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?

OP I had similar concerns early on, predominantly because DH simply hadn't read as much as me on it all so didn't have as much of an idea of the facts.

I would definitely recommend signing up for local NCT classes and persuading him to attend with you since this has really opened my DH's eyes to all this and we are 100% on the same page now which is important since when I start flagging (if this baby ever arrives - currently 40+3!) he will be my voice box.

I wouldn't worry too much about your mum since she is not exactly local so is much more easily managed :)
Good luck!

That's a good point Loopymumsy.

I forgot to say that consultants tend to be overly cautious because they only see worst case scenarios. they don't see all those thousands of births that go just fine without the aid of doctors.

I was thinking about this last night -- I was sent to hospital for foetal monitoring very late in my pregnancy, 40 weeks or something. The doc caught me on his rounds and decided that he'd like to see an induction at 40 +7 rather than the 40+14 that the midwife had booked. I knew from possible conception dates that my due date was probably a week early and that the vast majority of babies arrive after their due date, so I let him decide what he wanted, then promptly ignored him. Got the midwife to change induction date back to 40+14 and baby arrive at 40+8 - exactly when I thought she would! Nobody knows your body better than you do so do your research and keep an open mind.

Also, it's very early days. My DP didn't really want to discuss the baby at this stage and it only started to sink in after the scans and as I got bigger. So give him time and he may come around later. I would also recommend NCT classes as it gives men chance to talk to other men and get a different viewpoint. You get to set the agenda to some extent and the teacher should present the facts in a fairly unbiased way although the NCT is geared towards as natural a birth as possible.

I've been thinking about this a bit more and if it is possible for your dh to speak to a few dads who have been through the whole birth experience that might help? And perhaps not just straightforward birth but also complicated, emergency type births too?

Can you ask him to watch some births? One Born Every Minute on C4 has its flaws but does show birth in this country for what it is. Don't just watch one episode (they tend to show similar types of birth or just one type per programme) and it's also worth bearing in mind that midwife led units attached to a labour ward have the same levels of intervention as the labour ward.

I can personally recommend getting your dh to watch some natural births on You Tube. There was a brilliant one my dh watched of a home birth where the mother had previously had two very medicalised births (she had been induced both times and I think she'd had forceps too). She delivered at home in a birthing pool and mooed through the pain. What's interesting is nothing much happens for ages.

Here's an article I read in the Guardian about 6 months after DS was born about Ina May Gaskin if your dh isn't up to reading a whole book.

Just wanted to add one little thing.... you said DH's parents were medical professionals, and it sounds like DH is very swayed by this. Well, I have a very good friend who is a senior consultant surgeon (at one point was a world expert on something in a completely different field). If I were to rely on his obstetrics..... well, I dread to think what would happen He'd probably try and deliver through my nose or something :o:o

What I'm trying to say is that someone who is an expert in e.g. eye nose & throat will quite probably have not sat in an obstetrics lecture for 25-30 years plus, and you shouldn't feel intimidated by their 'knowledge' just because they're medical.

I'm a company law professional, but quite frankly wouldn't attempt to do the conveyancing on a house because I wouldn't know where to start!

sorry to hijack
MUMBLE- I didn't know, huge congratulations

Ermm aren't Midwives also medical professionals? They have to spend several years studying and practicing before becoming qualified, just the same as say a foot Doctor (who you wouldn't want at your birth).

The good thing is you still have the around 30 weeks to bring DH around to your way of thinking.

Just to say your DH's comparison between childbirth and heart surgery shows how little he understands about childbirth. That alone would prompt me to ignore what he says. When you have surgery you're unconscious and in no pain whatsoever. You don't have to do any work. When you're giving birth you have an active part in the whole process and you're not just on table being dealt with by the professionals. You actually have to contribute to the process in some way no matter how small, so it is absolutely essential to be informed. This is why they give pregnant ladies ante natal classes. If there was no need they wouldn't bother, believe me. Tell him that when he has a baby he can decide what the best way is to go about it, but until then he STFU and just support you. Even if you never use a shred of the information you find researching it all is not only interesting it helps you feel a bit more prepared.

As for your mother, just remember that her baby is going to go through what she sees as a very difficult process and she's terrified. That's normal but you're not responsible for making her feel better.

All in all go with what you want as you're the only one giving birth.

haven't read whole thread so apoligies if repeating. Firstly congratulations. Secondly they are speaking out of fear,not a good emotion to let govern your choices in childbirth. If you want to see some relaxed natural births take a look here

get reading and be aware that you may need to put your foot down with your mother and tell her thanks for her concern but you don't need her advice as there is a different system over here, that is just as safe.

Midwives are the guardians of safety and will look after you well and refer if they feel it necessary.

The idea that you are going to get better care if you see a consultant every five minutes and pester the staff constantly just demonstrates the that your mother is anxious about you giving birth. I was in hospital next to an Americian woman like this...the midwives HATED her. She drove them (and me as she was only 2 metres away) insane. The midwives have trained for three years and have years of experience behind them, definately have seen more births than anything other than an experienced Registar or Consultant. It is a different system. Where I am 48% of the low risk births are at home, the rest in a midwife led unit and all the high risk ones get sent into the District Hospital under consultant care. My husband wanted me to have a hospital birth, which I did but because I wasn't low risk but after seeing me give birth, this time, blood pressure permitting, he is happy for me to be at home.

Thank you again everyone for your wonderful and encouraging responses.

We had our usual Sunday night bath/wine/chat (now just bath/chat for me!) and I brought all this up again. One thing we discussed is how our perceptions of birth are so coloured by what we have seen in the media (in films especially). Labouring mothers are usually screaming in pain, being rushed to hospital in an ambulance, being rushed down hospital corridors on gurneys with hordes of doctors and nurses shouting, etc. I asked him whether he had ever seen an actual birth and he said no (in fairness, until about a week ago, neither had I), and he admitted that he thought it probably would be quite different to the movies. So at some point we will sit down and watch some natural births to counterbalance the drama-filled movie births.

Anyway I think some of that got through to him and made him a bit more uncertain of his own assumptions of what it will be like - that it may be possible to plan and aim for a more relaxed, quieter, gentler birth (while staying flexible in case something does go wrong).

I think that was the first step - making him question his own assumptions. Next step - education, NCT classes, and hopefully piquing his academic side which makes him go into overdrive when he needs to know about something and does weeks of exhaustive research...

My mother, as many of you have pointed out, is (a) a nutter and (b) far away, so can more easily be managed, especially now that I have a good argument in response (the crying wolf one, thanks for that!)

and I want to steal mamas12 's post word for word

"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."

sorry, I cross-posted.

Glad he listened to you finally.
:)

The NCT course was great for my dh, who's not a huge reader. It really enabled him to be an active, supportive birth partner.

However, we were also enormously lucky to have an excellent midwife who helped me be active despite needing contiunous monitoring. I had meconium in the waters so my MLU, water birth went out the window but it was still a good birth. My birth plan was flexible enough and my midwife was very supportive. These two are key, I think.

For my next I will get a doula in case I am not so fortunate with my mw.

Also, I changed my mind about the injection cos I was fecking exhausted.

I am a Dr (although not obgyn) and I would not want a medicalised birth and nor would many of my colleagues.

There is a lovely piece in the BMJ this week (sorry can't link as not free to view) by two obstetricians who are married. With their 1st baby they actually booked an elective C-section despite being entirely low risk and knowing it was against usual advice because they were so afraid of all the complications they saw on a daily basis. The baby came early so the section didn't go ahead but she had an epidural, forceps and a big tear.
With their 2nd child they were older and wiser and she gave birth in a midwife led centre with minimal intervention and for their 3rd birth she had a home water birth! They conclude that Drs need to be less coloured by their unrepresentative experiences and trust the natural process which most times goes just fine.

One to relate to your reluctant rellies!

This is a great site for videos of non-medicalised births.

This is also a great article for dads to read.

I'd ignore your mother but accept that sometimes people see you taking a different path as a criticism of the path they took. For example, particularly with homebirth, lots of people say "I would have died at home because I needed X, Y & Z" when, had they been at home with a MW with them for their entire labour (rather than left in a room in hospital by themselves sharing a midwife with 4 other labouring women) they wouldn't have had X and so not needed Y and Z was only the preference of the registrar on call anyway. It can be difficult to see there could have been another way.

My DH was of a "doctors know best" persuasion as regards childbirth and spent my first labour agreeing to every cascade of intervention on my behalf. It caused great issues for us. Second time round we had a doula who he learnt a lot off and used to my advantage 3rd and 4th times.

After what happened in my first labour, I have a lot of issues with informed consent. To some extent, I do not care how or what happens to me, as long as I have made the best decision for me based on all of the information available, because I am the one who will have to live with the consequences.

Good luck.

Haven't read the rest of the responses yet, but to me it seems that it does not matter what your mother thinks about your pregnancy or to a lesser extent your husband, because it is YOUR body and you are a grown up making grown up choices about what will happen to YOU. No one else has jurisdiction over your body and fear of upsetting medical professionals should be the last consideration when making choices. You don't need their permission or their approval, though you would be wise to listen to their advice and suggestions.

was one of the births we watched on You Tube.

We didn't watch it together and dh watched a few more after I suggested this one (I didn't feel the need).

Hiya,
I'm a medical researcher and just thought I'd give you some points to raise with your DH who you said was quite academic about things.
Obstetrics is a slightly different field from many in medicine because many interventions or policies have been brought in without any evidence that they improve outcomes. Then down the line, women have protested about them, the research has been done, and it has been found that there is no benefit of doing the intervention over doing nothing. Take for example continuous fetal monitoring. It was brought in with Drs thinking it would solve all the problems of missing things going wrong with the baby. But actually, it doesn't improve neonatal outcomes, it just increases the C section rate, and impedes the course of natural labour because women have to lie still.
This trend is borne out in the fact that in most obstetric randomised controlled trials now, the control group undergo the routine intervention and the experimental group (on whom something new is being tried out) get nothing!
In addition, medics are taught to think in black and white because it makes decision-making easier. So if group X have a 10% chance of problem A, and group Y have a 20% chance of problem A, group Y are all treated as if they will all get the problem, even though their risk is only a bit greater than group X. Does that make sense? So for example, between 41 and 42 weeks you have something like a 0.5% chance of stillbirth, and from 42 to 43 weeks you have a 1% chance of stillbirth. But everyone is treated as though they will definitely have a stillbirth after 42 weeks and is induced. However, induction carries lots of risks of it's own - fetal distress, caesarean etc etc.
So basically I'm saying, in obstetrics, lots of things the professionals "know are best" aren't necessarily best, and you may be herded into a one size fits all policy which doesn't actually fit you at all.
For me, standing firm against automatic hospital policies was something I couldn't be bothered to do so I had my baby at home

CalmInsomniac that is brilliant - fascinating to hear that these interventions were brought in without considering whether there was a statistically significant positive effect on neonatal outcomes.

So most obstetric studies now are between control (gets intervention) and test subjects (no intervention). That is just amazing - these are the studies that should have been done when these interventions were introduced, just with the control and test groups reversed.

The most question is - why were those tests not done at the time? Was it just that everyone put so much blind trust in technology improving outcomes? Or was it that where women are concerned there was very much a "doctor knows best" attitude, so no trials were needed? Or has childbirth always been a mysterious process to the decision makers who until recently have been predominantly men, so they didn't think about unintended consequences?

The black and white thinking when applied to probabilities is also incredible to me - surely medics need to be able to work with risks, likelihoods and probabilities, rather than just a black and white "increase in risk of X => you WILL get X". I would think this kind of decision making, not just in obstetrics but in all fields of medicine, might make decisions easier but would definitely cause more problems or ridiculous outcomes. One that springs to mind is doctors refusing to prescribe terminal cancer patients barbiturate painkillers because they could become addicted.

(Apologies for slightly derailing my own thread!! )

I would second the recommendation to read Ina May's Guide to Childbirth, and to get your DH and your mother to read it as well as it might help open their minds to the natural childbirth perspective (and for your mother, the problems with the US medicalised approach to childbirth).

I would also encourage you and your DH to take NCT classes (and sooner rather than later). My DH has always been supportive of my decision to pursue a natural childbirth, but is now a strong advocate himself after getting more information about it rather than just taking my word for it.

YA definitely NBU, but it is really important for your DH to be on your side, especially if he will be your birth partner and your advocate during labour.

Good luck!

Thanks Perpetual - have just ordered it off Amazon based on the comments in this thread, so it's good to know so many of you recommend it. If it's good I'll order another and send it to my mother.

I did look at the other one, Spiritual Midwifery, but thought I should start with the more guide to childbirth first. I think any whiff of spirituality or hippie-ness might set my cause back even further with DH.

For what it's worth, I had an induction (pessaries to start labour) with high blood pressure but still managed to give birth in about 7 hours with no drugs and no pain, people don't believe me but it's true. I did the hypnobirthing CD's which helped me stay calm, it was seriously okay! People may perceive the hypnobirthing thing as hippyish but to me it was about relaxing and staying calm and letting my body work effectively. There's loads of research into hypnosis and pain perception which generally suggests that hypnosis helps with the perception of pain. It's not a sure thing that it will but neither is an epidural. A recent webchat about epidurals said that they only work 60% of the time and lead to more intervention, so trying anything else is worth it even if later you think that didn't work for me. I think the thing is to be realistic, if somethings not working at the time, try something else, but have a toolkit of techniques to use rather rely on others to tell you what they think you should or should not have.

Birth Your Way is another good read.

Hi again Tyelperion,
I'm glad you found my post interesting. I think historically, interventions were just brought in because (male) doctors wanted to jump on the technology bandwagon in the 1970s and try to control every variable in a very unpredictable process. If you're into feminist discourse you could say that male doctors saw birth as an unpredictable female process which was bound to go wrong and which could be improved by plenty of male control. This started in the 18th Century when male physicians started to do births (rather than traditional wise women/midwives) and they started to introduce chloroform as an anaesthetic and invented forceps and had women lie on their backs for the doctor's convenience. Many midwives had used birthing stools and squatting before that.
Undoubtedly over the course of history forceps, caesareans, anaesthetics etc have saved countless lives and I don't believe birth would be as safe today if it wasn't for these things. It's just when they are part of a blanket policy that it is hard (for me) to go along with them. Much of the research has been done now though, so for example routine episiotomy, enemas, and pubic shaves, and even lying on your back, are things of history, even though our mothers had to submit to them.
In the UK we are lucky to have a vocal population of midwives who fight for normal birth and oppose many of the routine interventions, which causes the research to finally be done. In the US, midwives are pretty much banned and obstetricians rule the roost so births are much more medicalised and women's choice has hardly begun to be discussed. You can pretty much only access the care your insurance company will refund and you have to do what the Dr says as you can't necessarily change care provider.
There is a really good book called The Birth Machine by Elizabeth Baines, which is a novel, but it's written to parody the "doctor knows best" situation in the 70s where a woman has her labour induced for the convenience of the doctor and needless to say everything goes tits up. It may not be top of your reading list while pregnant but if you find you're interested in the politics of childbirth then it's an interesting read.
HTH.