Interesting article about the damaging concept of 'normal' birth being better than one that requires intervention

[clevername]

Just seen this article on the Guardian:

www.theguardian.com/society/2017/aug/12/midwives-to-stop-using-term-normal-birth

I'm fascinated by this subject as I ended up being induced and with an EMCS for my first child and I felt like a massive failure. I'm now a week away from my ELCS (following consultant advice) and, although I'm happy with my decision, I still worry about what people think.

The article highlights how damaging the attitude that 'normal' childbirth is superior can be.

I really don't get why you would worry what other people think or why people concern themselves with other peoples births. I once was at a party where a woman gloated that she had contractions for 28 hours without pain relief and how great she was for doing that. In truth it doesn't matter as long as the mother and baby are healthy after birth.

I let the dentist ffill my teeth without an injection and one of my wisdom teeth was extracted without painkillers. Should I go "wow I'm great look at me" and "this is the norm" and "you are not a real woman if you have not done this"! Because it sounds just as stupid to me.

I know - you're totally right. It's bizarre... And even though I know this, it doesn't really stop me from, deep down, feeling somewhat 'lesser' for having not had a natural birth.

The dentistry analogy is a good one. And all manner of medical procedures that previously (through necessity) would have been completed 'naturally' are now done with suitable pain relief and anesthesia.

From a feminist perspective, it feels like another stick with which to beat women.

I don't think the dentistry analogy is a great one, because lots of women do prefer to give birth without pain relief, or with maybe just gas and air rather than full anaesthesia. Certainly a far higher proportion than that of patients refusing pain relief for other procedures. So I believe there is an intrinsic difference between birth, and other medical procedures.

That belief doesn't carry an intrinsic value judgement though. It's up to women to choose how they want to give birth (assuming no other specific medical needs which make intervention unavoidable)

I chose to have my babies with just gas and air first and foremost because I was keen to deliver in a midwife led unit rather than hospital, and I was not keen to have an epidural anyway because there does seem to be a higher chance of then needing further intervention. That was my choice, it doesn't make it better or worse than anyone else's. I personally found it very empowering, but again, other women might find having a hospital birth with full pain relief empowering.

I just don't like the analogy people make that 'you wouldn't have a tooth pulled without pain relief' because I think it belittles the fact that a high percentage of women do actually approach child birth in a different way to other procedures. Many women would accept an injection for having a tooth out, or pain relief for minor surgery etc but opt to try to give birth as naturally as possible. So, they have reasons, which matter a lot to them even if not to others

Not in any way to belittle your experience, Babbity, or to attempt to devalue your point but your post does make me beg the question 'why' some women make that choice and 'why' birth is viewed so differently to other medical procedures.

I mean, obviously, the birth of a child is an enormously significant event in a woman's life (much more so than a tooth extraction or some other banal procedure!) but it feels as if, in some ways, the choices a woman makes around her child's birth (notwithstanding the fact that these choices are often somewhat out of her hands or taken in an emergency situation) are intrinsically linked to her identity as a mother.

Whilst so many people, rightly, say that there is no value judgment attached to these things, the fact is that there is. Natural = best. The article in my OP highlights this and how damaging it can be.

Well I can only answer for myself (and I guess on behalf of friends who have shared their views with me.)

For me it was as simple (or as complicated, whichever way you view it) as feeling that giving birth is intrinsically different to other things. Medical procedures are almost always about dealing with a problem, or patching something up, and usually aren't something that are willingly chosen, whereas childbirth is something I had chosen voluntarily and wasn't a problem (I had a normal pregnancy and no underlying problems which necessitated intervention.)

I didn't want to give birth in hospital if possible. Going down the epidural route necessitates doctors, closer monitoring and can't happen outside of hospital. It also seems that it does correlate with higher incidence of interventions such as ventouse or forceps.

And I just didn't want that. Many women don't. There's not really much more I can say, and I certainly don't think one way is 'better'. It's up to women to aim for the type of birth they want.

the reason I really dislike the dentist analogy is the underlying implication that it's totally normal to want pain relief and therefore mothers who opt to go without are a bit bonkers. I know that wasn't the intention here, but it's the logical conclusion isn't it. It's putting childbirth into the same category as things which for many women it simply isn't. That's the best I can explain it!

I think it's good they are changing the terminology. I read the article earlier.

There are many reasons women are encouraged to have "normal" births, both medical reasons and societal but the term normal is very unhelpful.

I also have a sense of failure that I couldn't deliver any of my children without intervention.

I can remember tears streaming down my face when they told me I had to go to theatre for my smallest DC. They were quite right, and I knew it, but I just wanted to deliver one child "normally."

I found huge pressure when having DD 20 months ago to give birth in the midwife led birth centre - it was assumed I would, written on my notes etc and I was told that anyone with a straightforward pregnancy would go there.

But i didn't want to. I wanted to be on the labour ward with easier access to the full range of drugs and interventions just in case, as I didn't know how I'd feel about it when I got there. I got some very patronising midwives telling me I could always transfer to the labour ward if necessary, which didn't sound great to me.

Ended up with diabetes which meant midwives apologising that I could no longer be in the birth centre (YAY! ), induction and an epidural. But I found it empowering, whereas 'natural birth' always sounded awful to me. I used to read those birth stories that involve crashing waves and breathing babies out with horror!

I had more than 28 hours of contractions without pain relief, not by choice, and it was fucking horrible.

The term 'normal birth' has never bothered me, but it does some people, and it's also not especially accurate. So it's good if it won't be used anymore.

Babbity the point is that I don't put a value on people who want pain relief for medical procedures, even if I choose not to. A birth is a private medical condition, even if you like to put it in a different category because of how you feel about it. People should just stop judging other peoples very private choices. It is really none of your business if I choose drugs or not for a pulled tooth or a birth. For some reason a lot of people would not care in the slightist what I do about my teeth, they equally shouldn't care about my wonb.

I don't understand the approach of discouraging women from having pain relief during birth. What happens if you do go for a midwife led unit and decide you really do need pain relief?

I think hospitals should be set up to provide a less clinical environment but with the capability of offering the full range of medical services.

If a woman wants to go 'natural' great but if she doesn't want to or can't then she should still have comfortable environment to give birth and recover in.

I disagree that pregnancy and birth are medical conditions brightlight. Maybe it's just a matter of semantics but not all women do look on it as a medical condition.

I don't put a value judgement on whether women have pain relief or not- I made that clear in my other posts. But it cuts both ways ... when people start using cliches like 'you wouldn't have a tooth out without pain relief' it's actually as belittling to women who have Natural births is, as scoffing at a women who used pain relief. Because it assumes that all women view childbirth as a medical condition comparable to other medical conditions- and many women don't

I don't object to any woman who chooses to view it as a medical condition; equally, I would hope there's equal respect from them towards those of who don't

Hopefully that clarifies my position!

The dental analogy isn't a comparison of two medical conditions - it's a comparison of two painful experiences. And the question of why women choose to experience the pain of childbirth when they wouldn't choose to do so under any other circumstances is important. On one level the types of pain relief used in childbirth are much more potent and have more side effects than the local anaesthetic used by your dentist, so that's one logical reason for women to opt out if possible - but if there are women who labour in agony due to social pressure then obviously that needs to be addressed.

I think the idea of 'normal birth' is part of that social pressure so I'm glad of that change.

I agree with the change.

Choices in childbirth are rarely actually down to the woman, it's about risk and the health of the baby. I don't think there are many women in the world who have said caesarean please because I can't be arsed. Or, I'm bored of this, please drag the baby out with two massive metal tools.

Equally, I wasn't some kind of hero (which people said and I felt very awkward) when DH delivered DS in the dining room with nobody else there... That was nothing to do with me and not at all what I would have chosen. The sofa was very stained for one, and I was shit scared.

It's more important to inform women of all the scenarios so that they can know everything that might happen and why. Then if there is a choice to be made at least all the information is at hand.

Babbity your reference to you "choosing" to only have G&A and that working for you with no acknowledgement that it may have been at least partially dependant on the size/shape/lie of your baby and your shape just re-emphasises the point that G&A is seen as morally superior.
With DC1, I chose to only have gas & air in a midwife led unit too. Unfortunately, DC1 was overdue which led to me being induced meaning I had to be on a consultant led ward. The pain once the drip kicked in was unbearable and I had an epidural. DC1 was delivered by high forceps in theatre whilst they were also prepping me for an EMCS. It turns out that her head circumference was off the charts and it would have been very unlikely for anyone to give birth to her with no pain relief/just gas & air and they obviously wouldn't have given me a c-section on just gas & air.
Additional complications were that DC1 wasn't breathing when she was born and spent a few minutes being bagged with oxygen on the resuscitation cot. As a result, I knew how quickly and badly things could go wrong and chose to have DC2 in a consultant led unit. He was delivered within 29 minutes of me arriving at hospital and I only had G&A for the last five minutes as they had tank was empty and they weren't expecting me to deliver for a good while longer.
Obviously the last 5 minutes of my labour with DC1 were terrifying as her heartbeat dropped and was't going back up again (it had been dipping for the a few hours before that) but for the previous 40 hours that I had been in labour, it had felt controlled. In contrast, the entire time I was labouring in my "normal" delivery felt chaotic as no one was listening to me (to be fair, I firstly vomited over a MW so she went to change & then my waters broke over her so she had to change again so there was no one to listen to me or replace the tank of gas etc whilst she was changing).

Obviously in some circumstances intervention is necessary, which is why I included this in my post:

'It's up to women to choose how they want to give birth (assuming no other specific medical needs which make intervention unavoidable)'

That makes my position very clear.

I was responding to the post which compared childbirth with dental work and explaining why many women feel it is intrinsically different.

The fact is, the majority of pregnancies are not high risk and there is the potential for the woman to have a low tech birth with no or minimal pain relief, or to have a hospital birth with epidural (or various things in between) And that's fine.