If childbirth was as dangerous as it was a few hundred years ago, would you do it?

[CuppaTeaJanice]

We are so fortunate in this country, and in this millennium, to be able to give birth in relative safety and comfort, and to have medical interventions and technology available to us when necessary which have saved the lives of many mothers and babies.

Just a few hundred years ago, when our great great.....great grandmothers were having children, the experience must have been very different. I know society would have been unrecognisable from what it is now, and they didn't know any different, and it was probably expected of women to produce children (more so than now). But it must still have been an incredibly scary experience to give birth without proper pain relief or midwifery care, even assuming that the birth was straightforward.

Antenatal scans, C-sections, epidurals, syntocin(sp?) drips, heartbeat monitors, forceps, kiwis, anaesthetic, special care baby units, NCT classes - just a few of the things not available to our ancestors.

So, assuming that our society was the same in all other ways, but modern birthing methods and assistance weren't available, and so giving birth was as dangerous as it was hundreds of years ago, would you still choose to have children?

Foxy - just reading the Tina Cassidy book and loving it!

Yes but wouldn't have had a second. My first DD was by emergency CS. Had a pelvic x-ray afterward which showed I cannot give birth naturally. 100 years ago I would have been one of those in labour for 3 days then both me and baby dying.

I had DD2 by elective CS.

I am very grateful for modern medicine!

I suspect that things weren't quite as 'primitive' as you assume, CuppaTea. Remember that midwifery evolved from what was already there, from what comes naturally to women: to huddle round the one in need, to support and protect her. 'Mid' means 'with' and 'wifw' means 'woman': 'the woman who stays with'.

200 years ago women gave birth within their community, not under the care of trained 'experts'. The granny, the experienced mother, and even the newly-wed woman, would look after and support the labouring woman. Childbirth was a feminine mystery, handed down through the generations. Women knew how to support each other through all the stages of life.

OK waterbirth is new, but upright labouring and using gravity to help birth the baby, changing positions to ease the baby's passage, breath-control, massage, aromatherapy, music, dimmed light, these are all age-old practices.

Improvements in hygiene and infection control were responsible for the largest (and earliest) reduction in mortality.

But to answer the original question: yes, I would.

If contraception were as good as it was a few hundred years ago, you might not have a choice.

Cleofartra can you recommend any others you may have read?

The desire for motherhood is a strong thing, so I probably would- but reckon if my blood pressure had not been managed etc that I might not have been around to try it a second time. Not sure dd would have made it through either.

I did meet someone once who had gone into eclamptic fits during delivery and it doesn't sound like the kind of experience you would want to add to your CV really. But that could easily have been me.

fwiw my (healthy) grandmother was so traumatised by giving birth in her village under the care of an oldfashioned midwife of suspect hygiene that she could never bring herself to have a second child

feminine mysteries are all very well, but without formal training it would depend on the common sense and experience of the person supporting you

yes.

but not in a hospital!

Thanks - I might have a look at the Tina Cassidy book.

Think I'll leave the 'Death in Childbirth' book until I've finished having my family. Sounds a terrifying read!!

I didn't realise it was as late as the 1940s and 50s that things got much safer. I know my friend's aunt had one of the first c-sections at around that time, to a 15lb baby!! God knows how she would have got that out the natural way!

I've just had a thought from one of my other threads - in the 16th Century the age of consent was just 10 years old so presumably there must have been a fair number of teenagers and pre-teens giving birth? Not sure about the average age of puberty back then but there must have been a lot of girls giving birth when their bodies had only just reached maturity.

I wonder how they coped with childbirth at such a young age.

actually, aren't there people on here who have faced a 1 in 100 chance of death if they got pregnant?

"feminine mysteries are all very well, but without formal training it would depend on the common sense and experience of the person supporting you"

True, but there was a heck of a lot more common sense and experience to do with childbirth available within the community than there is now, when it is almost exclusively the territory of experts.

Otherwise how come the majority of women survived multiple childbirths?

If I went into labour nowadays with my dc1 under the conditions the OP describes, and called on my neighbour for help, ds would die, as the common sense and experience would be lacking and he would have been strangled by the umbilical cord. But those conditions would not have been the case 200 y ago because the neighbour would have sent her son running to get the old lady who lives on the next street, and between them they would have had the common sense and experience to do exactly what my 21st century professional midwife did: to check his neck and to clamp and cut the cord while he was still inside me.

Of course I may yet have died from an infection caught from dirty hands!

Yes, but I am fairly certain I would now be dead.

Interesting when you look at The Farm stats (Ina May's birth centre in the US)

here

They had a c/s rate of only 1.46% in this study (from a cohort of 1400 low risk mothers). Instrumental delivery rate was 2.11%.

The comparison group of low risk mothers who had planned hospital births had c/s rates of 16% and 26% respectively.

Infant mortality and morbidity for both groups were similar.

Suggests that with midwives who are super-experienced in physiological birth that serious problems in birth requiring medical intervention might not crop up as often as you might suspect (at least with healthy, low risk mums)

Dirty midwifery saw off a good few mothers in the good old days.

I'd have actually died at my own birth but, if I'd got through that I'd have then died having DS2 ( and so would he).

So I'll stick with the evils of modern western medicine and be grateful for the choice I have.I wouldn't have had the luxury of choice a few hundred years ago ( as many, many women in other countries don't, even now).

The annoying thing Campion is that we don't use everything we know to make childbirth as safe and as bearable (and as cheap!) as it could be.

I think it's such a shame that in taking on all the good things of modern medicine (drugs to stop infections/excessive bleeding/eclampsia, safe surgery, good anaesthetics, sophisticated screening techniques) to make childbirth better and safer, we've thrown the baby out with the bath water, in terms of supporting normal physiological birth.

In my childbirth 'utopia' we'd have telemetry available in all NHS hospitals, obstetric flying squads and highly paid teams of experienced homebirth midwives to encourage more women to give birth outside hospital, birth pools in every birthing room, 24 hour consultant cover in every hospital, one midwife for every mother in labour, all birth centres and labour wards equipped with birthing chairs/stools/floor mats so that fewer mothers spent their labours lying on their backs on a bed squirming.

I reckon the maternal and infant mortality rate would go down overnight.

Oh well, we can dream!

Yes, it's an overwhelming biological urge.
I think the impact of modern contraception in bringing down the birth rates is overstated actually - family sizes came down drastically at several points in the last 200 years without any technological intervention. Later marriage helped a lot but so did a lot of old fashioned contraceptive methods.

Nice though all those things would be, Cleofartra, I don't think they'd make any difference to neonatal / maternal mortality figures here.

Much more significant are age, socio-economic background, health and nutritional status, accessing proper ante-natal care, ethnicity,geographic location,deprivation indicators,multiple pregnancy and congenital disease.No quick fixes there.

Happily the figures are improving ( and they are low anyway) so something must be getting better but I suspect birthing pools have little to do with it.

Cetainly some 'traditional' societies still have shocking death rates.

I've just had a thought that this is probably quite an unnerving thread to read for pregnant women - maybe I shouldn't have put it in the childbirth section.

Hopefully they're taking comfort from the fact that everyone is agreeing that modern western medicine and midwifery techniques have made childbirth a much, much safer experience than it has ever been in the past.

campion you mention ethnicity as a risk factor - are some ethnic groups more vulnerable than others? I hadn't heard this before, unless you mean immigrants who don't understand their entitlements for antenatal care etc., or cultures where multi-generational first cousin marriage is common (although the latter is more associated with neonatal illness and mortality afaik)

Cuppatea, though the age of consent was low in the 16th century, the actual age of first childbirth was normally higher than today. Most people did not have sex until they could afford to to be independent, so that would have been more likely to be late twenties than early teens. And even in the high society, where those famous pre-teen marriages took place, the marriage was often not consummated for years.

"Nice though all those things would be, Cleofartra, I don't think they'd make any difference to neonatal / maternal mortality figures here".

No - because they're already so low. But I think they'd make a huge difference to rates of morbidity, and having 24 hour consultant cover in all hospitals would SOME impact on infant mortality rates I reckon.

"Much more significant are age, socio-economic background, health and nutritional status, accessing proper ante-natal care, ethnicity,geographic location,deprivation indicators,multiple pregnancy and congenital disease.No quick fixes there."

No - very true.

"Happily the figures are improving ( and they are low anyway) so something must be getting better but I suspect birthing pools have little to do with it"

But birth should be as humane as possible. And birthing pools make it more humane, as do continuous care etc.

CuppaTea, just coming back to this.
The ethnicity factor is apparently straightforward but actually quite complicated, depending on many variables.

Immigrants ( ie born outside UK) are at much higher risk and the risk increases with certain countries more than others ( statistically).How much social factors play in this and how much is due to predisposing health factors is still unclear.

If you're feeling up to it the following makes interesting, if sobering, reading and highlights how some groups are at much greater risk.this report

And I really agree, Cleofartra, that birth should be as humane as possible but Maternity services seem just to get spread more thinly which is good for no-one.

Yes I would. I have always wanted a child and would have taken the risk.

And I'd have died - I had sepsis and 7 litre pph - no surviving losing your entire circulating volume of blood without transfusions.

Sobering thoughts. We are so, so lucky compared to those in other countries.

Cleofartra - IIRC Ina May accepts that a few conditions need medical intervention. With my placenta praevia i wouldn't have been allowed to birth at the Farm. As a result i think some of those stats are slightly skewed. Albeit, they have MUCH better outcomes using relaxation techniques and very experienced MW

Not sure if it has been mentioned on here as i only scanned, but 'Call the Midwife' is an excellent book by Susan Worth, giving her experiences as a MW in the East End post war

I'm another one who would have died during my own birth without modern medicine, along with my mum and twin sister. But I would still have risked it myself - it's not rational!

Yes, but the baby would have died.

My MW told me that in some third world countries it is quite normal for a first child to die during birth or shortly after, as though it maybe "paves the way" for subsequent babies. She speculated that if I lived in one of those places that might have happened to me. So we are all very grateful for the comparatively safe procedure that emcs is!

Assuming that I survived the experience, I then would have been killed by my subsequent ectopic. I am a reproductive dud...