Why do so few FTMs manage birth ‘naturally’?

[hopingforapeainapod]

Hi all, am 24 weeks with my first baby and have started online antenatal classes and have been quite scared by the stats they have shared with us. In my trust, 25% of first time mums are induced, 25+% end in c section, and around 25-35% end in instrumental births. Anecdotally, I have 4 friends who have given birth this year for the first time, and 3 have ended up in emergency c-sections, and 1 ended up with forceps and some quite nasty complications. Another one of my friends is now having an elective c-section because she has heard so many horror stories. All of this, plus all the maternity scandal and birth trauma stories in the news recently, has somewhat thrown my confidence and I now feel like giving birth vaginally without intervention is the exception rather than the norm. My mum also had complications with us (I was born via epistiomy and ventouse) and I’m quite petite, and I guess I am just doubting my ability here…!

What changes the figures is all the women who wouldn’t have survived, but are in the live birth data now. On the other hand birth and death records only exist for the periods when we moved entirely away from the habits and habitats of our evolution.

We evolved to walk miles and squat, not sit on chairs all day. Also, there’s a natural increase in appetite in the third trimester, that interacts badly with the ready availability of processed carbs and sugar.

Basically we are living like aliens in completely unsuitable environmental conditions.

Part of the issue are the natural childbirth hardliners creating unrealistic expectations around childbirth. Historically, women wouldn't have been patiently awaiting a beautiful, fairy-lit, lavender scented, intervention-free birth experience. They knew there was a high chance, they would die. Birth is an incredible, profound experience but it's frequently not beautiful and, most of all, it's a means to an end.

I have had 4 babies (including twins) all without intervention

I think its really hard to get your head around....
we comfort ourselves that medical intervention saves lives (it does of course) that in other times and places would be lost
but many factors in modern life predispose to intervention, as PP have said
having babies later
unfamiliarity with birth (not having seen sisters/aunts/mothers deliver)
sedentary life style, especially sitting a lot
raised BMI
labouring in unfamiliar circumstances, probably without continuous support from someone who knows and supports us
low tolerance for pain
risk averse practice- continual foetal monitoring will flag up issues that may not in fact be serious but Drs intervene to be on the safe side
cascade of intervention, starting with induction (see point above)

in contrast, high maternal and infant mortality in the past and elsewhere is not simply the result of lack of care in labour- other factors, which we can address are-
early and frequent childbearing
malnutrition - especially rickets and anaemia
poor hygiene in the perinatal period
lack of antenatal care to detect problems likely to arise in labour
poor or no understanding of birth

Of course there will always be super fit women who are well prepared but still end up with emergency C sections- statistically they will be like your uncle who smoked 60 a day and lived to be 90. Swing the odds in your favour OP by staying active and upright, learning relaxation/hypnobirthing, have a labour partner who loves you and will advocate for you, understand how your body works, but don't be attached to the idea of a 'perfect' birth.

OP, don’t listen to the horror stories! Childbirth is NOT inherently ‘dangerous’. Honestly, the scare-mongering these days around birth and motherhood is so bad.

I’m petite (5’4”, size 6) and had three vaginal deliveries no complications. Two were big babies.

Of my friends I can’t think of any who had a c-section, a few were induced or had an instrumental delivery, but most were also relatively uncomplicated deliveries.

I don’t know where they’ve got those stats from but they don’t seem to reflect my (wide) circle of friends at all.

I’d really be questioning the success rate of the trust if that’s their record. By and large women’s bodies are perfectly capable of birthing a baby — it’s what we’re designed to do.

Are you in the UK?

This. We have records of women writing letters to their husbands and children before labour, like soldiers going to war, to be opened in the event of their death in childbirth. Birth is primal and incredible however it happens, but it’s not pretty or sanitised and, while being relaxed and prepared certainly makes it more bearable, it’s not a process that is controllable. I was relaxed and happy throughout labour and still ended up with an emergency c-section. Me and DC would have been dead a hundred years ago, no question.

Some really good answers on this thread. One to add is that the NHS has a massive shortage of midwives and maternity staff so this makes last minute interventions and changes to plans more likely because of the lack of monitoring and personalised treatment.

I would also add that the 'human body' wasn't 'designed' to give birth naturally - it evolved and it evolved in a way (bipedal animals with massive brains that we are) that made us fairly rubbish at birth.

Edited to add that medical interventions in labour are NOT 'horror stories.' They are often stories with happy endings :-)

I had 3 DSes. The first was a forceps delivery due to his head not being flexed correctly. He was presenting his wide forehead instead of his crown and I'd been pushing for 3 hours. In Victorian times we would both have probably died. Babies 2 and 3 were very easy births in comparison with short labours. First time labours are often the longest and most complicated. I hope all goes well for you and you have an easy birth, but as others have said, we're lucky to have skilled medical interventions nowadays if necessary.

My birth was not a ‘horror story’. It was hard and involved intervention, but it had a good outcome. And childbirth absolutely is inherently dangerous; only someone with the privilege of being in the developed world in the 21st century would make such a statement to the contrary.

What?! Childbirth is inherently dangerous. Your anecdata does not disprove this fact.

100% agree with all of this.

There is a big mental element to giving birth. The more you let fear control you, generally the worse your outcome will be. You’d be amazed how much you can control your attitude to pain.

But start now. I would recommend a course in hypnobirthing if you are feeling nervous. Most of all, remember that your body is INCREDIBLE.

It isn’t. It’s a normal process that women’s bodies are expressly designed for. Surely that much is obvious?

women’s bodies are expressly designed for.

Who designed women's bodies out of interest? That sounds like a theological position to me.

And I’m pretty sure OP is in that context. So no, childbirth is not inherently dangerous.

You’ve completely misunderstood me. Childbirth is inherently dangerous, we just have the tools to mitigate that.

edit: the idea that because birth is safer for people in our time and place makes it not dangerous is astonishingly self-centred. What about all the women who don’t have access to modern intervention and end up with obstetric fistulae? Are they just not trying hard enough? Are their bodies not ‘designed’ well enough?

What?! Tell that to the many millions of women and children who have died in childbirth across the centuries. Child birth is LESS dangerous now but that's not what inherently means.

I think it's important to know that it can and may happen. Sometimes emergency sections are scary, sometimes they aren't. Do your research and know what to expect with both birthing outcomes.

It's fairly common for 45-50% of births in my area to be c-sections.

I've had two emergency c-sections. A life threatening cat 1 and a cat 2. I'm honestly not bothered that I didn't have a "normal" birth. There's very little you can do to control what will happen, so just keep yourself informed, you have loads of time to prepare.

40 years ago I was born by C-section.
If you'd have needed one you'd have had it so choice is irrelevant.

There's probably no point in worrying about it becaue none of us know how it's going to go until it happens. Like you, I expected interventions and was prepared for an EMCS but as it happened I ended up having to be induced due to pre-eclampsia and then I had the baby within a few hours of the pessary being inserted with no other interventions.

Majority of midwives are unskilled in birth. It's rare to find a midwife that has seen it all and more than 10 years as they just get burn out. There are quite a few power hungry midwives too but you get this with all careers.

If you watch Ricky Lake's birth it shows how it can be done with the right support most of the time.

Nutrition also plays a part. Food is mainly processed and along with all the medication during labour that passes through the placenta, it's just a great way to have a life long customer through birth trauma etc.

OP - here are some stats from the National Maternity and Perinatal Audit, if you want some context:

Women's bodies haven't been designed but they have evolved. The two concepts are very different. Evolution allows a certain amount of 'wastage' as long as enough babies survive to forward the species. This is why child birth has always been inherently dangerous for women because there is a high chance that you and/or your baby will die or be seriously damaged in the process.

I also think there is an argument that what natural selection there was is slowly diminishing as we intervene more to save mothers and babies. Previously the baby girls that would have inherited the genetic material that isn't compatible with smooth, easy births would have died when their mother tried to give birth to them. Now the baby survives, grows into adulthood and has babies of her own. Thus the genes live on and multiply causing lots more issues as the generations go on.

OP just go in with an open mind - whatever happens can't be helped

Pregnant with second, first birth was pretty smooth just needed a cut to save me tearing. Didn't even have drugs (not a brag, went to hospital too late and was 10cm dilated - too clueless to realise that pregnancy could progress quickly)

I'm not sure how my second birth will be but just waiting to see. Coincidentally out of my NCT (10), 3 had ECS the rest had "natural" births with no instruments needed

Inherently means ‘in itself’ or ‘in its nature’.

Childbirth in itself is NOT that dangerous. It was more dangerous years ago because we didn’t understand about infections, women were often very young, had poor nutrition, little understanding of health etc.

It’s less dangerous now because we have more understanding and medical knowledge.

It’s a little more dangerous in the last few years because we have some problems in maternity care.

These are all cultural and societal shifts and nuances that affect how ‘dangerous’ childbirth is.

But in and of itself — inherently — it is not that dangerous.

In fact, statistically (no. of deaths each year), getting in a car is more dangerous.

there is a high chance that you and/or your baby will die or be seriously damaged in the process.

This simply isn’t true!

These (wrong) messages are so unhelpful. Fewer than 300 women in the UK died in pregnancy or within 6 weeks of giving birth from ALL causes in 2020-22.

That is not a ‘high chance’!

I was induced with my first and had an elective c-section 2 months ago with my twins.

I also had epidurals both times.

I never had any desire to try it ‘naturally’. Thank god for modern medicine and pain relief.