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?

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I'm glad the thread has been useful to you Starlight, because it sounds as if your experience has left you feeling very isolated. Yes, birth is brutal and shocking. I think the coping thing is an interesting one. I certainly didnt feel I was coping for any of the second stage of my first birth, which lasted nearly 3 hours. The first stage was painful and hard; the second stage was excruciating. I've heard people describe it as like opening your legs and having a blow torch aimed there - and it's true! Some of it has blurred in my memory, but I remember moments of braying like some demented animal, sobbing, screaming and begging the midwife to make it stop. It definitely is not the case that those of us who did without epidurals didnt have a hard time of it!

I remember thinking very clearly during labour "this is just like going to war"

Yes - I've heard it said that 'men have to fight in wars, women have to have babies' - there's no escape from brutality!

What I should have added to my post, because it's not just incidental but a major factor in my ability to come out the other side of two difficult unmedicated labours emotionally unscathed, was that I had the same independent midwife for both my second and third births. I also had a friend with me to act as a doula. It's that that made a difference between coping and not coping for me. It makes all the difference to go through labour with a midwife who knows you, and who you've established a relationship with.

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You know I was reading some research last week that seems to show a very marked reduction in transfer rate for first time homebirth mums when they're being cared for by a midwife they've known before labour. Didn't come as any surprise to me.

i posted something similar a while ago, for someone who was getting anxious about birth...

you have to go into it like you would go into battle, strong , focused , eye on the prize!

it is a hard, physical effort, the most demanding thing a lot of us will ever do, knowing and understanding more about the process and how to make it better is only a good thing.

starlight, don;t worry about hijacking, it is really important to work through these things.

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gabygirl - absolutely agree. My first birth was in a midwife-led unit. Through ante natal clinics, I knew each midwife in the team, so i knew that whatever time I went into labour, it would be someone I knew who was with me. I can't begin to explain the difference that makes. As it turned out, the midwife who delivered me was the one I really took to and felt most comfortable with (they were all lovely btw) which was the icing on the cake. Birth is such an intense, personal experience, so it seems logical that we should feel better able to cope with someone we trust. In contrast, my third birth felt awful - loads of midwives and doctors coming and going, no time to find out more than their name.
I've said before, I'm a huge fan of midwife units and home birth, because I believe for a normal birth that's the way it should be. If medical intervention is absolutely unavoidable, then thank god it's there to save lives, but why turn what is a normal delivery into a medical procedure?

I was lucky as my mother who is a midwife advised me in advance to request an epidural. However, being overly optimistic and preferring to think about rose tinted outcomes is a part of human nature so that is probably why women are not given more realistic advice about childbirth. Also, when 'natural' births were all that was available, women were advised to make a will before the onset of labour. At least we get better advice than that now

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Even if you are prepared to discount the many deaths from obstructed labour and placenta praevia etc etc, why would it be advisable to use 'unnatural' products such as manmade and artificial antiseptics to remove the risk of infections?

also, due to women having contracted pelvises, due to rickets, malnutrition etc.. there were more obstructed labours or very protracted labours... women tend to be better fed in the first world and have adequate pelvises

a lot of maternal deaths were due to sepsis.

something that has not actually totally been eradicated.

we are trying to find the fine line and balance between women having to make a will, and rose tinting that says everything is going to be ok

i have totally said what you said , pruners !!

I had a natural birth as we didn't want our DS exposed to drugs (had gas and air though). We had a homebirth but I still got the drugs from the hospital just in case I needed them. I was however VERY prepared and had learned about all the stages of labour etc. The article mentions that women who have the best support generally cope better with the pain and I whole heartily agree. If it wasn't for all the loving support I got from DH during pregnancy and labour then I would NOT have been able to do it - I know that it was him who made it possible for me not to require pain relief- he never left my side for 17 hours and I had an episiotomy and 3rd degree tear and he got me through it!! But still my experience was a good one and I have him to thank for it. I just wish all women had this kind of support.

Moira - as I said in an earlier post, I dont think anyone is saying there aren't good things about the advances of modern medicine. Of course antiseptics are good. There is also a place for Csections etc (not that CS is modern btw!). The life of my dd2 was saved thanks to ultrasound/doppler which picked up that she had IUGR and needed to be delivered. But the vast majority of births are straightforward, and the over medicalisation of the process can cause complications, and leave women feeling disempowered. Did you see the article which Klaw linked to earlier? It discussed in depth the effects of an epidural, and tbh I was amazed at how many side effects there are. Women need to be informed about these things - not just encouraged to have an epidural to have a pain free birth. The most interesting point of the whole article was that although women who have an epidural rate their pain relief as excellent, it's the women who do without that rate the overall birth experience as better.

You are right, and obviously most women did not make wills because they had nothing to leave - ~I was thinking more about royalty. When my mother started her midwifery training, only first births were in hospital so she had masses of experience with home deliveries. Part of the job was to prepare a clean room at home using lots of manmade chemicals but the maternal death rate was still signficantly higher than today - and she wasn't working in the middle ages, it was the 1960s.

this thread is confusing me. how can we be 'unprepared for the possibilty of medical interventions' and yet 'live in a society that doesn't talk about unmedicalised births' at the same time?
my antenatal classes were informative and positive about vaginal deliveries, with a hell of a lot of emphasis placed on how positioning before and during labour can help with delivery (....my baby is back to back AND breech at present so i'll let you know if it works.)
in fact i felt sorry for one woman who is having a planned c-section as the midwife spent less than 5mins in a two hour session explaining what her experience would be like.
all the politics stuff is a bit beyond my understanding tho TBH.

I was very well informed about my epidural. I signed the disclaimer of all liability quite happily. I didn't manage to 'get' one with my second delivery as it was too fast but although it was quite survivable, I got no emotional high out of it whatsover so much for 'natural' endorphins I suppose.

trishpops - I agree it's confusing. My general impression is that most women go into their first birth expecting to not be able to cope, and expecting that they will need interventions. I attended NCT classes, which are generally very good at giving the alternative view - ie that natural birth can be achieved, and there is a big emphasis on breathing/positioning the body etc - but even so, out of our class there were only 2 of us who booked to have our babies in a midwife unit! I was amazed that the rest of them made quite a bit of effort to attend a course of NCT (which isnt cheap either) yet still their default position was 'better be in a big hospital where there are epidurals and doctors'.
Alongside this, although there is a wide knowledge that epidurals are effective in blocking pain, there is VERY scant knowledge of all the side effects/knock-ons. I couldnt believe it when I read that article Klaw showed us. I thought I was fairly well informed, but reading the article horrified me! So to sum up, I would say that women tend to have a skewed knowledge of birth and pain relief.

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I never realised women paid for NCT classes At least my mum was free.

Perhaps i'm just very lucky but between the books i have bought, the health professionals i have met and the 40-odd women that i work with generally paint a very positive experience of childbirth to me, no matter whether they delivered vaginally or had a c-section. i certainly can't claim to feel like i'm exopecting not to cope. in fact reading this thread is making me feel like i won't cope as i've been under-prepared for the true horror of childbirth! it is just me or are people talking at cross purposes on here?

Yes, I seem to remember it being quite a large amount, although there were subsidies for certain situations. I also attended the classes at the midwife unit and yes, they were free. I thought the NCT ones were worth it because of the emphasis on breathing techniques. A long section at the end of each class was devoted to relaxation etc and when I gave birth I found these techniques really helpful. The midwives were great, but the classes were more to do with factual infomation and looking around the unit etc plus feeding/bathing baby stuff. Really glad I did both.

I'm glad you piped up pruners cos actually it's you that is confusing me, with your first post at the beginning. the original post talked about being unprepared for medical interventions but you responded that unmedicalised birth is not promoted or talked about. that hasn't been my experience at all. my experience has been the opposite, with very little information given on any type of intervention at all

trishpops - oh dear! You can cope!! Millions of women have down the centuries. I agree that for a first timer, there have probably been things on the thread that sound alarming, but a lot of people have posted that they find it refreshing to have thread which talks honestly about how birth is messy, scary and brutal. I don't see any point in trying to deny that. Society these days tries to sanitize everything, and it's not necessarily helpful to anyone. Read that article from Klaw - i know I keep going on about it, but it's really powerful! The women who felt they had the best births were the ones who had less intervention!