The general feeling here seems to be anti-invervention and medical help. Why, when it has saved so many lives?

[greenwithyellowspots]

I am really interested in this question. I think that Mumsnet is really geat, I love it, but one thing I've noticed particularly on the childbirth thread is that on the whole people are anti-intervention or even that doctors etc are the enemy! With induction for example, but also generally, the consensus seems to be about letting women get on with it because 'their bodies know best.'

But in the past, and still today in many countries, it seems clear that women's bodies DON'T always know best - mortality in childbirth used to be/still is horribly high! It often seems as though the medical profession can't win when it comes to childbirth - if they intervene they are accused of being over zealous, but if they get it wrong, they are also to blame.

I'm sitting here pondering the fact that I'm likely to be induced soon-ish and am reasonably willingly putting myself in the hands of the medical profession. Is there not a danger or harking back to a golden age of childbirth that didn't exist? I hope this isn't a really inappropriate question but I'm generally interested in what people have to say about this, as I kind of feel like I'm missing the point somewhere!

I think it's anti unnecessary intervention.

Case closed.

It really struck me after my successful induction for pre eclampsia at just gone 35 weeks that had I lived in a country with less well developed maternity services i could have died! Focusses the mind!

I agree with ShowofHands.

I was monitored closely, scanned constantly and given a C Section at 35 weeks because my baby wasn't growing. It saved her life. I didn't have a bad word to say about the doctors!

However, my first and third babies were totally uneventful pregnancies, and straightforward natural births. I didn't need any intervention or drugs, so I didn't have them.

greenwithyellowspots - I agree with everything you say.

I do not understand why the huge and obvious benefits of modern medicine in childbirth seem to be rejected by so many people on MN.

Birth is an extraordinarily dangerous process that can go terribly wrong. Mostly it goes right but when it goes wrong you need the very best that modern medicine can offer.

I do think it is a sort of general anti-reaction to the uncertainty and horror of the modern world as a sort of attempt to return to an ideal fantasy world of naturalness. It is also a feature of our very urban society that does not have direct experience of how the natural world really works in all its beauty, horror and harshness.

I feel the same thing has driven the cult of organic food, cloth nappies, extended breast feeding (past 1 year) and climate change.

Its all the same reaction, a sort of rejection of the modern world and a retreat to a bucolic naturalness that never really existed.

Intervention can, in itself, cause problems.

Induction can lead to c-section for "failure to progress" when, if left to her own devices, the woman would most likely have gone into labour when ready.

Monitoring can result in being forced to lie on your back on a bed - this is not the right/best position to be in for labour.

Episiotmies can lead to nasty tears.

Of course, intervention can also save lives - I was born 4 weeks early by induction and thus survived - but many interventions are unnecessary and that is what people are "anti".

A natural birth at home is, in fact, statistically safer than a birth in hospital for a normal, low risk pregnancy.

I think the consensus is being against unnecessary interventions.
I can really recommend to read Naomi Wolf "Misconceptions"

The majority of births are straightforward and don't require intervention.
My first was like this. I had dd1 in a midwife led unit and it was the best thing I ever did.
My second required high tech life saving intervention as described above, and was absolutely right for that birth. In fact dd2 would probably not have survived if she'd been born a few decades ago.
My third birth was straightforward, and I didn't have intervention, but because I was in hospital rather than a midwife unit (because of previous c section) I really had to fight off intervention. The doctors and midwives were obviously far more geared up to things going wrong, and were desperate to intervene, monitor, have me flat on my back etc. It wasn't a good experience, and I ended up with more stitches than first time around.
That's why I'm a fan of non medicalised births where possible. Birth is a natural event. I'm not some lentil weaving mother earth figure btw. I just don't believe in pumping drugs into my body (and that of my unborn child) or subjecting myself to interventions which aren't actually medically necessary.
It's a shame that in this day and age so many women are brainwashed into believing they can't give birth without all sorts of interventions. Women should be encouraged to have more faith in their body.

Agree with the others who say it is about unnecessary intervention.

With my dd I was induced early (having been scanned and monitored constantly) and ended up with a c-sec. It was the most intervention-y birth possible. I have no regrets - it meant dd is here and possibly me too.

I am now 38+5 and trying for a natural birth - I do not have the issues I had with dd and so think there is - at this stage - no need for intervention. I also consider things like constant monitoring, if they make me lie on the bed, not condusive to a successful VBAC. That said, I am listening to all advice and will consider what needs doing at the time. If I'm advised to have a c-sec I will - I consider we're very lucky to live at a time and in a country where we can have a relatively low risk c-sec. But, if i can do it without intervention I consider that hopefully my recovery will be quicker/ things such as breastfeeding will be easier than first time round etc.

"I do disagree if they want to interfere just to make their lives and days work easier"

Agree - hedgewitch. I get the distinct impression the consultant I am under would be quite keen for me to agree to a c-sec but for no 'real' reason other than the fact I suspect it'd be a bit easier for them (although more expensive !).

"Birth is an extraordinarily dangerous process that can go terribly wrong."

Is it really extraordinarily dangerous? The vast majority of births in this country are straightforward so how does that imply danger? Things can go wrong yes, and thankfully there is medical assistance for those eventualities.

I think that's a myth that it's so very very dangerous. We are designed to give birth. Our whole body gives to it when we're in labour. It's amazing.

Unnecessary intervention is becoming far too commonplace though. From inductions to sections.

For me the ideas about giving birth should be based on how this mother can give birth to this child.

However, I think that for alot of giving birth is part of a medical process that happens day in day out and just because "some" women have very difficult birth's doesnt mean that all women need to be monitored all the time nor do they need regular internal examinations.

To give birth in an upright position gives your body every chance. to be on your back on a bed so the midwife doesn't have to bend down to deliver the baby seems to be unnecessary.

I think that informed decisions are fine. If ladies choose interventions with full knowledge then that is great, there are lots who don't and then they are surprised/upset about ending up with a section or forceps/ventouse.

The devil is in the detail here. What one person considers a necessary intervention another will scream a waste of NHS funds. I, personally, have no interest in ever attemptina a vaginal birth. Can't really understand why anyone would want to. But, I understand that many women do want that, and I think they should be supported in that choice. And those who want a medicalise birth should also be supported in that choice.

There is so much propaganda here about the horrors of medicalised births, it scares the whits out of people and probably contributes to PND post unexpected emergency caesareans.

I agree - of course - no unnecessary intervention. Absolutely. But do we (or more importantly Doctors) always absolutely know when it's necessary and when it's not? I don't know why I'm making this point really, other than I guess, I'm trying to work out why I love Mumsnet so much but seem to think so differently from the majority view on this issue.

Am I just extraordinarily naive about the medical profession and their desire to do things in order to fit their own schedule? I mean if induction makes things more lengthy (at times) and more intervention heavy, with more drugs, doesn't that make things more difficult for medics?

It's amazing how I can sit here anonymously and still feel a bit scared about posting this! And although I'm not a really regular poster or anything I have namechanged here!. But one of the other things that I've noticed is that people have often had a 'bad' 'intervention heavy' first birth, and then a second one with far less intervention. Then they say, if only I'd known that birth can be like this, etc, etc. But it seems to me that second births just are, often, not always of course, but often, easier than first. So it's not a fair comparison?

of course medical help is great and needed. the problem is that the medical establishment is run by people, some of whom make mistakes, they are not infallible and also things are done for convenience or other politically or socially driven reasons which don't improve outcomes. For example, lots of practices in obstetrics which have now been discredited (like enemas, shaving etc), were considered very necessary up to the 1970s. and things like massive Caesarian rates in countries like the US and increasingly in Europe, due to fear of litigation and profitability. So yes, medical care is good, but not unreservedly so, like any system operated by people, things can go wrong.

I think it's not so much that MN is anti intervention, but more that you tend to get people here presenting the other side of the argument.

Ie the consultant has generally already given the case for intervention, so the posters will naturally be giving the other side of the picture.

In cases where people don't seem to be listening to the professionals or where they are not involving them (freebirthing for eg) most posters you will find are advocating quite conservative views.

Also in terms of women dying in poverty/the past, that generally wasn't from childbirth itself (although there obviously were cases of that) but mainly from infection, malnutrition and poor hygiene. In the case of Victorian England, most of the infections were introduced by doctors. So I don't think you can say that past mortality was mainly due to NON-intervention, quite the reverse.

I second Misconceptions as a good read (although quite American) and for a historical perspective try Tina Cassidy's Birth, which is a fascinating history of childbirth.

abetadad, i couldn;t disagree with you more

but i shan't flame you

having had one medicalised birth ending in a c.s and one non medicalised ending in a vaginal birth, i see both sides

i also support other women in their pregnancies and births and am v v v interested in how the birth process and a woman's feelings on involvement and decision making in that process, can make her feel in the post natal period

i have found, in my own experience, that women who have medicalised births,and c.s , feel better psychologically if they understand why they have had the intervention , and do not feel forced into it, on a conveyor belt

as soupdragon has mentioned, there is a phenomenon of the cascade of intervention

for example, epidural leads to lack of mobility , reduced or total immobility, lack of progress in dilation due to lack of pressure from the baby's head if gravity not being used, lack of progress in the second stage , as the mother may not feel the expulsive contractions, and working against gravity, also, increased risk of needing an episiotomy for a ventouse or forceps delivery, as the pelvic floor is too relaxed to allow correct rotation of the baby's head for birth

induction of labour, before the woman is ready can mean a long drawn out process, a tired mother won;t labour as effectively , she might find the pain ahrder to cope with as it is artificially induced and/or augmented, therefore requires more pain releif, which can affect the speed of labour and its progression

but necessary intervention is a wonderful, life savign measure

the c.section was initially such a thing, now it accounts for up to 29 % or so of UK births, i don;t beleive that many women or babies are at risk of losing their lives or severe compromise

there is a balance out there

personally, i find the notion of freebirthing uncomfortable, and declining ante natal care is definitely a bad thing in my eyes

problem is protocols and policies do not take into account each and every mother's needs and wishes

but yuo will be amazed at how far protocols etc can be changed/compromised, if you just ask !

I agree that second births are usually more straightforward. on the medics thing though, they have a certain training which focusses heavily on disease and on deviations from the norm, and on diagnosis of problems. Obstetrics is one of the few areas where a process is happening which isn't, in itself, a problem. but because it is also part of medicine, it becomes problematised into what can go wrong, rather than being seen as a natural process or a process which has to proceed on its own. It involves lots of pain, which is also normally a medical sign of something very wrong which requires treatment. Also, it is the instinct of a doctor to act, to do something to help the patient, to intervene, not to let cruel nature take its course. That's why we have epidurals etc, and thank God we do! Of course women should have the birth they want, and if they feel safer basically outsourcing the birth to medical professionals, why not? But we just have to be aware of the downsides to any kind of system of helping people, that mistakes will happen and medics are only human.

I think you've hit the nail on the head greenwithyellowspots, in that last bit. Nearly all my friends who had babies around the same time as me, chose to give birth in a large hospital (rather than the midwife led unit a couple of miles along the road).Most of them decided that they would need an epidural, which in a number of cases led to further interventions, forceps, ventouse, etc. Most of them thought I was mad to book for my first baby in a midwife unit where I was attended by just a midwife and no doctors.
I never really understood why. I felt very happy and empowered by my birth experience, whereas a number of them felt cheated/upset/unhappy with theirs. Not all of them, but too many. And interestingly, a number of them decided to have midwife led births the second time around and felt it was a far better experience (although as you say, greenwithyellow, second births do tend to be easier so in a sense it's hard to compare).

For some reason, a large number of women seem to be almost brainwashed into thinking that they need a very medicalised environment, lots of heavy duty drugs etc to be able to give birth.

re mortality, the provision of ante natal care has had a profound effect on reducing mortality

greenwithyellowspots, may i ask why you are being induced?

That's all interesting. I see your point Gemzooks about previous practices, and about c-sections in the States etc. And thanks all for the book recommendations, I remember reading a review of Birth a while ago actually, looks interesting. I guess it's always in some sort of equilibrium isn't it between over medicalised and under, and maybe we're some way towards the former at the mo. Does anyone know a country/medical system that seems to get this really right?