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?

good post alfiesbabe

chibi, got your email, brief reply , more tomorrow xx

Going back to starlightmackenzie at 1 pm, quite a few mw's I work with do not necessarily wait until a woman is 5 cm to use the birth pool. I personally think that if a woman needs pain relief, far better to try using the pool than have some pethidine. If it really slows things down then she can get out and walk around. If it is real labour it will come back, if it is a false alarm she will have had a nice relaxing soak in a big tub.

When I was in labour with ds, I got in the pool when I was having extremely short and irregular but very painful contractions. Within half an hour of entering the pool I was having strong, 1 minute long contractions and he was born 2 hours later. I really felt like it actually sped things up for me and there is a small research study that came up with these conclusions a few years ago. (will look for it in a minute)

With regards to the fundal pressure thing, you might well be right to suspect that it was used as the mw led unit did not have access to instruments. After I posted the other day I realised that we do sometimes use fundal pressure in the uk. If a woman is having her waters broken with a high head we put gentle fundal pressure on to ensure that the baby does not float about and let the cord slip out.

Birth stools can be good, but there is evidence that women who actually deliver on them are more likely to have bad tears. I think that they are worth a good long try in situations like yours though so it is a shame that you were not able to use it for longer.

With regards to not pushing in the second stage of labour, if the second stage is diagnosed with a routine vaginal examination and the babys head is still high then initially the woman should not be encouraged to push as she can become too tired with little progress. An hour or less of breathing through the contractions will enable to head to descend with far less effort. Obviously it is different if the woman has a strong urge to push. If you have another baby (are you pg at the mo? I forget who is and who isn't ) you will almost certainly have a much shorter second stage of labour. It is very rare to have a second stage of labour of more than an hour in someone who has had a baby before (vaginally). I always tell student mw's that if a woman who has had a baby before has a strong urge to push then she should not leave the room and should be ready to catch a baby at any time. If a woman is on all fours or standing this advice is all the more important

I think its very true women are competitive about childbirth and I think many women who have given birth "naturally" can come across very smug.I have given birth both with and without drugs and I think many women who have not used drugs quite frankly have no idea about what labour can be like.

"I think many women who have given birth "naturally" can come across very smug."

Yup - I'm one of these.

Following a horrible 30 hour first labour (pethidine, epidural, forceps), I had an unmedicated homebirth with an 11 lb baby second time around and another unmedicated but very, very long labour with my third (36 hours in ACTIVE labour, posterior baby).

I completely disagree that women who don't use drugs 'have no idea what labour can be like'. I know what labour can be like - my labours were crap - all three of them. The only one that was a remotely normal length ended in two ambulances being called to my house and my baby being wrestled out of me by two very, very skilled midwives (shoulder dysctocia).

I reserve the right to feel proud of myself for the courage and strength I showed in my labours - I did everything I could not to take drugs with my second and third because I felt they'd affected my first baby in a way I was very unhappy about. I think it's rubbish that 'you don't get a medal for going without pain relief' (a cliche that's so often bandied about). I felt like I'd got a medal after my second and third births: alert babies who were able to breastfeed and didn't start life with opiates in their bodies.

Why the flip should women like me have to be apologetic about our births? I didn't have an easier time than other people: my labours were painful, long and at times quite scary. I know stoicism is deeply unfashionable these days but frankly it was stoicism and an acceptance of suffering that carried me through.....

My personal feeling about this whole debate is that half the problem comes down to the fact that as a society we're not prepared to acknowledge that suffering is a normal part of the human experience - in relation to both birth and death. We make women think that as long as they're happy to have all the drugs or do all right sort of birth training then they can avoid suffering in childbirth to a great extent.

The reality is that training or no training, drugs or no drugs, childbirth is a real ordeal for most people. If women were able to accept that and prepare themselves spiritually and emotionally for it, as women probably do in cultures where they don't have access to epidurals, then I think you wouldn't have quite so many traumatised, disappointed mothers around.

Well I don't think that's necessarily true fairymum. I did my first labour on gas and air, and I knew it was long, hard and at times almost unbearable. Even so, I probably wouldnt have had much idea how it compared to other labours, until the midwife who'd delivered me came back on duty a couple of days later and told me I'd had a really hard time.

Crossed posts there sabire - but as you can see I completely agree. I was immensely proud that I managed my first labour on gas and air - not because it was an easy labour (as I've described!) but because it made me feel amazed that my body could do that and I could live to tell the tale!

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Starlight - I remember that feeling exactly with my first labour. I remember vividly thinking that all I wanted was the pain to stop, whether that meant me dying or the baby. I've spoken to many other women who experience that exact same emotion - an overwhelming feeling that you're going to die because nothing can be that bad. I'm sorry if that sounds scary, but I just want to point out that it's a by no means uncommon feeling during labour.

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I have not had time to read the whole thread, have only just found it (have been busy in a discussion on another forum re Pramface babies)

Anyway, when it comes to women being given all the information I wonder if this information is something that we need to be telling all women.

"Epidurals have possible benefits but also significant risks for the laboring mother and her baby. These risks are well documented in the medical literature, but may not be disclosed to the laboring woman. Women who wish to avoid the use of epidurals are advised to choose carers and models of care that promote, support, and understand the principles and practice of natural and undisturbed birth."

It's interesting isnt it Starlight? I suppose there's a sense in which by pushing your body to the extreme, you feel the sense of exhilaration afterwards - a bit like an athlete. Look at the face of someone running the last 100 metres of a marathon - contorted with pain! You might ask 'Why would anyone do that?' but clearly it's for the sense of achievement and pride.
Someone posted earlier about the extremes of life - birth and death, and I think there's a really interesting point here. Our culture and society equates painfree with 'good', and I honestly dont think it's as simple as that. My FIL died in what I would describe as a sad, lonely way. He was in hospital and drugged up, but he felt out of control and scared. In contrast, my mother died at home - she was on self administered morphine for a while but actually chose to do without, because it was giving her very vivid dreams and making her feel 'out of it'. I think she died a 'good' dignified death. I don't think childbirth is totally different. A 'good' birth is one which leaves the woman feeling empowered. I had my dc2 by csection under epidural, so was technically a painfree birth. However, i was left feeling that I'd had a medical precedure 'done to me' - I didnt feel any of the achievement I did with my first birth.

Klaw - that article is fascinating. Makes me realise how little women are actually told.

My dearest wish is to have a smug HWBAC.....

Dr Sarah Buckley is great isn't she? She explains all the stuff to do with your hormones and childbirth so that you can understand why your body does what it does. Read her other articles, they are great and are all in her book which is brilliant.

this is all very interesting reading.
I remember thinking very clearly during labour "this is just like going to war"
and I remember saying that to my dh as well, though I think he had not a clue what I was on about.
It was a very testing experience, and a very formative one. I felt prepared, supported and extraordinarily scared. I felt I couldn't cope, and then I did cope and that feeling was (is) extraordinary.

Starlight - a pain free birth is not something that we will ever achieve through evolution. there is just no real advantage to it in evolutionary terms. the instinct to have sex and to reproduce is so extraordinarily strong.
the pain and difficulty of labour is the price/compromise we (willingly) pay and go on paying for the benefits of having a relatively enormous brain and walking on two legs. so the benefit of being human, basically.

harpsichord - that's a really good point that there is absolutely no evolutionary advantage to painfree birth. Nature is harsh, painful and messy. As the article quoted by Klaw points out, the more sophisticated the pain relief that's developed, the more complex side effects there are. Everything comes at a price. Modern medicine can do some remarkable things, but we shouldnt forget that there is often a downside.

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yes, it is brutal. the muscles have to work very powerfully to get the baby down, round the corner and out. it is a very strong and powerful process, and can certainly be overwhelming.
and, shockingly, the damage done to the woman's body is just a side effect.

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