Women Unprepared for Childbirth

[AtheneNoctua]

Interesting article on our perceptions of childbirth and how they affect how we feel about the experience when our (false) expectations are not met.

Women Unprepared for Childbirth

"But those involved in providing ante-natal sessions, while listening to these, need to make sure that women are aware of how things may go and help them construct realistic expectations," says Joanne Lally, who led the research.

I completely agree with this. My antenatal class, while it did cover pain relief, did not really communicate a true picture on what kind of pain to expect. Never mind intervention like forceps or worse yet a caesarean. Why not? Don't women have a right to go into labour fully informed of all the likely outcomes.

I wonder if not talking about caesareans and promoting natural childbirth contributes to a woman's sense of failure when she ends up in an unplanned caesarean or otherwise medicalised delivery. And furthermore does this contribute to the onset of PND?

Is it National - oops. More

Years of people talking about how they promote natural childbirth has coloured my view of what its name is.

Motherinferior - I am the same - I had to have the details. I know the books give an idealised and/or clinical view which you also get from midwives who have not had children themselves. You do need to speak to people who have been through it and back that up with the technical info from books and the professionals.

I suppose that is where MN comes in useful nowadays. It wasn't around when I was first pregnant so I read baby magazines with their real-life stories. Either way, you hear about people'e experiences first hand and although some may be scaremongering, at least you aren't going to come away with the view that it is easy and then find yourself shocked when it isn't.

(I had to look it up, btw!)

classes can only give you so much

they have to go by what is average, as it were , what labour will be like on the whole, and what will happen, on the whole, if X Y Z happens

each woman has her individual experience, and a class can give her a good idea of what it might be like...

I still don't feel as though I've done childbirth "properly" because of the epidural despite the fact that without it I think I would have gone into shock.

next time I'll go in earlier and with an open mind about what's available to me.

the reality of it for me is that there's an approx 50/50 split amongst the women I know who had a straightforward "textbook" labour and those who needed intervention/ceasarean.

It IS a natural procedure but things can happen and it's reasonable to be fully infromed about them and how they're addressed before you go into labour.

God yes, my antenatal yoga teacher (NHS, she was, at hospital and all) would say 'even if you have to have an epidural' in terms that made it very clear that this was akin to smoking crack...

what is it that you want to know and understand more, that you feel you have missed out on, starlight?

We just don't see women having babies anymore (the same could be said of seeing people dying and our attitude to death).

Not sure how to get round that one though.

I was told unrealistic things having DS1 (he's 7 today) and the midwife told us that very few women in their hospital end up even having an epiesiotomy etc.

We found out when i was in labour this is becasue it was a cottage hospital - i showed signs of trouble and was promptly whisked off to the nearest 'proper' hospital .

I shall answer as best I can in capitals, so you can see what i am writing:

1. There's the whole fundal pressure thing. I've had some views/info about it from people on MN and had a small no. of referals to websites, but still don't quite understand the mechanics of it.

FUNDAL PRESSURE IS NOT REALLY A COMMON THING IN THE UK. IT IS SUPPOSED TO HELP GET THE BABY DOWN AND OUT, BUT IT CAN BE PAINFUL, AND IT IS NOT A RECOMMENDED INTERVENTION AFAIK. IT MIGHT HAVE BEEN DONE INSTEAD OF AN INSTRUMENTAL DELIVERY. SPEAK TO YOUR CAREGIVERS ABOUT IT AS IT MIGHT BE PARTICUALR TO YOUR HOSPITAL

2. I don't understand the whole 'failure to progress' thing. Is there such a thing or does it really mean 'very slow to progress' and what are the dangers of waiting anyway. Will labour evenutally be successful?

FAILURE TO PROGRESS IS A CATCH ALL TERM. A LOT OF THE TIME FAILURE TO PROGRESS IS DUE TO IMMOBILE LABOUR OR WOMEN SIMPLY NOT PROGRESSING AT THE 1 CM AN HOUR THAT IS DICTATED BY SOME HOSPITALS. LABOUR CAN BE SLOW ADN IT CAN PAUSE, IT WON;T STOP UNTIL THE BABY IS BORN, AND ON THE WHOLE IT DOES CONTINUE ESPECIALLY IF THE WOMAN FEELS SAFE AND SUPPORTED AND NOT FRIGHTENED INTO THINKING SOMETHING BAD IS HAPPENING. DANGERS: BABY CAN GET DISTRESSED, MOTHER CAN GET EXHAUSTED,BUT IF THINGS ARE LEFT TO FLOW , THEN LABOUR TAKES AS LONG AS IT NEEDS TO . THERE MIGHT BE A GOOD REASON WHY LABOUR IS NOT PROGRESSING, AND THAT SHOULD BE EXPLAINED TO A MOTHER WHO IS BEING TOLD SHE WILL NEED AN INSTRUMENTAL OR C.SECTION BIRTH..

3. What is the point of waiting until you're 5cm dilated before you get into the pool when ime all the pain was before then. If it is because of failure to progress then see 2.

THE THINKING IS, IF YOU GET IN TOO SOON, YOU CAN SLOW THINGS. ONCE YOU GET IN THE POOL IN GOOD STRONG ESTABLISHED LABOUR, YOU SHOULD DELIVER WITHIN A COUPLE OF HOURS.. A SLOW LABOUR CAN BE VERY TIRING FOR THE MOTHER

4. If indeed you can refuse an internal examination, - are you going to be refused pain relief/birthing pool because they don't know if you are 5cm for example.

NOT SURE, BUT IF YOU ARE IN ESTABLISHED LABOUR THERE ARE OTHER WAYS OF ESTABLISHING IT, NOT JUST THROUGH DILATION.

5. What is wrong with slowing labour down if the pain is too much? Why the obsession with speeding it up?

IF LABOUR GOES AT ITS OWN PACE, THEN IT IS USUALLY COPEABLE WITH AS THE ENDORPHINS BUILD AND YOU GET IN THE ZONE. IF YOU ARE NOT COPING IT MIGHT WELL SLOW ITSELF. THERE IS OFTEN A REST AND BE THANKFUL PHASE, WHERE A WOMAN MIGHT HAVE SEVERAL MINUTES, OR LONGER WITH NO CONTRACTIONS , BEFORE HTE SECOND STAGE TO GATHER HER ENERGY. OBSESSION WITHI SPEEDING LABOUR UP IS DUE TO THE 1CM PER HOUR THING, THAT IS JUST NOT TRUE OF ALL WOMEN. OR IT MGITH BE DUE TO PROM AND LABOUR HAS TO BE KICKSTARTED OR AUGMENTED DUE TO RISK OF INFECITON.

6. If I had to have an induction, then it seems an epidural is recommended because the contractions come very quickly and intensly. What is wrong with giving only enough in the drip to make them come not quickly and intensly?

BECASUE SYNTOCINON IS NOT AS SUBTLE AS THE BODY'S OWN HORMONES. ALSO, WITHOUT THE BUILDUP OF A SPONTANEOUS LABOUR, THEY DO FEEL STRONGER AS YOU GO FROM NOTHING TO FULL ON CTX, IME. WOMEN DO COPE WITHOUT EPIDURALS IN INDUCED LABOURS TOO. BEING ABLE TO KEEP MOBILE IS REALLY IMPORTANT IN DELAING WITH THE PAIN TOO

7. What if you get half way through pushing and decide you'd like an hour or so off. Is this bad for the baby?

I DON;T KNOW IF YOU CAN DECIDE THAT! THE SECOND STAGE IS USUALLY QUITE OVERWHELMING IN THE URGE THAT YOU GET. A BABY STUCK IN THE BIRTH CANAL FOR A LONG TIME MIGHT GET UNHAPPY BEING THERE. YOU ARE PRESUMING YOU WOULD BE PUSHING FOR HOURS.THERE IS USUALLY A LIMIT IN HOSPITAL OF HOW LONG YOU CAN PSUH FOR.

8. Can you refuse to push at the beginning of the second stage if you just want a break, without any harm coming to you or the baby?

HOLDING BACK THE URGE TO PUSH MIGHT BE VERY HARD . WHY WOULD YOU WANT TO FIGHT AGAINST IT? IT MIGHT BE DISTRESSING FOR THE BABY WHO IS BEING SQUEEZED BY THE CTX

9. If I had a c/section, how likely is it really that the consultant would allow it without a screen?

YOU HAVE TO ASK, AND IT SHOULD BE YOUR CHOICE.

10. If you can't get an epidural is there any other form of pain relief that actually works?

NOT IN TERMS OF A TOTAL BLOCK OF THE PAIN, NO. BUT TENS, WATER, MASSAGE, OPIATES AND GAS AND AIR CAN TAKE THE EDGE OFF AND ALTER YOUR PERCEPTION OF THE PAIN

11. Why was I whipped off of the birthing stool everytime I felt like I was getting somewhere and made to lie on my back?

BECAUSE YOUR MIDWIVES WANTED YOU TO DELIVER ON YOUR BACK. WHICH IS NOT RIGHT IMO. BIRTH STOOL IS GREAT AS YOU USE GRAVITY.

i have writers' cramp now!!

I have one:

Please define "foetal distress" for me.

Or how about this one:

Why do you induce women who are two weeks overdue, baby not engaged, and no sign of labour without scanning them to see what the problem is?

Or this one:

Why did the midwife tell me that you can not see the cord on the scan when clearly she was either mistaken or lying? And why would I trust you next time. She is either ignorant or a liar and neither of those things are okay with me.

nothing much to add to lulu but just a few comments:

1. There's the whole fundal pressure thing. I've had some views/info about it from people on MN and had a small no. of referals to websites, but still don't quite understand the mechanics of it.

I have never heard of this being done in the UK at all. are you in the UK? I would be very wary of it imo.

2. I don't understand the whole 'failure to progress' thing. Is there such a thing or does it really mean 'very slow to progress' and what are the dangers of waiting anyway. Will labour evenutally be successful?

3. What is the point of waiting until you're 5cm dilated before you get into the pool when ime all the pain was before then. If it is because of failure to progress then see 2.

You can always have a bath or a shower, if you want water in early labour

6. If I had to have an induction, then it seems an epidural is recommended because the contractions come very quickly and intensly. What is wrong with giving only enough in the drip to make them come not quickly and intensly?

also, when being induced one is generally restricted in movements (on a bed, not able to move around, attached to monitor/drip) and this can make the pain harder to deal with. our local hospital does have a very gradual drip feed, gradually racking up.

7. What if you get half way through pushing and decide you'd like an hour or so off. Is this bad for the baby?

Second stage will generally only last for one-two hours anyway - BUT if you have to push you HAVE to push! often there is a period of "rest" bewteen 1st and 2nd stage (transition)

10. If you can't get an epidural is there any other form of pain relief that actually works?

it depends what you mean by "works" - nothing else will take the pain away, no. but other forms of pain relief can be very effective for dealin with the pain. have you thought about hypnotherapy and hypnobirthing.

starlight had fundal pressure in her first delivery.. in the uK

oh sorry starlight I didn't know.
thanks lulu.
I would be interested to know why and where! no doubt you have been through it too many times before

athene, sounds like you had a bad time of it, and feel you were not treated well..
what was the issue with the cord?

to my mind, foetal distress is a baby that is not tolerating labour well, who's heartbeat is taking too long to come back up, who passes fresh meconium ..

like failure to progress, it has become a catch all.. many women on here, or through the birth trauma assoc. have reported being given c.section or instrumental delivery for foetal distress and then the baby is born with apgars of 8 or 9.

true foetal distress does occur however.

if women have not gone into labour by 42 weeks, and the baby;s head is still high, i would have thought a scan would have been the first port of call, or some kind of examination to determine if there was something pysically stopping hte baby from descending into the pelvis

Just going back to Marjorie Tew...
even if you accept that all modern medicine has improved is survival from childbed fever, DIC and extreme blood loss, that still means it's quite useful for people like me who had all three of those things (after a completely uncomplicated pregnancy!) - in fact, saved my life.
And I too would have liked to be warned that gas and air, pethidine and TENS can do absolutely nothing for the pain for some people.

hmmm, you are a tricky one !

no urge to push - you were having your rest and be tahnkful stage! no doubt, had you been left alone, or allowed to sit on the birthing stool, you would have got the urge in your own time, and it might well have taken less than 3 hours..

what position was your baby in?

you had a traumatic birth. no doubt about it

the fact it was 'natural', does not really help

there is no need to feel guilt.. women who've had a hard time do not always react positiely at their first meeting of their baby

they will ask the MW to take the baby away, or not want to hold the baby.. which is ok.

you need time to process what happened.

hours of pain,that you doubted you would be able to endure , that left you exhausted and bewildered , feeling drained, was hardly the ideal way to meet your baby.

you bonded with him after though? it took me 48 hours to realise DS was actually my baby. until then, i had not 'clicked' , he was just a baby.

in the early pics, i look a bit detached

In my NCT class there was almost no info on what to expect if you are faced with making a decision about a c-section or are in an emergency situation, which is called a 'crash section' at some of hte local hospitals where I live. We spent in the region of forty minutes, on the other hand, discussing what to do if you have the baby unassisted at home (cause it comes so fast). As if. I wsa in labour for 32 hours, a very common theme in our 'team' and 5 out of 8 women ended up with c-sections. We all felt a bit let down about the prep in that area, although I know it's hard to strike a balance between the varying extremes of scaring people, being defeatest, and remaining positive that things are going to be fine. I felt the pain relief discussion was based on reality and very helpful, so full marks for that.

Lulu, It wasn't that bad. I just think someone shoe have said, hey now we're going to induce you. Here's the good the bad and the ugly...

It was only years later typing on mumsnet that mears mentioned on a thread that baby not engaging could be a sing of the cord wrapped round the neck and this light went off in my head and I thought Damn, those bllod y morons why didn't THEY tell me that.

But the point is, pregnant women are not well informed. Why are we all finding these things out on a chat site on the internet from a trainee doula?? This information would have been useful five years ago. Not now.

BTW, you know me and my story. I got bored and changed my name. I'm sure you can work it out.