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?

Still catching up.

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

Sardine Queen - Erm have they? How exciting but then again I can still see them so maybe I am only being randomly strange on occasion - thank you for noticing and pointing out, says a lot about you to be honest. Good to see that you focus on what is important eh? well done for bringing your own argument down to such a purile level

Some people disagree with your point of view, some people think you are voice of reason: that is the fun of it you see, we all have different views

"there are attitudes on this thread that seem to be perpetuating the myth that indiscriminate pain relief is all good in childbirth"

where?

shagmund your posts are confusing me. I have been saying throughout (and agree with the Op and others) that full factual information about different birth methods and different procedures and all the rest of it should be given as a matter of course to women who are pregnant for the first time as part of their ante-natal preparation.

This has been pushed back by brandy on the basis that people can look it up for themselves, and it will scare them shitless so it's the wrong thing to do

It has been pushed back by you on the basis that women know about this stuff already. But I don't think they do and on your latest post you seem to agree with that.

What is wrong with telling pregnant women the whole story, rather than the incomplete version that is all too often told at the moment? I think women deserve to know about things like forceps and tears and incontinence, so that if it happens to them they know it is a. normal and b. they won't get a terrible shock and c. they will feel able to seek help.

I do not understand that at all and it is exactly what the OP was talking about.

As for conspiracies - it was a figure of speech that I used - "conspiracy of silence" is quite a usual figure of speech to describe a situation where people are reluctant to talk about something and IME people were reluctant to talk about things like problems BF when I went to ante-natal classes.

OTOH OP has been accused of trying to persuade MNers on mass to elect for CS by scaring them which really is a loony suggestion.

?

Brandy

You were warning people on the thread that I was reporting people willy-nilly.
The fact that the posts of yours I reported were deleted is surely pertinent. ie I am not reporting people willy nilly - I reported 3 posts of yours which were trollhunting and personal attacks and they have now gone. What sort of person I am is one who thinks that you went too far and you pretending that you didn't is wrong when the evidence is there on the thread that you did.

Ah yes it is the bit about me thinking that collating stats about perineal damage and incontinence and then posting them on the internet is a bit f....d up (perhaps removing the actual expletive will help) - what i meant to say is those people must really have an axe to grind and too much time on their hands - I think it is a horrible thing to do to just post stats because it scares people.

Would you like to report me now? is that moderated enough for you because I do stand by it I do think it is extremely odd and smacks of a lot of ishoos..

No that is not what those posts said and you know it.

There is no point in this, everyone knows that MN do not object to people using the word fuck (unless it is aimed at another ie a personal attack).

You overstepped the mark and pretending that you didn't is quite silly now.

I also don't understand that what could have been a really interesting debate, and has been in some parts, has attracted such an aggressive stance from some people, with accusations of trolling and sock-puppetry.

the OP has not said anything peculiar or outrageous and I simply do not understand why this has happened.

is this the reaction that women get when they post in this section for support?

"I'm just talking about being better informed about what it actually entails and not living in denial about the true risks"

Maybe we should apply this type of reasoning to all aspects of life: marriage (domestic abuse, family breakdown); driving (show learner drivers pictures of horrific accidents and tell them about all the different types of death and injury caused by driving); sex (make people read research papers on sexually transmitted diseases) getting old - again, like pregnancy and natural life process and the 'default mode' unless you do something to opt out like committing suicide (so people could be informed about all the diseases old people are more likely to get, be shown pictures of bed sores etc).

Seriously - what's wrong with just having better antenatal education and better postnatal care, so that women have a clearer idea of what might happen during birth, and help with coping afterwards?

The alternative is .... GRIM.

And I think if you overwhelm people with information about the more challenging aspects of childbirth when they're not emotionally ready even to consider pregnancy - well, I think it would be very, very ineffectual. I suspect if someone had subjected me to a litany or horrors about pregnancy and birth as a teenager I'd either have mentally blocked the information out, deliberately forgotten it, or become phobic about childbirth.

and agree with the OP and others... , yea whatever

Look it is not just me who has said that the information available if you want it - really I am not a lone voice in this. We just disagree is all, you don't have to get your knickers in a twist I just think you and the OP and others (haha) are wrong

I think post natally is how it should be handled - that this sort of care needs to be more comprehensive and not blowing people's minds with information when they are pregnant and have an imminent birth - general information is good of course (and actually with hindsight the info I got when I had my first was pretty comprehensive - had a look around scbu and theatre and they did talk about if it goes wrong stuff) but bunging a load of stats at people without sensible interpretation is dumb and cruel. It is tantamount to them being faced with a load of stats (from unmoderated sources) on an internet forum. The information needs to be moderated and delivered careful and ante natal care in this country as it stands not able to do this sensitively.

Like I said a lot of personal axes being ground and that does not necessarily translate into a national campaign does it.

is this the reaction that women get when they post in this section for support?

No Dear it isn't, shall I tell you why? because this is not a support thread that is why. I have never seen anyone be anything but kind and helpful to those who have suffered injuries or trauma and are asking for support.

Shagmund as ever you hit the nail on the head - yes absolutely - information overload does no good.

and I will be honest with you SQ I have no idea what I posted in those particular entries but was honestly writing what I thought was missing - I would love to have the time to go all the way through and work it out but I can honestly assure you that I am not intending to deceive - I just cannot remember every word I have contributed (unlike you of course who may have even cut and paste)

And again thinking about it I have had a birth injury - my third came out with his hand about his head and I have some nerve damage. He was born at home, he and I were fine although I did suffer for a long time after with painful leg and fanjo (still do on occasion) but honestly I fail to see how this (very rare) outcome could be discussed with any meaning. Most people sustain damage from a hand by the face or above the head (usually tearing apparently) how could me knowing about this rare occurrence have changed anything at all? I would love to know how all these stats translate into useful and real help for women. This was third child, my second home birth, textbook birth and really quick and not awful at all - why would knowing that the baby could possibly have his hand in the wrong place help me or him in any way whatsoever??

Why is telling women factual information equated with exposing them to a "litany of horrors".

Isn't it possible that the idea that these things are so horrifying they must not be spoken about, part of the whole problem? Women are not pathetic feeble creatures who must have the truth kept from them. Someone posted a statistic upthread that I just checked the RCOG site, which said that 'up to nine in 100' women suffer a third or fourth degree tear. That is nearly 10%! So not rare, nto unusual, and something that women who are going to have a baby need to know about IMO.

I would far rather know what complications and risks are there, so that I can better face them if they happen. Rather than go into something unprepared and end up with terrible things happening that hadn't even crossed my mind as possibilities.

Maybe this is just a difference between people who like to know what is going on, and those who stick their heads in the sand.

"unlike you of course who may have even cut and paste"

What does that even mean?
I am surprised that you can't remember what you wrote as well, but there you go.

What good will it do?

If a woman is aware of the possibility of tearing she will

Know is it a possibility, and that it does happen
Know that if it does, what that will mean for her and the baby during the birth
Understand about stitching up, that anaesthetic will be used, that she will need to care for the wound, how long it will take to heal
Understand that this is something that happens to lots of women
Understand what side-effects of tears can be and which are not resolvable, which might take a long time to get better, and what needs attention from a HCP. ie what is normal and what is not

If she doesn't know about it, then that puts her in a horrible position. Is this normal, why did it happen, what happens now, will they use anaesthetic when they stitch me up, will I need a catheter, what is going on???

Incidentally I haven't had a tear myself so this is my best guess - about anaesthetic and healing and so on. Why do I have to give a best guess? Well because I still only have a sketchy idea of what happens when a woman tears during birth.

Can anyone explain as well why I am being accused of cavalier reporting, sock puppetry, and recording people's comments elsewhere (I assume this is what the cut and paste comment means?).

Why? I have never met with a reception like this on MN before and given that the thread is pretty evenly balanced in terms of those who think women should have more info and those who think they should not (or whatever the "sides" are) I don't understand the accusations. It's not as if I'm the only person with these views on the thread, and I know my views aren't wildly outrageous as I have had similar conversations before on MN, so why am I being accused of these things?

Nobody is discouraging spontaneous discussion of this issue.

The question is whether prior to pregnancy even being on the horizon people should be formally taught about

Episiotomy
Labial tears
Fistula
Fecal and urinary incontinence
Perineal and pelvic floor damage
Colostomy
Adhesions
Abnormal placentation
Infection
Urinary infections and bladder damage
Piles
birth trauma
Pnd

Oh, and let's add on some pregnancy problems - pre eclampsia, OC, severe hyperemesis and antenatal depression. What about preterm birth and stillbirth?

What else should be delivered through a formal programme of antenatal education?

Seriously? When would you find time to discuss the emotional challenges of becoming a parent? Those which are about more than just the physical process?

Absolutely agree that all women who are contemplating getting pregnant should be made aware of as much information as they want. No problem with that. Every choice we make is better with more information. My second and third deliveries were much easier because I was forearmed.

However I do take issue with the change that the OP wants to see in society towards birth. I don't understand that TBH. It's a bit vague really. Like it or not, pregnancy is only really important to those closely involved. The rest of society isn't that bothered generally. I would have found it quite disturbing if total strangers started treating me like some kind of plaster saint or recounting the risks of VB at tbe bus stop

"When would you find time to discuss the emotional challenges of becoming a parent"

My classes didn't cover this either. It was all about birth. I asked both classes if it would be possible to talk more about what would happen once the baby was actually there - looking after it and so on - and was told no, the classes focis on birth as that is what people want to know about.

And your list

Episiotomy
Labial tears
Fistula
Fecal and urinary incontinence
Perineal and pelvic floor damage
Colostomy
Adhesions
Abnormal placentation
Infection
Urinary infections and bladder damage
Piles
birth trauma
Pnd

Yes. Even if were just a couple of minutes on each, just so that people are aware that they can happen and what they should do if they have them, what help is available etc.

Orm I would have appreciated a bit more leeway at my place of work and on my commute - the view in society is that pregnancy is not an illness which is of course true, but this seems to have been interpreted as women who are pregnant must carry on as usual which is sometimes hard.

Hard if they are feeling unwell or have something wrong with them etc.

recounting the risks of VB at tbe bus stop

Bloody Hell OrmIrian you have been lucky then. I do find people love to tell horror stories (particularly to first time mummies) and the competitive horror birth stories too... when i was pregnant with my first a woman in a waiting room told me all about her stitches and incontinence, yea, thanks for that love! I was of course sorry for her but clearly she didn't give a toss how it made me feel.

I don't think that the title of the Op is really what this is about of course, I think this is someone all these horrible things have happened to me (and genuinely for that I am sorry because it sounds dreadful) and everyone has to know everything about everything that can happened so they can make and 'informed choice'- whatever the fuck that is anyway

I don't think we have a casual or callous attitude at all.

OrmIrian has hit the nail on the head. None of us disagreeing with the OP are saying there should not be support, advice and information during pregnancy and childbirth on the common complications (and the less common when they occur).

I think what we are disputing, and what is being ignored about our posts, is the validity of perpetuating more fear and worry regarding the process of childbirth.

As I've already said, I have experienced medical birth trauma, and I believe it was directly as a result of society's attitude to, and the resulting over medicalisation, of birth. Having an attitude that birth is a normal thing and giving women back power, choice and dignity in the process would be an almost unthinkable step forward for society at this time.

Almost worse than my physical trauma was the lack of power and dignity afforded to me and again I believe this is due to society's, and the medical professions, attitude towards birth as a dangerous undertaking.

"I find your attitude a bit casual as well. It is only pain, but would you say the same to someone who is having an amputation or surgery? "It is just pain, it's temporary, so get on with it"? I imagine not. Then why treat the very real pain of childbirth casually?"

"Avoidance of pain is a personal decision. I am not suggesting that women avoid labour pains (not sure where you got that from) I am merely suggesting that we show a little compassion towards women who experience that pain.
Pain does involve suffering and most people don't exactly enjoy being in pain or discomfort, so I find it bizarre that you should oppose pain relief."

I read these comments as saying that avoidance of all pain is just fine, maybe I was wrong. Similarly likening it to tooth removal or an amputation is disingenous. I just think that given that this thread is all about 'telling the truth about childbirth' the modern idea that you don't have to be a martyr to pain, men wouldn't go through it, it is your choice, pain relief is all good, in the modern day we don't have to suffer etc (not on this thread specifically, on many others) is an equally valid one-sided argument to challenge.

As I said, I ended up with every form of pain relief going, but I can pinpoint the exact moment my labour started going awry. As a result of the labour I had, I have to have the next on the surgical ward to mitigate the risk of the PPH I suffered post episiotomy when I needed forceps to deliver DD. I am not anti-intervention, or medicalisation, or pain relief at all...

The NHS classes I attended were terrifying. The MW assumed we all wanted pain relief and laughed in my face at my perceived naivete when I said I didn't. I had an induction WITHOUT informed consent, was given drugs I didn't want or need, a litany of abuse. That my baby and I survived the CLU was down to luck.

I don't want or need shroud waving, or dire warnings of fistulas etc. With my two other births (at home) I got nothing but horror stories from HCP. Including outright lies, statistical nonsense and anecdotal exaggeration. Hospital HCP, especially on CLU, are terrified of birth.

The CS rate is too high. I do not doubt for a second that the women given EmCS need them at that point in time - but if they were not abandoned/ drugged/ forced into labour etc, then many could be avoided.

It is no coincidence that the only birth injuries in 3 births were sustained in a hospital setting. And that the only one of my babies to experience foetal distress was the one in the "safe" hospital. Or that the only birth which was followed with severe PND was the hospital one.

I will not trust anything said to me regarding pregnancy and birth by any person who works on a CLU. They have a fearful, negative view of both.

Going into birth 2, I was terrifed - but not of birth. Terrified of what the HCP might do to me this time. Thankfully, despite it being a bit of a tricky birth, we stayed at home and all was well. Had I been in hospital, I would have certainly been on a drip, and therefore epidural, and probably a CS for failure to progress.

With number 3, I had the best MW in the universe (NHS) who supported me totally, researched with me etc. Had I not had them, I would almost certainly have caved into the pressure to induce (DS2 was 42+3) and ended up with intervention again.

I believe it is our responsibility to weigh up our own individual risks. NHS policy is totally one size fits all, and that, IMO, leads to massive problems. For example, I knew the numbers for CS, but also knew that my individual profile made me less likely to need one if I stayed at home without drugs.

The simple fact that so many women are still birthing on their backs is one that could be causing so many difficulties - you are far, far less likely to tear kneeling or on all fours!

Weird thread.

sardine - I think that courtesy should be extended to anyone who is in discomfort. I would always offer to give up my seat for an obviously pregnant woman, as I would for someone elderly or ill. If a woman is suffering during pregnancy - ie extreme sickess or tiredness any workplace is required to make allowances by law aren't they?