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?

I thought 'excessive' pain relief was actually to blame for many of the interventions used in childbirth because it lessens the woman's control over what is happening? Makes her less in tune? Whereas an amputation carried out without pain relief would send the body into shock, and possible death. There is a huge difference, it would be ignorant in the extreme to suggest otherwise.

Still catching up.

Brandy your posts got deleted in case you hadn't noticed

So why you are warning people about me (?) when MNHQ decided that you were out of line is odd.

This is all odd, I don't understand it.

Phew got the the end!

Great post by fruitybread Wed 18-Jan-12 23:15:34, totally agree with all of it.

Doubledare your situation sounds horrific, I am so sorry, I don't know what to say.

What I won't be saying is "ooh look at me I'm a size 8" which is a strange post under any circumstances on this thread let alone when people are talking about their experiences.

Ninkynonker you seem to be saying that pain relief for women in labour is undesirable. Can you clarify your point?

Oh Doubledare, oh goodness, I just don't know what to say.

Please let me know if you need anything, or just want to talk, or...I'm sorry, anything I can say sounds so inadequate. I will be thinking of you.

Wow Doubledare, what a scary situation. How are you feeling about it?

I just remembered something vaguely relevant to this thread last night. The absolute numpty of a midwife who ran our antenatal classes told us that it was "very rare" to poo to during labour. Now, I know for a fact that that isn't true so I challenged her on it. She went bright red (making me feel very bad) and blustered something about "not wanting women to worry about it." It made me very angry. Labour is something you do, not something that passively happens to you. The idea that you don't need to know what's going on is just so incredibly weird - how can you feel in control and safe if things are happening and you don't understand them? Pushing is quite difficult and there is a feeling that you might poo. If you know that a lot of people poo and it's nothing to worry about then you're just going to say "fuck it, it happens to everyone." If, on the other hand you've been told by some idiot that it's "very rare" you're going to think "fuck it, I can't push, I'm going to poo, that's not supposed to happen!"

All I wish for is for the information given to be less sugar-coated and more matter-of-fact. Labour and childbirth are messy and unpleasant, there's no getting away from it. Injuries happen, things go wrong sometimes, but for most people it's fine. I'd like to see the whole "Oh it doesn't matter, your baby is healthy" attitude completely thrown out the window - if a woman is injured and traumatised by the birth she experienced then that's real and she needs to be listened to, not dismissed.

There was a thread recently written by a woman who had a truly horrendous birth, it made my stomach churn to read it. Her baby was healthy, thank god, but she was an absolute mess, physically and mentally. No one in her family asked her once how she was feeling, her midwife told her she would be "fine" and her husband wouldn't talk about it (as he was traumatised too). Had that been a car crash she'd experienced people would have been falling over themselves to help her, but because it was "only" childbirth she was supposed to just get on with looking after a tiny baby and forget about the huge upheaval she'd been through. Not acceptable in my opinion.

Another great post cailin, agree with all of that too.

One of my friends also had PTSD after a VBAC - if she had known how the birth was going to go she would have chosen another section. But the baby was fine, and her damage was the sort of damage that doesn't get talked about and women are expected to soldier on with, so to anyone except those very close to her the whole thing was a great success.

My friend had a CS (due to failure to progress, so there wasn't any particular rush that might have led to a mistake). Unfortunately the anaesthetic didn't work on half of her body so she felt the whole procedure.

She had massive sympathy and support for as long as she needed it (obviously she was utterly traumatised) and her ds being fine was not the point, in anyone's mind - again, is it because VB damages the genitals and therefore the taboo is there about discussing it?

I think the issue here is that people really struggle to get their head round other people's approaches to the same issue.

Having had an emergency section with my first when I was pregnant again I had to decide whether to VBAC or have an elective. One of the biggest factors for me in deciding was the continuous monitoring the doctors would have recommended had I tried for a VBAC. The statistics are actually pretty favourable that you can have intermittent monitoring and all will be well. So one woman would have been reassured to ignore this advice while I wasn't comfortable to do so and opted for an elective section. Neither approach is wrong as long as the mother is happy with her decision.

The key thing would be that either woman had the information available and made the decision that suits them. Information on things like forceps should be available especially as there is more than one kind.

I know some people would say that the information is there but in my experience it isn't easily accessible. My decision to have an elective relied a lot on research I carried out including reading articles in journals. I've got a science degree and am more able than many in the population to understand these.

I think so suzi. People are very willing to talk about CS scars, even to show them to people and to talk about infections, numbness etc. I know the full details of my DH's cousin's CS, because her family talked endlessly about it. None of them know anything about my vaginal birth as no one ever asked me about it, and if I did mention anything it was glossed over, as though I was talking about my pooing habits or something. There is huge taboo around talking about your "bits." There are regular discussion from parents on MN asking what to call their daughters' vulva - and the responses are usually "I don't know, I call it {insert silly name}". Why not call it a vulva?? That's what it is for god's sake. All this silly secrecy eventually leads to women who are ashamed to discuss their birth because they just don't have the vocabulary to talk about it, and everyone is too embarrassed to listen. Therefore, a huge experience in a woman's life is shrouded in secrecy and shame. It's such a pity. My birth was a wonderful, scary experience and I don't want to feel like I can't mention it, it's a huge part of who I am now.

No, far from it. I had everything known to man. But saying (as on page 9) that it is the same as pain relief for an amputation is misleading. We are talking about getting accurate information out aren't we? Isn't that the whole point of this thread? In which case it is important that the cons of lots of pain relief are put across too, as against just a blanket "pain relief good, pain bad." Sometimes pain is telling us something, for example that you are having a contraction, a whopping epidural (as I ended up with) removes that knowledge, u was reliant on a mw with her hand on my belly telling me when to push.

Likewise, when I was off my head on gas and air and pethidine I was barely aware of my surroundings and not in control of what was happening.

We need a balance.

This is why I think it is unreasonable to expect and embrace a little pain, it is totally different to the examples given over the page.

not unreasonable...

"There is huge taboo around talking about your "bits."

Not in my social circle or within my family there isn't.

Or on mumsnet.

Or on other forums like netmums.

Though I will admit that I've never heard anyone speaking at length about their c/s wound, unless it's infected or causing them difficulty.

Just goes to show - everyone is different.

Great post, Cailin

I wonder if the sympathy for CS vs VB ( in terms of finding out how the mother is and not just happy that the baby is here) is because CS is "unnatural" and VB is "natural"?

CS is an operation, therefore we should be checking how the patient is (whilst baby is just a by-product). VB is what you're supposed to do, so even if you are physically and emotionally traumatised, people don't really care because it happened as it was supposed to.

I know that's a simplistic view, but YKWIM.

Doubledare I'm so sorry for everything you're going through. Big hugs.

BadDay I appreciate your last post about how lucky you are and you that you know it. But all your previous posts simply prove the OP's original point:

• labours went fine
• no physical damage
• no emotional damage
• pain comparable to marathon running
• size 8, no stretch marks, no cellulite, no saggy boobs.

Let me outline mine in contrast:

• horrific 44hr labour
• intervention, 3rd degree tear and infection
• lasting emotional trauma, counselling no help, DS only child as result
• pain so severe and uncontrollable that even whilst unconscious after 2 pethidine doses, the contractions had me rearing up out of bed
• size 10, scarring from infected stretch marks from PUPPS, no cellulite, very saggy breasts

Just because it didn't happen to you doesn't mean that it's not an issue that doesn't need addressing, and that everyone else should just get on with it because it's not that bad.

Never in all my life have I heard a bunch of women talking about their vaginas. Never. I don't think I'm unusual in that. I've seen discussions about it here on MN but that's partially due to the fact that people are anonymous. Look at poor Bupcakes - she wanted to talk about her "vagine" , but tried to namechange to do it and now has MN infamy fame possibly because people know it was her who started the thread. I don't see how anyone could deny that there is a taboo around discussing women's genitals. Shagmund, have you never seen the threads where there are long discussions about what to call children's gentials? There seems to be one every few weeks, and as far a I can see a lot of mums are opposed to calling their daughters' genitals by their actual anatomical names, does that not indicate a level of taboo?

I think my problem with this thread is that people are giving examples of poor practice (bad teaching in an antenatal class, or poor listening from a midwife) and assuming it's a reflection of some sort of formal conspiracy to deliberately deny women access to important knowledge.

The truth is that hospital antenatal classes vary HUGELY. The ones delivered at my local hospital are often very poor. They're done in rotation by midwives, some of whom clearly hate doing it and have poor communication skills. The classes have been reduced from 10 hours to 3, which gives only enough time to cover the absolute basics. If I was teaching these classes I'd be incredibly concerned about using these sessions to tell women IN HUGE detail about all the things which can go wrong during childbirth. There are ways of giving this information that is more sensitive and more helpful to women.

Postnatal care is also very, very poor in many parts of the UK. Women in some areas are getting only one visit at home, and then waiting several weeks to see their health visitor. Midwives are so caught up with doing routine testing and paperwork, and so overwhelmed by the volume of their work that they don't have time to sit and properly listen. It's very worrying that women who've had difficult births are getting so little support or acknowledgement from their midwives, but I assure you, it's not a reflection of a lack of professional concern about this issue in the midwifery profession generally. Midwifery journals are bulging with articles on birth trauma and birth injuries, and on meeting women's emotional needs in pregnancy, birth and afterwards. It's on the ground that things are going wrong.

The problem is the system of healthcare we have in the UK, which neglects postnatal mental and physical health.

I also blame a system of maternity care which results in much larger women experiencing damage at birth than is necessary.

We should be focusing on what needs to change - in real life. Not polarising this issue by making vague accusatory comments about national conspiracies to cover the issue up. There is no conspiracy. There is just poor maternity care and poor antenatal education.

"I also blame a system of maternity care which results in much larger women experiencing damage at birth than is necessary."

Sorry - that should read "which results in much larger numbers of women"

"does that not indicate a level of taboo?"

Yes there are taboos. Doesn't stop me and my friends discussing at length the state of our foo foo/lady garden/wanny/punani/ninky nanky noo/minnie etc

Maybe I move in different social circles to you Cailin.

We're all a bit rough and ready round my way.

My antenatal classes were both very clear that pain relief = bad, so I think that message is thoroughly out there

I think the word conspiracy was used in a rhetorical way and was then picked up too seriously by other posters. I'm not sure anyone on the thread does think there's a conspiracy going on.

What I think is that general attitudes need to change as this will have a knock-on effect on services. I agree with you shagmund that the care given is the problem, but I think that's partly due to the fact that women feel they can't complain, or if they do complain they're told "but your baby's healthy, that's the main thing," and are not listened to. Having damage from childbirth can be an incredibly lonely thing as society in general seems not to want to know about it and so women feel like they just have to shut up and put up. If we try to foster a more open attitude then I think women will become more bolshy about the whole thing and will be less likely to stay silent. I think the main aim is to have more of a general acknowledgement that childbirth is straightforward for many women, but for many others it's a horrendous ordeal that they have every right to feel upset about.

Well I am an Irish Catholic Shagmund, so that might explain a lot :)

""There is huge taboo around talking about your "bits."

Not in my social circle or within my family there isn't.

Or on mumsnet.

Or on other forums like netmums."

But there is before you have had children.

Most of the time before I had my first child was spent at work, and with people who hadn't yet had children. People never spoke about their birth experiences - it wasn't something that came up. When I was pregnant I never had people talking to me about tears and things. And when my friends had children, they didn't really go into detail about what had happened with people who didn't have children.

Certainly after people have had children there is a period where this sort of thing is discussed a lot with eg people in postnatal group and friends who have had babies at a similar time, but for most people the need to talk about it has passed after a few months and they stop talking about it. I no longer feel the need to offload about my first birth experience as although it was not great, it was nearly 5 years ago now and is not so raw.

In my life, anyway, people just don't talk to each other about their genitals and incontinence and things, sometimes even when they are pretty close. We are still mainly UK people here aren't we? Have we morphed to a different culture and I somehow missed it?

shagmund I completely agree with you (bring out the bells and whistles!! )

Lack of resources and time in ante-natal care, plus more of the same post-natally, makes for a very confusing time, especially for first time mums.

I never saw the same midwife more than once in my entire ante-natal care. And the midwives that were there at my birth were all complete strangers to me.

This sentence especially: "I also blame a system of maternity care which results in much larger numbers of women experiencing damage at birth than is necessary." My hospital has freely admitted (and with no kind of apology) that they should have given me and EMCS after 27 hours labour when my contractions were 60secs apart yet I was only 1cm dilated. They didn't though, and weren't able to furnish me with any reasons, probably because their reasons were along the lines of not have the staff/anaesthetist/surgeon/operating room/post-natal recovery bed, etc, etc.

I know that an EMCS would have come with its own set of "what ifs" but I'd choose a "what if" over what ACTUALLY happened to me any day.

"But there is before you have had children."

IMO there is no value in casual discussion of this issue for women prior to having their first baby. No more value than hearing old people talking about their piles or varicose veins. It's going to happen to us all, and when it does we'll deal with it. But talking about it at length to someone who can't do anything about it isn't helpful, it's just depressing.

However - there is a lot of value in a midwife explaining to a pregnant woman clearly and concisely the range of problems mothers can experience during and after birth, and giving women enough time afterwards to identify problems accurately and refer for help.

"probably because their reasons were along the lines of not have the staff/anaesthetist/surgeon/operating room/post-natal recovery bed, etc, etc."

About one third of c/s could be avoided apparently, without damage to mother or baby. The fact that there are so many avoidable c/s happening is putting huge strain on the system, which simply wasn't designed to accommodate these sorts of problems in such large numbers (remember - cs rate has almost doubled in the past 20 years). That means that some women will end up waiting for a c/s they and their baby desperately need. Not good.

Well, mine weren't, at all. Regardless, there are attitudes on this thread that seem to be perpetuating the myth that indiscriminate pain relief is all good in childbirth, after all...we wouldn't have a tooth out or a leg amputated without it would we?!