Childbirth- inherently risky or inherently safe? Painful or not?

[WhatTheHellJustHappened]

My friend recently made the fatal mistake of saying in the company of some female colleagues that childbirth was the most painful, horrifying thing she had experienced. An argument ensued and majority of the ladies there believed it was wrong to call childbirth risky or painful. They said they pitied women who looked at such a beautiful and empowering experience in such a negative manner. They said that even sitting on a lawn was risky but sensible people didn't spend time fretting over it. My friend asked me later "When did it become a crime to call childbirth painful or risky? ".
While I personally agree that childbirth can be very empowering and rewarding, I also do agree that it is painful and potentially risky.

What are you views? Do you think childbirth is painful? Do you think it is inherently risky or safe?

Primafacie "But certainly it is a country where there is less sexism and women are more empowered, which I am convinced plays a role." That is so interesting.

I agree but the puzzle is in the UK the opposition to pain relief comes from midwives and they are mainly women.

I agree women should be able to CHOOSE natural birth if that's what they want but on One Born Every Minute there were midwives telling women 'no chance' when they requested an epidural. No public outcry - nothing in the paper. Apparently perfectly ok to leave a terrified women in agony. It is blatant mysogyny and yet no-one challenges it here.

Why do you think the US is so enlightened and the UK is in the dark ages? I'd love to know why you think UK is so different and so far behind most of the rest of the developed world.

I think you're right about that Primafacie.

I don't know if you read the postnatal ward horror thread, but that could only happen in a country where women are not empowered enough.

I meant Canada, Primafacie sorry!

Ushy -- I think that's what happens when ideology takes over. People lose sight of the effects it's having on people.

I'm not sure the US is so enlightened (look at the dramas around birth control and abortion!) but I think American women have higher expectations and are more demanding when it comes to health care. That's why we get to see gynecologists without a referral, we have yearly exams that are more likely to detect cancers earlier, etc.

American feminists have waged a lot of campaigns to get women's health treated as well as men's health. Pain relief is a big part of that.

Actually, maybe it's not that there is less sexism in the US, more that the feminist movement is more organised and developed. They do some amazing lobbying.

x-post

Oh Canada is definitely more enlightened than the US!

Colder though

dreaming I think that's what happens when ideology takes over. People lose sight of the effects it's having on people* So true

The problem is in the UK women have been brainwashed by exactly what the opening poster complained off.

If you have caesareans you are really sneered at in the media 'too posh to push' - even if it was a medical caesarean.

When I had an epidural, one midwife said afterward she hoped I wasn't too upset that I hadn't 'managed' to 'achieve' a 'normal birth' without pain relief!

The language is all very controlling - only inadequate women need pain relief - the losers - the non-achievers have to have epidurals.

It's a loaded message but it gets compliance and then gets repeated by the lucky ones who get through labour without pain relief. The ones who have had a horrible experience keep quiet so they don't scare anyone.

I'd just love to know how you US and Canada guys broke the cyle or was the same kind of pressure never there in the first place?

"I'd just love to know how you US and Canada guys broke the cycle"

US c-section rate is 34% at the moment.

Is that something we should be aiming for here in the UK?

"I agree women should be able to CHOOSE natural birth if that's what they want"

You've got fuck all chance of doing that in a system where invasive and routine monitoring, high rates of induction and defensive obstetrics is the norm.

In that sort of system if you want a c/s, a birth involving loads of monitoring, an induction for non-medical reasons, and an epidural - you're quids in, because that's what everyone else is having.

World wide rates of assisted delivery are between 7 - 11% of deliveries according to this: here

The UK doesn't come out of that too badly at 12.5%, which is actually quite good considering that UK mothers tend to be fatter and older than everyone except Americans (who have a much higher CS rate).

Odd really, that despite an apparently vocal and bullying natural birth lobby around the world, the normal birth rate just carries on going down, and down, and down, no matter what women say they want.

"In that sort of system if you want a c/s, a birth involving loads of monitoring, an induction for non-medical reasons, and an epidural - you're quids in, because that's what everyone else is having."

But if you request a CS beforehand, you are met with obstruction and have to argue a case for having one. You are also NOT encouraged to have epidural as routine.

Ah sorry, have realised that you're talking about the US system not the UK system with that statement.

In the UK you're just pushed towards 'natural', then shunted into a system which can't really cope with providing all the extra support that 'natural' requires.

"But if you request a CS beforehand, you are met with obstruction and have to argue a case for having one. You are also NOT encouraged to have epidural as routine."

Yes - because the focus in the NHS is on having as many normal births as possible. They want the best health outcomes for the least money, and this seems most achievable with a system of midwife led care in labour.

I know there are people on this thread who are making a case for continuous monitoring and epidural having no impact on birth outcomes on the basis of other countries having lower higher epidural and lower assisted delivery rates the the UK, but UK midwives and doctors really need to base their practice on good quality evidence from large scale studies based in the UK as these are most relevant to our system of maternity care and our demographic.

"In the UK you're just pushed towards 'natural'"

No - that's simply not true. High induction rates, high rates of continuous monitoring, high rates of supine birth, and in a busy medicalised environment where women may not get continuous care - none of these things have 'natural birth' stamped on them. They all have 'medicalised birth' stamped on them.

"No - that's simply not true. High induction rates, high rates of continuous monitoring, high rates of supine birth, and in a busy medicalised environment where women may not get continuous care - none of these things have 'natural birth' stamped on them. They all have 'medicalised birth' stamped on them."

That's kind of my point - you're pushed towards doing it 'as naturally as possible' (ie without any pain relief) then forced to suffer your 'natural birth' it in a brutal and unsympathetic environment.

"In the UK you're just pushed towards 'natural', then shunted into a system which can't really cope with providing all the extra support that 'natural' requires"

Bonfire, I agree with you about the UK system.

Being pushed into natural is just as bad as being pushed into lots of unnecessary interventions.

Each of us has personal preferences - even a 34% caesarean rate is ok by me if 34% of women genuinely needed or wanted them. It's not my business. I don't think we should look at intervention statistics and say 'that's terrible'.

Interventions are only wrong if they are inflicted on people against their will. Some women WANT elective caesareans. Fine by me - how other people give birth is not my business.

Ditto monitoring. I was fine about that - quite reassuring.

What I do feel I have a right to complain about is ending up traumatised and psycologically damaged as a result of other people's ideologies being inflicted on me.

But Minifingers, there are a lot of women saying they actively want the NHS to change the way it deals with birth. Why can't we look at other countries who achieve better results? Looking at studies done here is not going to give us much insight on how things could be done differently - when by definition they are done in the context we think should change.

This is what I find odd, you have to have alot of discussions about a c section if you know your going to have one, but what preparation for this " major" surgery do you get if your having a so called " normal" labour that then goes wrong.
Its ok then to do major surgery with no idea of what goes on. I dont expect them to risk babie and mums life of course to go into it then, but I found the NCT and the local midwife birth preparation classes not informative enough. To say it hurts - with a smile isnt conveying that actually - to alot of women, its torture. Its never ending torture and you dont know what is going to happen to you.

I don't see how Canada is 'more enlightened' if the only form of pain relief available is an epidural.

(Although if epidurals are available when people want them, that's A Good Thing, of course.)

A woman's perspective of birth, and also her provider's perspective of birth, can have a big influence on which birth plan they prefer.

Some view birth as inherently risky, and favour medical intervention over Mother Nature (I fall into this category), while others view birth as an inherently safe, natural process, and only want medical intervention as a last resort.

The important thing is for midwives and doctors to recognise and respect these different perspectives that women have, and to be willing to support their birth plan choice even if it is one that does not match their own.

choosing
"The important thing is for midwives and doctors to recognise and respect these different perspectives that women have, and to be willing to support their birth plan choice even if it is one that does not match their own".

I completely agree with you but in the UK they don't, do they? Look at recent threads. Women denied epidurals, pushed into VBAC they don't want, refused homebirth, denied caesareans......etc etc....a very long etc

Whenever I see health professionals going on about promoting 'informed choice' I feel like piping up Nooooo.... your choice...for 'informing' read 'brainwashing' grrr...

Inherently safe where there is good antenatal care. See the Birthplace Study 2012.

Bearhugs I think choosing is saying it is about how an individual perceives risk.

If your worst imaginable nightmare is risking any kind of perineal trauma or spending a long time in severe pain in labour, you might wish to choose a caesarean.

If you believe birth is a natural life event and want to give birth as naturally as you can, then obviously you would want a vaginal birth - possibly at home where there is less chance of interventions.

But that doesn't make either choice inherently safe or better, does it?

Ushy I wholeheartedly agree.

I have been "educated" by shagmundfreud on a different thread almost to death. What if I don't want to be educated like that and I'll take the spinal and cesarean, thank you very much? I did my math and I see these choices as much more preferrable to me because some of the risks of VB are simply unacceptable for me and if I can avoid them thanks to technology and science, I'll do it.
All that talk of education is, IMHO, very patronizing and only aimed to humiliate the opponents (or even the midwives' patients) into submission and obedience. Because we know better what's good for you and even if we don't, we'll do it our way anyway.

I also agree that there are basically two opposing views of childbirth (natural vs. completely medical) and women will act according to which view they share because it is based on their value systems, experience and etc. and can't be just switched off because they take some course or read a book.

I think I was (especially after my NCT ante-natal classes) pretty much on the natural birth side of things. But it was still important to me to cover all bases in my preparation and birth plan.

When I wrote mine there was a lot of anecdotal talk about how the "birth plan went out the window" once there were complications or a long, painful birth.

I didn't want to feel like that - I wanted to feel like we'd moved on to plan B if that became necessary.

So, my birth plan mentioned everything from water-pool to caesarian, and everything in between.

As I said upthread I don't feel women should be asked to choose between options as firmly as they are now asked to do. If HCPs could work together in a more integrated way instead of having midwife led care versus consultant led care, then more flexible options could be offered to women. Important for every birth, but especially with the unknown experience of a first birth.

Sorry - I wasn't responding to choosing - had only read the thread title and only had time for my 2p's worth

Just was a comment on the results of the study that overwhelmingly found that birth in the uk is inherently safe wherever it happens. Although vastly increased risk of intervention in obstetric setting obviously..

"
I also agree that there are basically two opposing views of childbirth (natural vs. completely medical"

there is evidence based medicine. -Though of course if someone wants to make different choices to those indicated by the evidence relevant to their case that should be supported too. If you are following the evidence, there is no opposition.