AIBU about medicalised birth, or are DH and my mother?

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This is a bit of an AIBU but I thought I might get more informed advice here in childbirth (if I get no responses I may move it to AIBU and brace myself for flaming!) Sorry in advance for the length.

I'm 11+4 and have recently had my booking in appointment. I met the midwife, who was lovely, and am lucky enough to be low risk and have the choice of two birth centres in my area. She even suggested I could give birth at home which I love the idea of, but don't think it would work where we live.

I felt so encouraged to be told that I was just "a healthy woman who is pregnant" and felt very supported by the midwife who had a very reassuring manner. It was all very much geared towards women-centred, midwife led care. She was honest and open to all the questions I asked her, and I felt encouraged when I left the appointment. At my next appointment I plan to ask her about things like skin-to-skin contact, delayed cord clamping etc, all the things I've been reading about on the internet, and hope she'll be very open to discussing those things too.

However, relating this to my (American) mother on Skype later that evening, she had a very negative reaction. She felt that I should want the medical professionals to feel I am supremely high risk, terrified of birth, etc so they will be more vigilant in watching out for problems and catch things earlier, and give me more care and attention during childbirth - a sort of "squeaky wheel" attitude, where if I whine and moan about every tiny thing they will be more willing to pay attention to me. She thinks that midwives will have a blase, grin and bear it attitude which could mean they discount my pain levels ("oh don't be such a crybaby, it's only childbirth!") She is badgering me to have regular private consultations with an obstetrician throughout, to make sure I have "proper care". I am worried an obstetrician will only see problems - but she said that's exactly what you want, someone to see problems and treat them before they cause any harm.

Separately, DH thinks all the research I'm doing into active birth, cord clamping, whether to accept the injection after birth to speed up placenta delivery etc could be counterproductive and will antagonise the people caring for me, and I should just do what I'm told rather than insist on anything. His argument is that they're the professionals not me, I wouldn't do research if I had open heart surgery and instruct the surgeon what to do, and I should do what I'm told by the midwife and/or doctors because they'll be doing what's best for me. I'm not sure I believe this since many of the stories I read sound like they are often doing what is best/most convenient/habitual for them, not for the mother and baby.

Admittedly my mother had 2 emergency c-sections so you can see why she thinks things will go wrong, and DH's parents are both medical professionals so he feels they should be trusted implicitly and that of course they would never just be doing what they're used to or what's most convenient.

Do either DH or my mother make any sense? AIBU to try to be as informed as possible and have the attitude that having a baby is not an illness to be treated?

Yanbu!

Your mum is used to a very different medical system, I feel that the USA way is about making money ie over medicalising things. Plus you seem much more relaxed and not as scared as your mum.
As for your dh, you get choices in chilbiryh because there are choices, whereas there's not with heart surgery. No one will be pissed off with the things you've mentioned so far. Maybe he should go with you to the next appt?

Yanbu to be well informed - and think again about a home birth if that's what you fancy.

there are plenty of women on here who have had better/safer experiences as a consequence of such preparation.

although some HCPs do have a blase attitude to the pain of childbirth - that goes for consultants as well as MWs.

in the US, birth is very medicalised, and there is a culture of suing - there are loads of news articles where a birth has gone wrong, and becausethe mother didn't accept all the intervnetion, she's been prosecuted for neglect.
seriously, ignore anything about birth coming from someon who livesin the US - their methods and the UK methods are completely different.

Why don't you think a homebirth would work where you live?
I live in a rural town where the nearest hospital specializing in maternity is 9 miles away - the rate of Home Birth is much higher round here.

Plus, it's your bloody baby, not hers - do what the fuck you want. (sorry, went a bit ranty there)

I planned a homebirth, which meant I got to see the same community midwives during my pregnancy and when I was in labour. They were very open to all the things you mention and quite happy to discuss the pros and cons - there was no "doing as I was told".

I laboured at home with gas and air, a birth pool and 1:1 (actually 2:1 as there was a student midwife too) but when I decided I wanted to go to hospital for additional pain relief the midwives organised it immediately.

I did find the balance of power was a little different in hospital - more focus on what the machines were saying, what the protocol was, lying on the bed and doing as you were told.

I would do exactly as you are doing - be informed, be positive, and be a little flexible too. There's no need to medicalise birth unless there is a problem, and if there is a problem then you'll be able to take advantage of all the medical solutions available. You and your birth partner need to be prepared to be informed AND assertive though to get the things you want.

Thanks for all the supportive replies, I really appreciate it.

Re homebirth, we live on the third floor with very narrow steep stairs, so I would be a bit worried about access if something went wrong, but the bigger issue is we live in a boy's boarding school and I don't want to freak out any of the poor things - not quite ready for over-educating them like in Monty Python's Meaning of Life

yanbu, but re the injection to speed up the placenta coming out - my experience is as follows. For DC1, I was resolute that I wasn't going to have it, as it wasn't natural or necessary etc, and there were some small risks. I didn't have it and was fine. Took 15 mins or so for placenta to be delivered.

For DC2 I didn't have it either, as all had been fine the previous time. Took ages for placenta to come out (think nearly an hour) and I bled a lot. Reallly lots. Took longer to recover from birth as I'd lost so much blood.

For DC3 I had in my birth plan that I didn't want the injection. DD comes out, midwife says, placenta should be here in 15 mins or so, I thought I can't be faffed with this bleeding and waiting and discomfort and had the injection and it was all over in a couple of minutes. Turned out not to be a big deal.

If I had a fourth (and believe me, this is not on the cards) I would have the injection, no question.

Good luck with the pregnancy and birth, and you sound like you're preparing really well. Being flexible is very helpful, because you never know how things will turn out and you may need intervention and all sorts of procedures you hadn't planned to keep you and the baby safe. If you've got an open mind about it all, it won't seem like such a big deal. I do think the advice from your mum about squeaking wheels is a bit loony though :)

I think a boys' boarding school would be the perfect palce to havea home birth!
Might make them think twice before trying to persuade a girl that she really wants to have sex....

YANBU. If it helps, I had a v. similar conversation with my mother who is American before the birth of my DD. I had a lovely home-birth which I would highly recommend and now my mum is fully supportive of the idea. As to access, my midwives have delivered babies in top-floor high rise estate flats and it was fine. They are also hyper-vigilant so at any sign of trouble, they will take you to hospital.

As to noise, I asked my neighbours on both sides (we live in a terraced house), both blunt couples, if they'd heard anything and they hadn't. In fact, one of them had no idea we'd had a baby til she was 4 months old.

I did have the injection to get the placenta out, but that was because DD shot out so fast she snapped her umbilical cord and I thought it was pointless to wait as DD wasn't getting the benefit.

The most important thing is that you do what you feel is best for you. You are birthing the baby, not your DH and not your mum. You also sound very well-prepared. Congratulations and good luck!

nickelbabe true, would be very educational for them, but I fear neither the boys nor the other teachers would be able to look at me the same way again if they heard me labouring through the walls

Thank you everyone for the encouragement, support and personal experiences - all grist for the mill!! I will stick to my guns, continue to inform myself about all the options and stay flexible when the time comes.

I think the midwife said that I would see her all the way through but there was no guarantee I would see her during labour as they had a rota system so I could end up with a hide-bound unsympathetic midwife or nurse/doctor who will ignore any birth plan or choices I want to make. I do worry I can't rely on DH to be assertive and informed because he seems to feel the medical professionals are all knowing and all powerful. Maybe over the next few months I can pass on the fruits of my research and he will become more sceptical.

DP was invaluable in sticking up for me against pushy midwives when I wasn't able to assert myself - if you don't think your DH will be comfortable in that role I'd consider hiring a doula. She can fight your corner and your DH can do the handholding/emotional support side of things.

forgot to add: read Spiritual Midwifery by Ina May Gaskin.

Childbirth is a normal human function. You will have excellent medical care with a homebirth in the UK. I loved my homebirth. It was painful, but the pain was bareable. I used TENS and natal hypnotherphy before hand. Most community midwives love homebirths. There are lots of lovely midwives that you haven't met.

I think its important that any birth plan is flexible and realistic. You need to be open minded a first time mum.

yanbu, nickelbabe said it all very well.
I am a Yank ex-pat, too, and was delighted at how non-interventionist UK pregnancy and childbirth management could be.

I had a similar conversation with my (British) mother, who kept insisting I should be under consultant-led care in case I had any problems. She keeps telling me I'll probably need an emergency caesarian due to having a small pelvis! (She had 2 despite having "child bearing hips") Also that I'm bound to need an epidural as I'm a wimp - thanks mother

I am currently 32 weeks, the care from my community midwife has been wonderful, the baby is bang on the 50th centile and would like my birth to be as low-intervention as possible in a birth centre - but I appreciate that things don't always go to plan, so my birth plan is ultimately "healthy baby, healthy mum". I just smile and nod when she starts going on, I think she has realised this as she isn't quite as insistent as she used to be!

As for educating yourself as to active birth etc - knowledge is power so if this helps you to make the best decisions for you and your baby, this can only be a good thing. It would be nice for your partner to get involved as well so he can act as your advocate if necessary, I know my DP has really enjoyed our antenatal classes because he feels more knowledgeable about the whole thing now.

YANBU. I personally think someone who moans and makes a big deal out of every trifling thing is much less likely to be taken seriously. A bit The boy who cried wolf if you will.

If you take the open heart surgery analogy it falls down a bit because no one expects you to have a go at operating on yourself and letting someone else take over if you have problems. Childbirth only become a medical issue if something goes wrong. A bit like breathing. If everything's fine no doctor is interested. If it's not fine it becomes a medical situation and you want some intervention but until that point you just need to know there are people who would help if needed but you don't need to see them.

If you want some medical views of natural birth look at MIDIRS www.midirs.org who look at it from a midwifery point of view. They have just merged with the NCT who do classes focusing on minimising intervention (not anti but promoting the benefits of reducing intervention) if you want to look them up too.

I second the reading of Ina May Gaskill - very interesting.

yanbu to be as informed as possible. I was. I wanted a waterbirth in the midwife led centre and that's where I started out. However due to a low foetal heartbeat and then, when they broke them, meconium in my waters I ended up having to sign papers for a c-section. Thankfully it didn't get to a c-section but I am glad I had also researched the possible interventions beforehand as it meant I wasn't really scared when I ended up having an epidural.

RE the attitude of midwives... I think you really have to get your DH to know your birthplan inside out so that he can support you in labour. I felt like the midwives in the MLU left me to it far too much and as DH and I weren't particularly pushy we were ignored for most of my labour.

It sounds like you have a great midwife.

It's a good idea to be as informed as possible and think about what you would like to happen, and if the birth doesn't go exactly as you hope, then what choices will you make. Being informed will just make it easier for you to make decisions. You've got quite a while yet to work on your DH!

I had a home birth and had fabulous care and one-to-one attention throughout but I can see how you would be reluctant to do so in your circumstances.

Also look at the figures for c-sections and assisted deliveries at your local hospitals. Non-interventionist births mean quicker recoveries and you're less likely to need surgery.

I find my American friends are very geared towards being medically interventionist and run to the doctor for drugs for every little sniffle and they can't even get their heads around the idea that it is possible to give birth with nothing more than gas and air and a good midwife.

Obviously it's good to be as informed as possible.

However, a lot of the time reality does not meet your expectations and you should, in the back of your mind, be prepared for that.

I remember doing my birth plan with my midwife and being so optimistic about the whole thing. Long story short - utter disaster and I ended up with a hideous and long labour, 999 call and an em section at the end.

I really really hope you get the birth you want but you need to have a think about other options so you don't feel this huge sense of failure that I had. I wouldn't wish it on anyone and it haunted me for months.

I agree with what the others have said.

I am currently 39+6 and been having consultant lead care due to my liver condition and my DH started out very much sounding like yours but he's come around now.
Knowledge really is best and I have found information out gone to my consultant and MW to say I would like ect and they then can tell me why or why not they would recommend that ect.

I nearly jumped up to hug DH last week when they where talking about an early induction and he said 'and what if we don't?'
Hopefully he will soon see the benefits of supporting you to have the birth experience you want and feel is best for both of you.

Good luck x

YANBU - absolutely not !

As has already been said the American system of obsteric care is very very different ad their attitude to midewives is completely different from the UK, in fact it is illegal to act as a midwife in some states (goes back to the turn of the century when midwives were pretty much outlawed !). I would recommend getting hold of a copy of The Business of Being Born. It's a film produced by Riki Lake after her own experience of becoming a mother.....might make interesting watching for your mother too . Would also recommend reading Ina May Gaskin. Spiritual Midwifery is very 70's hippy and a bit too far out much for some (also, it's quite midwifery based in parts) although I personally love it, but Ina May's Guide to Childbirth is fantastic. I was lucky enough to see her speak last year and she is a pretty awsome woman (and American if that helps with your mother).

Regarding the third stage injection and some of the comments about extra bleeding and the time a natural delivery of the placenta can take - there is a middle ground. You can opt to have a delayed injection in which case you wait for the cord to stop pulsating so that baby get all the extra blood and oxygen they should (usually only around 5-10 mins or so) and then have them clamp the cord and give you the injection.

I'm 37wks today with DC no4 and having had two serious postpartum haemhorrages with no1 and no2 I'm classed as high risk and therefore the hospital have a fit if I even suggest I might not have the injection so this is what I have agreed with them for this time round. You can have the injection anytime so if you do take a long time to deliver your placenta naturally you can alway ask for it if you are 'fed up' waiting. Rather depends on what your reasons are for not wanting it.

I have been hoping for a home birth this time but no2 was a caesarean and with my 2 PPHs I am meeting a hugh amount of resitance from the professionals. I have the same problem with my DH as you do - he can't understand why a consultant/midwife would want me to do anything other than what was the best thing. Surely they will alway work to the most upto date research and evidence?? Having done a hugh amount o my own research he is very critical or my arguments and finds it hard to understand why I should favour the results of my research when clearly the professionals must be aware of the papers/evidence I have found and if they haven't changed their policy/procedure surely there is a reason for that ie I must have it wrong. It is a very hard position to be in.

Sorry this has turned into such a long post but it rather struck a chord with me and I thought it might help to know that tou are not alone with these problems.

Best of luck

Thank you again everyone, for your encouragement, reading suggestions and sharing your personal experiences, it is massively appreciated.

To everyone and especially mumblemum - I wonder if the reason that men feel it is easier to trust medical professionals is that the system in the past has been geared towards convenience for mainly male consultants. My MIL told me when she was taken to the hospital to give birth she was shaved and given an enema, both of which were the routine procedure, but she found it embarrassing and degrading - and only later found out that neither was medically necessary, it just made it cleaner and easier for the male consultants.

My previous contacts with doctors, male and female, as regards "female problems" (eg. getting contraception prescribed, a suspected ovarian cyst, etc) have not been great - I've felt dismissed or talked down to and have had to speak up quite loudly to get what I felt I needed. DH's experience with doctors has been the opposite and it's been eye opening to see how he doesn't really believe doctors would ever be patronising or dismissive. (He even said to me tonight after I brought the subject up, "I could read every medical paper in the next 6 months and I still wouldn't know as much as the consultant, so we should just leave it to them!")

oh no, you have to tell our dh that you need him to be on your side during labour and delivery. If he can't then you will be hiring a doula. Give him your research and tell him you'd like to discuss and make your birth plan with him and give him a date to decide by. Sounds a bit like he wants to take a back seat really.
He needs to be told that his patronising attitude to you and your genuine feelings about what to do with your own body is not very helpful.
You do not need this stress of whether or not you may have some medical intervention that you don't want but are not able to articulate properly during labour and the subsequent feeling of being 'violated' and/or abused.
Show him the childbirth section here on mn for some added research.

Your dh is at serious risk of hating himself afterwards if he doesn't learn to stick up for you and the baby now.

Is there a midwife led centre near you?

I really think getting him to speak to the mw or antenatal classes asap. Is there any recent dads he could speak too?