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?

yes they are risk assessed now in the workplace, one of the girls who worked for my DH has just gone off on Mat Leave and he was lovely to her. She has SPD a bit at the end so he arranged for her to work from home etc and let her come in later and leave earlier so avoiding rush hour. I these small concessions are given to a lot of women.

Pregnancy has not been devalued in any way by society - many many (poor) wwomen in past times have been forced to carry on and on working until they almost drop. This country has good maternity care and benefits which enable women to make choices, which is what it should all be about.

Not giving up seats etc is nothing to do with societies view of pregnancy and everything to do with peoples general lack of care for others and just plain bad manners. The amount of times I have been barged out of the way whilst holding the hand of a very small child because we are being too slow or in the way is countless - just bad manners and impatience.

"and was told no, the classes focis on birth as that is what people want to know about"

How long was the class?

"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."

You can't talk about PND/PTSD/stillbirth/serious pregnancy health problems/serious problems with health after birth in a couple of minutes each. You can't. And you shouldn't. And if you did people wouldn't remember anything useful about it if at a later stage they did experience these problems.

CrunchyFrog your first experience sounds horrific, but to me (and I'm aware I could be wrong) it sounds like a lot of it happened because of the very reason we're talking about here - you weren't given correct and honest information. It surprises me how many women don't realise the negative effects induction and an epidural can have. I've spoken to women who were horrified and amused that I'd spent practically my entire labour on my knees - in fact the second midwife I had wanted me on a bed right away, and it was only due to the support of the first midwife that I didn't give in. There does seem to be an agenda among hospitals to make labour as "smooth" as possible, not for the woman but for the midwife.

Women should be told honestly that a homebirth for first time mums is slightly riskier than having a hospital birth. They should be told that at hospital they will be offered pain relief, but that all pain relief has a down side - pethidine can make you sick and disoriented, epidural can slow things down and increase the risk of intervention, etc. They should be shown in antenatal classes how to keep active during labour, and told that if they do lie down this could make contractions harder to bear and less effective. All we were given on active labour was a single badly drawn leaflet. It wasn't even mentioned in antenatal classes. Detailed information should be given on tears, what is done to repair them, and what to do to keep them clean and help them heal and what help is available if things go wrong. Overall the message should be that yes, labour is difficult and can be dangerous, but that all women should try to trust their bodies and take control of their labour. Instead the message I got was that forceps would be used on me if the midwife said so, but I wasn't allowed to see them as I was a silly little woman who might be frightened. Not exactly empowering.

We were given a lot of detail on c-sections, complete with little duplo figures playing the parts of the theatre staff but there was very little detail on the intricacies of a vaginal birth, which I think is not a good state of affairs.

Also with childbirth classes a lot of Fathers are also present and I think a factor might be for women that they would not wish to discuss ( and by this i mean the tearing and incontinence and piles stuff) in front of their men - you can take an opinion on whether that is right or wrong but i do think it would be a factor

cailin I had lots of information. But I was lied to.

I got the impression that the OP wanted the (statistically less likely) damaging stuff to be taught about, but without the many, many things that can be done to avoid going down the CS/ instrumental route, as in the OP's view, these things are unavoidable and hospital birth the default.

I don't have the information at my fingertips, but something like 40-odd % of mothers have a CS or instrumental delivery. That is way, way, WAY too high. But when women are terrified, and therefore malleable, and HCP are risk-averse in a statistically invalid way (ie, they will follow protocol to arse cover, even when protocol may not be the most effective treatment) then more interventions will happen.

If women are to be given accurate information about everything that can/ may/ vanishingly rarely does happen, they would need to commit serious time and resources to it. I know that because in my 3rd pregnancy I spent upwards of 25 hours a week learning about everything I needed. And in my case, I only learned about things relevant to me - so induction, GD, big babies, OFP, anaemia etc, and treatments for SD. Plus also techniques for birth. I actually did know more than the SHO I saw at 42 weeks - I had more up to date research, more knowledge etc. That doctor made an utter fool of herself with her shroud waving bare faced lies.

Gosh, what convoluted sentence structure.

shagmund the NCT classes were 3 hours each once a week for about 6 or weeks, I didn't attend the last one or 2 though as the woman taking it was really horrible.

Once class involved sitting watching videos of adverts for DVDs about pregnancy yoga and baby stuff and hypnobirthing CDs and stuff, one was a BF session which was crap, there was a lot of sitting in pairs and breathing and stuff. I remember one bit as well we had to label a cross-section through a woman's reproductive system.

The NHS classes were a lot better - 4 weeks I think and again about 2 hours each. We covered all the different types of drugs in (negative) detail, went round the birthing suite, there was some info on BF.

6 or 7 weeks that should say, my 7 is sticking!

"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. "

If no-one on the thread has said it then why are you challenging it?

This thread gets stranger and stranger

"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. "

Isn't it dangerous to do this?

I was advised to have anti-D injections, as I am rhesus negative. With my second child I had placenta praevia and was recommended a section.

I can understand that HCPs don't always do a great job, and sometimes they do a terrible one, but to ignore / mistrust everything they say, to turn your back on modern medicine and diagnostic procedures and all the rest of it - now that I think really is a dangerous message to propagate.

Orm no workplaces are not required to make allowances for women who are eg knackered to the core in first trimester!

Obviously if the woman is signed off sick that is a different matter.

The risk assessment they are supposed to make is to do with things like lifting, climbing ladders, manual work, and in offices whether seating is appropriate, that sort of thing. Not that I have ever had one I have read that many employers don't really bother with this piece of H&S at work.

Sorry for multiple posts, I keep going out to do things and coming back again!

There really is a difference between giving accurate information including realistic risks and scaremongering. There is no reason why the message still can't be positive and aimed at minimising and reducing risks and interventions.

You can't compare the risks of childbirth to the risks of driving or the list of things you mention shagmund I can't think of another planned, expected one off event where the risk you might be so psychologically traumatised you develop PTSD is so high. I certainly don't expect to take that risk on my drive home tonight and I wouldn't be recommending just detailed risk assessment and preparation if that were the case I'd expect someone to ban me from driving.

And that is why statistics are important brandy though I accept that it is very difficult to interpret and understand stats and scientific research accurately and accept that it is a persons right to choose what info they want.

However it angers me that sometimes women are not given the sort of information that might have helped them prepare and perhaps reduce the risk of serious and unnecessary psychological damage.

I think for me pregnancy is one of the few times in your life (other than elective surgery) that you know that making a decision to do it, will put you in hospital.
To deny that you will be injured, torn, bruised is silly of course you will, you are expelling another human being from your fanjo - do pregnant ladies want you to point it out to them? no thank you.

"Pregnancy has not been devalued in any way by society - many many (poor) wwomen in past times have been forced to carry on and on working until they almost drop. This country has good maternity care and benefits which enable women to make choices, which is what it should all be about. "

Seriously?

See here 30,000 women sacked annually for being pregnant

And individual case that came up on google from last month

They cover different types of drugs quite negatively because from a Midwives point of view they often lead to a cascade of intervention. Epidurals in particular as it immobilises the Mummy, opiates make the mummy sick and the baby dopey and it can have problems after - how the hell can you put a positive spin on these? Yes you can have pain relief but it can lead to other stuff, that is the message surely? Quite sensible and absolutely in keeping with the 'telling the truth' thing you apparently want. You cannot have it both ways. This is not a strange thread at all just that people are disagreeing.

I think the over riding thing here is that a lot of people think the battering with the truth approach is unhelpful to them. Better general care and information ante natally and certainly better care and follow up post natally is what is required not lots of stats

cailin another great post. Agree with you entirely again.

I was induced with my first child. I was not warned of any of the possible side effects, or about what I think are called "prostin pains", nor told that it was my choice whether to be induced or not and that actually if I didn't want to be it wouldn't mean automatic disaster for my baby.

If they had told me the statistics about placenta degradation or whatever it's called, and that I could be monitored, and that induction came with all these possible risks, I would probably have opted to hold on for longer and see if nature took its course.

But I didn't have the full information, and that was bad.

"There really is a difference between giving accurate information including realistic risks and scaremongering. There is no reason why the message still can't be positive and aimed at minimising and reducing risks and interventions.
"

Yes exactly.

But there is a positive of pain relief. It helps the pain.
The negative is that it can lead to cascade of intervention.
But what are the stats? How often does eg gas and air or pethadine lead to cascade? How much of this cascade is due to the fact that a woman who is asking for pain relief may not be having a great labour?

Drugs = bad is an incomplete message. And sets a lot of women up to feel that if they have drugs then they have failed - a message which comes through in the way the message is delivered.

I posted this earlier:

"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???"

People think the second option is better? I just find that really difficult to understand.

But stats are not important to the Mother at point of contact ante natally - they are important to form policy etc but really without careful interpretation and communication they are confusing and can be damaging. And for the record I do think people are well informed by Midwives about the risks of homesbirth (lots of people on this forum talk about Midwives and Doctors trying to scare them into hospital) also they use them again when trying to get women in to be induced for going over term (even though term is not really until 42 weeks) - On the occasion you meet a sensitive HCP who puts these stats in context it is an amazing thing. Which is why printing it all out, giving it out and leaving it with the parents to come back with questions is dangerous. Lots of people on MN come for support to even raise subjects with their Midwives due to a lack of confidence or familiarity of the HCP they are dealing with. A lady here a couple of days ago wanted to change her hospital for instance and felt difficult about raising it with her Midwife because the last two times she saw different people. Until you sort that out you cannot just dump this sort of information in peoples laps and expect them to be able to cope with it.

I have not said that stats should be handed out

I have said that common problems with VB and procedures and common postnatal problems should be at least broached as part of the antenatal preparation that women get when they are having their first child.

Incidentally the idea that these things not be mentioned because there are men present is ridiculous.

So, if this is all so necessary and improves outcomes for women, why do they not do it then? Do you not think that they may have thought this through (and by 'they' I mean HCPs and trusts etc) and thought better of it?

NO the OP said stats should be handed out and then people allowed to come back and ask questions

You really think it was unnecessary to have the risks of induction explained to me before I had one, and all the options laid out?

That gets a

Incidentally the idea that these things not be mentioned because there are men present is ridiculous.

As I made clear that may be so but I do think this would be a factor for some women

Sardine - if you are being offered a medical procedure or drug, then you need to give informed consent. I agree that this often doesn't happen with induction in particular. I think this is very poor.

But a large part of this thread has been about women being given extensive and detailed information about possible poor outcomes associated with a normal physiological process, possibly before they're even thinking about having a baby. For the purpose of increasing general understanding of birth trauma and birth injuries.

Big difference.

"Drugs = bad is an incomplete message"

And one which is almost never given. Midwives acknowledge that sometimes pain relief is necessary and that it helps many women.

But you're not talking to the OP, she hasn't posted for yonks.