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 those are very encouraging posts.

kaykay, you can't even read accurately enough to pay attention to what women are ACTUALLY saying here - where I and other posters have REPEATEDLY mentioned positive examples of midwives we have had care for us who are NOT like the awful posters on both midwifery threads discussed here.

I really bloody hope you aren't a mw or trainee MW. If you can't even listen to people you have no place in a caring profession.

"Firstly, I'd like to say that the second link that was posted - to The Midwifery Sanctuary - I personally wouldn't be associated with that site if you paid me, as everything I've ever read on there is either unsupportive to other members or downright offensive about 'service users'! I was just as disgusted as you all are when I read that thread - anonymous or not, talking about women like that is disrespectful.. as well as it causing the minority to make the rest of us look terrible."

Absolutely. So don't feel sad at this thread, sparks. Feel outraged with the small minority who contribute to a situation in which women feel so let down by midwives who don't care that it becomes a major part of how they discuss and evaluate their care and ends up contributing to a climate of fear and entrapment on behalf of service users.

Remember that people are less likely to post on fora like these about great experiences with midwives so it may seem biased against your profession but that situation reflects a) issues of resourcing in the system at large and b) the fact that sadly, as the Midwifery Sanctuary thread shows, there are bad eggs out there who do contribute to the "birth horror stories" told by women.

I think all of us should report that thread to the NCM who should investigate what's on that site and issue guidance that sort of thing should not be tolerated, even anonymously. If people really want to be so evil, they should at least have the sense to operate a closed forum.

Missriri you sound lovely - some for you and the other lovely midwives...

BUT... have to say, I'm with Ushy in wondering why you are concerned about 'medicalised' births.

The hippy in me loves the idea of a hypnobirth in a hot bath, swaying about like a daisy in a field but I will be having a planned section because of previous surgery and a greatly increased risk of continence issues. I've always expected this and am preparing for it as positively as I can. And one of the positives I see is that I will hopefully find the birth a positive, painfree experience - the wonders of technology! Yes I anticipate pain afterwards - but I still prefer that to having repeated surgery to make all my down below bits work again.

I have to say threads like those (especially the second one, Midwifery Sanctuary) make me positively GLAD to be having a section and not being left in agony begging for pain relief because a MW has decided I don't need it .

In other words by confirming women's worst fears about midwives they have ironically made more women want to scurry off to their consultant and demand a section! Thank God for you and the small number of lovely sounding MWs on the forums - the few who seemed to remember they are working with actual human beings, rather than whiny, inconvenient inflatable dolls.

I wondered whether MissRiri was referring to 'medicalised' births where the interventions could have been avoided with decent support, and not those where it was clearly indicated?

Maybe LaVolcan as she sounds lovely and very caring - but tbh I do actually believe that if women want to have epidurals etc it should be totally up to them. I don't expect to go through any other painful medical procedure without some kind of pain relief / blocker so if women choose to have a painless birth I honestly don't see the problem. Personally if I was going to have VB I would quite like all the hypno stuff but equally could see myself begging for drugs at a certain point :o

I find it odd that some people think you should get a medal for going through hours of purposeful agony giving birth but would think you were mental if you demanded to (equally purposefully) have your infected appendix out without anaesthetic

I am also an SMNETter and Midwife and have been greatly saddened by some of the discussions that have been ongoing today. I can only re-iterate the above really- we have long been battling against the reputation that precedes The Midwifery Sanctuary and the kind of atmosphere and derogatory comments it promotes- not only against the women in their care but also against each other.

I just wanted to answer your question re: why we are concerned about the rising number of medicalised births. As Midwives we understand the necessity of medical intervention. I have experience of working within a third world country and I appreciate, more than I can express, the level of care we have here. Intervention saves lives.

I'm going to try my best to word this as well as I can but just wanted to say that as Midwife who has worked very recently on a 'high risk' consultant unit, and has conversely looked after women experiencing many birth complications, that I do not sit in judgement about anyone's experiences.

I am, however, an advocate of physiological birth and as such have a natural and vested interest in supporting and educating the women under my care to achieve that, in whichever 'form' they choose, guided by the information I give them/they research and addressing any concerns they may have.

There is very recent research to suggest that the use of certain interventions can have long-term consequences on the population as a whole- in particular the use of synthetic Oxytocin (ie. a hormone drip that speeds contractions) which can effect natural oxytocin. This can effect long term bonding and breastfeeding, as well as leading to a further 'cascade of intervention'. If anyone is interested (though I'm sure it may bore the pants off you!!) two prolific obstetricians have done research on this subject- Kerstin Uvnas-Moberg and Michel Odent, that supports this. We know that epidural anaesthesia is more likely to result in the administration of synthetic oxytocin, and so the cycle can self-perpetuate.

We all know that sometimes these interventions are necessary, and I am not demonising the use of an epidural nor sitting in judgement for those who choose it as their preferred form of pain relief, either before, in early, or late, labour, but the risks are there. Our job is to ensure women are fully informed of these risks, suggest alternatives and other options, and then support them in the choices they make.

My concern is with the liberal use of routine interfering with a process that may do better to be left without HCP intervention, particularly in cases where a pregnancy or labour is progressing without indications of ill-health for mum or baby.

As a Midwife I am predominantly concerned, always, with the wellbeing of the individual woman, but I am also aware of my 'responsibility' if you like to wider public health, to promote this, and to look at the wider picture of childbirth practices and what this means to society as a whole.

I hope I have explained myself properly and haven't upset anyone- I'm certainly not trying to belittle anyone's experiences or suggest that the use of medical intervention is 'wrong'- just trying to (perhaps badly!) highlight why we hold this view.

I am also interested to see how we might move forward with this and I am interested to hear any suggestions you may have- it is a real and growing concern for us as a profession that women are having increasingly negative experiences- it would be nice to hear how we might go some way to rectifying this.

p.s sorry for long winded post :)

Lulabelle thanks for posting. I'm always interested in hearing about new research but it can be presented as somewhat one-sided rather than informing women, especially when it is very recent / small scale research and so long-term effects haven't been measured. I think when an intelligent, educated mum-to-be is interested it would probably be helpful for them to be given this kind of information so they can make an informed choice.

Unfortunately I suspect part of the problem is time and resources - certainly I found my community MW just about had time to slap a doppler on and test my wee before turfing me. She asked how I was and I explained I had been concerned about some ongoing spotting and pelvic pressure.

When I left I checked notes and she had written 'All fine' with no reference to either spotting or pressure.

I have since changed to private antenatal consultant care

Interesting though that The Midwifery Sanctuary has such a bad reputation even amongst the midwifery community!

Someone pm'd me this before I posted link to it earlier:
skepticalob.blogspot.co.uk/2012/05/how-does-your-midwife-really-feels.html

I think that pretty conclusively proves that public fora are, well, public and threads like these can bring a profession into disrepute.

Sorry: this is the link

?I am, however, an advocate of physiological birth and as such have a natural and vested interest in supporting and educating the women under my care to achieve that, in whichever 'form' they choose, guided by the information I give them/they research and addressing any concerns they may have?. As a Midwife I am predominantly concerned, always, with the wellbeing of the individual woman, but I am also aware of my 'responsibility' if you like to wider public health, to promote this, and to look at the wider picture of childbirth practices and what this means to society as a whole.?

This is not directed particularly at you Lulla but it absolutely baffles me that the midwifery profession as a whole fails to recognise the fundamental conflict demonstrated by those sentences. Then again, maybe it?s not so surprising. To be blunt, it may be a case of it being difficult for anyone to understand something when their salary depends on their not understanding it. You claim that women?s wellbeing is always the predominant concern and I have no doubt that midwives genuinely believe this. Yet public health promotion and the sociology and politics of childbirth practices should have no place in how you care for or advise a particular patient. Midwives are not merely ?aware of their responsibility?to wider public health, the wider picture of childbirth practices and what this means to society as a whole?. They begin with a vested interest in a particular physiological process. The entire existence of your profession as an autonomous one depends on it and that is no small motivation. So you find evidence that physiological birth is best for public health and society as a whole. It?s motivated reasoning at its worst.

It?s at the very heart of your profession yet you can?t see it. Physiological processes don?t need advocates. They don?t have feelings. Women don?t necessarily need advocates either. Some of us just need care. And not all of us share your values or your beliefs. Some of us frankly don?t give a damn about physiological birth. We don?t wish to be educated about it, supported through it or empowered to achieve it. We don?t want or need to 'achieve? it, be respected for it, praised for it or revered for it. Really.

Our ?natural and vested interests? are therefore not the same as yours. It?s not a case of some midwives being good and some bad (although some are no doubt more caring and understanding than others?), it?s a basic problem with the ideology that the profession is based on. You?re trying to serve two masters ? Physiological Birth and women. Often that causes no conflict since the women under your care largely, if vaguely, share your values. Naturalism and misunderstandings of evolution are so rife that that's not surprising. The rest of the time, it causes midwifery to rationalize away conflicting values by claiming that women are in fact just uneducated, unsupported, afraid, brainwashed by tv or whatever.

It also causes midwives to, usually unintentionally, take a cherrypicking approach to science. An advocate can never be an unbiased judge. It simply isn?t possible. So you quote people like Odent. You claim as part of your role the job of educating women. Yet an advocate can?t be an unbiased educator either. So we have cherrypicked science, filtered through bias, being used to ?support? women to make the limited range of choices that the educator has a fundamental vested interest in advocating. That?s neither education not support, it?s manipulation, however unintentional and well meant. It?s deeply wrong to base an entire healthcare profession on both advocacy for one particular physiological process and caring for patients well being. You simply can?t serve two masters.

Interesting discussion. I hve no doubt that the first thread on the student's site has been totally taken out of context, the op is clearly a kind and caring midwife, its not hard to see that! However the other site - wow! I definitely think we need to report that to the NMC!

Hi all,

I've read through some of the responses to my posts, and there are a few that I'd like to respond to. Unfortunately, I'm about to head out and will be working until late tonight. I will pop back tomorrow and respond.

Riri.

LullaThanks for your post and I understand your feelings about epidurals but please understand our perspective.

NICE does not recommend telling women that epidurals affect bonding because no valid evidence exists for that.

There will always be a link between long difficult labour and epidurals because these are the ones where epidural is requested - doesn't mean the epidural caused it.

There is actually a good article about the research you refer to here: PTSD. theadequatemother.wordpress.com/2011/12/30/labour-epidural-pain-relief-will-it-keep-me-from-bonding-with-my-baby/

I have had a wonderful birth with an epidural and a tortuous nightmare with a so called 'natural' birth. The one that affected bonding was the natural one not the one where I got effective pain relief.

The important thing is that women get the right information.

The problem is that we all value most highly research that fits our underlying beliefs. So if midwives have a bias towards natural birth, they will tell women about the research that supports their viewpoint.

What would be best is if midwives just dropped the natural birth bias and gave balanced information based on NICE.

I also believe the risks of non-intervention should be given as well as intervention because how can you compare risks if you are only told one side.

No-one mentioned to me 3rd and 4th degree tears, incontinence, PTSD, wrecked sex life and the need for possible reconstructive surgery.

I was told all the risks of 'intervention' and none of the risks of natural birth and I felt betrayed.

Sioda brilliant post - mine crossed with yours but you have put it so much better.

Some of us just need care.

All of us just need care. IMO that's the thing which has been forgotten by the powers that be. This is probably what has led to the rise of the doula - they were unheard of a few years ago.

Also severe anxiety, of the type that propels women to request cs etc also has a public health component. We are more likely to suffer poor obstetric outcomes in spontaneous vb and pnd, which has far greater research to suggest longterm consequences for mothers and babies than use of analgesia in labour.

I have read this thread many times over the last 24 hours and I have to say that this is a very biased argument. Having perused The Midwifery Sanctuary a few times I see that you fail to see the times on other threads when the same midwives come on and say how fantastically their women did, how happy they were that they advocated the birth that the women wanted, despite the attempted interference of consultants and registrars. I am planning my next baby and would HAPPILY allow any one of those midwives to care for me. I don't really care what the midwives say about me out of my hearing, as long as I am looked after whilst I am having my child. I would rather that my midwife was able to vent frustrations away from the workplace, so that she comes to me refreshed and less frustrated. And I do not want to take away from some peoples Tocophobia, IF it has been diagnosed by a psychiatrist. But in the same veign, everyone is afraid of labour, Tocophobia is that fear in the extremis.

Any who, that is my take on it, feel free to shoot me down now

I agree with much of what you say Kazb4. I too have perused The Midwifery Sanctuary a few times, and see a lot of concerned midwives trying to do their best for the women and babies in their care. There is a lot of venting about the dangerous levels of staffing that they have to put up with, which means that everyone suffers - the women not getting the support they need, the midwife being expected to look after far more women than is safe, and ending up burnt out and stressed.

"everyone is afraid of labour, tokophobia is just that fear in extremis"

kaz - you don't understand this condition. Can you understand, for example, the difference between feeling a bit down, or a bit miserable, and having severe clinical depression? Or do you just think people who are very depressed (who can kill themselves, let's just remember that) are people who have a case of being 'down in the dumps' in extremis?

One of the problems tokophobics face is is dismissive attitudes from other women, alng the lines of 'oh, we all get worried, lovey - cheer up, it'll be fine' (or sometimes a more agressive 'get over yourself' attitude). I hope one day there will be more awareness of this condition.

Well after reading stuff over on that website it would appear that there's tokophobia and then there's fear of being in the hands of certain midwives whilst in a vulnerable state undergoing childbirth ! Is there a name for that phobia ?

Fruitybread, perhaps I should have put that Tocophobia is the extreme of the fear of labour. the "just" was unwarrented and accidental. As a person with a less recognised Phobia, that is all consuming and controls my life at time, I certainly do not want to down play the seriousness of Tocophobia. But I do believe that the term Tocophobe, should only be used on people that have been truly diagnosed as such by the appropriate practitioner.

Kaz you wrote "..midwives come on and say how fantastically their women did, how happy they were that they advocated the birth that the women wanted, despite the attempted interference of consultants and registrars. "

But can't you see we are saying the same thing? It is all about respecting what the individual woman wants.

When it coincides with what midwives ALSO support (i.e. physiological birth) women get support but as you can see from other posts not all women place such high value on physiological birth or see it as important at all.

See Sioda's brilliant and eloquent post.

Midwifery philosophy supports only SOME women - those who want to avoid medical intervention - but what about those who don't see any reason to avoid it? Do you hear from women denied epidurals saying how good their experience was? Remember when Mnet got inundated by hundreds of angry women in response to the denied epidural post?

And I will say there are good midwives out there who ignore the ideology and put women first. But they must be brave because the prevailing view is that 'natural' is best and all these dim women must be 'educated' to understand that!

Grrr, I think that's a fair point. It's a very sad state of affairs.