergency c section

@FourPlasticRings plus if there was just one source of information, if someone said it was crap and didnt work for them, whatither options are there?

If I had listened to medical advice I would have had a stillbirth. I demanded an induction at 40 weeks (they wanted me to wait until 41 weeks despite my having a clotting disorder and being almost 40) because of a gut feeling and good thing too as his heart nearly failed during the delivery.

@Chiwi I think there is a lot negativity around induction from non medical professionals, at least that was my experience, I guess because there are higher risks but even so, it’s not very often you see stories of positive induction experiences on here and I think the horror stories create a fear that you absolutely will end up with ongoing problems if you are induced or have any kind of instrumental delivery (as I did).

I got a lot of pitying looks from the antenatal class leader at our meet up because I was induced, I made it very clear to her that I’d chosen that route (based on the options given to me by the consultant and what she thought was the best option) and that I was very happy with it, I was out walking round the village the day after I gave birth and felt pretty much normal within a couple of weeks with no lasting damage! I was really scared before I gave birth because I hadn’t read any positive induction stories (or had any friends who’d been induced) beforehand.

@skigal86

Agreed, I know the word 'traumatic' is subjective but I always see it in relation to any birth outside of a textbook one.

I had a 5 day induction and a forceps delivery. Would I call it traumatic? No.

I really don't mean to sound too harsh but because of all the hypnobirthing and whale song stuff, people have forgotten that birth by its nature is incredibly painful and very very hard work.

There are positive induction stories but there are also negative ones and the evidence suggests the risks of a negative experience are greater with induction.

I agree that the doctors’ advice about increased risk of stillbirth and getting the baby out is reasonable because they can’t tell in advance who will be the exception to the rule that it would be ok to continue. But they should be giving women the full picture of the risk, and caesarean should be an option alongside induction if the baby is coming out.

It’s good to get a second opinion and do your own research. Doctors don’t know everything.
An A&E doctor prescribed my sister a medicine which she is categorically not allowed to take and would have resulted in emergency surgery.

I agree that the doctors’ advice about increased risk of stillbirth and getting the baby out is reasonable because they can’t tell in advance who will be the exception to the rule that it would be ok to continue. But they should be giving women the full picture of the risk, and caesarean should be an option alongside induction if the baby is coming out.

THIS

I have no idea why everyone seems to think watching family members breastfeed is the answer.

It's the culture more than anything. If you've grown up around breastfeeding you're more likely to view it is as possible and persevere through difficulties. If you've always prefaced every sentence about breastfeeding with, 'If I'm lucky enough to be able to,' and no one around you has ever done it successfully, you're more likely to be encouraged to quit when faced with problems than to be encouraged to persevere. It's fairly obvious when you think about it. And also, if you know enough women who've breastfed, the odds are you know someone who's had your problem. If you're relying on the guidance of a HCP who may have had less training on breastfeeding than your average NCT class provides, it's unlikely that they know enough to be able to troubleshoot. So what happens? They say your supply is insufficient and suggest formula as an alternative.

I had a 5 day induction and a forceps delivery. Would I call it traumatic? No.

Well, bully for you. Does that qualify you to decide whether the experiences of other women are traumatic then? Or are they just wimps?

I really don't mean to sound too harsh but because of all the hypnobirthing and whale song stuff, people have forgotten that birth by its nature is incredibly painful and very very hard work.

It doesn't have to be, really. But that's the line we're fed by the media, so most of us believe it. It's generally not fun, but nor does it have to be incredibly painful and very hard work. Inductions generally are though, based on anecdotes from here and information online.

My hypnobirthing was brilliant it actually helped me accept that whatever happens is the right decision at the time but just taught me to manage my anxiety. It really helped my breathing through an induction and back to back labour which I definitely would have panicked through without those skills. It was bloody painful but not a pain similar to any other.

I have no idea why everyone seems to think watching family members breastfeed is the answer.

I think seeing how women you know breasfeed is definitely the answer. It’s no accident that countries with extended families and high breastfeeding rates have lower (or sometimes negligible) rates of problems mastitis or blocked milk ducts or supply issues.

For example there are specific ways to breastfeed a tongue tied baby - I found this out via La Leche League and when I told friend (who also had a severely tonguetied baby but without the weight gain issues that mine had) she said she was taught the technique by her mum.

@fourplasticrings

But it isn't family, HCP or nothing. What about all those sources of specialist information I mentioned above? Are they all useless?

I found breastfeeding easy. Good supply, no mastitis, didnt have even the slightest bit of soreness. If someone came to me with an issue I would have no idea what to suggest.

Well, bully for you. Does that qualify you to decide whether the experiences of other women are traumatic then? Or are they just wimps?

Of course not. But I think the transformation of birth from a fact of life to an 'experience' has raised the expectations of women to think any intervention makes it 'traumatic'.

Of course it has to be painful and hard work, it's childbirth?!? I know it isnt fair but it's a fact of life isnt it?

FourPlasticRings I generally agree with your post, but I dislike the pressure on women to ‘persevere’ no matter the cost to them. Being in excruciating pain for many hours of every single day, or never having time for an older child because of relentless cluster feeding are more than good enough reasons not to persevere with it, IMV.

Of course not. But I think the transformation of birth from a fact of life to an 'experience' has raised the expectations of women to think any intervention makes it 'traumatic'.

I think events turning out differently from expectation can make a difference to how women perceive their birth experience and how traumatic it was. We do need more of an attitude of going with the flow. But much of trauma is down to things like how a woman is treated by the HCPs, rather than what actually happens. More explanations, more autonomy, more kindness would help. Downs and Byrom speak well of this in their book, the title of which temporarily escapes me.

I have a lot of cynicism about the whole birth experience thing, I think it can lead to a lot of disappointment. That said a lot of women do have very negative experiences of induction.

Mine was OK, had the epidural put in at the same time as the drip and was properly monitored throughout. I know multiple other women who were given pessaries and left on antenatal without any pain relief or monitoring for long periods. They have all said that if they had the time again they would have refused the induction and waited for a cesarean as it was such a bad experience.

It get that it makes life easier for the doctors if they can avoid even a low % of risk from not inducing but that isn't the patients problem.

I know for a fact that midwives wrote on my discharge papers I was fully bf when I was discharged from hospital
I was fully FF when I left. They asked me if they could dodge the papers in exchange for early discharge so it looked better for their bf rates and hospital funding as a bf inecitive hospital (In Aus)
You think any woman who FF got support there? Hell no.

Some Drs, nurses, midwives, lie and are wrong. It's wise to question

Being in excruciating pain for many hours of every single day, or never having time for an older child because of relentless cluster feeding are more than good enough reasons not to persevere with it, IMV

Agree 100%. MN is full of threads posted by desperate women who have sought all the help under the sun but are in pain and exhausted. It is clear they need to hear that it is okay to stop if they want to. But they just get a load of posts egging them on, telling them to try weird supplements and how they 'didnt listen to the doctors, my child is still absolutely tiny at 12 but fine'. Pressure pressure pressure.

I had my last child at 41+ 2 they wanted to induce me at 40 weeks as that's their standard. I choose to wait because I was healthy but also I am hypermobile which puts me at greater risk for complications such as bleeding and uterine rupture or fatigue from induction. For me those risks are higher than the risk of stillbirth although I would have probably booked an induction if I hadn't have given birth that day.

The problem with the statistics is they don't individualise so a smoker with underlying health conditions is treated the same as a healthy 30 year old with previous successful births.

I wouldn't say I have exactly 'distrust' of medics/HCPs, just that I have a certain amount of awareness of how little training, information and up to date evidence they are actually able to keep on top of. So I research things thoroughly, seek out the best evidence that I can and then make decisions based on that. Sometimes it's frustrating to find that doctors/nurses are not following the NHS' own guidance, let alone using evidence-based information to inform their decisions.

Of course in general medics will be vastly better informed and have more experience than non-medics, but when it comes to specific conditions patients are often quite capable of researching the evidence, and making their own informed decisions. I think if a medic and a patient work together with mutual respect then it should work in everyone's best interests, though our model of healthcare often doesn't allow for this.