'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?

Having had an early miscarriage, 4 rounds of IVF and losing twins at 20+3 after PROM last May, I am now 30+5 with another pg, originally suspected to be ectopic and with lots of episodes of bleeding and a cervical stitch inserted to try to keep the pg safe, and I couldn't give a stuff about 'the birth experience' as long as a I get a healthy baby at the end of this pg. I think instrumental births look horrific and I'd rather have a c-section, but fundamentally I'd rather they saved the baby than me if there was a choice, and I've made DH aware of this.

I appreciate I don't have the most objective opinion though :)

Thanks LaVolcan Bubb & Patsy, sorry, think you are misunderstanding: this wasn't a homebirth v CLU-birth question but more about the sentiment.

tbh Patsy, of course I don't and can't know how giving birth feels yet, but just look at the number of women on these boards who talk about bad birth experiences, avoidable birth injuries, having their wishes disregarded, etc. I don't know how you can read stuff like that and assume that 'hopefully none of the rest of it will matter' It's great if you've had good births, but would you seriously say that to a woman with PND?

And no birth isn't a magical experience - I said that in the OP!!

Highlander - exactly. You said it lots better!

Hmm OP, now I think you have misunderstood me! I wasn't getting into a homebirth debate at all and I totally agree that people should be prepared and try to make their labours and births as positive as possible. Of course I do! For my part I did active birth classes, hypnobirthing, planned for a water birth etc. I was much more prepared second time around and I believe that helped me. I would particularly recommend active birth classes.

However, I don't actually know a single person in real life whose birth went to their plan. It actually makes me quite annoyed that there is such an illusion of choice when the reality is quite different for many women. I think the disparity between the plan and the reality is often what upsets many women - they feel like they've failed or been failed in some way (and I do know some women really are failed too). That said, all of those people I know whose births didn't go to plan did have healthy babies. And I sincerely hope that, eventually at least, the fact that they've had healthy babies is the only thing that really matters.

I think that was what your friend was trying to tell you. I think she was being kind. Why on earth we she care more about a baby that hasn't even been conceived yet over her friend?

Don't particularly appreciate the by the way. My first birth was horrific and the second much better but still bloody awful. I've also experienced PND. Does that make my opinion any more valid?

The BEST thing I did second time around was to be open-minded about the way labour might pan out.

RevoltingPeasant, just realised you did a and not a - sorry for arsiness!

Honestly - I always feel like slapping people with a wet fish when they dredge up the 'only thing is a life baby' comment. We have a situation now where the majority of births in some hospitals involve some sort of unpleasant buggering around with the mother - episiotomies, augmentation, induction, catheterisation, c/s, forceps, ventouse, continuous monitoring.

In trying to identify and help the small minority of mothers and babies who benefit from medical input we mess up the labours of many of the rest by bringing them into hospital and subjecting them to too much interference, so that far larger numbers end up needing help than should do.

I honestly think the 'the most important thing is a well baby' is the only answer some people can think of in response to the dogs dinner birth has become in this country.

There is no need for this 'either/or' mentality. We can create a system where mothers can be safely cared for in such a way as to optimise their chance of a straightforward and happy birth, while at the same time being vigilant for complications. It's called 'case loading midwifery', and 'one to one care'. It also involves us valuing the work of midwives and not tolerating systemic short staffing in maternity units.

I absolutely agree with everything Shagmund said. In some ways I wish I could convince myself all the intervention is necessary because I think it would help me to deal with my own experience of being buffered around with. But unfortunately I know that is was mostly unwarranted and sadly have to process that.

I don't understand the whole 'birth is unpredictable' argument in relation to women's birth choices. Of course it's unpredictable, as is life in general. That doesn't mean that women should not be empowered to make plans, and contingency plans, and be treated with dignity and respect as the decision maker when plans need to change?

"Of course it's unpredictable"

Oh I don't know. When I hear of a first time mum age 35 going for an induction for post-dates pregnancy, in a large teaching hospital with a 20% emergency c/s rate, I think it's usually pretty predictable that she's going to have a horrible time and often end up in surgery.

But when I do hear about someone who fits this profile who manages to dodge the doctors and birth her baby without help, I send up a little cheer.

Having read the general comments that people have put on here about how hospital midwives treat patients I can only wholly concur. I remember feeling this way after DS2s birth. I had been so battered and bruised by the hospital staff my stitches took weeks to heal and I remember feeling that I had not been treated with dignity at all (it has also been suggested that there could have been a case for negligence had anything gone wrong).

I also appreciate that live births are what they should be striving for. However, I don't feel that doing one thing well should be at the cost of doing nothing else well. I am sure that achieving live births and well mothers can also mean that the old fashioned principle of 'care' (which fundamentally is a midwives' job) could be included. After my experience in hospital I would not be surprised if hospitals actually induce PND in some cases.

I wish someone would start a movement to improve the level of care in hospitals for mothers who decide to have hospital births. It would be way overdue.

I didn't finish my post entirely - of course birth is unpredictable but it could be made more predictable by actually "caring" for the mother when she came into hospital in labour rather than what I am guessing they do, which is leave her to it until the last minute and then rush her in for a c-section because guess what? something has gone wrong.

Ha :) make the above statistic 30% and just a standard hospital and you have my 'unpredictable' birth experience!

Hoping to buck the trend this time round...

If I had had a homebirth it is extremely likely that ds would have died. If he had been born in the hospital I wanted then I would have been left in that hospital whilst he was blue-lighted to the other hospital. If I hadn't allowed the interventions that I did ds would definitely have died. Lots of decisions and the second most scariest time of my life (the first being caught up in an event where I honestly thought I would die and then baby ds would be left an orphan).

All that I went through meant that I would never want to go through it again and therefore ds is an only. I would rather that than the other and therefore I think that a healthy live baby is the only thing that matters. Assuming of course that there is competent maternal care.

Haven't read the thread but would say after waiting for DD3 for 6 years that actually I didn't care what the manner of her birth was by the time she was born (crash CS and narrow escape as it turned out) as long as she got here and healthy.

I had had 3 perfectly healthy and relatively straightforward births before, two of them pretty nearly ideal (apart from the fecking painful labour bit) at home, so I wasn't jaded about birth at all. But when it came to it at 2am, when midwives were trying desperately to find my daughter's heartbeat with their monitors and I was signing consent forms, I honestly didn't care what they did as long as my child came out of it as safely as possible.

In the event, I very fortunately had a near ideal CS, way better than than I could have wished for in the circumstances, and a baby who although sick and in NICU went on to make a full recovery and whose existence I feel grateful and thankful for every single day.

Patsy that's okay - now that one is unmistakable!!

Yes, I am quite flexible in my approach and I know it doesn't go according to plan - lurking on MN has taught me that!

I want a HB but DP is not keen so might go to hosp. I have a kind of 'pecking order' in mind: HB, birth in CLU with gasnair, birth in CLU with epidural, CS, then forceps/ ventouse bottom of the pile - just depending on how things go. I'm hoping that's a realistic approach as it means I can 'move down the list' if something goes wrong rather than being fixated on one approach.

I don't think our experiences (or not!) of birth make our opinions more or less valid, BUT there are people on MN like the lady who can't walk properly after her episiotomy damaged a nerve (can't remember her name). I think that matters enormously and would fill me with regret.

Tbh op - the only 'approach' you can choose is deciding where you book to have your baby and who you want with you for the birth.

All the other things you mention will be the doctors choice not yours. (of course in a formal sense you have to consent to treatment but in real terms most women don't feel they have any choice but to accept emergency procedures).

Should add - the usual 'pecking order' is that c/s is the procedure of last resort. It'll only be done if the doctor thinks that forceps or ventouse won't work.

shagmund I got that idea from someone else on here recently who said that she had specified in her birth plan that if things were looking iffy she wanted to go to CS rather than forceps. Can you not do that, then?

You can put that in your birth plan. But the bottom line is that if the baby is low enough in the birth canal to deliver vaginally with instruments that's what the doctor will try to do in preference to a c/s.

You really wouldn't want a doctor pushing a baby who was already low down in the birth canal (as most babies delivered by instruments are) back up into the uterus to try to deliver abdominally. Puts you at risk of a rupture.

...we mess up the labours of many of the rest by bringing them into hospital and subjecting them to too much interference, so that far larger numbers end up needing help than should do.

I honestly think the 'the most important thing is a well baby' is the only answer some people can think of in response to the dogs dinner birth has become in this country.

I think you hit the nail on the head here shagmund. There are differences between CLUs - some have many more interventions, EMCS etc. than others, despite serving similar populations and yet they don't have better outcomes. To say 'the important thing is a well baby' allows them to get away with continuing to make excuses for the fact that their standards are not as good as they ought to be.

shagmundfreud Sat 25-Feb-12 20:17:59
"Of course it's unpredictable"

Oh I don't know. When I hear of a first time mum age 35 going for an induction for post-dates pregnancy, in a large teaching hospital with a 20% emergency c/s rate, I think it's usually pretty predictable that she's going to have a horrible time and often end up in surgery.

Precisely the reason why I support the right for an ELCS on request. If your chances of intervention or a deeply traumatic birth are particularly high, then it should be a more easily available option. Especially given the fact that EMCS are so risky.

I definitely agree that a first time mum facing an induction with an unfavourable cervix should be encouraged to feel she has alternatives:

planned c/s
or
expectant management, with good midwifery support

shagmundfreud Sat 25-Feb-12 20:17:59

"Oh I don't know. When I hear of a first time mum age 35 going for an induction for post-dates pregnancy, in a large teaching hospital with a 20% emergency c/s rate, I think it's usually pretty predictable that she's going to have a horrible time and often end up in surgery."

Depends on the actual hospital. I was in precisely that position (except that my induction was pre-term) and actually had a good birth. But that is less likely to happen the more financial pressure is put on hospitals. It was a few years ago, which may well have made a difference.

If I could go back and have a horrible birth with unsympathetic midwives and have a dd who was not disabled and in chronic pain I would do it like a shot. It is simply very difficult to look at a child who is suffering every day and take that any consolation from the thought that "I am more important as a mother, so it's better that I'm all right". I am sure I would feel the same if dd's sufferings had been caused by a birth injury and involved a genuine situation of choice: in the longterm it would be difficult to take comfort from my being all right. Having to deal with a child in that situation is as draining as being in pain yourself- no advantage really that I can see.

But seeing that my suffering wouldn't have made dd's current situation, it is at least better that some suffering was avoided and I am more physically fit to deal with whatever has to be dealt with.

And in many, many cases better resources and a more thought-out approach could avoid damage to mother and child: a win-win situation.

I don't think a healthy baby is the only thing that matters - everyone wants a healthy mother and baby as the outcome. I think what your friend meant was that sometimes your longed for birth experiences does not go to plan. If the baby's heart rate starts to drop, you just want that baby out so it can breathe. It doesn't matter if you didn't get to listen to the music you wanted or have a mystical birth momentor if you are bruised and battered.
This is your first moment as a parent realising that in fact your comfort and your fantasy experience are not as important as your child's safety or well being. Welcome to motherhood!

Either way, whether you end up damaged or your child ends up damaged, it will be the same person who has to deal with it: you. That is the first big shock of motherhood: that for the first time your own wellbeing is completely tied up with the wellbeing of another person.