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?

[CailinDana]

I agree with NoWay. The midwife at our NHS antenatal class honestly thought it would be "better" for us not to see the forceps. On what planet? How can anyone think it's better for someone to know nothing about an intervention that might happen to them in the not too distant future? It would be one thing if forceps were something used only in surgery while the patient was unconscious - then there would be no point in seeing them, but they're used on a fully conscious woman who can often feel what's being done - hiding them from her will only make her feel more unsure and afraid.

[NoWayNoHow]

Sorry, that should read "as a woman who went through"

[shagmundfreud]

"Shagmund the midwives in the NHS classes are telling the women that their births will be straightforward, either by saying this directly (as was the case in my class) or by omitting to mention all the various complications and interventions that frequently happen that aren't straightforward."

Which hospital did you do your antenatal classes at?

My NHS classes mentioned emergency c/s, forceps and ventouse.

If the midwife told women that they would have no complications in their births or spoke in such a way that women came away from the classes believing that the 27% c/s rate in the UK is actually a myth and that ventouse and forceps use are vanishingly rare, then I grant you there are grounds there for and official complaint.

Luckily for us we now have 'One Born Every Minute', which will reveal the truth of hospital birth the UK - that it usually seems to involve drips, continuous monitoring, lying on your back crying for long periods of time, instruments, surgery, and probably being left on your own a lot.

[shagmundfreud]

"mummy magazines are ridiculous in the headlines, 'get the birth you want'. thats crap, you get the birth you get and theres very little you can do to alter this."

Given that there are some very basic things you can do that can signficantly improve the likelihood of getting through birth without needing surgery or other intervention I think it's very reasonable for magazines to discuss the issue of choices in childbirth. As long as women are clear that nothing can guarantee a straightforward birth, just increase a mothers chances of having one.

"I hate the attitude of the types who say all births can be vaginal if you stay calm or go to the right classes, crap crap crap."

I've never met anyone who's said that all births can be vaginal. Have you?

[shagmundfreud]

Sorry - meant to add, that the articles about 'get the birth you want' would hopefully include a discussion of elective c/s and access to pain relief.

[NoWayNoHow]

shagmund it was West Middlesex. I'd heard good things about it, but unfortunately the poor experience that began at ante natal simply continued...

Nobody believes that 27% is a myth (like I said, EMCS isn't the be all and end all of complications), however I didn't find out the national statistic from the class, but from my own research whilst pregnant. It's not even that they denied the facts of intervention or EMCS, it's that the facts weren't even mentioned (with the exception, as I mentioned above, of using forceps as a method of scaring us into staying away from evil epidurals).

Got to agree with you about OBEM - watched it for the first time and I do sense that there's not a lot that goes on in that programme besides waiting and wailing

[PeaceAndHope]

Shagmundfreud:

Why all this hostility? Perhaps you might actually contribute to the discussion instead of poking holes in what others have to say.

I'm curious about something. Your last statement- 1 in 4 women have emergency cesarians and that to you indicates that a birth may not be straightforward? Why no mention of ventouse and forceps which are capable of as much, if not more damage? Why no mention of birth asphyxia, hypoxia, shoulder dystocia, and spontaneous third degree tears? Or is none of that important so as long as we avoid a cesarian?

[PeaceAndHope]

I'm a bit concerned to think that some women form opinions on birthing and maternity care based on programs like OBEM. At the end of the day, even 'reality shows' are meant to grab attention and sensationalise.

[NinkyNonker]

I see quite the opposite tbh. The expectation that something will go wrong, you will need intervention, pain relief, long recoveries etc is far more common than the expectation that everything will be fine.

[shagmundfreud]

No hostility at all PeaceAndHope - sorry if my tone or my use of questions suggests this, because none is intended.

I'm simply questioning your repeated assertions that the 'general' attitude towards childbirth in the UK is that it's easy and straightforward. The questions are intended to get you to be specific about how you have arrived at your conclusion that this is the way people think.


"Your last statement- 1 in 4 women have emergency cesarians and that to you indicates that a birth may not be straightforward? Why no mention of ventouse and forceps which are capable of as much, if not more damage?"

Actually only 14% of births nationally are by emergency c/s. The rest are planned.

You are right that women could and should be told in antenatal classes and at midwife appointments about the problems sometimes associated with ventouse and forceps and the likelihood of their being used in birth. Because there is an argument that it's not possible for women to give truly informed consent if these things are mentioned when seeking consent at the time of use. Ditto with c/s or any other medical intervention in birth. Can you suggest a workable format for this? At my local hospital antenatal classes have been reduced to one 3 hour session on a Saturday morning. How much detail would midwives need to go into? What percentage of the time allocated for antenatal education would you apportion for the giving of this information? Or would it be acceptable for women to be given this information in written format for them to take home and digest in their own time?


"Why no mention of birth asphyxia, hypoxia, shoulder dystocia, and spontaneous third degree tears? Or is none of that important so as long as we avoid a cesarian?"

No - it's all important if it happens to you.

[SardineQueen]

Just got in and catching up, just wanted to anser QTpie's question - I did NHS and NCT ante-natal (PFB overkill which was just as well as I didn't get on with NCT and jacked them in) - they both gave the same info. The attitude about BF was similar - all about the benefits and very little about how to spot potential problems, what sort of things can happen, and what to do if they happen to you. All of my friends in RL had probs with BF and I was keen to find out how to avoid them but they simply would not talk about anything like that which I found peculiar and infuriating TBH.

[shagmundfreud]

"I'm a bit concerned to think that some women form opinions on birthing and maternity care based on programs like OBEM. At the end of the day, even 'reality shows' are meant to grab attention and sensationalise."

Yes - this is true.

However, as childbirth no longer takes place in the home this is the only way for most parents/women to see what birth can look like. But yes - it's important to take on board that the picture which emerges has been 'shaped' with entertainment in mind.

[SardineQueen]

forceps and ventouse were not mentioned at my NHS classes, or NCT (although I didn't go to the last 2 NCT ones).

Neither were tears or episiotomies or things like incontinence, loss of sexual function, loss of sensation and all the rest of it.

[SardineQueen]

Why has the OP brought out such aggressive responses here?

[SardineQueen]

With all other medical procedures people have it explained in great detail what will be done, how, when, what with, what the risks are and so on. So as to obtain informed consent.

It is not right if the first time a woman finds out about episiotomy is when she has one, or that a side effect of a really bad tear is severe incontinence.

I don't understand why the conspiracy of silence - which is exactly what the OP was talking about when she started the thread.

[PeaceAndHope]

Brandysoaked:

Your screen name is apt because you sound a bit intoxicated to me;)
The opening line of my post clearly mentions that I'm new here. I don't know why you would imagine I'm someone else?

Since I can't make head or tail of your post, I don't know what else to say to you.

[IWantMyHatBack]

"What dismays me is that women seem to collude in this playing down charade, particularly when they expect pregnant women to carry on as if nothing is happening to them (the whole "you're not ill, you're pregnant!" thing). The fact of the matter is, pregnancy and childbirth are way outside the normal experience of most people - they're a unique thing that most women only go through a few times in their lives. It's a dangerous process, and one that should be cherished, and recognised for the life-changing event that it is. It seems that women nowadays are expected to sail through their pregnancies, working till the last minute, pop the baby out with no pain relief, and be back in their pre-pregnancy clothes out walking with their perfect baby in a few days.

It's no wonder so many women end up feeling like failures."


Couldn't have put it better myself.

[PeaceAndHope]

Shagmundfreud:

1. I'm not talking about attitudes specific to the UK. I'm a well travelled person and I've noticed a similar attitude almost everywhere.
   

1. In my opinion, women should be given written research papers and facts informing them about possible complications from all modes of delivery and intervention and the ways of avoiding them. There should be an opportunity to discuss individual concerns regarding the written matter in antenatal appointments.
   

1. Please point out where I have said vaginal birth is evil and all women should opt for elective cesarians. I'm talking about something entirely different but you are determined to make this thread about something it's not.

[PeaceAndHope]

SardineQueen:

I'm very confused.

[CailinDana]

I find it really odd that anyone would advocate hiding forceps from pregnant women, which is essentially what my MW did. How can you give informed consent if you don't even know what they're talking about? Keeping people ignorant does not help - and the idea that having the information will scare people doesn't make sense to me. Labour can be scary enough without having something new and unknown sprung on you in the middle of it.