Is there a casual and callous attitude towards pregnancy and childbirth in society?

[PeaceAndHope]

Hello everyone:)

I'm sorry if I have posted my question in the wrong section but since I am a newbie I hope you'll all overlook it.

I have spent a lot of time recently wondering about the varied attitudes to childbirth and pregnancy and the lack of proper information regarding the process amongst most people.

I do believe that with the advancement of technology and better care we have been able to make the process a lot safer than it was in say the 1700s when the maternal mortality rate was 35%. However, it is my observation that people tend to take the whole thing for granted and assume all will be well because "women have been doing this for millenia".

I have keenly researched this subject and I have noticed that whenever I point out the risks associated with pregnancy and birth the reactions are those of disbelief and annoyance. I once brought up the possibility of fecal incontinence post childbirth and was admonished (by a man) to stop 'scaring people'.

I recently read a comment on a men's website that said "Pregnancy is the safest thing ever. It's not dangerous-to say that it is dangerous is misleading".
I certainly agree that the mortality rates in the developed world are rather low, but death is not the only thing that makes a process risky.

Pregnancy comes with superficial risks like permanent body changes to more serious ones such as permanent incontinence, diabetes, hypertension, uterine prolapse, obstetric fistulas (although these are rare), and even a permanent colostomy. Even in the developed world women still die of haemorrhage and aneurysms while giving birth.

Why is it that bringing this up tends to anger most people? Why do most people deny that these complications exist despite clear cut medical evidence that they do?

Is it traditionalism by virtue of which women are "meant" to bear children and therefore how can the process not be safe? Or is it just a paternalistic refusal to acknowledge that women do put themselves at risk for a series of complications (irrespective of whether they occur) when they have children?

I am not trying to imply that pregnancy and childbirth are horrible, evil things but I do believe that the attitude towards them is a bit casual and ignorant.

Your thoughts please?

[BritishDruid101]

"Is it traditionalism by virtue of which women are "meant" to bear children"
For you it was of-course 'tradition' as the reason you were capable and did give birth
But for the humans we were biologically meant to have wombs and be able to give birth (and to know this even!) since we evolved into mammals.
the last 40k years matters

[PeaceAndHope]

Shagmundfreud:

I know he's completely wrong. But this is the kind of apathy and misinformation I was referring to in my OP. Apparently, some People seem to think that childbirth takes a couple days to recover from and that newborns are easy to handle while recovering from 40 odd weeks of pregnancy and a delivery.

You make a very important point about breastfeeding. I'd like to point out that many women opt not to breastfeed and they too need at least 4 weeks of taking it easy. Doing heavy housework within weeks of giving birth is dicey.
It's actually insensitive and inhuman to even expect it of your wife!! I'm glad I'm not married to that bozo.

[shagmundfreud]

"The consequence is that the 'birth is a normal life experience' group are much more vocal about birth and they predominate in maternity professions"

Two things: birth is a normal life experience. Doesn't mean it's not deeply shocking!

Second thing: midwives as a profession are deeply wedded to the notion of normality. But they ARE a) aware of and b) concerned about, those women who have extremely difficult births. Because it's what they're doing day in and day out: caring for these women. They've seen more third degree tears, more emergency c/s, more emergency hysterectomies, readmissions to hospital following birth, babies in SCBU, than you can shake a stick at. Every week they'll probably care for at least one woman whose labour ends in theatre (at least this is the case for midwives working in a CLU). It's their bread and butter.

And the ones who've failed to maintain their humanity in the face of women's suffering - well, it's not the result of a philosophy which promotes normality in childbirth. It's the result of them becoming emotionally and intellectually fucked up from working too long in a sausage factory like maternity system.

[shagmundfreud]

"Protagonists on both sides will produce evidence to support their ideas and dismiss research which does not support their beliefs as flawed."

If research is flawed, it's flawed.


"There is a problem in this though Those who think birth is a 'lovely, normal, experience? are more likely to be attracted to midwifery, to being NCT teachers, doulas and independent midwives."

I think what you find is that those people who think that birth can be a BETTER experience for most, if not all women, with good care, tend to be attracted to being NCT teachers, doulas, midwives and independent midwives.

And actually many people are attracted to these professions following horrible experiences at their own births: they want to do something to make birth better for other women.

Nobody who knows anything about childbirth believes that birth is intrinsically 'lovely' for everyone.

PeaceandHope - your friend is SO wrong. He also needs to remember that women are completely focused during this time on the care of an intensely vulnerable individual, and in that need support for themselves, no matter how well they have recovered from the birth. It takes 3 to 6 weeks to establish lactation properly . If for nothing else mums need to be given consideration during this time so that they can breastfeed their baby. I'm convinced that breastfeeding goes down the pan for so many UK mums because they're not given that special down time at the start to focus on this.

[PeaceAndHope]

Helsinkihelen:
Congratulations on your new baby:)

Yes, the attitude of your friends sounds very apathetic and is exactly the kind of attitude I'm referring to.

I've been away on a business trip, and I want to share a story with all of you.
One of my colleagues has had a baby and he was asking the rest of us how he could help his wife cope with housework and the new baby. One of my male colleagues told him there was no need for her to have help.

He felt that since the women in his family had all gotten back to housework within two days of giving birth, there was no need for any woman to require any help or a prolonged period of recovery. I mentioned that in certain Asian cultures women are given 40 days of complete rest from household duties, so that they can recoup and focus on the little one. He said forty days was just crazy and it was disgusting to use the baby as an 'excuse to avoid work'.

I pointed out that most women take approximately 4-12 weeks to recover and that depression, exhaustion, uterine cramping, perineal pain, pain while going to the loo, weakness, sickness, pain in the tailbone etc. were all common post birth. I also explained that doing too much too soon could lead to issues such as bursting open the stitches, excess blood loss, fainting spells, anemia, hernias etc. To which he replied that I was talking about 'strange and uncommon' possibilities. I tried to explain that doctors themselves ask women to take it easy for about 6 weeks post birth. He thought it was insane to take six weeks to recover and that he had no patience for whiners.

Is it that difficult to understand that childbirth causes pain and injuries (no matter how it happens- naturally or via cesarian) which take time to heal? Is it perceived as so easy that six weeks are too long a recovery? It's shocking that some men actually their wives to just get back to normal on their own timeframe instead of patiently letting them heal.

[PamBeesly]

Congratulations on the new baby helsinkihelen

Hope you are recovering well and enjoying your baby :)

[helsinkihelen]

I have not been able to follow this thread for the past week and a half as i was in hospital having DC2 :0)


However, my birth experience in short ... laboured for 10 hours with just a tens machine, only 3 cm dilated and in agony - then EMCS.

6 days later my partner got food poisoning and was admitted to hosp for 12 hours and put on a drip to rehydrate. He suffered with vomiting and diarrhea.

Last night we were at a cafe with friends. They asked me how long i was in labour for. I said 10 hours. Their response was 'that's not bad'. Conversation moved on. then they spent 10 minutes sympathising with my partner regarding how awful food poisoning is and what a poor thing he was.

This thread rang in my ears!

[Ushy]

Peaceandhope Well done on raising this - you've started a really thought provoking discussion.

My take on this is that people have 'beliefs' about birth and beliefs as opposed to views are not easily shaken. Protagonists on both sides will produce evidence to support their ideas and dismiss research which does not support their beliefs as flawed.

There is a problem in this though Those who think birth is a 'lovely, normal, experience? are more likely to be attracted to midwifery, to being NCT teachers, doulas and independent midwives. The cautious pragmatists, with their preferences for epidurals, caesareans and horror at the yukkies of 4th degree tears and hypoxia don't much want to dicuss childbirth or think about it and would rather move on from the memory of it as soon as possible.

The consequence is that the 'birth is a normal life experience' group are much more vocal about birth and they predominate in maternity professions and the general childbirth scene.

Evidence? My own straw poll on Mumsnet. Look at how many threads and posts there are about home birth. Despite most women in the UK being offered homebirth, less than a few percent choose it.

Look, too, at the rise of private maternity care. 'Willingness to pay' is a believed to be one of the most accurate indicators of choice. What do women do when they 'buy' maternity care? They buy more epidurals, more caesareans and more doctors at their birth.

Could this be a possible explanation?

[tiggersreturn]

Are people casual ? Yes because it's a fact of life. It's more common for women to go through it than not. Are people callous ? Some are because their own or their partner's personal experience has been straightforward and they are unable to conceive that life can be different. Pointing this out means they have to confront the fact that either they are ignorant or not empathetic neither of which are great. Alternatively there are people who'd rather take an ostrich approach and don't want to know these things in advance.

When it comes to men's magazines not noted for their pro-feminist views it may also be an attempt to downplay the role women play which they can't.

There is a lot of emphasis on the natural side of childbirth and a whole movement on it but a response to "childbirth is natural " is "death by childbirth is also natural "

[Pastabee]

Welcome to Holland is very powerful isn't it? So sad of course but contains an important message for all expectant parents not just in terms of your own child but in terms of understanding how those not as fortunate as you feel.

I don't think it is wrong to face up to the fact that things don't always go in accordance with your plans and dreams. It can only help to know that you are not alone and that others feel the same.

[CheerfulYank]

I love Welcome to Holland! I've only read it, though, never seen it performed.

[CarrieInAnotherTWOBabiTWINS]

wow never heard of welcome to holand, before so just gooled it and got this

wow very powerful just had me in tears.
extremely moving

[Pastabee]

My NCT teacher did discuss PPH, MROP, 3rd/4th degree tear, interventions, episiotomy, babies born with severe disability and still birth. It was great for DH and I to be prepared as it meant we knew what might happen and what the medical staff would do as a result.

It was all presented in a non scaremongering way and we had a chance to discuss all these issues.

She read 'Welcome to Holland' by Emily Kingsley to start discussion on still birth and disability. I will never forget how much it upset me but talking to a friend who had a still born son it made me realise how important it is to confront the fact that what you want to happen and how you imagine things to be might not be how they turn out to be in terms of birth and the health of your baby.

I'm shocked when I read about NCT groups where none of this is discussed - I thought it was standard but I now realise my teacher was just incredibly experienced and had taught women who have gone on to experience all these things.

[tiggersreturn]

I remember my first family planning appointment in which all the side effects of various pills were listed. I must have looked slightly aghast because tge nice nurse said "but that's nothing compared to the risks of pg"

[PamBeesly]

AlpinePony thats very sad that the woman from the Philippines that she didn't know how it happened. How frightening for her, I'm glad that you could speak to the parents on her behalf.
I also did not know about degrees of tearing or a lot of other aspects of childbirth until I discovered Mumsnet. I'm glad I do know however, I've my first ante natal class on Tuesday so it will be interesting to see if its discussed at all. Good luck with your C-section.

[AlpinePony]

I'm based in The Netherlands. Home births under midwife led care are very much encouraged, but ultimately it is the mother's choice whether she births at home or in hospital - the first time anyway. As far as a "high" (lower than UK/US/Australia etc.) mortality rate goes there seem to be two major factors with this i) recent immigrants as per PamBeesley* and ii) many, many women choose not to be screened for anomolies which are perhaps ultimately incompatible with life. Until 2003 (I think!) NF testing was not standard, even now it is only "free" to women over 36 years of age.

*I know an immigrant woman here from the Philippines who is pregnant, first of all she has "no idea how it happened", she has no idea what to expect. I've given her a book, sent her along to my midwife unit and insisted that she gets registered at a doctor - she refused to see a male doctor so I directed her to a practice that has 2 female doctors. She speaks no Dutch and doesn't have proper health insurance cover. I've sort of bullied the parents of her Dutch boyfriend in to getting this organised for her. The same story is repeated throughout all countries with a high immigrant population.

Our post-natal care is indeed wonderful - I will have a doula come to my house for 5 days after birth (elcs) to clean, cook, help, etc. so that my husband and I can bond with the baby. Last time I had an unexpected bleed post-partum and covered the bathroom in blood, she showered me and popped me in to bed. When I woke up the bathroom was spotless - I will always remember that as wonderful help.

Wrt a topic brought up on this thread, until mn I had no idea about 3rd/4th degree tears and long-term incontinence. I often cry when I read such threads. I knew that a woman could tear, but I thought perhaps a cm or two. I just didn't know how bad it could be. I'm 38 years old and well versed with real life - but I didn't know. It's one of the reasons I've opted for an elcs this time, I don't believe I'm a good candidate for vbac without such complications.

[CailinDana]

I think you have hit the nail on the head working - there are plenty of good reasons to give out clear information, but there are no good reasons for not giving it out. If clear information could lessen the suffering of those who do suffer even a tiny bit, isn't it worth it?

[working9while5]

Incidentally I couldn't make it to antenatal classes when pg so watched a dvd called birthwise. They had a section on what would happen if your baby was born still. I found it very, very sad but I recognised that some of the information might be important.. information about getting as many pictures as possible and holding your baby, spending as much time with your baby as possible examining and getting to know him/her, looking for all the little quirks that made him/her unique as any new parent does. I think it is possible to hear information presented sensitively and perhaps, just perhaps, that might make people feel less like a freak if it happens to them. 19 babies every day are stillborn in the UK, it is not that uncommon. LunaticFringe, I am so very sorry for your loss.

The other thing I remember about that dvd was so important to me - it described how 1/5 women feel an instant rush of love, 3/5 just feel glad labour is over and want a cup of tea and 1/5 really feel repulsion at the first sight of their child. I was one of the 3/5 but I found it hugely comforting not to buy into the myth it had to be instant/automatic and I'm sure that knowing that 20% may actually feel negative feelings might be very helpful to women who go on to have PND.

I don't think whitewashing the reality is helpful for anyone and I'm not sure why our society finds anything painful to be so unpalatable. Come on Great Britain, you got through two world Wars... get a grip, it is possible to share info without being squeamish. It is no harm to the people who will never need it, but could be tremendously important to those who do!

[working9while5]

I think the OP makes a lot of sense. Both my grandmothers gave birth to babies who died shortly after birth. My grandmother gave birth to three. My aunt gave birth to a baby at seven months who was born still. In the last three years, I know of seven babies who have died at or before birth from within my circle of friends and their friends, I know three women who have had pre-eclampsia, I know four who have had post-partum haemmorhage, a woman who died of dvt three weeks after birth, a mother who lost part of her bowel when having a cs and nine babies who were born at less than 30 weeks.

This is a small sample, anecdotal blah blah but to me pregnancy and birth are dangerous and unpredictable. Yes, I know many more women who have given birth naturally and without these complications, but who have had e.g. fourth degree tears, gestational diabetes, clotting issues etc. No one knows, that's the problem. It doesn't much matter if the incidence is low if you are the one that it happens to, does it? I think people take a lot for granted now, and pregnancy isn't treated with any real degree of seriousness when it has the potential to absolutely lead to serious health concerns for mother and/or baby.

[CarrieInAnotherTWOBabiTWINS]

shag the message was very much if you have an epidural you will end up having forceps, or if you have pain relief you will lose the sensation to push.

it wasn't simple facts like. say, if you have an epidural you have 25% more chance of having forceps or whatever.
the message was you will.

for what its worth i had no interventions, spontaneous labour at term, no pain relief,mainly due to what i was told, i was calm, the baby wasnt distressed, nothing that actually that went wrong, yet i still got a 4th degree tear.

[bigmouthstrikesagain]

I haven't read all of this thread so excuse me if this has been discussed already. I do not happen to agree with the OP's analysis - but this is purely based on my own experience/ analysis as I suspect the OP's view is but no less valid for being anecdotal I suppose.

Anyway I have always viewed birth as pretty painful and traumatic as that was my Mum's experience in the 70's and early 80's. She had a breech birth, was transfered to a different hospital during labour, forcep's deliver, 2nd degree tears at each of her three births she also had a very distressing and dangerous late miscarrige. There was no conspiracy of silence or downplaying of the difficulties of birth in our house! I knew all of these stories (in detail) by the time I was in my teens. Surely our Mothers and grandmothers are responsible for informing us about the process of childbirth - the knowledge of older generations passed down, innocence and experience...? Or am I missing something - do most Mothers flatly refuse to discuss birth with their children - I most certainly will - dd1 already knows she was born at home and exactly where on the rug! .

I think information is power and have always been willing to find out about things other people prefer to be vague and hopeful - nowt wrong with that as long as you don't put yourself at risk through ignorance.

[EdlessAllenPoe]

i need to refresh more often :)

[EdlessAllenPoe]

sardine there is no such thing as unbiased information.

not at the point it has been presented and understood anyway.

[PamBeesly]

I'd love to birth at home (I'm a 25 minute drive from hospital if any emergencies did crop up) I feel relaxed and at ease in my own house, I feel I could scream and shout and poo all over the place if I needed too and wouldn't care. I also think midwives can be more skilled in helping a woman deliver than a doctor who sees it as a problem to be solved medically immediately (Now I know that sometimes we need medical intervention and its great its available) Unfortnately home birthing isn't an option where I live, it is only available in a small part of South East Ireland and even that scheme might see their funding cut. There is only one MLU in the country too.

[SardineQueen]

unbiased may be the wrong word

more balanced information, more complete information, is what I mean