Normal birth - what does it mean to you

[Olderbutnotwiser]

Hi
I have been a midwife for ten years and I have an interview for a senior post next week and have to give a presentation on 'keeping birth normal'. I have loads of info so far but mostly from a midwifery / medical perspective and would appreciate coments on what the phrase means to you
Thanks

Have only read op btw

To me "normal" means natural. Therefore with minimum medical intervention as possible with the same positive outcome, ie a healthy lo is born and mother is well.

Hope this helps.

Ive had 2 sections so no normal/natural brith for me ever experienced.

Gonna read rest of thread now, i might be back.

only read OP too. I think normal is a bit vague as anything that happens routinely is, by definition, normal. I would assume they mean natural birth which to me is vag birth with no interventions or drugs. Or you could say that any vag deliv is normal and vag deliv without drugs or intervention is natural - that is how I view it I think?

As many people have said it is such a unique experience it's hard to define "normal". After delivering and having ongoing problems, I would say a normal birth is one which leaves both mother and child in reasonably good shape at the end of it. i.e. a well child, and a mother able to get on with things. A CS is usually more painful afterward, but from what I have been told it is managable with good pain relief.

I had a natural, unassisted delivery but everything in the aftermath of that was so traumatic that I would have to say mine didn't feel normal to me in any way. Had I recovered as I was told to expect it would have been difficult but ok. Normal to me would have meant having some recognition that I had a difficult labour and had sustained serious injury and maybe would need some extra help. Trying to get help for a recovery that wasn't happening (and didn't happen for about a year), does nothing to help a perception or normality. Even a difficult labour could feel reasonably 'normal' with the right understanding, support and care.

i went through I.V.F to have ds now 3yrs, made no plans for pain relief, wanted all natural, but low and behold 9cm's and was told i need cs as baby was to big, i'm 5f 2" my ds waide (dyslexia) 11bls! thank god i was as said 2 posh 2 push

Whose getting het up? I know the question is 'what does normal mean to you' but midwives do refer to 'normal birth' to mean drug and intervention free. But as everyone says, what is normal? Do I need your permission to not like a phrase?

thank you everyone - very interesting to hear all your points of view. all helping my presentation take shape. will let you know how i get on at interview. Thanks again

well when asked by mw/hv etc a normal birth to them seems to be one without intervention. with dd I kept saying yes I had a normal birth no complications. Then mentioned having forceps and was told(by mw) that was not a 'normal' birth But with ds, I had nothing but gas and air, apparently that IS normal

But I do agree with everyone who says that there is no 'normal' birth just individuals having babies in whatever way they need to.

Not at all Luella and I have say once again don't get so het up. You really must be desperate for an argument!

hm...normal doesn't mean anything, imo...because, well...what is normal is determined by the environment...so, over here in the UK,. I would say normal means a Interventional, frequently monitored Birth, with free offer of any painrelief, without taking into consideration which intervention could follow due to this, and without proper advice on the possible consequences.
Normal also seems to be that Births are induced on highly unrealiable EDD's

In other countries, normal could means something completely different...

But in teh UK Birth can, imo, be classed into follwing categories.
-Natural Births (this means imo no painrelief, no interventions of any kind)
-Vaginal Births, which could include all sorts of painrelief and interventions
(of course there are different levels of intervention within this categorie, fromjust using a bit of gas and air, to the whole hog of epi and instrumental Birthinterventions)
-and then there is C-Section which is a complete medical Birth

3andnogore i think you make an interesting point. A lot depends on the culture of where you're living. With c-section rates at nearly 25% for some UK hospitals, I suppose that would be considered 'normal practice'. I have a friend on the continent who tells me that eoidurals are totally the norm where she is - it is automatically assumed you would want one.
Personally, to me, normal birth means treating the process as a natural event rather than something that needs over medicalisation. Unless, of course, there are specific circumstances that require intervention - but I think these days. I have two very different births - first one in a midwife-led unit where I laboured with my dh and one midwife. I had gas and air for some of first stage, nothing for second stage. DC2 was a c-section as very samll and early plus breech. Obviously a totally medicalised experience but necessary, so i guess, given the circumstances, 'normal' for this pregnancy, given that the pregnancy had taken several turns that seemed far from normal to me!!
I imagine the context of the OP is looking at how to keep straightforward, textbook pregnancies as natural and unmedicalised as possible to the point of delivery. From discussions with friends, I'm surprised at the number of women who have very straightforward preganancies who then end up with all kinds of interventions at birth particularly with first babies - induction,epidural, instrumental birth, c-section etc - and its statistically true that some interventions can slow labour down and lead to others. Which personally I feel is a shame, because ultimately pregnancy and birth is a natural function and I feel that women are sometimes undermined by the medical profession and made to feel that they can't do it themselves.

sorry realised i missed the end of a sentence out!! -'i think these days, the definition of situations requiring intervention has become widened to include far too much'.

ebenezer, if you are right with your assumption of what teh op mihgt have wanted to know...i.e how to achieve it, I think m/w's should be trained to observe more, staffnumbers would ahve to be increased, so women receive a one-2-one care, where not so much notice and importance is laid onto the readings of technical deices, but where a woman is observed as an individual. Also, m/w should be trained to "sit on their hands" more...because it's when they interfere (with teh best intentions of course) when things can lead to interventions

totally agree 3andnogore. I think a lot comes down to having enough experienced midwives who have the TIME to give to each woman in labour. The single most important factor when i had dc1 was my midwife - she listened to me, encouraged me, held my hand and persuaded me that I COULD push this baby out by myself. It was a long labour, the pain felt horrendous but she remained totally soothing and calm. In contrast, when i had dc 3 (which was a VBAC and therefore in a large hospital out of necessity)there was a constant stream of people in and out of my room, I felt really disempowered and that the medical staff were rushed off their feet and just wanted to get everyone's baby delivered as soon as possible. I felt less able to cope with the pain than first time round even though this was second vaginal delivery and therefore my body had done it all before. In an ideal world I guess all straightforward pregnancies should end in a birth that's non medicalised. One thing that i remember too is that the midwife in the lovely unit where i delivered dc1 told me that she'd moved from a large teaching hospital because she just got no job satisfaction - she felt it was a conveyor belt and she wasn't able to give each birth the time it deserved.

'keeping birth normal' to me means what Ina May Gaskin achieves at The Farm, what Pam England and Dr Sarah Buckley write about, what Jean Sutton and Mary Cronk talk about....

For me it means midwives being trained in the normal physiological birth process and believing in the ability of women to birth their babies in their own individual ways. I do wonder what can be taught from 'the Journals' (which I was told my local mw school use), do you get many normal births described in them or is it all risk management?

For me it means midwives guiding women in childbirth as many go into labour very naive and trusting that they will receive guidance. Eg: it means mobilising women if they have an OP baby, it means trying a pelvic press for a brow presentation, it means listening to the woman and working with her to help baby get born. It means keeping hands off the breech birth and only going to section if it does not progress as per Mary Cronk. It means not relying so heavily on machinery but taking more note of the labouring woman. It means allowing the midwives to spend time with each woman, during and after the birth, building up trust and mutual respect, rather than being sent on to the next labour on the conveyor belt (guess that's a politics issue).

It means educating women antenatally that they are designed to birth and CAN birth their babies, it means instilling a confidence in them that they lack and which very often leads to a self-fulfilling prophecy. It means explaining how her hormones work and that chemical pain relief can interfere with this. It means giving her so much more information so that she can make informed choices. It means working 'with woman' rather than bowing to hospital protocols, as each mother and baby pair are completely different from the next and do not conform to 'averages'.

I could probably go on and on but I'm sure you get my drift! If Ina May can have a

Have only read the OP.

Who really gives a shit.........as long as you have a child at the end of your labour.

Great post Klaw.

Bree - Probably someone like my mum whose treatment at the end of her pregnancies and subsequent c-sections affected her loooonnng after her deliveries

Well I certainly gave a shit - and judging by the posts so do lots of other women. Maybe there's a few who genuinely go into labour not minding what is done to them, but as far as I was concerned it was my body, my birth and my baby.

"Normal" is a loaded term wrt childbirth.

I know what it means in "medical" terms, but it will invoke a lot of strong feelings with women, because it is a term that sounds judgemental of women who've had births that required intervention of whatever kind - and no judgement is necessary or helpful of anything surrounding such a personal and tumultuous experience as birth.

Good luck with your presentation and interview.

I cared, but not at the expense of my baby.

I went with the flow, questioned some stuff but went with the flow. My DS arrived by CS 16 hours later (after 9 years of TTC,) it felt pretty normal to me.

I had a baby.

QED

And a bloody lovely one at that, LGJ!

Havne't read the thread ... but would make a big distinction between 'keeping birth normal' - ie allowing women to feel that they were in a 'normal' situation, that could be managed (through natural or more interventionist means), avoiding situations where the mother/baby will need additional support as much as poss (eg CS)

A normal birth is just what happens most usually, and as such, means nothing other than how x hospital likes to work

BUT that said, if I heard someone had a 'normal' birth, I'd think, humm, so it was OK, but not as good as it could be. That's not meant to sound judgemental, just that I think birth can be an amazing experience. i would describe dd's birth as very abnormal (no pain relief, very fast & easy) - ds was probably more normal.

'keeping birth normal' suggests to me that it be viewed as a natural process rather than a medical one. Regardless of how medical it ends up being....

God absolutely not at the expense of the baby. I had a c-section with dc 1 because that was medically necessary. With dc 2 I had a natural birth because I didnt need a c-section. Personally I just think its a shame when women end up with interventions that AREN'T needed simply because hospitals are understaffed, too busy and terrified of litigation