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 really think this just boils down to the age old argument of free will versus predestination.

can the great minds on mumsnet figure out what the great minds in human history could not?

Maybe the answer is to be philosphical about birth? ( and be grateful if you've wide hips)

Diggers,

In my case, it was nothing to do with the size of my hips - my pelvic bones are formed in such a way that the baby would never have come out naturally.

Came to light when baby was discovered to be a full/extended breech. I was scanned, x-rayed and it was then realsied that there was only one way out for this baby. The x-ray was clear. It was nothing to do with the shape of my body.

I had prepared for the text book birth, but it was never going to be. I still feel lucky that I gave birth in an era when I came out the other side of it alive.

'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 '

Good grief, why are people getting contentious about this?! Of course if a mother doesn't have access to a MLU then that isn't an option for her!! However, in the example I gave, 6 of us at NCT classes did have the option of delivering at the MLU, and only 2 of us chose that. There was a choice - and that choice would have been one factor in the whole process of giving birth. Women do have choices about certain aspects of birth - where to give birth (because everyone has the right for a home birth, though obviously if you are high risk you'd be mad to do it), choice for whether to have pain relief and what type... choice is a good thing, where it's possible.

As for saying I'm a little bit too coloured by my own experience... well, aren't we all? Though having said that, my second birth had very little choice involved - I had to have a csection to save my baby. My third birth involved some elements of choice - I could have elected another csection, or gone for VBAC. I didn't have as much choice as first time for where I delivered - the MLU wouldn't touch a woman who'd had a CSection, so it was either hospital or home - which would have been madness with a Csection scar. And once I'd accepted that hospital was the place to be, again, it was a mixture of various factors. I discussed VBAC in detail with the consultant, and her advice was to try to labour naturally, to stand the greatest chance of ending up with another csection. So, my third birth was a natural one, but with careful monitoring in a large hospital.

So to say I am coloured by my experience is interesting - as I've had 3 quite different experiences, ranging from totally natural to fully medicalised csection.

Duh - that should of course be,
'to try to labour naturally, to stand the greatest chance of ending up withOUT another csection. '

Luck.

I had 2 vaginal deliveries (tore both times) but 2nd stage was about 10 mins long for each!!!

Every birth is different, you could have 12 normal deliveries and need intervention with the 13th!

I also think its luck, and maybe a bit of genetics.

I was determined not to prepare too much before my first, as I knew a few people who had planned ideal births for them and things hadn't panned out and they were very disappointed.

My two deliveries were fairly typical amongst the people I know, ie. long, protracted first one with assistance at the end ( ventouse ), followed by an hour long labour no intervention with my second.

So ok violet hill, your experiences of birth in all 3 sets of circumstance have led you to believe that you do have choices in any situation that influence it's outcome. Sometimes you have less of a choice, but you can still be informed and aware inorder to influence the way you view the outcome?

I'm actually interested now if pepple's attitude to whether childbirth is down to luck or to the choices we make mirrors their attitude to life?

For instance violethill, do you think
that you have the power to influence the course of your life, regardless of what it throws at you?

And gonesouth, thank you for clarification! Yes, we're damn lucky to be living in the country and era we are, good to never loose sight of that . :-)

I really don't think that it's possible to quantify any further than to say, many events (not all, but many) are a mix of luck and other factors. 'Choice' covers a huge spectrum in itself, as you say. I had limited choices with my last birth, for instance - I couldn't total choice about where to deliver, but I did have choice abut pain relief.

It's interesting - I have two colleagues currently pregnant, and already they both have totally opposing ideas about the kind of birth they want. One wants 'drugs, and lots of them' while the other is aiming for a natural birth. I'm sure the fact that they each already have a view on things will be one factor in the process. Events may turn out differently - but they already want different things from their births, so it's a bit odd to think it's all a matter of luck.

I do find myself wondering about the now highly medicalised child birth scenario.

I am convinced that had I been allowed to try for a bit longer and stay mobile I could have had her 'normally'. The midwife had to 'pass me on' because she felt I had been having contractions for too long with no progression and the rules told her to. Once I was in the surgical unit I was more or less strapped down; on a drip, monitors and then one on her head as the belly ones weren't working. Despite the fact that she kept spinning (meaning that she ended up back to back, cue enormous pain when lying on back!) and correct posture/movement could have helped I was kept on the bed. In hindsight I should have been more assertive, but I was tired and scared and trusted the doctors.

Just before the massive epidural I felt the urge to push, meaning that my body had got there eventually. I will never know whether I could have delivered her normally as by then she had got herself into brow presentation and was distressed...if I had been allowed to be mobile, stay calm, use pool etc perhaps she would have been in the right position when my body was ready?

Who knows. But both she and I are here and fine, so I'll keep this experience in mind when the next comes along!

From talking to others at post natal my experience is not unusual, in fact it is the norm. Out of 4 low risk, normal pregnancies, normal sized babies etc only one managed an intervention free birth.

Luck for sure;

Never did a birth plan and never really had any strong feelings about natural or not. Decided to put my faith in the midwives and have an open mind.

With DS1, went to hospital after 2 hours of contractions thinking can't do another 12 or so hours of this I'll have an epidural thanks only to be told I was 10cm dilated and he arrived 20 minutes later. no pain relief what so ever but was ripped to shreds by the speed of delivery.

With DS2 was advised to try or a home birth due to speed of the first one. Had an uncomplicated homebirth in the bath, much bigger baby, no tearing, wonderful wonderful midwives who helped make it quite a euphoric experience. The gas and air helped I suspect. Ultimately lucky that I lived in an area where homebirth was actively encouraged as I wouldn't have considered it otherwise.

Two uncomplicated speedy labours, Lucky I most definately am!

I've mentioned before that the Dutch system advocates home birth as being the norm. There the expectent mother collects a birthing box from the local chemist which contains all that will be needed for the birth. The midwife brings only a limited kit with her.

I think that the Dutch system is great but (I'm not joking) I do think that the fact that most mothers will have cycled everywhere since the age dot has a huge effect.

We can learn from countries which advocate less interventionist approaches very successfully but we do need to look at the whole society in which these systems exist not just at the child birth part.

While I am a big fan of the Dutch system my own experience was rather different.

My first DC was a crash CS after a long and fairly awful labour.

DH and I agreed never again.

For DC2 we were offered the choice of 'having a go' or just going for an elective CS. For us this was a no brainer. Lovely CS, during the day, no mad panic.

I consider myself lucky to live in a country where a CS is a safe alternative to a ghastly, dangerous birth (if that is likely).

Go for a natural birth if it works for you but be glad that there are alternatives to wrestling the baby out with the salad tongs if it all goes pear shaped.

digggers Sat 02-Oct-10 09:43:12
"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."

Interesting question, but the answer surely has to lie somewhere in between: sometimes nature is right, sometimes it isn't.

I have found reading about animal birthing (and breeding tropical fish myself) quite a revealing experience. You often hear it suggested that it's only humans who have trouble giving birth (because we are so far removed from Nature). But the truth is that animals do die in childbirth, in some species a very high proportion of babies die within the first few weeks, some are born deformed and die very quickly (snakes with two heads don't tend to hack it in the wild), some mammal species regularly have more babies than the surplus sibling dies. Nature is not kind.

In my own case, I don't think it's my experience of childbirth that has coloured my attitude towards the controllability of life. It is the realisation that both my children are born with genetically caused disabilities: no frame of mind that I could possibly have summoned up (except one of resolute chastity!) would have made an atom of difference to that. Obviously Nature has no interest in children like mine surviving at all- but I did.

So my attitude towards life in general is very much what Carmen said: how you play the hand you've been dealt.

some mammal species regularly have more babies than the mother has teats- then the surplus sibling dies

Agree Suzie.

If it were as simple as 'luck', then why would rates of intervention and csection vary so enormously from country to country?

Are the huge numbers of women who have csections in the U.S just incredibly unlucky and medically need csections, or - far more likely- is it to do with the whole culture of childbirth, and wider issues in the States?

And what about areas which have much higher rates of natural birth? Pure luck, that those countries have hugely higher rates of non-intervention? Hardly! It's a far more complex and big issue.

I think you make a good point Cory. Nature accepts a very high level of wastage in some species. As humans we have evolved and developed socially to value all lives.

To be able to do this we need to accept that intervention may be required.

I am grateful that a CS was possible for my first DC. In earlier times we would have both died and this would have been one of those sad tragedies which are now thankfully so much rarer.

I would imagine factors like obesity, maternal health (smoking, drinking, blood pressure) play a huge role in determining childbirth. So for that reason alone you would expect to see a higher proportion of natural births in populations with healthy, well exercised mothers. (which incidentally is often wealthier and better educated mothers too). (Also, some genetic disorders which lead to monitoring may be more prevalent in certain populations.)

I am sure attitudes/fear of labour play a big role too, but one should not underestimate these physical causes.

This of course does not mean that every mother who suffers health problems in pregnancy has an unhealthy lifestyle. I am not obese nor a smoker nor a drinker, I ate healthy food and was quite fit, nor did I suffer from hospital stress, but high blood pressure runs in all my (healthy living) family, I have had it since my teens and I imagine that was a major factor in my children's IUGR = my monitored births.

Has anyone ever argued that life saving interventions aren't a good thing though? I've certainly never heard anyone advocate that view!

I am enormously grateful for the modern technology that saved my baby's life, as in earlier times, without scans and doppler tests, she would have died in utero and been a stillbirth.

However, it's also true to say that many births which are potentially totally straightforward (which the majority of births are, statistically) end up being very medicalised. Sometimes that's the woman's choice, because she opts for interventions, but intervention isn't always a good thing, or unavoidable.

I am often struck by the number of women who have a very medicalised birth first time, but are actually very keen to try for a natural birth second time around. If the first time was so good, why the motivation to do it differently second time? I think many women do feel that huge medicalisation of birth isn't always a good thing.

People who have had interventions tend to think it's luck, people who have had natural deliveries tend to think it's something they did...

I was all ready for a natural delivery, went to birthing centre, did hypnobirthing and relaxation, my mum had had 4 births with no intervention, spent hours doing optimal foetal positioning and keeping active...then ended up with emcs after 27 hours of unproductive labour. If that wasn't bad luck I'd love to know what I did wrong so I can do it differently next time!

People who go on about their natural deliveries and how it was because they were relaxed, not afraid of the pain and kept active really get up my nose, they just don't know how lucky they were.

isn't it down to the way society views birth as well - the fact that it is now seen as normal to go into a hospital to give birth. i just can't see how that's a natural choice, or a good start to be aiming for a natural birth - i wouldn't choose to go into hospital for any other reason than to treat serious illness or to have surgery, which the vast majority of births are not. to see and know about all those machines and instruments sitting 'waiting' to be used would be like a self-fulfilling prophesy for me.

the fact that many women grow up with little or no information about giving birth possibly also plays a big part. if you've spent 99% of your lifetime assuming you need to go into hospital to give birth by screaming your head off with a doctor between your legs shouting at you then it's going to take a heck of an effort to retrain your brain and convince yourself, and your body in a matter of weeks, that you can do it naturally on your own with midwives on hand, in the background.

you make your own luck. there's a lot to be said about positive thinking and the influence it has in all parts of life and i consider this played the biggest part in my planned homebirth.

I think its just down to whatever happens on the day..you can prepare so much,but in the end what will be,will be..

My first was induced and forceps,he was quite big and iam only 5 foot..

2nd really easy and straight forward;

3rd,thought i have the hang on it now...she had cord round her neck twice,and i had to go on oxygen to help her,really painful,but happy ending..

4th..fully dilated and he decided to stay high up in my pelvis,rushed to theatre twice to push him down,signed for a cesar and ended up with keiland forceps..

so as i say,it just depends how it goes on the day...

'I was all ready for a natural delivery, went to birthing centre, did hypnobirthing and relaxation, my mum had had 4 births with no intervention, spent hours doing optimal foetal positioning and keeping active...then ended up with emcs after 27 hours of unproductive labour. If that wasn't bad luck I'd love to know what I did wrong so I can do it differently next time!'

who has said you did something 'wrong'? There are some very defensive posts on here!

I 'should', statistically, have had a really straightforward birth second time around. I didn't drink or smoke, ate well, and had already delivered my first (large) baby entirely naturally. I totally assumed that having had my first naturally, it would just be the same again only shorter and easier.Instead, I got a Csection and a prem baby in NICU. I didn't do anything wrong. That's a really weird turn of phrase actually.

All people are saying is that MOST births (and this is a statistical fact, not anecdotal) don't have complications. The mother has the potential to go through labour and deliver her baby naturally. It's therefore worth asking why so many women end up with interventions. Not for the sake of the minority of women who need that intervention to save their life, or their baby's life (because thankfully, that is only a small proportion of cases). But for the sake of the interventions which aren't a medical necessity.

If a woman really truly doesn't mind having a medicalised birth, if she has weighed up the risks and made an informed choice, then that's her decision. And there are, and always will be, women who opt for medicalised, like my colleague who hasn't given birth yet, but has decided she wants an epidural. That's fine. But until every woman is totally happy with the way her birth turns out, surely it's worth asking the questions about unecessary medicalisation. I know so many women who have very medicalised first births, and are so keen to avoid that second time, which suggests that actually, they aren't happy with the level of intervention they had.

I also think the whole thing about people feeling 'offended' cuts both ways. Sure, if you have had complications and a difficult birth, I can well understand how you'd feel pissed off if people imply that you could have avoided complications by 'better' preparation.

But equally, when you've had a natural birth, it's irritating for people to just go on about 'luck' or how it must have been 'easier'.

I didn't feel particularly lucky when I felt I was going to die from the pain, after hours of labour, and I certainly didn't feel 'this is a breeze' when I felt like someone was blowtorching my fanjo and tearing it in two as my baby crowned!! Let's face it, we're all 'lucky' if we have a healthy baby at the end, but natural birth doesn't mean the process is easy.

I think you have to keep an open mind. There are some elements in your control and some that are not.

I prepared for a natural birth and used hypnobirthing, which I'm sure made the twelve hours of labour more comfortable, but in the final stages, DS got distressed so I was rushed into theatre for a forceps delivery. I don't think there is anything we could have done differently. I kept mobile according to the recommendations, but DS still ended up in a strange position with the cord around his neck. I was very grateful for the intervention as without it, the outcome could have been pretty grim.