'the only thing that matters is a healthy baby'

[RevoltingPeasant]

I was talking to a friend about ttc and wanting a homebirth recently (whooooole other thread there) but in the midst of trying to dissuade me, she said, 'Birth isn't an experience, it's a process, and really the only thing that matters is a healthy baby'.

Okay - I'd agree with the first bit. I don't expect to go into it and have a Magical Experience Which Will Last A Lifetime. I think it'll hurt and large part of it will be boring and literally shit.

But - it occurred to me that the second bit is something I have heard lots of people say when discussing birth, inc HCPs. And tbh, it really gives me a chill. There are two people involved in birth and the mother counts as well. I do think the mother has the right to think about herself too when negotiating interventions, choices etc. AIBU to think this attitude is really horrid and totally devalues women?

Or is that just because I don't have DC yet?

You don't give a lot of detail about the whole conversation with your friend, but they way I suspect it was going was that you probably have a very strong, but possibly quite idealised opinion of how you want to give birth, and that your friend was trying to gently point out that the whale music and candles are all just fluff compared to a healthy baby. For a first-timer a HB is generally a lucky occurence, as is a water birth, straight forward birth, etc. Many women go blinkered into childbirth first time round, expecting that their birth plan will be followed down to what track they want their baby to be born to, and are traumatized if it doesn't go according to plan. They are wiser second time round, with a more open mind and the attitude 'all that matters is a healthy baby.' I don't think anyone is saying that the mother doesn't count.

As an old midwife, labour is only normal in retrospect. Nothing would have persuaded me to have a home birth. Saw a young mother die at home, postpartum haemorrhage. It terrified me.

I don't think anybody can really comment until they've been there.

Thankfully most births go well.Those who have natural that went swimmingly and got everything they wanted out of it can't comment really as mother nature can pull nasty tricks over which you have no control what so ever.

Once you've been there and stared the fragility of the human race and what can go wrong in the face anybody would think differently.

I think a lot of women think oh it'll never happen to me I'm a natural at birthing,they would think differently if they had experienced first hand that the body and births you get in most cases are down to huge amounts of luck.

I speak as somebody who nearly died in my own birth as did my mother. Consequently as a family we have quite a pragmatic/realistic approach to the whole birthing process.

I hate the "as long as its healthy" comment. It's suggesting i it's not healthy it's not worth it. I'm not expressing it properly but you know what I mean.

I would always put my life over the life of a baby I was carrying - that's always going to be a bit controversial, and of course won't be the same for everyone, but if there was a situation in which there was a choice to be made, I would want to live - for my partner, for my existing children, for myself, for any future babies I may have. Such a situation is the very extreme end of the discussion though.

I wouldn't put my health or comfort over the life of my baby, of course. I've given birth, I've lost babies, I know it's not magical life-giving birthing goddess stuff, most of the time. But I do expect to be listened to, I do expect to have my needs met, I do not expect to have things done to me without explanation need or risk/benefit analysis. I expect to be treated with respect and to be asked permission for touch, examination, treatment if needed. Every time. That's a basic, basic principle of practising medicine.

I'm not sure if 'first do no harm' genuinely applies to childbirth, as there is a lot of harm done to women in its name......a lot of good, but a lot of harm, as well.

I went for a HB with my first as was worried that interventions would be bad for my baby etc etc. I was probably a bit naive but believe that as the majority of births are fine and that things go wrong in hospitals too, home was better. In the end DS was fine - I was a bit battered by it all.

With DD, I decided to go to a MLU within a hospital as was more worried about the possibility of something going wrong. After having DS, I realised what I could lose.

However, I think the experience of the mother is important because labour is bloody tough and it can affect you mentally whether you like it or not.

The 'choose between mother and baby' wouldn't happen because the mother's life always comes first (until the baby is born). The doctors have no choice - they have to treat the mother first.

I have a severely disabled child and two others - three very mixed births - all sections but yes the one with least intervention was by far the best, and the elective (the second) was by far the worst. Ultimately though I have to agree that the thing that will end being most important to you is a healthy child (especially if you end up not getting one). That doesn't mean you shouldn't have a home birth or whatever, just that if a situation becomes critical (however you're having your baby) then you won't care what they do. That doesn't mean that you should become a vessel just that ultimately all you will care about is having a healthy baby. (even though actually having a severely disabled child isn't actually the terrible thing I thought and has weirdly improved my life - although prob not his).

So I can see what your friend means, although I think you're perfectly entitled to strive for the type of birth you want as well.

I just think it is very odd. I don't think your friend meant this the way you are interpreting it. I suspect what she's really saying is ''look, the risk isn't worth it for either of you" (i'm not trying to argue here about home births vs hopsital births, just talking about what i think she was saying). Not many people think that a home birth is safer for the woman but not the baby - in fact, the reasons for having a hospital birth, if that is what one chooses, generally include the health of the mother and the desire to be close to help if she needs it.

I would certainly argue that a healthy baby trumps a woman getting the kind of birth she planned. I would also argue that a healthy woman trumps getting the kind of birth she planned.

Sorry if I have misunderstood the question!

I think it has a lot to do with expectation. With dd2 I was 35weeks pg and had a scan due to reduced movements which showed she needed to be born asap. She was delivered less than 40mins from when the decision was made to go to section. So very very fast and whilst it was clear it was her health at that point that was absolutely paramount (I was being stripped, shaved, canula's in whilst being wheeled down a corridor) I didn't feel I wasn't being treated as a human at all. I felt grateful to the numbers of people who were acting incredibly quickly to try and save my baby. And even though we didn't have a happy outcome I am still incredibly grateful to those people for trying so hard to save her however undignified it was for me. I know they all gave her the very best chance by acting the way they did, sadly she was just too poorly.

OP - I think you're compared apples with pears, so on this basis YABU.

I'll explain. You keep repeating the health of the baby compared with the health of the Mother.

But that's not actually what's necessarily being compared, is it?

It's potentially the life of the baby with health of the Mum. Two very different things - and surely, if there is any sort of risk to either, it should be the life of the baby which takes precedence.

Please don't get me in any way wrong - I am not suggesting that women are lower down the rung than babies; that they're just incubators or any such nonsense. I am a pro-choice feminist and proud of it.

I am just saying that when it comes to birth you're not always comparing like with like and the reason that some/many women will prioritise the baby is because it is their whole life that matters, not just one aspect (i.e. healthiness or non-healthiness) of it.

Does this make sense?

Labour is the single most dangerous routine medical procedure that is carried out. The primary aim of any delivery is to have a live mother and a live baby, it is less than 100 years since it became expected that both parties would be alive at the end of the process.
Even as little as 50 years ago DD would not have survived her delivery and probably I would not have survived either.
When it came to it I would have agreed to anything to just have it over and the relief I felt when that doctor said to me ' I promise you that one way or another your baby will be born in the next hour'.

lisad I know exactly what you mean, hard to put into words. Would they be not as important if they were not perfect.

But the point of the waterbirth, homebirth, etc, and whatever you bring to the room to make yourself relax, is that it's most likely to lead to a healthy and safe delivery. Therefore it isn't just fluff. It's part of creating the optimal environment for allowing the birthing process to work correctly.

It doesn't mean that it always will, but in many hospital births the interference with the natural process will itself lead to complications that would not have happened at home.

Looking at the worst case scenario, such as catastrophic PPH which is exceptionally rare, is not taking into consideration the fact that by birthing in a place that's right for the mum (in this case she's arguing for HB) is more likely to lead to lower level morbidity.

And to approach PPH which is a big concern for many, almost everything that can be done in hospital to stop a bleed can be done at home, other than surgery. And if you're near enough to the hospital (ie not hours away, and who is in the UK) then you can get there in a transfer perfectly well in time. Of course there will be very rare cases of things going worst-case-scenario. But what many people just don't realise is that in hospital so many things go wrong because they're in hospital that when stuff needs to be done (eg forceps) to "save the baby" they feel gratitude to the doctors, without recognising what led to that situation in the first place.

No, birth doesn't always go smoothly. No, "just" being in hospital doesn't lead to all the problems that people experience. It's all a balance of risk, though, and actually the risks of things going relatively but not catastrophically badly in hospital are far greater than at home, if the women is happy there.

Lizcat - labour is not a medical procedure which is carried out.

It's what women's bodies do to get babies out, regardless of who is there and where they are.

Unless having a poo is a medical procedure too.

Quite shocked at misscoffee, I didn't think anyone would choose their own life over their baby's.

My baby is perfect to me and enjoys good health, these days :)

I think the unspoken implication in a lot of posts on threads like these is that a hospital birth is inherently less risky than a home birth. Although that may sometimes very much be the case it is also sometimes the reverse.

Additionally, saying that all that matters is a healthy baby can be a very difficult message for women struggling with the aftermath of a difficult birth.

Rationally you may want to feel this way but emotions are not rational. This message adds another layer of guilt and many other complicated emotions upon women already struggling with what can often result in PND or PTSD. Ultimately it can imply that if you were truly selfless you would not feel this way. Given that some women can already feel that their birth experience has diminished them as a mother it can be a really damaging thing to hear and make you feel quite alone.

Of course not all women planning home birth have had a traumatic prior experience but I'm sure that pretty much all of them are basing their decision on what they think will be safest for them and their babies, physically and emotionally. Hindsight is not a luxury we have when planning births and so all decisions are somewhat of a gamble.

Having an unmedicated vaginal delivery is most likely to lead to the most healthy baby AND mother. Planning whatever it takes to achieve that therefore makes sense, and if the mother feels that a homebirth is most likely then seems perfectly reasonable to me.

Babies risk get damaged (short or long term) by most medical interventions in one way or another, so avoiding them is a good plan, really! The NHS isn't great at the balance of risk thing. Of course they're needed sometime, just not as often as they're used.

I would prioritise my own life over any new baby's too. I already have two children and another would wreck me physically, which is bad enough for my existing children as they rely on me as their primary carer. If I were to die, my existing children would suffer enormously as do all children whose mothers die when they are young. DH and I have taken every precaution to ensure we don't have to make such a decision. I still worry enormously about it, partly as I am a christian and couldn't have an abortion (though am still 100% pro choice in case anyone jumps on me - it's a personal decision).

I'm sure a lot of people would choose their own life over their baby's, especially if they have older children. Regardless you don't get the option, the doctors would work to save you, if any such situation ever really arose, which is incredibly unlikely in this country I'm happy to say.

But like I say it's the extreme and extremely unlikely end of the discussion and somewhat of a red herring. It sidetracks the main issue.

Of course YANBU. Taken to its logical conclusion, "the only thing that matters is a healthy baby" could mean that it doesn't matter if the mother is dead, disabled or severely traumatised - as long as you have a healthy baby.

In any case, the NHS actively encourages women to have home births provided the mother is low-risk. They'll send out two midwives to help you deliver the baby. If home births were really dangerous, there is no way, in a risk-averse society, that the NHS would allow them to happen.

As the mother of a birth damaged, unhealthy baby I don't think it devalues women. The stakes are just so high and to me, the idea of prioritising my desire for a good birth experience or to give birth in a particular way over my tiny baby's dying brain cells is horrific. I'm glad I was cut open so widely and with so little care because it got my dying child out quicker and he survived.

The phrase is grating because of the implications about the non healthy population who are much loved individuals but at least in the context of birth it has some meaning. What really bugs me is when it is used smugly by people who have chosen to not find out their baby's gender, the implication that if you do want to know what you are having then your priorities are screwed as if somehow caring about whether you have a dd or a ds and caring whether they are alive healthy or are mutually exclusive.

Lizcat, I think it's absurd to refer to birth as a dangerous medical procedure, unless you're referring to how the medical industry view a natural physiological process, in which case you're spot on. Sadly.

well, of course the baby's life/health isn't automatically MORE important than the mother's mlife/health but I dont think that is what this thread is asking.

The friend who made the comment isnt talking about that, she means that the additional risks of a home birth (ie serious unexpected complications which require immediate treatment unavailable at home birth - see real life examples up thread) are, in her view, much more important that the mother's wish to deliver her baby at home.

I understand the desire for home birth completely, and I know people who have had them - but for each successful homebirth I imagine there would be at least one mother whose baby would have died or been seriously injured (or the mother even) if they had chosen a home birth instead of the hospital with immediate specialist treatment on hand.

So although I would have liked a home birth in many ways, the risks outweighed the benefits - not least of all because I, the mother, would have had to bear the consequences of that home birth choice if it had all gone wrong

headfairy your poor friend. That is tw sort of thing that crossed my mind when I read the thread title and op.

I think OPs friend is coming at it the wrong way, TBH. IMO, the primary concern during labour is the lives of the mum and baby, followed by the health - and I think that mum and baby are of equal importance in both.

I was lucky enough to have a very positive birth experience, but suffer totally separately from PND and almost killed myself. I think that the mothers mental health shiuld br viewed with much higher importance, and that includes making the birth a positive as possible for the mother because a traumatic birth can be devastating to a woman's mental health.

Unfortunately, childbirth can be very high risk for both women and their babies, and this kind of distinction is a bit if a moot point sometimes.

Sorry for rambling post. OP, I think your friend is BU. You should plan for the best birth that you think you could hope for, but accept that your birth might differ from your ideal, because of your health / the baby's.