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?

Juggling You are SO right. It really shouldn't be one or the other and it needn't be but I think there has always been a power struggle between midwives and obstetricians.

Unfortunately women pay the price. A single integrated service would be so much better.

shagmundfreud why is pain relief considered an avoidable intervention? How have we got to this place where we have ways of making childbirth less traumatic but we are sold the notion that because it's allegedly natural (I dispute this!) we have to do without.

We don't have teeth extracted at the dentist without pain relief so what's the difference?

I still feel traumatised by the pain I felt which led to huge amounts of fear. But never mind - it's all natural.

I can't help thinking it's a feminist issue. My husband asked the midwife at my 3rd labour why anyone would NOT have an epidural. She rolled her eyes and said "men!". We women are our own worst enemies.

Iloved Great post and so true!

It's certainly not beautiful!

It is painful, although I found gas n air did the trick; the thought of a needle in my spine terrified me.

Howver, I did have 2 fast, easy labours and come from a family where this is the norm.

BF was worse, because it hurt like hell for the first 4 weeks.

I think while Shagmund makes some reasonable points, I suspect I won't give a damn about them when labour kicks in.

I believe women should not be made to feel guilty for costing the NHS more if they choose intervention/pain relief for what is essentially a really, really agonising experience. Especially when on the next floor they're dealing with bariatrics, junkies and other assorted people who have wound up needing hugely expensive, often long term medical care by their own hand. Why should labouring women martyr themselves for a want of not causing a fuss while pissed up twats wreck A&E?

I don't care what other women have in their birth plans. Do what you want. Why would they care about mine?

Garlic ...you just put it in a nutshell

definitely risky and painful in my experience. DD is 14 months old and i still don't think I'm fully recovered down there. Would I do it again - yes! But only once I've mentally recovered from my expeirence

Diddly what a shame though that you feel you need to recover mentally. [Sad]

Ushy it was that I had very poor care while in labour, if I say too much I might out myself here! Every time a different HV would visit me and ask me about the birth I would say oh it wasn't too bad I suppose while crying as I think I was in denial. One HV told me I should write a letter to the hospital and complain as I had been treated very badly and that she had never heard such a horror story. That upset me more as I at least wanted to think what I had been through was somewhat normal!

I want another baby, but I don't think I can do it through the NHS so will have to wait until we can move home.

Doess a bear shit in the woods?

(that was in response to is childbirth painful)

I think the issue is childbirth can be seen as/portrayed as primarily about PAIN, and for many many women, it's simply not about pain at all.

My 2 labours were very different (long & slow vs fast & intense), and while yes it did hurt, it wasn't about pain for me at all. I don't think back now, or even at the time, and think or talk about the pain. The levels I experienced, along with all else that was going on, simply don't merit that attention/importance in my view.

Whereas my sister had first labour pains, and thought "this hurts & this sucks - epidural now please" :) and she got it. She will talk very much about how painful it was and how absolutely marvellous epidural was for her.

Who knows if it's our tolerance to pain that is different? Certainly our attitudes to life are very different. Or maybe it is simply our actual level of pain was different? How can you tell?

Ilove - I've not argued that women should be routinely denied pain relief on ANY grounds, least of all because the pain of labour is 'natural'. But hey ho - you have a point to make irrelevant though it is to my post or most of the other posts on this thread

I could tell your husband why I chose not to have an epidural after my first experience with one: because I didn't want to be catheterised, because I didn't want to spend my labour on the bed, because I wanted to improve my chances of pushing out a 11lb baby without complications, because I didn't want to raise my core temperature in labour (a side effect of some epidurals) as this can result in your baby becoming tachycardic and distressed; I didn't want to risk the 1 in a 100 chance of a dural tap which has ruined the first week of new motherhood for two of my friends. I also didn't want a longer labour or an overnight hospital stay - both things that come with an epidural. I appreciate there are many women who are willing to accept these risks in exchange for good pain relief, that is their prerogative. I personally would rather have the pain.

I can only assume your dh wasn't aware of the risks of epidural, otherwise he woukdn't have asked e midwife such a silly question.

By the way - I wasn't referring to an epidural as 'avoidable intervention' but the instrumental deliveries which are so often associated with it. And the increased risk of c/s which arises from giving birth in an obstetric unit, which is where you have to be if you want an epidural.

Garlic - women need only think of themselves and their babies when making decisions about how they want their labour managed and whee they want to give birth.

But at a societal level we need to decide on how we want to use the limited number of midwives and doctors that we currently have working in maternity services. Ushy has made a case for directing more funds into obstetric services for low risk women. I'm not clear whether she'd be happy to have this happen without an increase in overall midwife numbers.

Ushy - there is an 'integrated service' .

Doctors are not involved in the care of women with uncomplicated pregnancies because their job is to identify and treat problems. Midwives provide routine care as this is their area of expertise.

What sort of system would you prefer?

What involvement could doctors have in the care of healthy women (other than obstetric anaesthetist input in the case of epidurals) that would justify the extra money it would cost to do this?

shagmundfreud sorry, did I say I wanted a doctor to look after me?

I don't mind who looks after me, as long as they give a shit and all the midwives I saw during my labour couldn't have given a fig about me or what I was going through. Their sheer incompentance and shocking attitude towards the whole process is what shocks me the most now when I think about it. It was literally just once cock up after another which ended in a very bad experience.

oh and obviously are qualified to look after me!

Entropygirl - I'm sorry you've had such a horrible time of it and I wouldn't want you to take my posts as any sort of comment on your personal experience.

I'm just very interested in the fact that though you'd expect to see higher levels of satisfaction and lower levels of trauma associated with giving birth in environments where there is greater usage of epidurals (if lack of easy access to good pain relief was at the root of our current dissatisfaction with birth) that actually in the uk the opposite appears to be the case.

Women who book to give birth in MLUs or at home are more likely to be satisfied with their births, even when you take into account the experience of those who end up transferring because of complications.

To me this suggests that it's not the level of obstetric anaesthetist services available to healthy mothers that's the main problem, but a lack of responsiveness in the type of care women are generally receiving in the UK.

wow - I'm 39 weeks pregnant with my first and reading this thread (maybe not the best plan!) and you all seem quite down on hypnobirthing.

I have been reading and practising some of the techniques with DH, but that doesn't mean I am ruling anything out. Of course pain relief should be available to all. I fully expect to use some of those 'treehugging' relaxation techniques when at home, along with pain meds and hot baths etc, but will be very happy to move on to an G&A, diamorphine and an epi if necessary at the hospital. This is what I expect to happen. I could be wrong - baby could be distressed and I'll need a CS.

i've heard that if you want an epi to ask early as these things take time...and i'm fully expecting it to hurt like buggery.

That doesn't mean that relaxation tehniques and active birthing can't help get me some of the way there though, does it - before the mega pain kicks in and I'm taking all the drugs to which I'm entitled?

shag on the topic of thinking for yourself...

I had a run in with some morphine based drugs a week before giving birth and they had the effect of sending my to the happy fairies but also they made baby unresponsive for almost 8 hours.

So during labour I told the midwives that I didn't think morphine based drugs were the way forward...I knew they would help me but I was worried about the effect on the baby - and being rushed off for an unnecessary C-section. They told me not to be daft, they would never give me anything that would hurt the baby...

I couldn't be arsed to argue with them so just declined all morphine and signed on the dotted line for the epidural instead...

Essentially midwives are very very good at telling you that you won't be different to the average labouring woman....and this is in spite of the huge natural variation that they MUST be witnessing day in day out. I really can't understand it...

Also as it turns out I am an individual. I have a heart condition that required antibiotics throughout, I, and the rest of my family, have a genetic predisposition towards useless internal pain management (we are genetically low pain thresholders), I didn't respond to local anaesthetic well and had continual pain in spite of a well set epidural and multiple top ups. I had a spinal tap also which did precious little and in the end they had to GA me. I then haemorrhaged.

So really all this 'oh it's natural and your body is designed to do it' is just so much pissing in the wind....

shag oh it's fine - I know where you are coming from really and do not take comments personally!

but I do think 'satisfaction' is a really bollocks measure of anything.

We are trained to think that a cs is suboptimal, so when we express greater satisfaction about vb what does that really mean?

I feel dismayed at the fact that I missed that actual birth of my child by 2 hours...but I think almost all of my lack of 'satisfaction' is to do with the pain I had to endure...

Maybe the problem is that anyone requesting an epidural is already experiencing pain that they cannot cope with....so the higher the number of epidurals the worse the average experience. But this doesn't put the epidurals at fault! It just means that we need to be MUCH faster at administering them - which means more anaesthetists. I spent a total of around 6 hours waiting (in various levels of mind destroying pain) for people to get to me.

Using those more natural methods can get you a long way spanner - I had both my two like this and found water very helpful - DC1 was born in water pool, DC2 a faster birth and used some G&A (also pool not available for his birth)

It was painful - particularly for me the pushing stage, and with DC2 late stage 1 into transition. But it wasn't, for me, an un-manageable amount of pain - though I did say to DH during transition with DC2 "I don't want to do this !"

Everyone's experience is different though. I know I've been very fortunate - but also think everyone should be able to hope for a good birth with well managed pain and the opportunity to make informed decisions about their care. Sounds like you are going into it with a positive, pro-active, yet realistic attitude - which I'm sure can help you.

All the very best to you, and yes, maybe you could find/start a more encouraging thread to share with others the exciting events of the next few weeks !

I'll be looking out for news of babyspanner

ohhh I would have loved to try the water thing.....sadly my heart problem prevented it.

I agree that there is nothing wrong with going in armed with relaxation/breathing methods, especially when coupled with an acceptance that it will not be your fault if things don't pan out the way you hope.

It is a biological FACT that people do not experience pain the same way and that labour pain varies MASSIVELY from person to person. No one else can tell you that you made bad decisions during labour...and if you can possibly try not to tell yourself that you did, then you will have had as close to the perfect birth for you that is possible.

My experience was that labour itself was not very painful - the painful part was the head crowning and that did hurt but it was over so quickly that it wasn't really an issue for me. I had a home water birth with no other pain relief needed except the warm water, but my entire labour was only two and a half hours so this must bias my view. I can imagine that a long labour would be more painful, partly because it is more likely that there is a problem with baby's position or with dilation if labour is continuing for a very long time and also partly due to fatigue - I am sure that tiredness increases your perception of pain.

@shagmundfreud
I think most of us are well aware of the risks of an epidural. Yet, we may still want one. Just as I'm sure you were aware of the risks of pushing out an 11pound baby instead of opting for a section (as so many do with macrosomic babies) but you chose it anyway. I'm sure you knew about the added risks of severe tearing, long term pelvic floor complications, birth injuries to the baby, shoulder dystocia etc. but you still preferred them to the risks of a section. Others are allowed to make similar decisions regarding their birth.