Student midwives say Mumsnet posters on the birth forum just peddle horror stories about birth and midwife bashing WTF?

[Ushy]

This is the link and it made me feel really upset.
They have no idea how traumatic birth can affect people. This forum is one of the few places people can share their experiences without being judged.
www.studentmidwife.net/fob/mumsnet-and-the-promotion-of-medicalised-birth-thoughts.69784/
Not at any point do any of them question whether their apporach is wrong. No - it is all WE need 'empowering' 'educating' 'encouraging' to do things their way.

I did it their way once - big mistake and PTSD. Subsequently went for caesarean and epidural.

What scares me to death is that if I ever had another child, then I could fall into the grips of this lot and I just think that is scary.

Anyone else feel the same?

I'm going to put forward a controversial point of view here if I may?

The NHS is publically funded healthcare. It doesn't have a lot of money so it has to make tough decision re funding cancer treatments etc.

Childbirth (in most cases) is a normal natural process.

I am not an HCP but I would bet that gas and air is cheaper than pethidine is cheaper than an epidural is cheaper than an ELCS, and that is without taking into account the extra care/interventions that may become necessary.

Childbirth fecking hurts. There is no dispute about that. We all know that. So what right do we to demand highly expensive drugs/medical procedures to stop that pain. It is not 'bad' pain we have not broken anything, we are not ill. It is part of childbirth. These drugs/interventions aren't strictly necessary for our wellbeing. We choose to have a child after all.

People who complain they couldn't get an epidural - well maybe the anaesthetist was busy with somone who needed a life saving operation?

I am NOT saying that pain relief should be refused. I am saying consider the fact that the NHS has limited resources, and yes maybe you shouldn't be expecting an immediate epidural without even trying to see how you get on without.

It is precisely due to limited resources that midwives should listen to women. It is inefficient and short termism not to.

The impact of not doing can have massive cost implication. Perhaps not for the maternity budget, but for the NHS as a whole.

And the way that birthing women are 'processed' even inwhat pretend to be low intervention units is still miles a way from anything that can be described as 'natural'.

So basically you are saying thatfor immediate cost reasons, women should put up and shut up and be grateful for what they get because there isn't enough money for cancer treatments!?

Fruitybread. Thanks for your response.

In answer to your query, I agree, I added only one piece of information. In no way was I disputing the fact that the research indicates that birth by elective CS reduced risk of birth injury. In posting what I did, I was merely indicating that the view that CS is "safer" on the whole was misguided - again, it's about balancing the percieved risk of birth injury against the perceived risk of baby developing respiratory problems. I was in no way suggesting that any particular view is right or wrong, just that as an idividual everyone has a view on what risks they are willing to take and accept.

I highly recommend the work of Michel Odent on oxytocin and CS birth - he really does have some interesting views, and it is interesting to consider the longer term effects of CS birth compared to vaginal birth on the population as a whole. There are a great many things we don't know about labour and birth as a whole and Odent has some interesting theories on the use of synthetic oxytocics and the effects on the lack of oxytocics (the love, sex and birth hormone) in caesarean section birth.
Again, I'm not saying either is right or wrong, merely that research is ongoing - in 20 years' time, our views on birth may have changed again completely based on new technology, techniques and research.

From a midwife's perspective, I do give women all of the information regarding their options for birth and analgesia, both deemed good and bad. I also give them information about where they can find further information.

However, as I said before, the decision as to whether the woman has a CS is not mine to make - it is made with the woman and obstetrician in partnership based upon clinical indication.

We can all present information which is biased towards our own personal views. I'd like to think as a midwife my own personal views aren't apparent. At the end of the day I'm not living that woman's liife. I won't be going through labour, feeling her pain nor taking home her baby, therefore the decisions she makes based on her own personal views will not be made by myself. I give information and allow women to make their own decisions, and support them through that.

Because, ItsAllGoingToBeFine, treating a woman for birth trauma is going to come a whole lot more expensive.

The argument "you knew it was going to hurt" only makes sense if all women experienced the same level of pain in childbirth and it was consequently possible to predict exactly what you were letting yourself in for. Which is clearly not the case.

And I don't get this thing about a good and bad pain either. For somebody who is suffering more pain in childbirth than they can bear, that makes it a bad pain, far worse than say the pain I experienced the other day when I had to have surgery without painkillers because the local anaesthetic didn't work on the inflamed tissue.

Obviously, in one sense that was also a "good" pain because it was healing an area of bad infection. And given the circumstances you could argue that I had let myself in for it. But nobody would have insisted that I should be allowed to experience this "good" pain if I didn't want to, just for the sake of it. I am sure they would have let me off the anaesthetic if I'd asked, but it would be up to me.

My grandmother was traumatised by giving birth; she could never contemplate having another. Of course in those days there was no expensive counselling to worry about, but it did set her up for a lifetime of hypochondria and anxiety.

If you want women to have a natural and physiological birth, you do it by nurturing them, not bullying and frightening them!

Good point starlight

Could I also add that pregnancy/childbirth is a natural process that kills more than half a million women a year. Not nice sudden deaths - mostly deaths from haemorrhage and exhaustion after days of indescribable agony. Countless more women are shunned by families as a result of constant wee and piss drizzling done their legs as a result of fistula.

Natural birth being a lovely empowering experience is a modern first world construct which has arisen entirely because we have modern medical backup and can largely prevent the nightmare scenarios that the third world lives with daily.

Birth may be natural but nature is a bit of a bitch to women

Finally, there is no clear evidence at all that planned natural vaginal birth is cheaper than elective caesarean or birth with epidural. That's what NICE concluded. Psychological and perineal trauma are MUCH higher after planned vaginal and unendurable traumatic pain can result in PND and PTSD - all costly for the NHS to treat.

How far would you like to take this? Why bother with pain relief for vasectomy? Lets do root canal work without anaesthesia?

No man would have dared to argue what you have just argued "Itsallgoingtobe"

Women are the worst enemy of women.

Starlightmajesty, I completely agree with your point above.

Cory, I think that what Itsallgoingtobefine was getting at with the comment on "good" pain was that pain during labour is not seen as pathological pain - the pain of labour actually comes from contraction of the muscle of the uterus, rather than from a pathological and potentially life-threatening cause.
I don't think they were saying that the pain shouldn't be recognised, just that the pain doesn't necessarily have a pathological cause.

Miss I'm sorry to single you out for this but just HOW on earth do you give women full information on her options including where to research more?

For a start no appointment i have ever been too has been long enough for any kind of discussion and secondly, the lack of consistency of care means that you can't possibly account for the woman's prior learning, or not.

I find it interesting that you mention CS and the role of oxytocin, but I wonder how many woman you have given that reference to in a clinic setting.

The role of oxytocin in the birth process underpins my whole attitude to intervention, including my refusal of VEs and cord cutting before the placenta is delivered. This is due to having a child after a very frightening but 'text book' birth who now has ASD.

But whenever I have tried to discuss my 'reasons' I am treated as being a bit difficult or worse a bit nuts with too much access to google.

Missriri I love your approach and would have loved a midwife like you so don't want to be picky about your recommendation to read Michelle Odent.

If you do read him, read this too

skepticalob.blogspot.co.uk/2011/10/why-lie-about-childbirth-pain-and.html

Starlighmajesty, perhaps I was wrong myself in saying that I give full information. As you've rightly pointed out, it's difficult in clinical situations to do this. To clarify, I work within a maternity unit, therefore the care I give is based around antenatal ward, labour ward and postnatal. In this way I'm lucky in that I'm not bound by appintment schedules. Most of the time I get chance to have frank discussions with women, and by giving information I suppose I do summarise the most recent research into "risks, benefits and what the research says in summary".

With respect to giving more information to be able to point women towards relevant information for further research I'm lucky that my trust has available information leaflets to give out (NICE ones), and I do also add in the names of other organisations which are there to support women and where information can be found onto these.

If the NHS has such limited resources then they shouldn't be treating every tom dick and harry that walks in with a broken finger or head gash because they fell over from drinking too many stella's on a friday or saturday night. Just cutting those cases out alone should mean that every woman who wants to have an epidural or elcs should get one.

(Sorry I'm an angry 39 weeks pregnant woman, hell hath no fury like a woman who has been through a traumatic labour previously....!)

I have (prior to getting utterly fed up with the injustice of everything) worked with the NHS Foundation Trusts and I know for example that one year they spent £2.3bn in leadership training courses - which I helped to plan and prepare.... Basically a lot of managers standing outside in a car park trying to roll a marble along a plastic pipe in a group in the name of "teamwork", amongst other similar things... wtf?

And then David Cameron says he's going to roll out some new pledge to text everyone with their appointment details so they don't miss it - again, at a cost of £3 billion.

And yet time and time again we are told women have to get on with things as maternity services have stretched budgets?!! For fucks sake. How is any of this fair?

Also....

I don't care about whether I can breastfeed or not after having my elcs (booked for Thursday this week). I have no interest or willingness to breastfeed. So the usual arguements about lack of oxytocin do not apply to someone like me. I am sure there are plenty of others who feel the same way and get fed up with things like that being bandied around.

All that matters to a person such as myself is that my elcs is a more positive experience than the 67 hours of agonising labour and patronising treatment I had with my dd 9 years ago. Being unable to breastfeed (IF that was the case, and it doesn't mean it would be with an elcs anyway) is the very very least of my worries!

"Seriously, who doesn't have uncharitable thoughts from time to time?"

most people have a barrier between HAVING an uncharitable thought, and putting it out there on the internet and encouraging it in others!

Oops! Posted before I'd finished...

I'm not a perfect person or midwife, but I do try my very hardest to give as much information as I can. I'm upset that my posts are giving people the impression that I have an agenda other than providing good care and support to women.

Ushy, I have read skepticalOB's blogs and she does raise some interesting points. I am aware that many of Odent's theories are just that - theories and musings, but they do provoke interesting discussions and are the basis of future research.
As for the oxytocin/bonding thing - I don't actually agree with the fact that he suggests that babies born by CS won't bond with their parents in the same way that a baby born vaginally after labour would. This is like suggesting that adopted children never bond with their adopted parents, but that's going into a whole other nature/nurture debate.

There have been small research studies to suggest that babies born by elective CS are more likely to develop behavioural issues later in life. However, these studies are small, likely to be flawed and we really will not be able to specifically state that CS birth causes these issues as there are so many variables which could influence behaviour.
Research gives us ideas, but rarely gives us definite answers, so we work with the best available research at that time.

I'm unsure really whether I can comment any further on this thread. I think I've said all I can to try to indicate that not all midwives are horrible people who hate women, babies and their jobs. I love my job and think that you're all incredible in sharing your stories and experiences.
If you don't mind I'd like to hang around and get to know the site a little more. I really hope that there is some way in which we can all work together to make a really quite crap system better.

I hope you don't think I was suggesting you had an agenda miss. I'm very glad you posted and your posts have been largely reassuring.

Not at all Starlight - I've really found everyone's posts really interesting and have been great in challenging my views as a person and as a midwife.

I just hope you all know that we're not all monsters who think we know everything about everything.

missriri I'm not a perfect person or midwife

That may be true but I bet you are a really good one because you WANT to listen. That makes all the difference.

Oh stop it! Now you're making me an emotional wibbler! lol.

Thanks all for being so welcoming.

MissRiri, It is unhelpful to tell mothers that their risks would be lower in labour if they had an normal VB when this is not achievable for all mothers.
I desperately wanted a normal VB in my first three births and failed three times to achieve it but that is not possible for me, so why should I accept the more risky emergency section after failing to vbac again versus the safer elective section ?

WiggleWoo, I had a CS with DC2 and am still breastfeeding him 3.5 years later. Don't feel that having a section will negatively affect feeding your baby. I had DS on the breast in the recovery room just after leaving theatre. Best of luck.

Re. Dealing with Natural/Good labour Pain IMO this depends on being lucky enough to have a well positioned baby during labour. I managed to get to fully dilluted with no drugs with normal positioned DC2 (before he moved transverse and ended up being an EMCS), yet couldn't cope with the pain of my two back to back babies at 2cm dillated.

The word 'risk' IMO should never be usedwhen talking to a pg or labouring woman.

'chance' is good enough.

I.e 'there is a chance we might need to recommend forceps'

There is never a 'risk' of forceps anyway.

They don't time your second stage and climb out of the cupboard pushing midwives aside toattack your nethers.

There are so many things wrong with your point itsallgoingtobefine, but I'd just like to make the one point in answer to your assertion that childbirth fecking hurts and that we all knew it would. Well, actually no. Not to the degree it did hurt. No one told me that the pain would be more unbearably awful than anything else I had experienced or could imagine and that I would be convinced I would die, not necessarily because I thought anything had gone wrong, but because I thought the pain alone would kill me. If I'd had a knife and been capable of directed movement I would have killed myself. That's not exaggeration - I am shocked at how certain of that I was at the time. I was constantly lied to told that it would hurt, but that I would be able to cope with it/get through it/bear it. To borrow from palliative care - Pain is what the patient says it is. So if "you knew it would hurt and let yourself in for it anyway" is to be used as an argument, then HCPs need to 'fess up and say that childbirth may be more horrifying than you can possibly imagine and the experience may haunt you for years to come and prevent you from ever wanting more children.

Thanks I realise that having a c section doesn't necessarily affect breastfeeding - someone earlier just mentioned that there is less oxytocin with a c section and this can sometimes mean a delayed start to breastfeeding... (not always, I know loads of people bf successfully after a c section) :) I was just making the point that not every woman perceives the ability to breastfeed as the holy grail of motherhood and so using the idea that "if you have a c section it might affect your ability to breastfeed" doesn't matter to many people like myself.

If the baby was cut out of my butt cheek and I had no hope in hell of doing anything other than feeding it Cow and Gate then that would be absolutely fine with me and I don't think the midwifery world should feel they have the right to pass judgement on that or decide how I give birth.

I'm with card on this one - I knew full well that labour was going to hurt, but nobody warned me that from 2cm dilated (until 9cm when I was given morphine) my legs would feel like they were going to break, and my pelvis was going to snap in half. I didn't even feel the pain of the contractions with gas and air.

Luckily, I did have two very good midwives, who seemed to have my best interests at heart.

You do need to remember that with the internet, you tend to only hear about the complaints rather than the good stuff.