Does it bother you that so many women are so uneducated about childbirth?

[Rohan]

Right, let me start by saying that I know that not everyone is interested in the whys and wherefores, and that many women are happy with their experiences regardless of whether they understood every technical detail or not. And that's all fine. I'm not suggesting everyone should have a midwifery degree in order to give birth.

But does it rankle with anyone else when you hear mothers talking about their experiences and those of others without the faintest clue about the fundamentals of childbirth? I mean, they've been through it, surely they had some passing interest in what their options were and what would/could happen? Surely they were offered some type of education on the subject? Yet there they are spreading misinformation time and again. I'm not suggesting they're malicious or stupid or anything like that, honest I'm not - but there are some things I'd honestly expect every mother and mother to be to know, even if they don't particularly care.

To give an example of what I mean, these are a few things I've heard recently from mothers I know (and like!! I'm not making this a competition)

"I can't believe they're making her have a natural birth this time, if she couldn't get the first one out she won't be able to get this one out either, will she?' (Without knowing what the preferences of the mother were)

"I cannot believe they've let her go overdue, and it's supposed to be a big baby too! It's cruel" (Again without knowing preferences)

"Water birth can drown the baby"

I just don't get it? Feel free to flame me, although I'd prefer if it you didn't , I'm trying to get some frustration out here and still be fair. I'm not saying against these women, merely wondering how they can be so disinterested in a subject that affects them so personally?

I've heard much worse than those but I don't want to start an argument

yes it has always astonished me.

Hmm I'm afraid I was one of these uneducated women before I gave birth... I kind of assumed I didn't need to know anything, and would just have to squat down, open my legs and plop baby is delivered.. Of course now I wish I had educated myself about the ins and outs of childbirth and cannot believe how naieve I was about the whole thing. It was only after my bloody horrendous birth that I found out what terms like "ventouse" "perenium" and "sphincter" actually meant. God how I wished I'd read up before. The embarrassing thing is that I'm a reseacher by trade so should have researched the most fundamental thing that could ever have happened to me.

What I don't get are these women who don't seem to know whether they've had any stitches after giving birth and if they did are oblivious as to whether its first/second degree tear etc. How can they a)not know or b)not be interested enough in finding out?

So yes I am astonished, but not surprised. I think part of the problem is womens reluctance to talk to other women about what childbirth involves.

does it bother me? erm, well, only in as much as if more women knew more then they might have a better chance of a more positive birth experience

i think sometimes caregivers are a little remiss in projecting their experiences/ personal feelings onto a pregnant woman and these things can hamper the ability to make an informed choice

i think women should know more and understand more, but how? NHS Classes... very often unavailable and have heard some not very good things about some of them.. NCT classes... very often oversubscribed and many women can;t afford them...

MWs don;t have time to discuss things in depth

i don;t necessarily think it is disinterest, but the presumption that hte MW or consultant who is talking to you is telling you the best thing for you personally , therefore, if they tell you no waterbirth/ homebirth/ VBAC or that you must be induced due to big baby / small baby / over due etc then it must be the right thing

parents to be need to have the confidence to challenge and ask questions of their caregivers

Doesn't really bother me tbh. I didn't know too much about childbirth and options and still don't now we are expecting number 2. As long as he comes out safely, I don't really mind how it's done.
That's awful isn't it?
There's so much to plan and do without doubting what you're being told by caregivers, although mine are all rubbish, I just don't have the energy to battle with them over it, you know? The baby will get here one way or another and to me that's all that matters.
I am due for a growth scan with the possibility of induction if big baby, but not sure what to do about that as I get the feeling it's all hit and miss and they make it all up anyway........

Agree with lulumama.

However, you can learn a lot from books; I did! Most people could afford one decent pregnancy book.

I went to no antenatal classes at all; just pregnancy yoga classes.

Gowri Motha (not otherwise necessarily someone whose 'plan' I would follow, as it's exceptionally strict & expensive ), does remark that "I have always been bemused that many pregnant women spend longer preparing the nursery for the baby than their bodies.' And she's right: it's weird.

It bothers me that most women - and men - have absorbed media portrayals of birth for years (sudden births, flat on back, legs in stirrups stuff) and that coupled with some probably appalling video they had in school has formed their education.

When I teach classes one of the first activities the group does is to look at the pelvis and a doll and how the doll moves through the pelvis to be born. They also get a sheet of possible positions for labour and birth and are asked to work out what position the pelvis will be in in each picture. I can pretty much guarantee at least one person will ask 'So don't you/doesn't she just lie on her back?'

SueW please tell me you always manage to get the doll through the pelvis. At my first NHS ante natal class the midwife tried to show us this , but couldn't get the doll through the pelvis. Funily enough, I needed an assisted delivery.

With my first pregnancy, I read the Miram Stoppard pregnancy and birth book, attended NHS and NCT antenatal classes, and presumed I educated myself suffiecently on childbirth.

It was by nowhere near sufficient though, and I learned so much more about giving birth during my second pregnancy from my hypnobirthing instructor. I learned even more during my third pregnancy by reading Child Birth Without Fear by Grantly Dick Reed, and other books by Micheal Odent, etc, and I also scoured the net for info.

So when DC3 was born, I was finally sufficintly educated to be able to give birth.

People will alsways gossip, and say things with no real basis to them, though. It has happened since the begining of time, and will continue utill the end of the human race, I expect.

I never put the doll through the pelvis. I let the dads do it and they always manage it.

I can't say this exercise stops anyone having an assisted delivery - people in my classes have a variety of births - but it does tend to help parents to understand the mechanics of birth.

I do think it's unrealistic to expect a woman to be 'educated' for her first birth. It's such a unique and mystifying process to undergo, with so many possible outcomes that it's very hard to know what's what.

I personally would like to see many more appt's for first-time mum's by m/w's, say every fortnight, from 12 weeks then weekly from 28 weeeks offered. That way a lot of the questions and concerns that you have with your first could be answered promptly.

It's a bit lazy to not be informed by your second though tbh, most women seem to be.

I don't get riled by a lack of knowledge because we can forget certain aspects of pregnancy or labour especially if there's a bit of a gap between our babies, BUT what does get my goat is the "will they induce me early because I'm fed up?" "I want a sweep at a stupid stage of my pg"

Babies come when they're ready, if it's your second onwards you should know this, moaning about being pg still at 38 weeks is ridiculous, when you surely know that a pg lasts 40 weeks.
Why whinge that you're still pg and no one is doing anything about it for the last 2/3 weeks?

Pointless and quite frankly annoying!

I wish I'd known more and read more on here about CS before DS birth.
I read here a few weeks back that the abdominal muscles are ripped apart rather than cut through, whereas I had assumed I'd simply been sliced through like a big sweaty cake. I think I would have recovered better had I known more, as all my activity was based on me imagining that I'd been sliced into and had three lots of stitches on top of each other.

I was talking to a group of first time mums recently and saying how difficult it is to put across to someone who hasn't experienced labour or childbirth exactly what it's like and that experience will help them to be better informed next time.

In classes, I try to liken it to sex, since chances are they've done that otherwise they wouldn't be there! You can read about sexual intercourse and understand the mechanics of it and you can listen to other people's experience of it but until you actually do It, you have no idea of what it's like for you, for you and that partner, how in or out of control you are/want to be and as you learn more about your body you find out what works for you.

the thing that really gets to me is that so many women (especially american women) think that they don't have options when it comes to their treatment during labor and delivery. They don't research the effects of just wanting a c/s because they don't want to be stretched down there or they want an induction because they want the baby out sooner (or the doc is going on holiday and it's more convenient for them). Sometimes I just want to shake my friends when they're talking about their doctors in a god-like way. it's like wake up ! this is a natural occurrence and women have been doing it in the rainforests without doctors, come on now!

i have a friend (in the states) who was told by some nurse that she didn't need to give her baby the colostrom because they have formula and she wouldn't be producing enough for the baby so... since "doctors know best" she listened and missed out on breastfeeding completely (which she now moans about all the time because formula is expensive for her to keep buying)

It's not confined to the USA though now is it?

I simply don't understand why people want to ask/opt for surgery when they haven't even considered trying alternatives. It's just crazy!

Try turning a breech baby through natural methods, acupuncture etc, even ecv if you want to, don't pin your hopes on the most unnatural way for a child to enter the world for Christs sake.

I honestly feel if you have a traumatic first birth, the best thing you can do is prepare, research and take control of your next. Don't just assume because you tore the first time you will again and sob to a doctor that you want a section. Each birth is different.

When you take control of your birth choices you can feel empowered

I guess i usally feel more sad than annoyed...but i did start to get frustrated the other day when i was in hosptial and i had to wait half an hour in triage whilst the triage midwife explained to the couple ahead of me that the woman could not be admitted to the labour ward because she was not in labour. Fair enough. But the couple did not know what a cervix was (or neck of the womb or uterus or any other biological description the midwife tried) nor did they understand what the process of dilation was or any other fundamentals.

I am fortunate enough to have attended a number of antenatal classes etc but i also make use of my local library and get out books
on pregancy and childbirth - for free - on a weekly basis.

What really bothers me is the use of the word "allowed" and similar. "I'm not allowed a homebirth", "I wasn't allowed to move around", "They don't let you go more than 10 days over", "They said I had to have a section"..... The list is endless.

I think you can educate women all you like - but no matter how much they think they know about childbirth the vast majority get sucked into our risk-obsessed, highly medicalised system of maternity care, and end up feeling as though they have no choice as to how their births are managed.

I personally feel very strongly that the modern approach to childbirth is hugely damaging to women and babies. Yes - some women and babies are saved by technology and modern medicine, but lots of people are unnecessarily damaged and traumatised by it.

I see this again and again: women who go to antenatal classes, read loads, talk the talk, then go like meek little lambs along to be induced at 2 weeks past their due date - end up with really painful labours and a huge cascade of intervention.

As a culture our whole approach to childbirth is based on fear of something going wrong. You can know all you like about childbirth, but it won't help you have a normal birth once you step through the door of your average consultant led unit.

Personally there are only three things that I think women benefit from knowing about childbirth. If she takes any of them on board she's massively more likely to have a good birth experience than a woman birthing in hospital - even if that woman has swallowed an entire midwifery textbook. They are:

Get an independent midwife

Have a homebirth

Get a doula

I was appalled when this woman was telling me she went into labour and was bleeding but thought nothing of it and stayed home because 'it was just twinges' a miracle she did loose the baby, it was placenta previa

also things like strep B etc

once pregnant I wanted as much info as possible about what was happening and what was going to happen otherwise how do you make choices? and how do you make sure you are aware of potential problems?
and no it is not about paranoia or incessantly bothering the midwife/ doctor but just feel confident about what is going on

sparklyxmasfairy - sometimes knowing loads makes things harder, not easier.

One in four women carries strep B - will they and their babies all actually benefit from knowing, given the implications for how their labours will be managed afterwards?

Personally I feel that for every woman who benefits from knowing that she has strep b there will be hundreds more for whom knowing leads to them having a more difficult labour.....

gabygirl: "I see this again and again: women who go to antenatal classes, read loads, talk the talk, then go like meek little lambs along to be induced at 2 weeks past their due date - end up with really painful labours and a huge cascade of intervention."

I object to the use of your expression of 'meek lambs'. I read up loads on active birth and swore I would doing anything to avoid an induction. But if the obstetrician is telling the woman of the risk of stillbirth for the pregnancy to continue, if you were to doula, what would you advise? If anything were to go wrong, on who's head would that decision be? Do you have any idea the sort of pressure an obstetrician can put a woman under to consent to an induction, particularly if it is her first time.

Can you understand that it is not all about women being spineless.

gabygirl, I disagree about getting an imedpendant midwife. The midwife I had with my home birth was absolutely outstanding. And didn't cost me a penny.

Also, I would have hated having a doula.

I didn't mean 'meek lambs' in an unkind or judgemental way so sorry if it came across like that. I think in the back of my mind was more 'sacrificial lamb'.

As a doula you can't tell someone that they 'should' or 'shouldn't' take any particular course of action.

But I'd advise her to look closely at the research the recommendations on induction are based on, to seek out a RANGE of expert opinion and to try to step back and consider the facts and figures, to get the risks in perspective.

Obstetricians seem to always simplify the issue - emphasising the risk of not having an induction, without explaining how complex and sometimes conflicting research into postdates pregnancy really is. And they rarely talk frankly about the risks of induction. I was at a birth recently with someone who had an emergency c-section after an induction with her first - who was trying for a VBAC with her second. The hospital she went to induces VBACS with a drip - something many hospitals won't do because it really increases the risk of scar rupture. And actually her scar did nearly rupture and she ended up with another emergency c-section - this time a crash one.
I sat there thinking - one in 5 women who comes to this hospital is terrified into accepting an induction to reduce the very small risk of stillbirth, but the hospital is quite happy to allow VBACS to risk their health and the health of their babies by inducing them and putting them at risk of scar rupture, just so it can bring down its overall c-section rates.

Shroud waving is something doctors the world over do. Mine did it to me when I booked a homebirth with my second because I was a 'high risk' pregnancy (I had gestational diabetes). If I hadn't had the support of a really good independent midwife (who did loads of research for me, and who got input from a consultant midwife at another hospital) to help me put the risk of birthing out of hospital in perspective, then it would have been really hard to have stood up to him.

So really women aren't properly educated about childbirth untill they are empowered with enough information to stand up to someone who is highly qualified in their field.

Lynette - a lot of community midwives are outstanding.

But you can't guarantee you're going to get someone you gel with, or - anyone tbh, in the case of staff shortages on the night, especially round where I live. I didn't want to take a chance. In my case the community team wouldn't support me anyway, so I was stuck. And if you go into hospital.... well, you're taking pot luck with who ever just happens to be on the ward that night.... who - even if they're good, you're likely to be sharing with several other women.

You're also not likely to get someone with who you've had a chance to establish a proper, trusting relationship (unless you live in an area with caseloading - and they're few and far between) - and that's the really massive difference with an IM. By the time you give birth you will have spent many hours in their company and have a real rapport.

Re: not wanting a doula. Well - that's fair enough. It's not for everyone. But all women have the right to know that having one appears to significantly reduce their chance of ending up in theatre or needing an epidural......... (which is why it's in the NICE guidelines on c-section as important information that women should be given to reduce their risk of operative birth).

While I understand the appeal of having an independent midwife, or being able to work as one, I really feel very strongly about the importance of choices through the NHS.

I don't feel I was that well prepared first time round and hope that this time I benefit from having more idea.