Is wanting a natrual birth unrealistic? Is it all down to luck?

[digggers]

my own experience and the experience of friends really makes me wonder about this. There's no ryhme or reason, it's just so random.

Are people who prepare for and experience the birth they want just lucky? Is childbirth something you can prepare for and influence? Or is an open mind and a thankfulness that in our country we have medical help on hand the best approach? Or should all medical help be viewed with distrust!

I think the WHO says most regions should have a c-section rate no greater than 10 to 15 percent.

Tittybangbang - do you have the figures for maternal and baby mortality in the 60s? How do they compare to the figures now?

I agree MotherofHobbit - it isn't about having the 'wrong attitude'and this myth makes women feel failures if they can't do what comes easily to others. Some people have wonderful singing voices, some people are artistic etc I just happen to get pregnant really easily and give birth really easily-it isn't my attitude- it is sheer luck!

I go into it with a complete open mind, if you have huge expectations then you are set up for disappontment. I don't see the point of a birth plan, rather than calming music and candles etc I am finishing the washing up!I really don't mind who is in the room and I opt for the hospital because I am a pessimist who wants to be in the right place if things go wrong I have had 3 lovely births with that system.

I'm not sure about luck or not. For me, I had a very long natural birth, but it took a lot of perseverance to have any intervention.

If I think about luck, then I'd say I was lucky enough to have one of the best most experiences midwives in the hospital.

Yeah, not all went to plan, but it was good enough. The prep did help a lot, more to get me mentally determined and in the right place.

They were three times what they are now.

I think the really big decreases have been in reducing deaths caused by eclamsia. And deaths linked to operative birth are much rarer too. c/s is a really safe operation now compared to what it used to be.

Meant to add - good job c/s is so safe now, given the huge number of them being done at the moment!

Luck! Had a natural birth in mind first time round but DS was 10lb 3ozs and REALLY hurt when I was only 1cm dilated. Remained at 1cm for 6 hrs! Epidural was great.

Was totally natural second time round and totally loved it. Was a much more positive experience and I was so in control. Again I still think, LUCK! Good luck. lol

Have skimmed last part of this thread - but I also wanted to comment on Carmen's wonderful deck of cards analogy - that 1-10 thing makes SO much sense, and negates the rational for guilt amoungst those who have had the shitty end of the stick.

For those normal people in the 3-6 camp, the other thing that makes me feel that (whilst not negating lady luck) that mentality can contribute, is the first/second birth phenomena - ie that most people find childbirth hugely easier the second time round. Whilst there are obviously physical reasons, my second birth felt totally different to my first birth because I knew I had got through it before - I knew my mind and body had handled labour without collapsing into a Casulty style heap. I knew it would smart and that I would be alive at the end of it.
It's SUCH a different place to be in vs. your first birth - which for most women in the west at least, will be their first experience of being anywhere near a real childbirth, where you just don't know wtf is going to happen.

its just luck,i grew up in a third wolrd country,all these intervensions you talk about,they do not exist in my country,when a woman is pregnant,she is never told about the actual pain of childbirth,it is seen as a natural thing for a woman to do,

my mum had 8 of us,7 vaginally but my brotherwas delivered via c section,my mum had lost 4 babies before,she gave birth to them dead,because after labouring for hours,she couldn't deliver,and they died,di she plan the others?no,just luck

my sister has 3kids,all delivered vaginally,she also lost one baby bcoz of the same reason with my mum,did she plan anything?no,just luck

i got pregnant,didn't think there was any other way other than natual,after all thats whats done in my family,i went 14days overdue,i was not dilated even after being induced,got the epidural,nothing helped,i had to get emcs bcoz the baby's heartrate dropped,did i plan on this?no,i was just unlucky,i was only glad when my baby was placed in my arms that she was alive and i was ok,,i did everything to prepare,running up stairs,exercising,reading,you name it,next time i am doing NOTHING bcoz everything will fly out the window when the actual labour starts,sorry too long

third world

I had a birth plan and I wanted a natural birth at home (first child).

Unfortunately I ended up having a "natural" birth at hospital after 39 hours, 5 mins; having heavily laboured at home for 24 hours.

I couldn't have pain relief as I'd had a bad reaction to dental anaesthetic.I couldn't even have gas and air as it made me hurl.
It wasn't great but I lived.

It's not offensive in the slightest. It just means they didn't prepare if something were to go wrong. I prepared for EVERYTHING, even visting a a surgeon should I need a cs as well as a anaesthetist to mix me a pain relief should I need an operation. So yes it is down to preparation.

Just to add my opinion to this massive thread.

My own view is that you can prepare in that you can understand how birth happens so that you go into labour with less fear and an understanding of avoiding continuous monitoring where possible, staying upright etc

However, I also think blaming the mother for how birth happens is absolutely pointless. It doesn't take into account the babies role in birth and also the environment in which a women gives birth.

Every labour and birth is different, different mother, different baby. The majority of women in this country give birth in a hospital and unfortunately the NHS model of birth doesn't accommodate too many deviations from their idea of the "standard".

So like Starlight's link to the Rest and Be Thankful phase, I know a lot of women who's labours have followed this pattern but they have been put on syntocin & ended up with forceps or ventouse - after labouring without intervention so far.

The same goes for going past your EDD (I was booked in for induction with DD at 2 days past EDD), ELCS for having previous CS, ELCS for previous tear, blood pressure issues, women having CS for labours that are "too long", early induction follow a labour which was "too short"...

Once my waters broke the clock was ticking to get DD out ("she'll have to turn, babies don't come out this way"), not really conducive with relaxing and fear-free environment in which to give birth naturally!

I am not saying that having intervention for any of these reasons is wrong but how many of us actually fit into the obstetric model of "normal pregnancy/labour" in the first place? The odds can be stacked against us before we even get to the delivery suite!

Then we are left feeling guilty and to blame for not having the natural, drug-free birth we hoped for.

Love Carmen's pack of cards analogy.

Confused by your post Muddle, earlier you say that women having medical interference didn't prepare enough, then something about not preparing for something going wrong? Surely that is saying that you were prepared because you considered the possibility of a CS, but others weren't because they had to have one? Also, dare I say if you are allergic to opiates it is no great feat of preparation to arrange for suitable pain relief. Par of the course I would think. I also think unless you went private, you would have very little say in who performed a CS.

I say that with no grudge to hold, I had a foceps delivery as the baby was distressed and brow presentation...nothing to do with poor prep. (As previously stated: hypnobirthing, birthing pool use in MWLU, healthy mother, v low blood pressure, natural onset, pain relief free dilation to 8cms, visits to all units, well thought out birth plan etc.)

Oh, and I went into the process very calm and trusting having read Ina May Gaskin. I still feel the same way about childbirth, despite it not working out that way for me.

Yeah point taken. I believe you should prepare for the worst, I just think so people opt for the easy way because labour has an air of mystery about it and people do indeed get the fear of the unknown....
Thankfully I had a normal birth, no stitches, no pain relief and no hospital...and I was prepared. I was also determined not to have any intervention to the extent of not going into a hospital. There's only so much they can do from home. People go into the hospital, as if it's going to hurt less. If you're not ill I don't recommend a hospital birth (unless of course there are major complications). THere are a number of women who go into hospitals and have normal healthy labours and normal healthy children, at a massive cost to the public. Stay at home and do it naturally fgs.

its a combination of so many things,your body,the baby,your state of mind,luck and i think a biggy is the midwife.for the first 10 hrs of my labour i had a very poor midwife,who didnt communicate with me,made me feel as though i wasnt coping very well, and i totally lost it.i was crying scared,demanding anything they could give me to ease the pain. when the midwives swapped shifts i had the most wonderful woman and i instantly became a different person.i was calm,resumed the fact i wanted a natural water birth and coped with the pain.unfortunatly the baby got stuck and i had an episiotamy.so i think you need to be as open minded as poss,it doesnt always go the way you would like.

I had scan to check the size of the baby which they determined would be no problem for me to birth. He was in the right position, my blood pressure was low, I was fully prepared and there were no foreseable complications. I chose to go to the hospital because it was my first baby and I wanted the security that gave me. Thank God I did. Meconium in the waters, non-consistant contractions which didn't change when they tried inducing me, 14 hours of labour getting me to 1cm and the baby's heart rate down to 40bmp. When they did the emcs it took 4 people to unwedge my son from inside me and his head was the shape of my pelvis. There was no way he was ever going to get through. I wasn't ill, everything was textbook in terms of his position and no-one thought it would be a problem. I'm grateful I didn't risk his life or waste valuable funding and put another life in danger by using an ambulance. Nothing, no-one, or anything could have changed the fact that he would have died without an emcs so I'm, bloody glad I used a hospital.

Life is unpredictable. I think that good ante natal preparation improves the odds of a good birth experience, but nothing in life is guarenteed. Prehaps what is more important is good midwifery care and finding the balance between caution and allowing the body to get on with the job it was made to do.

Many women end up with bad birth experiences because of the casade of intervention. I am sure that my NCT classes stopped me from having a hideous birth experience with my first baby. The hospital were desperate to induce me because they were short staffed. The NCT classes taught me that I had to right to say no to any medical intervention. My son was born relatively naturally and had a good APGAR score inspite of a 33 hour labour.

I did have an epidura after 28 hours, but it had worn off completely by the second stage so I managed an active second stage.

My second birth was at home and a lovely experience. It was luck, but also excellent midwifery care.

For example knowing good birth positions. lying on your back during the second stage is best avoided. Its best to have gravity doing the work for you.

Agree reallytired. It's about improving the odds, not trying to pretend there are cast iron guarantees.

I also felt that I owe my good first birth experience in part to the NCT, simply because it gave me access to clear, accurate information. I would probably have believed that I needed to be in hospital if it hadn't been for the NCT explaining to me that because I was a low risk pregnancy, it would be just as safe at the MLU or at home. Because I opted for the MLU, where I had a known and trusted midwife, rather than whoever happened to be on shift, I felt more empowered from the outset. Because she was able to exercise her own professional judgement, rather than having half a dozen doctors popping in and out, she didn't rush things. She interpreted my long, tough labour as perfectly normal for a first one. So, although the pain was shocking, I can honestly say it wasn'ta hideous experience. Fear always makes things worse, and because she helped me to stay calm and reassured me that I really wasn't dying, and that before long I'd be holding my baby in my arms, I kept going and managed to deliver my large baby completely naturally.

While there are no guarantees with childbirth (as with many things in life) there definitely are steps you can take which will improve the odds.

Another point is that one woman's relaxing surroundings is another woman's nightmare.

Not everybody likes candles and classical music. Not everybody wants a doula; I would have been seriously annoyed by anyone who tried to take dh's role of being there for me.

One thing that always comes up in these posts is the importance of continuous care of a familiar midwife. But I didn't like the first midwife I saw and was very relieved when she came off her shift and an unfamiliar but friendly face appeared round the door. I would have hated her to have supervised me throughout a homebirth or MLU birth.

On the other hand, lots of different people popping in didn't bother me at all, that kind of thing just doesn't worry me. I was the one who was quite happy to be prodded by a team of students whilst still on the ante-natal ward and provide their teacher with feedback concerning their bedside manner. And I actually enjoyed being in a ward with other women, and would have disliked a private room.

People are all different.

"People are all different"

Very true, but the NHS has to make policy about staffing and birth environment on the basis of best health outcimes. The best outcomes are found in situations where mums get continuous care in a low tech environment. Hence all the money spent developing new birth centres over the last few years.

"On the other hand, lots of different people popping in didn't bother me at all, that kind of thing just doesn't worry me"

I would say the same for myself. Not sure though that at some other level being exposed to lots of disturbance is helpful to the normal hormonal cascade necessary for a smooth functioning labour. We are mammals after all - maybe our deeper instincts run counter to what our civilised consciousness might tell us we like.

news.bbc.co.uk/1/hi/health/8068889.stm

interesting?

This came out a while ago. There was a really good discussion of it in one of the journals. I'll see if I can dig it out. Seem to remember questions being raised about the amount of physical preparation involved in the trial and the selection methods used for the midwives taking part in the trial.

I personally think the most important factor in determining your likelihood of a normal birth is the type of maternity care you get. Send any woman into a hospital where the vast majority of women are receiving epidurals in labour and it's very likely they'll have one too, no matter what preparation they've done, particularly if that preparation consists of just six or so 15 or 20 minute physical skills sessions taught alongside a standard antenatal syllabus.

Re: 'natural' and 'normal' - as far as I'm concerned 'natural' birth is the same as a 'normal' birth - ie a birth without medical interventions (forceps,ventouse,c/s, synto)

Have to say - it certainly contradicts the huge wealth of anecdotal evidence here on mumsnet by women who've used breathing techniques to help them cope in labour.

The midwife you get is HUGELY important in giving you the best chance to labour well and have a natural birth. It is of course just chance, but optimising your chances is all you can do, in the end.

I think the biggest factor is hospital. As soon as you go into hospital, birth becomes (and I am making the word up) medicalised IYSWIM.

It becomes a procedure, sthg that needs intervention.