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!

Selina, you sound like a lovely doula!

Thank you!
And I apologise for all my typos, I never spell check!

Oh I agree music can be helpful - i listened to an eclectic mix, just not whale music! The point really though, is that its annoying when people use stereotypes and assume that a woman who weighs up the risks and looks at the options, and makes a considered choice to give birth at home or in a nonmedicalised environment must be some sort of tree hugging hippy. Why is it so hard to believe that we're motivated by a desire to avoid the risk of intervention as far as we can?

'Well - maybe you do, but I try to draw on other people's experiences as well as my own, plus professional knowledge and an awareness of what the medical research says

It isn't a lot of help if it is telling you that it is best to have something that you don't want! It may all point one way but it could still be wrong for the individual. I agree with cory and I just do not want to be in my own home-I want to leave it all behind and concentrate on the baby. I don't want to worry about the effect on other DCs. I don't want to have to immediately respond to the feelings of the other DCs, I want the new baby to be central for a short time, as soon as I get home they can't be. I don't find music in the least helpful and I don't want soft lighting. The poem did zilch for me too. I haven't had much to do with doctors but I had a student one who was lovely.
I think it is sad when medical staff are viewed as the enemy-I have found them all friendly and approachable.

I am all for people having home births and soft music-if they want them- but it isn't better-it is just better for them.

I think we just need to separate the two issues.

It's absolutely undeniable that some interventions carry additional risks and therefore are best avoided unless the medical need for it outweighs that risk.

For example, my second baby was so small and prem, that the consultant advised Csection was the safer option than vb for that pregnancy - even though overall, statistically Csection is less safe.

My first birth had the potential to be totally straightforward and non medicalised - baby within average weight range, went to full term but not overdue, I had no complicating medical factors. Therefore, a CSection would have posed a greater risk than vb for that pregnancy. In fact, I did my research, and decided I would go for midwife led, natural birth if possible - which was what I had. DC3 was a VBAC - again, I took advice, and acted on it. The advice was: for this pregnancy, VBAC was safer on balance than csection, induction was to be avoided at all costs due to the scar, and best to avoid epidural as the midwife relies very much on the mother feeling each contraction with a VBAC. I would have liked to deliver at the MLU, but was told I was too high risk, so it was a hospital birth that time round.
So, three very different births, which reflected the needs of each baby.

The second issue, is where the mother has strong feelings about her needs, and whether these are best met in hospital/at home/with a lot of pain relief/ no pain relief etc. Again, different people will have different feelings. I don't feel comfortable with hospitals unless I medically need to be in one. Other people would only feel comfortable in hospital. I have quoted the example previously of my two work colleagues - both pg - who already have totally different ideas of what they want from birth - one wants to be in hospital and wants as many drugs as possible (her words!) while the other is aiming for a home birth.

My advice to any expectant mum would be to arm yourself with the FACTS - not hearsay- weigh them up, factor in your own personal perspective, ie whether you feel better at home/hospital etc, and then use that knowledge to plan for the birth you hope to have, but bear in mind that while there are things you can do to increase your chances, there are no 100% guarantees.

"I am all for people having home births and soft music-if they want them- but it isn't better-it is just better for them"

Lower rates of stalled labours, episiotomies, fetal distress, low apgar scores at birth, lower likelyhood of breastfeeding difficulties, reduced need for pain relief, lower likelihood of pnd, lower rates of perineal damage, lower rates of pph, lower rates of postnatal infections, lower rates of assisted and operative birth. All these things are associated with homebirth. Do you feel this is because women who have homebirths are getting the birth they want? If that's the case, why wouldn't you have the same outcomes for low risk women having hospital births - given that they presumably are getting the birth environment and pattern of care which they clearly have a preference for?

"I think it is sad when medical staff are viewed as the enemy-I have found them all friendly and approachable."

Again - straw-man argument! Who has portrayed medical staff as 'the enemy'? There's not a single person here who doesn't believe that doctors' skills are necessary when birth becomes complicated. And in any case - don't midwives also count as 'medical staff'?

"I don't want to have to immediately respond to the feelings of the other DCs"

Agree it is a matter of values and priorities. My priority was an uncomplicated delivery. Felt this was a good trade off for the 24 hours of substandard postnatal and care in a crowded ward I was missing out on by not opting to give birth in my local hospital. I assume your hospital was vastly nicer than mine!

Erm - who said doctors were the enemy? Some of my closest friends are doctors (and nurses and medical researchers) so I'd certainly take issue with any doctor-bashing.

And who said that it was best for you to be at home no matter what?

No one.

All that I am saying is that planned homebirths attended by qualified midwives in the UK, for low-risk women, have the same perinatal death rate but produce a higher rate of other positive birth outcomes than hospital births for matched groups of women.

This is a statement of fact, not an instruction to expectant mothers.

The evidence doesn't tell you what to do. Research just gives you a guide as to likely outcomes in populations or groups similar to those studied. You are perfectly at liberty to ignore it if you don't like it, don't understand it or are in possession of information not taken into account by the researchers.

I chose homebirth with an IM because the evidence indicated that it was the most likely route for someone like me with a low-risk pregnancy in the UK to have a positive birth, to avoid physical or mental injury to me or DD, and to experience a very quick recovery.

'The evidence doesn't tell you what to do. Research just gives you a guide as to likely outcomes in populations or groups similar to those studied. You are perfectly at liberty to ignore it if you don't like it, don't understand it or are in possession of information not taken into account by the researchers.'

.I chose homebirth with an IM because the evidence indicated that it was the most likely route for someone like me with a low-risk pregnancy in the UK to have a positive birth, to avoid physical or mental injury to me or DD, and to experience a very quick recovery'

Hear hear - very well put togarama.

They certainly seemed like the enemy in the poem! It painted a dire picture-the idea being that you should imagine milk and honey etc at home.

'My advice to any expectant mum would be to arm yourself with the FACTS - not hearsay- weigh them up, factor in your own personal perspective, ie whether you feel better at home/hospital etc, and then use that knowledge to plan for the birth you hope to have, but bear in mind that while there are things you can do to increase your chances, there are no 100% guarantees.'

I think that violethill has it right in this paragraph. We weigh them up differently. I am all for people making up their own mind and not being influenced by those who 'know better'. I don't think that my way is 'better'-it certainly wouldn't suit those who want a birthpool and their own home. All I can say is that I made informed choices-for me.
I just get the impression that people think that it is a better birth, for every mother and every baby, to be in their own home and that somehow my baby is missing out by having a mother who is very practical and can't stand candles and talk of anemones!

I find that in hospital I can spend hours with the baby, I don't have people calling, phone calls, other DCs who need my attention, questions about 'where do I find....?etc. It all happens soon enough when I get home-it is a lovely interlude from 'real life'.
I was terrified when I had my first-having no idea what to do with a baby! If I hadn't been in hospital, with staff on hand, I would never have managed to bf -I thought it would come naturally and it didn't. I also needed to be shown how to bath him, change nappies etc. (I didn't need it with 2nd and 3rd as it was natural by then)

Not strapped down,
With them crowding round and shouting that you are useless, that you aren?t trying
-that your baby is going to die if you don?t push harder.

That is the bit that sounds like the enemy! I have never been strapped down-no one has shouted and they certainly haven't said I was useless-they have given encouragement-calmly -all the way. It sounds like the hospital and staff from hell! I think that people become doctors and nurses through a vocation-they don't tell them their baby is about to die unless you try harder!!
I fail to see why:
midwife in hospital=unfeeling old battleaxe
midwife at home= compassionate empowering woman.
Surely some midwives do both?

"a birth experience where you feel you made choices and did everything in your power to protect yourself and your baby in my experience usualy leave women feeling at peace about their births and able to move \on confidently into motherhood and in the relationship with heir babies father as a strong and competent woman, rather than a traumatised woman, and this matters, to them and their children."

From SelinaDoula. This is ABSOLUTELY what it is all about. And the more research you do and the more you are prepared, whatever your choices may be, the more able to make these decisions you will be if the birth turns into a bit of a crisis. Whether you feel more comfortable in a hospital, but still have the presence of mind to be sure about the kind of atmosphere you wish to create for your labour, or whether you want to be at home with a highly skilled midwife makes no difference. In the end, what matters is how you feel afterwards, and how you feel about the whole adventure, and Selina's point about being happy with the choices WE make during labour, traumatic or a walk in the park, hits the nail on the head.

piscesmoon: I just read back along the thread - no one says that doctors are the enemy or that all midwives are lovely in a home setting. It appears that you're arguing with your own deeply-held stereotype of women who choose "natural" or home birth rather than with the actual posts made on this thread.

SelinaDoula did post a piece of poetry about a traumatic birth which featured awful medical staff. But I think it's a bit of a stretch of the imagination to see this as a statement that all doctors are evil.

Selina clearly states that it's a poem about traumatic birth.

Poetry is a subjective medium, generally used to express feelings, emotions, spirituality or tell a story in a way which captures the feelings of the audience. It is not the normal medium for expressing statements of fact.

Taking a look at the traumatic birth thread, it does seem that unpleasant, disrespectful doctors and midwives are a frequent feature. I guess this is part of what makes them so traumatic.

are you guys all srguing agains yourselves now? This wasn't to be a home vs hospital thread! Please don't argue, tisn't helpful atall and doesn't add anything to what I thought was a facinating and helpful thread for a while.

Don't think anyone is arguing!

Think most of us are agreed it isn't just down to luck, as there are many factors which can increase the odds - such as where you book to have your baby, what type of pain relief you will request/refuse.

We're also agreed that not everyone wants a natural birth in the first place - I know several people who have decided from the outset they are quite happy with a medicalised birth.

If you were at home and it was as traumatic as that you would be rushed to hospital and end up the same way! It was very emotive and the very thing that I was arguing about-the fact that if women think they can have the birth of their choice they end up disppointed and feeling a failure when it doesn't fit the dream.
I agree that we shouldn't be about home v hospital -but is down to luck in my opinion. It doesn't matter if 99 out of a 100 have a lovely,calm hospital/home birth -the statistics are utterly meaningless if you happen to have the bad luck to be the one of out of a 100!

"the fact that if women think they can have the birth of their choice they end up disppointed and feeling a failure when it doesn't fit the dream"

Realistic expectations are important WHERE EVER you have your baby.

"I find that in hospital I can spend hours with the baby, I don't have people calling, phone calls, other DCs who need my attention, questions about 'where do I find....?etc. It all happens soon enough when I get home-it is a lovely interlude from 'real life'."

I got the gold-star treatment at home in my own very comfortable bed, being waited on hand and foot by DH and my mum. I read your post and it made me wonder whether your dp/dh just left you to it the minute you got home. Feel lucky that I was so well looked after by my partner, to the point that I never felt 'oppressed' by my other children or by the demands of family life generally. Was able to loll about in bed eating biscuits and cuddling my babies for days.

You must have been at a very nice hospital to have made your postnatal stay so relaxing. Which one was it? (hope you don't mind me asking)

£I just get the impression that people think that it is a better birth, for every mother and every baby, to be in their own home and that somehow my baby is missing out by having a mother who is very practical and can't stand candles and talk of anemones!"

You should stop stereotyping piscesmoon! I'm supremely practical, didn't have a single candle at my homebirth, did nhs antenatal classes, have no interest in alternative therapies, chanting, having a water birth or listening to whale music. I would have wet my pants laughing if anyone had so much as mentioned anemones to me in labour. I just wanted to get it over with as quickly and as easily as possible, just like you! That's why I opted to have my baby at home!

But nobody is saying that a homebirth is desirable for all or even most women!

Like Togorama says, it is a poem about traumatic birth, not in any way trying to demonise medical staff, I have worked with many lovely midwivs and consultants!
S x

I know that we are not arguing about home v hospital- but I actually have a very capable, cherishing DH and lovely mother and MIL!! I am not op
pressed by family life. I would be able to stay in bed and do nothing. However if there is a toddler I would have to pay attention to them and show that I wasn't totally obsessed with the new baby. Hospital, shelfishly, lets me do nothing except spend time with the baby-with no distractions. The time is precious and short-after that other people have to come first some of the time.

I had 3 children, in 3 hospitals over a 10 yr period so it is probably a bigger cross section than most. I expect I was lucky.

I have no doubt that many people would hate it and wouldn't dream of a hospital if they had the choice but this doesn't detract from the fact that I weighed up the information and hospital was better for me. The home birth isn't the superior option-it is merely the superior option for you.

I am really not quite sure what we are arging about tittybangbang! Women choose what they want-I ,like you, want it over as quickly as possible-see it as a natural process and don't want fuss. I just have a different way of doing things. I think the world would be dreadfully dull if we all got the same information and used it to come to the same conclusions.
We also jump to conclusions by reading between the lines - e.g. my home life would be ideally suited to a home birth if I wanted one-which isn't the conclusion that has been made. I think that people are equally reading more into my posts than I am actually saying. Also we are way off OP's question.

"Also we are way off OP's question."

These super long threads do have a habit of going off topic. I quite like the meandering nature of it!

"The home birth isn't the superior option-it is merely the superior option for you".

Well it's true we all have our personal preferences, but there does also have to be some sort of objective measure of how safe and how effective different types of medical care are wouldn't you say? And in terms of maternal mental and physical health, home birth seems to be clearly associated with better clinical outcomes. I do think it's important that women are made aware of this fact when they are in a position to choose where they want to give birth. Of course they're still going to choose to go where they feel most comfortable and most safe, and for most people that will be hospital.

Of course I think that women should have all the facts and statistics-it is extremely important that they can make an informed choice. However when they make their own informed choice they shouldn't be made to feel that they have made the 'wrong' choice (either way).
I can quite see that some women choose home. To be perfectly honest, if I had had a 4th I think that I would have had a home birth myself because I would be in real danger of not getting there and having it in the car in the layby!! Also I might have tried it to see what I was missing and I wouldn't need to be in hospital to get help with bfeeding.

I am not quite sure about the poem, unless it is to make women feel good about a home birth decision. If it was a normal birth there would be no need for the shouting, strapping down etc-it would be very like the home birth, but in a different setting. If it was a birth where lives were in danger then an ambulance would be called. If the mother or baby is in danger of dying I think that everything has to be thrown at saving them.

But who are these people who make women feel they have made the 'wrong' choice? I really struggle to understand this one, because I really don't see people on MN, or in RL, trying to convince anyone else that they had the 'wrong' sort of birth.

What I have see, both on here and in RL, is women who themself feel disappointed by their experience, and actively seek to change the experience second time around - eg you regularly see threads from people who have had masses of intervention first time around and seek advice on how to avoid it second time - which also supports the view that there are active steps you can take to increase your chances of natural birth.

Personally, I couldn't care less how anyone else gives birth - what I cared about was how I did. However, a big part of my decision making was wrapped up in wanting to know the safest options. For a normal pregnancy, with no complicating factors, then a vaginal birth, without invasive interventions such as epidural, is statistically safest. And statistically, you are more likely to achieve this in a 'low tech' environment.

Once you factor in additional issues (eg complications with the baby, or previous pregnancies, and the feelings/anxieties of the mother) then the situation may change. eg for a woman with severe tokophobia, an epidural from the very start of labour, or even a Csection, may be the better option for THAT woman, even though statistically those procedures carry greater risks. It's about factoring in the personal element for the mother and the baby.

I think that there are definitely people who think that a home birth is wrong -hence the term lentil weaver being flung around!! (not my view, I hasten to add). I also get the impression that people think that my experience was second best because I went into hospital!
Maybe I am just reading too much into it all -so will stop commenting. It all gets rather like WOHM and SAHM and there is no need for conflict.
In answer to OP-you can lower the risks by making wise choices, but you can't rule out luck.

"You can lower the risks by making wise choices, but you can't rule out luck."

Thanks piscesmoon - I think most of us will agree on that!