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?

MissRiri, don't get all emotionally on us! Haha, really I don't think midwives are hated at all here, and there are a few who post and I don't think I've ever really seen any attacked directly. I think people are genuinely interested and welcome input from anyone. And where there is 'midwife bashing', I do think it would benefit midwives being able to see how they are perceived and to work out why that is the case if it is negative, rather than see it as an attack. People never say things like that without a motivation behind it, not with such emotion. There are really important lessons to be learned on both sides and we can't do that without midwives having the guts to face criticism in a positive way.

Mr Odent. The man who says that men should stay away in childbirth. Hmm yes. Not the best example you could have used, I have to say! I can see where he's coming from, but I do think its more about making a woman feel safe and supported, rather than removing a man from the situation! Misogynistic isn't the word.

Given that last time the dentist suggested that my DH leave the room, I had to be restrained from running out the door. Not sure that would be too helpful to my oxytocin levels!

Worth considering some of his ideas, but yeah hes a pretty repellent individual and unlikely to win too many friends here!

I definitely agree a lot of the stuff about oxytocin with regard to fear, but I do think very odd ways to reduce intervention are being suggested and very strange things omitted. Mr Odent is a good example of that. Another is this suggestion to reduce CS utterly floored me. I wonder how women would respond to rising rates of Kelland forceps... I think there are a few people who totally don't get it to say the least!

In many respects I do think my beliefs about fear are very much on the same page as midwives, however I do think that for some women, it doesn't matter how much you try reassure them they are always going to response in an 'irrational' way. So how do you deal with them?

I do think there a lot of women who end up with self fulfilling prophecies and then feeling justified in how she felt in the first place because of it. Its a vicious cycle that needs to be broken, and I can't help but think that ELCS definitely have a place in being able to achieve that, so long as they aren't used as the only solution indefinitely. There are clearly much deeper things going on here. Sadly, under the current circumstances though, I think it is the only one that a lot of women have open to them.

Trouble is, that since the government recommendation from 2003 to look at why women are requesting CS, not a lot seems to be have been done in this area and you would think that by 2012 we'd have at least something. Its pretty shameful we haven't.

That said I totally agree about the long term information about CS. It was something NICE acknowledged as a major weakness in their guidelines and did recommend. Thing is, in the absence of that, we are left just looking at the fact that most people who were born by CS seem not to be too different from anyone else, and aren't seriously disadvantaged as I'm sure it would have been picked up long ago if it were the case.

As something of a side note to this, I really wish that the media was far better at reporting studies and journalists looked at weaknesses in them rather than always pandering to the headline. I expect it from the likes of the Mail, but I've seen very bad reporting from the BBC, Guardian and the Telegraph who I would expect to be better. Not just on this, but on other subjects.

Great post Hmm I def agree with the keillands forceps issue!

You mention that some women will respond irrationally however much they are reassured. I am not sure they are ever irrational.

May be it is just not understanding why they are making that choice

Take caesarean. If your worst imaginable nightmare is suffering a fourth degree tear and being incontinent then you are going to want ELCS. If your worst fear is having a big slit in your stomach, you're going to want VB. All sorts of experienes shape how we decide to do things.

Our decisions are never irrational - but they can be a mystery to people who don't understand us.

MissRiri I have found your posts really interesting and insightful, so thank you for joining the discussion.

Just to continue my theme of "we're all different and our views should all be respected" (which I know you support ) I want to add that for me personally my last two labours have not been painful, so whoever said that pain was inevitable, no it's not, not for everyone. I completely accept that for many women it is very very painful and would never want to see pain relief witheld from those who request it. However, it is simply untrue to say labour is agonising for everyone.

Secondly, it was claimed that midwives don't 'offer' pain relief. Well, in my first labour the first thing the very kindly midwife who came to see me on delivery suite did was to say "Oh, has no-one given you any G&A yet? Here you go" and hand it to me. My birth plan specifically stated that I did not want to be offered pain relief, and the G&A led to me getting more and more out of control (I don't react well to it ) and then a lovely cascade of interventions followed. I found out later that it was recorded in my notes on the antenatal ward that I was being transferred to delivery because I had requested pain relief (I also irritated the MCA by insisting on walking rather than letting her push me in a wheelchair, which would have been more convenient for her, but v uncomfortable for me). DH was there taking notes (!) and I also have very clear memories of that stage of labour. This statement was categorically untrue, and I can only reason that it was written by the midwife on duty on the ward because she needed a reason to transfer me. I guess my repeatedly requesting privacy (I was in a large brightly-lit day room, and there were other women around) was not sufficient. I had asked to use the pool, but was told it was against protocol for inductions . I am sure both midwives did whatever they did with the best of intentions.

What I actually needed and wanted was that first midwife I saw on delivery to sit with me, reassure me and help me calm down -not whizz in for 1 minute, hand me gas and air and then vanish until over an hour later when my waters broke and DH had called for help 3 times. I am sure it was not her fault. They were exceptionally busy that day and I do not know how many women she was caring for. She seemed genuinely lovely and I was gutted she couldn't stay with me. She even popped back later to say hello to me and baby in our blood-spattered room after delivery. To this day I think there's a chance that an hour or two's one-to-one care at that early stage could have prevented the need for epidural, syntocinon drip forceps, breastfeeding dificulties, extra night on postnatal and ultimately being re-admitted after discharge, then numerous GP appointments about my recovery. She could have suggested a bath (that was in my plan but I forgot!), or just held my hand and helped me calm down. Would giving me an hour or two of one midwife have really been more expensive than all that followed? I doubt it, especially as once I had the epidural hospital policy was that I had to have a midwife 1-2-1 for the next 12 hrs. Ironic, eh?! Why not just give me a midwife's time and save the fucking expense of the epidural, anaesthetist etc etc? But, as MissRiri says, the system is crap.

Finally, I have a lot of respect for Odent and think the role of oxytocin in general is under-researched and there's a lot more yet to learn. However, I can see that for some people, even if there were good evidence showing downsides of epidurals/c-sections related to hormonal effects then for them these risks would not outweigh the risks to them of avoiding the interventions. For many, a c-section is a necessity not a choice anyway.

It must be a nightmare for midwives walking the tightrope between people like me with views at one end of the spectrum and others on this thread at the other!

I wonder if SMNET still think we're all pro-medicalisation ?

Oxytocin may well be a wonderful hormone to take seriously, but it isn't triggered by refusing a frightened woman care or pain relief!

Odent is hugely important in future discussions about childbirth, but let's remember he does make a case for men having more than one wife, so they can each be left alone to breastfeed!

Yes - the same Michel Odent who says that men witnessing childbirth can ruin the sexual attraction between a couple and lead to them getting divorced - or the dads might even end up with schizophrenia or other mental disorders.

So it's important that we look after a dad's mental health by not letting him simply witness birth - less important that we listen to women who say they find the pain of labour traumatising. Because it's all natural, right?

I just want to draw attention to something MissRiri said - maybe I didn't express myself well. I wanted to say, MissRiri, that you only presented ONE negative risk of CS - combatting the view that cs's were 'safer for babies'. When I pointed out that you had left out the BENEFIT to babies in terms of minimising risk, below the risk of vb, you said of course, you were just offering up the risk of vb in terms of breathing difficulties and scbu stay against the more positive elements.

But YOU HADN'T MENTIONED the negative risks of vb/positive risks of cs. You were just listing the negatives. No balance there. That was exactly the point I am making.

and when you conceded that yes, planned cs did reduce the risk of birth injury to babies - you then offered up a piece of unsubstantiated 'research' suggesting that children born by cs may be at increased risk of mental illness (nothing inflammatory there, then...) - then backtracked by saying ah, but it's only a tiny bit of research, lots more needs to be done before we can say anything conclusively etc etc.

Well - can I question whether 'studies' which are, as you say, small, likely to be flawed and contain so many variables that establishing a causal relationship is virtually impossible, should be used at all? If you want to raise issues at that level, you are going to offering up all kinds of tinpot theories based on unscientific surveys, none of which currently forms NICE guidance, or even RCOG or RCM guidance.

This is exactly what I mean about someone with a bias skewing information. You say you give women a balanced view of the risks - but inevitably this just doesn't happen where someone has very firm beliefs.

I'm doing all I can to get an oxytocin birth because I believe it will lead to the best outcome for me and my baby. I don't believe that will happen in a mlu due to having had experience of a mlu where the opposite happened.

If my oxytocin birth is in anyway scuppered then I expect a c/s. There are almost no situations where I'd agree to anything in between or risk a birth injury that way.

The problem with maternity care IMO is the 'cascade' of interventions, rather than the ultimate intervention.

As this thread has developed I resolved to read the copy of 'Superfreakonomics' I have had sat on my shelf for the past 12 months.

I'm on page 14.

I'm already nodding at how it should be made compulsory reading.

They don't understand it at all
yes you progress better at home IF YOU ARE RELAXED AT HOME!
if being at home makes you feel frantic and unsafe then you will progress better in hospital where you can relax because you're there!

its taking the best possible outcome and applying it to everything!:

• Being relaxed and resting at home as long as possible = good, therefore being at home NO MATTER HOW IT MAKES YOU FEEL = good! err nope! its about being relaxed and restful and calm!
• a fully natural non traumatic vaginal birth = better than any sort of CS, therefore any vaginal birth = better than a CS.. no wrong again!
• Relatively problem free BFing helps bonding, therefore struggling on and on with traumatic painfull failing BFing = a better way to bond with your baby than calmly cuddling up to them while they have a bottle of formula

fruitybread when you say

you then offered up a piece of unsubstantiated 'research' suggesting that children born by cs may be at increased risk of mental illness (nothing inflammatory there, then...) - then backtracked by saying ah, but it's only a tiny bit of research, lots more needs to be done before we can say anything conclusively etc etc.

Was I reading the same paragraph?

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.

Suggesting that there might be behavioural issues is a long way from talking about mental illness. Did MissRiri say anywhere that she agreed with this research? The fact that she highlights that it?s a small, likely to be flawed study suggested not to me.

She then goes on to say:
Research gives us ideas, but rarely gives us definite answers, so we work with the best available research at that time.

This to me implies a healthy scepticism, but a willingness to learn from research.

FruityBread,

I am not willing any longer to talk in circles. I think I've said all I'm going to say without getting into a heated discussion. Ok, so you believe my thinking is flawed by the small amount of discussion I've entered into. That's ok with me to accept that we're unlikely to agree.

I never came here to have what I say pulled apart and twisted - I came here to try and reassure people that not all midwives are evil and that we don't think that others are wrong for having different views. I'm a little upset that you feel the need to tear into what I've said in what appears to be such a vicious and relentless manner. Perhaps it's because I'm a midwife and this makes me sad. I'm also a human being and a woman with my own feelings, fears and ideas.

I'm a human being who works within a flawed system and who feels deeply saddened that women aren't being listened to and getting what for them is a good outcome. I hoped that by being open and posting here I might open the channels of communication in order to try to work towards making the situation better, but it does appear that that may not be possible for people who feel unable to recognise and work through differences in a dimplomatic and constructive manner.

To add to others' comments regarding Mr Odent - I don't agree with every idea the man has ever had. Neither do I consider Ina May Gaskin the complete authority on normality - some of her ideas to me are fab, others I'm not sure about. I don't appreciate the assumption that purely because I find SOME of his theories interesting that I find them all so. The same goes with all writers/articles/research within the midwifery field - I like to think that I am able to see more than one view of a particular situation.

On that note I really think this is my time to scurry back to where I came from.
I wish you all the best.

Fruitybread why are you so desperate to convince us that VB is a disaster waiting to happen for every women? You have your point of view, ELCS has it's benefits but like all aspects of medicine it is not a magic solution without any side effects at all.

MissRiri, I'm sorry if we've scared you off. Not intended. My comments about Mr Odent are not an attack on you, and most definitely an attack on him. I well understood where you were coming from with the oxytocin stuff and that you don't support everything he says. I just find him extremely unpleasant and I do think when you start quoting him, you have to do so with caution because of the other stuff he comes out with which is extremely damaging.

I REALLY hope you don't 'scurry off' anywhere too quickly.

I have found your presence here a very good thing.

I do think that M Odent was right about water helping you to relax but at the same time I don't doubt that there was many an old-fashioned midwife who could have told him that without all the fanfare that he got.

Still, he did give good publicity to what many find a valuable form of pain relief.

Sorry? 'vicious and relentless'? because I politely question what you say? wow. You feel wounded because of what I've said and then you come out with that!

And I'm 'desperate to convince us that VB is a disaster waiting to happen to any woman'?

Nowhere have I said that. Nowhere. At all. I support every woman's right to be well informed about risks and benefits and to be able to make decision based on that. To be treated like adults and not like children. Also not to be derided for their views where they differ from that of someone else.

That applies whether you are making a rational personal choice to have an elcs or to have a homebirth. Or to refuse induction against medical advice.

I have pointed out a couple of BENEFITS of planned CS WITHOUT in any way denying or negating the risks as mentioned by NICE. In the interests of balanced information.

That someone interprets that as 'being desperate to convince us that VB is a disaster waiting to happen to any woman' is just nonsensical.

Ps MissRiRi - I do find it sad that just by politely trying to enage with what you have said, and yes, politely question a couple of things you have said, that you can only view this as 'tearing into' what you say in a 'vicious and relentless way.'

I really don't feel that is a fair or balanced account, and I am sorry that you are so upset you feel the need to attack me in that way. I'm sure you are aware that I am also a human being with my own feelings, fears and ideas - and it's not pleasant being on the receiving end of that.

Furryones, thanks for pointing out that ELCS 'is not a magic solution without any side effects at all'.

I mean, really - thanks. Because that is of course TOTALLY what I was trying to say. Phrases like 'I support every woman's right to be well informed about risks and benefits' mean exactly that.

So good to have a debate where we can all listen to each other.

I think all this is hard on fruitybread because there is a very valid underlying point.

There are all sorts of weird and whacky bits of research out there - 90% of which is biased rubbish.

I don't have a problem with MissRiri expressing her view as a woman and an individual - that's fine by me and OK on Mumsnet. Not sure, though, it is ok to be telling women this in an NHS setting.

So IMO there are two issues. Research that we might choose to look up ourselves and use for our own circumstances where anything goes and research that HCPs should be telling women about as NHS customers.

I think on the latter case, it is important to stick to the RCOG, NICE and Royal Colleges validated and peer reviewed evidence and not research we might personally consider interesting.

Ushy, yes. Thank you for a sensible post.

Agree Ushy. Missriri you genuinely sound lovely and caring but I really did not like the way you flung in the random, small scale piece of research about behaviour problems being linked to ELCS.

That kind of inflammatory 'research' is what gets my blood boiling as it's not credible but tends to get seized upon by certain professionals and bad journalists to get attention. It is also unnecessarily frightening for women who may already be struggling with the difficult choice of what kind of birth to have, especially when larger scale research will probably quietly find that it's bollocks. Funnily enough though the rumour will linger on long after it has been found to be crap, mostly on certain kinds of midwifery / natural birth websites.

Please don't ever repeat that piece of research to a woman in your care unless it has been fully substantiated - which I doubt it ever will be. Having worked with young people for years I can tell you that some of the worst cases of poor attachment I saw were when mothers had experienced utterly horrendous VBs and had subsequently failed to bond. (This was going back years ago BTW and I would like to believe that the NHS is much better at screening women for this kind of severe PTSD now). Frankly these women would have been far better off having a section! :(

Its worth pointing out that the NICE guidelines on CS reference a whole pile of studies. Some of these had completely opposing findings, which meant that NICE were unable to draw satisfactory conclusions in a number of areas.

Recently there has been a big fuss in the media about a paper which concluded that CSs were associated with higher rates of obesity. Thing is there is also another recent paper which stated exactly the opposite.

Whilst I've seen papers that say that children who are born by CS are more likely to have behavioural issues, I've seen others that state that children born by ELCS are calmer.

Its easy to find things to back your position. It can be a lot harder to seek out research that disproves your position. But really you have to do both.

Btw, I've read a cracking line in the book today which I LOVE and have to share:

The average adult human has one breast and one testicle.

The dangers of generalisation and not looking closely enough at groups.

What a shame that the snippets of discussion on the Midwifery Sanctuary are not put in context. If you were to read the whole forum in its entirety you will find a bunch of midwives absolutely dedicated to woman centred care. Not 'natural childbirth' or any other ideology other than woman centred care. These midwives (and I have been browsing the forum for some time) are totally committed to the variety of women's needs in their care and share countless stories of how their advocacy for their women has got them into trouble with seniours/colleagues/ etc Their commitment to the women in spite of working in severely under-resourced units- 20+women and their babies to ONE midwife and perhaps one MCA, some are looking after multiple women in labour. It is these midwives that go on to the Sanctuary to cry about the limitations to their care that they can give simply because management are not willing/able ? to increase staffing ratios. It is these bunch of midwives who are being put under mental and psychical stress which is impacting their health, and family life yet are still wanting to fight for women's rights in childbirth. These midwives give a shit.

This is a fundamental organisational problem which is chewing up childbearing women AND the midwives that care for them. It is a fundamental woman's issue and yet we spend more time bitching at each other, pointing the finger at each other rather than seeing the over riding problems; it is the system that means hardly anyone is getting their needs addressed. For all of you that want an ELCS and are fighting for it, there are women who are fighting for a natural childbirth or a homebirth- so how can it always be the midwives ideology that prevents both ends of the spectrum getting what they want? You are all saying the SAME thing. And it is all caused by the SAME problems. Until we stop bitching at each other, nothing will change.

Hmm Brilliant..doesn't that say it all

Fluff sorry crossed posts with you.

Proves how thick skinned I must be - I thought we were just having a discussion - quite a witty one in places- I hadn't noticed any bitchiness