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 had a natural birth. It was what I wanted but I truly believe it was luck, and good midwives.

Mentally I wasn't particularly in control at all. My body took over.

Luck in that my body was put together the right way for dd. It was a shortish labour for a first (11hrs from pop to drop), I did love the birthing pool as I thought I would (I've heard of people who think that's what they want, and then can't cope with it in reality), and good midwives (did I say that before!?) who I absolutely trusted.

I just made that up - from pop to drop - think I should patent it. Or have I had too much wine?

yes, patent it. Pop to drop has a good ring to it.

I agree that luck is the major factor in the good birth/bad birth debate. I had a typical long, painful, instrumental first delivery and a speedy natural second birth. I did use hypnobirthing for the second - the only real effect of that was that I didn't panic. That does make a huge difference, I think: so you can definitely prepare, but the rest is down to luck.

Partly luck, and partly other factors.

There is clear evidence that certain procedures or practices will increase the risk of intervention; therefore, if a woman makes choices which avoid those risk factors, she is increasing her chances of a natural birth. eg it is usually good to keep mobile during labour, and indeed, staying mobile can help the baby move from an awkward position to a better one.

I am always reminded of my NCT class, where most of us (6 out of the group of 8) were classfied as low risk throughout pregnancy, and where we us started labour with all the signs that potentially we could deliver naturally. However, 4 of this group had epidurals, and ended up with further interventions (forceps, ventouse). It's hard to believe it's totally down to luck in situations like that. There is choice about where you deliver, what pain relief you accept and so on, and all those factors will have an influence on the outcome.

Of course luck plays a part too - but there are many aspects of birth which the mother makes choices about.

Violethill, depending on luck, as to what midwife you get, what time you go into labour, how your baby is presenting, how long your labour is etc etc. Try telling a woman who has been in back labour for 3 days, constantly active, utterly exhausted, at home with a doula but not dilating that she has a choice not to go into hospital for an epidural. Not all choice is real choice.

I think you've misunderstood my post.
I didn't say 'luck' isn't involved at all.
I said that alongside luck, there are elements a woman does have control over.

For example, at the NCT class I mentioned, the 6 of us who were low risk, with straightforward pregnancies, had the option of delivering at a MLU along the road, or in a large regional hospital 20 miles away. The MLU was staffed by a small team of midwives, so anyone having their antenatal care there knew everyone in the team. I knew before going into labour, that whatever time I ended up going there, I would be met and supported by a familiar face.

On the other hand, the regional hospital had dozens of midwives, and the chances were, when you turned up in labour, you wouldn't have met the midwife before. Also, the midwives at the MLU were all highly experienced, they weren't in training, or newly qualified.

Given that a familiar, experienced, supportive midwife is one of the factors which contributes towards a postive, natural birth experience, it's clear that choice of where you deliver is important. All 6 of us did have the choice to deliver at the MLU - only 2 of us took it. It seems a bit of a coincidence that we were the only 2 who ended up without major interventions like epidural and ventouse.

Sometimes there aren't choices - but often there are. The majority of births are medically straightforward, ie, there are no complications and the woman has the potential to give birth naturally.

A bit of both a baby's dropping heartrate is entirely down to luck. To be honest I don't know WTF happened on ds birth, I was kinda dead lucky and kinda not

I did very little reasearch for Ds he was undiagnosed back to back waters broke my cc started immediately with no breaks this went on for 23 hours the nursing staff plonked me on a bed wired me up and made me stay in hospital because my waters were ruptured. After 12 hours I was checked no dilation no pain relief. After 23 hours I was panicking and the pain had changed I went into the mw and she told me to go lie back down I tried to explain but she said no, so I screamed there was blood everywhere, she checked, ds was hanging out about to be born. I pushed him out still star gazing.

I was dead lucky we had no major problems op baby, ruptered waters, made to lie on my back, and ignored all for 23 hours. Definetely luck I did very little planning I am amazed I didn't need a csec and that nothing went wrong.

One thing which also struck me, is that my fantastic MLU midwife told me after the birth that she was about 95% sure if I'd been birthing in hospital, I would have been pushed towards interventions, because I was labouring a very long time. She said that what she saw as a normal first birth - ie painful, exhausting and long - many hospitals would see as requiring intervention to 'speed things up and get the baby delivered'.

Her comment made me see really clearly that there could be several different outcomes for a normal labour, depending on things like how experienced the midwife is, how well staffed the place is etc. My midwife allowed me to labour for a long time in first stage, and for an incredibly long time in second stage, because she had the confidence and experience, and the time to let me. She enabled me to feel empowered that I could do it, whereas in a busy, large, rushed hospital, I might have ended up accepting pain relief and monitoring, or other things such as breaking my waters to hurry things along.

Much of it down to luck but state of mind important too.

Dd1 was breech (to this day has no sense of direction ). Had a cs and that was the end of that.

With dd2 I really wanted vbac (still not sure why it was so important to me) but was concerned about all that I had heard and read(including medical journal articles). Consultant said it was basically up to me.

In the end I stopped reading, even the pop pregnancy magazines on how to prepare for labour. Looked at my family history of births - mum and sisters did ok, no narrow pelvis, healthy etc and decided to go for vbac.

Contractions started at 8pm, delivered at 1am, had only gas and air but it wasn't as straightforward as that.

I think luck played a part even at the end. I was told by the midwife few days post delivery (we stayed a week bcos of jaundice) that when I came in and she looked at my notes ie previous cs, fact that I was a lawyer (I'm serious - she did tell me this) she was quite ready to send me over to the op theater. Not sure if fact that she had a student with her made her go through the ropes.

Anyway she measures me (in the midst of me howling) and finds that I am very dilated and tells me to push. I must say it was very quick and she was very experienced. But I think if I had gone in at early stages of labour it would have been another cs.

Worse part was post delivery as I needed stitches but I am told that she did a very good job of stitching me up (literally thank goodness rather than the other way round).

Dd2 born nice and healthy and def has a better sense of direction than her sister!

I'm finding it actual a little hurtful that a few people seem to think it's all down to preparation and behaviour. I did everything 'right' and wanted a natural birth. But I developed pre-eclampsia when I went into labour and eventually the docs more or less insisted I had an epidural and likewise a ventouse. It would have been dangerous to refuse. But I assure you that right up till the point of ending up with a load of wires and tubes in me, I had the right frame of mind and had been active and all that. I think the deck of cards is a much more accurate analogy.

Tinier, yes, a deck of cards is the most realistic. I have a dodgy pelvis and would not have been able to give birth naturally.

I had the right frame of mind and had read thoroughly beforehand, but nature had its own path already planned for me.

Three children later and the births are a distant memory, its the bringing up which requires a good state of mind.

I was lucky - I had great hospital care and both me and my babies came out of the experience in one piece.

In my first pregnancy I had a birth plan, a real mental image of what I wanted & didn't want. Read everything I could get my hands on & tbh probably knew too much.

DD was 10 hours from first contraction to placenta being delivered. Pain was managable with G&A, I did have to have an episotomy & the pushing stage was harder then I anticipated but all in all it was a good birth. I was, however, quite ill after. I went into shock when DD was born, my stitches burst resulting in an infection & within 4 weeks of her birth I was diagnosed with PND. That first year after her birth is all a bit of blur as I was in such a deep depression. I do think I was pretty lucky with her actual delivery though for a first timer, I had a sweep that brought on labour & I was already 3cms at the sweep without experiencing any pain at all.

DS I was in & out of hospital for the last 7 weeks after going into premature labour at 33 weeks. I had no birth plan at all & decided to just go with it. My waters broke at 39+5 but I wasn't contracting & as I had meconium in my waters I was put on a drip, I was only 1cm when I went in & was like that for ages. After 11 hours of awful pain (it was far worse then what I'd experienced with DD) I was crying for an epidural, an hour later I was being whisked off for an EMCS as DS was in distress & I wasn't dilating anymore. After DS's birth I felt amazing, I fell in love with him instantly & I was literally on cloud 9.

In many ways I found DD's birth far more traumatic yet technically hers was the more straight forward.

I guess luck plays a certain part, you can read as much as you want, have a birth plan etc but then that can all go out the window on the day so I think the best thing to be is completely open minded.

"I'm finding it actual a little hurtful that a few people seem to think it's all down to preparation and behaviour. "

Is anyone really saying this?

Having skimmed the thread, I'd say there are more people saying it's totally down to luck, rather than totally down to preparation/behaviour.

Most people, however, seem to be saying it's a mixture of both.

I am firmly of the belief that it's a mixture of factors. It doesn't make sense to claim it's either just luck or either just preparation. If you claim it's entirely luck, then basically you're saying that every single labour always has only one inevitable way to go. It will either be natural, or if there is intervention - epidural, ventouse,csection etc- then that was totally inevitable from the moment of the first contraction! Nonsense! I don't believe that every single Csection carried out is entirely due to 'luck', or indeed any other intervention. Certainly with my first birth, I'm sure there were several ways it could have gone - including epidural if I'd opted for hospital, and chosen that form of pain relief, which then would have led to labouring on a bed with monitors which could have led to instrumental delivery etc. The fact that I had a natural birth was due to a great extent to the choice I made to not deliver in hospital, and not opt for invasive pain relief.

On the other hand, anyone claiming it's all down to preparation is ignoring the fact that complications can arise which are totally a fluke. eg after my natural first birth, I had to have a csection second time around because my baby had severe IUGR, was distressed and needed delivering urgently at 32 weeks.

Of course it's a mixture of various factors - some luck, some choice about where you will deliver, what pain relief you will accept and what you refuse.

Still think you're ignoring the fact that not all labouring women have a proper choice due to the kind of labour are having.

Another woman might have been at the same mlu as you and had a different set of circumstances dealt to her by her body and therefore didn't have the ability to choose not transfer and have an epidural etc etc

For example, imagine a woman who had laboured at home for 4 days with only gas and air and tens, very slow to dilate. she had amazing attitude, had done the prep, had a doula etc. She got to 8 cm and then stopped making progress as baby's head was the wrong position. Can you really say that after 4 days of no sleep and pain she had a choice to refuse the hospital transfer and epidural?

It doesn't matter sometimes how prepared you are and how good your state of mind is, if your body has other ideas then that's you.

Are you also of the opinion that you make your own luck in life and by leading a healthy life with a good mental state you're less likely to have anything bad happen to you?

DD was back to back and lying diagonally. Her face was tilted backwards, her arm was curled round her head. She was never fully descended. I was never fully dilated. After 29 hours of labour, being told to push despite having absolutely no desire to, and pushing in agony and getting nowhere, I finally had an EMC. 100 years ago I expect we both would have eventually ended up dead. Luck? Yes - bad luck.

I'm not ignoring anything! I have said several times that it is a mixture of luck and other factors! What is so difficult to understand about that?! All I am saying is that most births are medically 'normal', without complications, and there is the potential to give birth naturally. My first birth could have been very medicalised, and indeed my midwife told me later that had I been in hospital it probably would have been. The decision to book in to a MLU where the midwives were known to me and trusted, and where they were more willing to see long, painful, exhausting first labours as 'normal' rather than rushing towards intervention, was probably the biggest factor in my having a natural birth. As I've said - my second birth was totally different and medicalised as my baby needed a csection to save her life. No amount of preparation could have altered that.

I've one of them pelvises too Gonesouth not sure I could pass anything through it!

I've never met anyone in RL who seems to thinks it's all down to preparation and behaviour and that any size baby and pass through any pelvis but I have encountered one or two online however I've come to the conclusion that they are totally twonks who are completely ignorant of reality and totally lack empathy (and stupid to boot)

I do think that if you had a totally crap birth experience you can be sensitive to people's comment about preparing for birth interpret them like tinierclanger did and feel like they are telling you that you could have avoid having the shite time you did (I speak from personal experience here!!)

Yes it's down to luck, but preparing and informing yourself about what might happen and they way it might be resolved (in other words what intervention are needed and when they are really needed) will increase your luck somewhat.

It is about 80% luck I would say, which is why people shouldn't beat themselves up if they don't get the birth they want.
I had 3 easy, normal births but I have wide, childbearing hips which is the first piece of luck! DS2 was a breach and a C section was likely but it was sheer luck he turned at the last minute. (I tried hanging upsidedown from the end of the bed a lot -to give room to turn!However he turned when I was sitting down and he must have been very restricted).
I went to all the right classes and prepared, but it comes to nothing if there are complications.(it is a help but nothing more)

P.S there can also be a choice about transfer to hospital in some situations. Because my first labour was so long and exhausting, the midwife got to the point where she thought I might need forceps, and discussed with me the options: transfer to hospital where I could have forceps with epidural, or calling in the GP trained in obstetrics to perform forceps in the MLU. I chose the latter - and the GP got as far as turning up and getting gowned up ready, though actually I managed to push the baby out naturally with the support of my wonderful midwife. That's an example where there was a choice. Obviously if my baby had gone into severe distress, and the midwife had recommended a transfer to hospital for the safety of the baby, then I would have gone like a shot - that would have been no choice as far as I was concerned.

There was an interesting thread about homebirths on here recently, following a Guardian article which stated that most transfers from home are due to the mothers choice, not because of a medical emergency.

I don't see any need for this to be a contentious issue btw - I think it's great that women have choices. I'm just being honest about the fact that luck alone, or preparation alone, have very little to do with birth - it's so much more complex than that.

I see what you're saying? That the choices you make can influence your outcome in a situation? aswell as it being down to luck. But I do think that you are a little too coloured by your own experience. Another woman might have been in the exact same mlu as you with the exact same midwives and had a very different outcome.

This is becoming abit of a philosophical argument really isn't it ? Haven't all these same arguments been going on for centuries about whether you make your own luck or whether fate deals you a hand. Any philosphers amongst us?

violet just out of interest do you think it's down to luck or the mother's choices if she doesn't have access to a MLU - meaning the option is only an acute hospital or a home birth? In response to your point, 'If you claim it's entirely luck, then basically you're saying that every single labour always has only one inevitable way to go.' I actually belive that that's true - basically, I think it's down to fate (and therefore, luck)

I put it down largely to fate e.g. a woman with large hips is going to have an easier time than a woman with narrow hips. A person with a high pain threshold is going to do better than one with a low pain threshold.
However you can influence it a bit with preparation and attitude e.g. you can have the same midwife and one person can get on really well with her and aother could have the opposite-depending on attitudes.

I thought it was very sweet when the hospital team were so apologetic about having to suggest a caesarian; they obviously took my birthplan very seriously. I took it less seriously and almost felt like reassuring them. And in the end I remember it as a far more positive experience than my vaginal birth- not because that was particularly mismanaged or traumatic, but because the operating team were really pulling out all stops to help me feel good and part of the process.

Moral: a different experience from what you expected doesn't have to be a shite experience.

I've had an easy time with giving birth & afterwards but some people have a tough time so I think it's luck & fate. If you look at places where there is very little medical care some mothers are fine but others have terrible problems - also for the baby as well.

Just out of interest, there's been alot of talk about whether the size of your hips is a predetermining factor. Have to say that when preparing for my son's birth I totally believed the ina may type reasoning about no baby being too big for a woman to birth. I found it very comforting and it helped put me in a positive state of mind without fear. But is it just a nice lie to try and make women feel more positive? Or is it true? Is nature always right? Seems insulting to those who experienced otherwise to suggest so.

There has to be some compensation for big hips diggers!!