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Childbirth

Share experiences and get support around labour, birth and recovery.

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

415 replies

greenwithyellowspots · 04/03/2009 19:59

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!

OP posts:
Are your children’s vaccines up to date?
Chellesgirl · 13/03/2009 22:57

birthright I hope I can be as strong as you next time around.

olissa 'Poor maternal effort' - it annoys the shit out of me, how degrading is that to a mother trying to do her best to bring her child into the world?!!

birthright · 13/03/2009 23:03

i prefer the term failure to wait for progress rather than failure to progress.
i also prefer fully delighted to fully dilated.
i also dislike the term incompetent cervix or inadequate pelvis/contractions- all very negative! no wonder we feel we've failed.
language is very powerful.
i dont suppose men would put up with their reproductive organs being referred to as incompetent or inadequate

treedelivery · 13/03/2009 23:13

OMG - someone else who has a thing with incompetent cervix. I hate all the terms listed here but that brings me out in a rash.

I started a protest at the last hospital I was at and told the lead consultant plainly it was just bad language. He agreed and agreed to say 'This is the medical term, but what we have here is a cervix that may struggle under the pressure of a pregnancy' Bless him. Such a gentle gentleman.

It's Crap bloody phrase. As if in IVF clinics registrars go around stating -'Ah yes, you're the man with the piss-pot sperm who don't know north from south, although I see you are also incompetent at getting it on'

Grrrrr.

birthright · 13/03/2009 23:17

chellesgirl i think you are as strong, if not stronger than me. i applaud your strength to do what wasbest for your daughter rather than whats best for the system - which i believe this discussion is mostly about. treating women and babies as individuals and listening when women know things are going wrong - or right.

Gemzooks · 13/03/2009 23:26

on a lighter note, I was told off by the doctor in early labour because she couldn't find my cervix. She said, 'well is it on the right or the left?' I loved the implication that I was deliberately hiding it from her

Chellesgirl · 14/03/2009 00:13

Thank you birthright. I am so broody at the moment but just putting off having another baby. I so dont want to experience the awful NHS again and next time will go private at my Nearest ' MUM'S ' Clinic. But £2500 for a birth package is a bit too much at the mo. And I want twins!

drosophila · 14/03/2009 17:50

www.birthinternational.com/articles/painlabour.html Wish I could take on board what is said here but the fear takes over. I hope to get some hypnobirthing but I only have 2 weeks to go. Is it too late do you think?

Chellesgirl · 14/03/2009 19:09

drosophila what are you fearing?

Chellesgirl · 14/03/2009 19:33

'Many women have found that labour pain is bearable if it means better health for the baby.'(www.birthinternational.com/articles/painlabour.html) This is so true for me.

olissa 'These normal and expected reactions and symptoms are often misdiagnosed as:

"Failure to progress".
"Inco-ordinate uterine action".
"Dystocia".
"Inefficient myometrial action".

when a more accurate diagnosis would read:

"a natural response in a threatening situation".
"perfect hormonal interplay in the circumstances".
"normal reaction to hostile surroundings".

This comes from the link that drosophilia added above. Everything this consultant says is so so right!

Chellesgirl · 14/03/2009 19:35

drosophilia its never too late to try and conquer old hurtful feelings. And to let you know I felt the same way about 'letting my daughter down' becuase I couldnt voice my concerns when in labour and no one asked me anything.

TinkerBellesMumandFiFi2 · 15/03/2009 11:08

Chellesgirl, I think that book should be read by anyone going to deliver a baby! I delivered my first like that, I was actually trying to pull rather than push, which I had no urge to do, I didn?t want to deliver her because at 20 weeks I was well aware of the ramifications of delivering. Every time I got a contraction I raised my hips off the bed so that I was taking my weight on my shoulders and feet, I had no control of it I just had to do it.

frasersmummy, I know you know, but it was repeated several times by others who had changed it to being basically birth related deaths and stillbirth so I wanted to make sure it was said The problem with monitoring all pregnancies like that is that those of us who would be picked up aren?t in the majority, it might seem like it when you spend time on the SANDS or Bliss websites and go to support groups or have a high risk pregnancy when you?re meeting other mothers parents who?ve been through similar things but it would put an amazing strain on our services and probably wouldn?t make enough of a difference. I think that probably the most important thing that would make a difference would be to test all new mothers for Hughes Syndrome, it?s cheap and quick and they would have a better idea who to monitor more closely and it dramatically improve outcomes.

Knax, it depends though. If the mother and child would be ok if they didn?t have medical intervention but the doctor was feeling twitchy then is it better? I didn?t want a section second time but they were too worried about the less than 2% risk of rupture with my scar type. Funnily enough in telling me the risks of an epidural they said that headache isn?t very common 98% of women are fine. What?s the difference?

Olissa, I know what you mean; you can tell this is bad when the staff just have that quiet pained look. I snapped at a midwife and the look on her face took me back. I thought that she must have had worse but now looking back on it I know it wasn?t me snapping, it was the whole situation. No one told me I was in labour, no one told me much. I don?t think I?d want to say to someone ?you?re losing your baby?.

Tree, you reminded me of Friends when Monica and Chandler went to a fertility clinic.

Drosophila try The Water Birth Book, it will really help you!

BonyM · 15/03/2009 12:01

drosophila - you should read "Childbirth without Fear" by Grantly Dick-Read. I have just finished it and it is enlightening and inspiring. It describes the Fear-tension-pain relationship, showing that labour should not and need not, in normal circumstances, be painful. The pain is caused by fear which leads to tension. Please try to get hold of a copy.

Chellesgirl · 15/03/2009 15:23

Thants true BonyM pain is induced by fear. I found it really really helpful to have my partner by my side. He was my pain relief because I knew that we had a connection and that we had made this baby together so we can bring this baby into the world together. The birth was painfree - except for some aching in my back and my hip locking but thats another story.

It was straight sfter the birth where things started to go wrong and the fear crept in, that I could lose dd and the medical staff being of NO help. Im going private next time just so I know I can have that 1-1 care from an independent midwife.

mrspooh · 15/03/2009 16:29

having had a difficult pregnancy, regular emergency trips to hospital with bleeding, my birth plan was one line - do what you have to to get the baby out safely. having gone into hosp 4 days before he was born to check he wasnt breach, i had bleeding the day before he was born and was immediately taken in again to be monitored. when i went into labour at home the next day, i was again admitted qickly and had a midwife with me the whole way through. half an hour after arrival i was strapped to table for monitoring and stayed there for 16 hours! i had a drip as my cervix wouldnt dilate beyond 9cm and after 7 hours monitoring and an epidural(which was amazing), i had a cesaerean. I had excellent care, everything explained, choices offered and all this in our local hosp which is meant to be awful!! yes i ended up with a nasty infection afterwards in the cesaerean, was incontinent and couldnt walk by the evening for the first few days, but i have a beautiful son who is gurggling on his dads lap next to me. i was already discussing my birth options for number 2 with mw when baby was 5 days old! the most important thing is surely having a beautiful baby to take home and after my pregnancy, that was all i cared about.

ephrinedaily · 15/03/2009 16:44

To say pain is induced by fear is absolute rubbish as well as massively insulting. With my first child I had a great birth experience and quite a lot of pain and I suppose I was scared, in that I was scared the baby would die. Recently I gave birth to a second trimester baby that had already died - I was not at all scared because the baby was dead and I just wanted it out. And it really really bloody hurt. Worse than the first baby actually.

standanddeliver · 15/03/2009 17:21

Ephrinedaily - while I don't think that fear is the ONLY thing that makes labour painful, I do strongly agree that fear and pain go hand in hand. Fear can and does make pain much worse. And being in pain can make you feel intensely fearful. And there are other emotions that can intensify pain - feelings of powerlessness and grief being two of them. The physical experience of birth is bound up with the emotional experience - don't you think?

MrsPooh - I think we'd all agree that having a healthy baby is what we all want primarily, but that doesn't mean that it necessarily follows that it 'doesn't matter' what happens to someone in labour.

TinkerBellesMumandFiFi2 · 15/03/2009 17:39

"To say pain is induced by fear is absolute rubbish"

Do you know anything about the role of hormones in pain and fear? Fight or flight? Adrenaline and oxytocin?

TinkerBellesMumandFiFi2 · 15/03/2009 17:46

I lost my baby in the second trimester too, she was born alive but too early for them to treat her. You are right, earlier babies do hurt more and are harder to deliver. It's something us premature mums have to explain over and over again, and makes some of us very cross when we hear people saying they want a small baby because it seems so natural to think that smaller babies are easier.

Of course there will always be pain in labour but it certainly is made worse by fear. I was "fortunate" with Tink I had a crash section so by the time we knew something was going on I didn't have time to really be scared. With Fifi I was further on and had been in labour for 11 weeks, for some reason I was so tired I couldn't open my eyes between contractions so they and fear didn't both me that much. I told Mum if they weren't going to do a GA I'd be asleep during the delivery anyway I was so tired!

drosophila · 15/03/2009 18:38

Thanks. I think I am afraid of the pain and also afraid that something will happen to me made worse by the fact my DS is worried. He saw a silly movie where Jenifer Lopez died in Childbirth. I thought he was in bed but he was on the stairs looking through the door. His fear is rubbing off on me. I also don't feel prepared - still have to buy things.

OK need to buy a couple of books and book a hypnobirthing session. Not to mention trip to IKEA.

birthright · 15/03/2009 22:23

There are different pains in childbirth. all are made worse by fear, lack of sleep, immobility, lack of support, size and position of baby, length of labour etc etc.
I've only given birth twice. The first was a medicalised obstructed labour which ended in caesarean. the second was an easy VBAC. I can honestly say trying to artificially force a baby throuh my pelvis with syntocinon and an epidural which paralysed but didnt relieve pain caused the worst pain imaginable. if someone would have offered to put me out of my misery permanently I would have accepted. my second birth was enjoyable and quick. although it wasnt pain free it was fun and the pain was never more than i could deal with. the huge difference for me was normal versus obstructed labour, lack of information and support, and neglect from those supposedly caring for me.
pain is very subjective and so are birth outcomes.
i was very glad my daughter's life was saved by skilled surgeons but couldnt enjoy her through the postnatal depression.
i only appreciated the huge difference a normal birth had for me when i managed to give birth without help.
the type of birth is not as important as how you feel after it. the care, explanation and support you receive make the difference between a good or bad experience.

Chellesgirl · 15/03/2009 22:47

Yes birthright I agree with that too. I think If the midwives and consultants had been a bit more caring and thoughtful I dont think I would have suffered the PND.

drosophilia Ive seen that film and it always makes me
Poor DS. I recon hypnobirthing could really help.

ephrinedaily Have you read the article that drosophilia attached? Dont you recon what the consultant is saying is true? Its like when you were little and you fell over and cut yourself, it would hurt, and then you'd cry and it would hurt more. My mum used to tell me to stop crying and it wouldnt hurt so much.And she was right. If you can block the pain by inducing endorphines instead of the adrenaline that comes with fear, the hurting will subside.

trafficwarden · 16/03/2009 09:39

I'm new here but am compelled to add my thoughts. After 18 years as a Midwife, I still love my job. I have worked in different countries and settings from Homebirths to full on Intensive care and feel I have a pretty wide range of experience to offer. It makes me sad to read opinions that label ALL Midwives as awful. Some of us really do try to make a difference and act as your advocate. As mentioned before, working in a hospital environment usually means policies and protocols to follow but that should not inhibit a "good" midwife from supporting your informed choice.
Consider these situations I found myself facing as the Team Leader/Sister in a large teaching hospital a couple of years ago. This hospital has a Midwifery led model of care and a supportive team of Obstetricians but sadly there is no legal Homebirth Midwife option in the area. (Not UK).
Situation 1: Woman, husband, Doula, Granny present to the delivery Unit. Previous CS for Placenta praevia. Aiming for VBAC this time. NO antenatal care, not registered at the hospital. Midwife unable to establish any relationship so I went to introduce myself. Woman appeared to be in established labour, contracting regularly and using breathing/shower to manage pain. I explained who I was, that I needed to talk about options for her but realised she was concentrating and was it OK to speak with her family and doula in the room whle she was in the shower with the door ajar so I didn't interfere too much. She nodded so I went on to explain to the others what hospital policy was (IV cannula, continuous CTG, X match blood available, quick scan to assess placental site/presentation) but wanted to know what their thoughts were and what they would accept and how much information they already had. Also explained nothing would be forced on them but asked them to let me know what they expected from us. Father and doula told me they wanted no tests, no monitoring, no assessments, no touching, NOTHING and told me to leave as I was spoiling the flow of energy. I accepted that a confrontation was not going to help the woman's labour and asked the father and doula to come to another room to discuss things while Granny stayed for support. After much coming and going we managed to establish that they wanted no intervention, fair enough, but they were unable to acknowledge the legal implications for us if we did not inform them fully of risks/options. The Consultant asked if they would be willing to sign the notes to confirm all that had been discussed and they declined. Eventually, over the course of more than 3 hours of negotiating (and believe me I had plenty other things I could have been doing!) Granny said the woman had had enough, that she was terrified, in agony but didn't want to disappoint the husband and doula, that she wanted an epidural, would accept any monitoring we recommended after that. Woman crawls out the shower into my arms to confirm this. Once epidural in, monitoring suggested a severely compromised baby and she agreed to emergency CS where a ruptured uterus was found and a very sick baby delivered. Afterwards, the father was adamant it was all our fault for interfering. Woman and Granny grateful for help, Doula disappeared.

Situation 2: Couple present to Delivery Unit after normal antenatal care and Consultant discussion to plan birth. Previous CS for breech presentation. Aiming for VBAC. Accept 20 min CTG to establish fetal wellbeing at that time, then intermittent monitoring with hand held doppler. No IV, lots of mobility, minimal examinations, will listen to suggestions and plan from there. I was lucky enough to be able to stay with them throughout the labour, we crawled around the floor and hung out the window, we nibbled tea and digestives and when she decided to push we built a nest of beanbags and mats in the corner. She accepted a visit from the Consultant at this point who popped in, agreed he was surplus to requirements but had his pager if need be.She gave birth to a screaming girl, physiological 3rd stage in the loo, intact perineum. She then proceeded to have a large haemorrhage but despite all the emergency treatment required she sent me a wonderful letter thanking me and the Consultant for our care and for the wondeful experience she had.

Sorry, it's a very long first post but it real life and might give some of you pause for thought. These are the kinds of situations we deal with. Would anyone expect me to have acted differently?

mummc2 · 16/03/2009 10:06

i really wanted as little intervention as possible with my 2. They both decided to enter the world early at 36 and 38 weeks and i went to the hospital but made it clear how i wanted things to go. I was left to get on with it and was just checked every hour or when i felt i needed something and with dd1 she got stuck and had the cord wrapped round her neck so tight it needed to be cut before she was delivered (just head out) so many thanks for that and dd2 completely natural no pain relief and all the midwifes did was catch!! So i think natural or intervention it doesnt really matter as long as you have a healthy baby and you try to make it clear how you want things to go, its amazing if you actually talk to the doctors and midwives how much they listen and try to get you the birth you want but in a safe way.

Chellesgirl · 16/03/2009 10:40

traffiwarden what made situation2 haemorrhage? Did you find out?

You havent mentioned any births that were purely VBACs without the first being a CS.

And also the ruptured uterus:"A uterine rupture is a tear in the wall of the uterus, most often at the site of a previous c-section incision. In a complete rupture, the tear goes through all layers of the uterine wall and the consequences can be dire for mother and baby. Fortunately, these ruptures are relatively rare events ? exceedingly rare for women who've never had a c-section, a previous rupture, or other uterine surgery. The vast majority of uterine ruptures occur during labor, but they can also happen during pregnancy.

The first sign of a rupture is usually an abnormality in the baby's heart rate. (This is why a woman attempting a vaginal birth after cesarean, or VBAC, needs continuous fetal monitoring.) The mother may have symptoms such as abdominal pain, vaginal bleeding, a rapid pulse, and other signs of shock, and may even experience referred pain in her chest caused by irritation to the diaphragm from internal bleeding.

What causes uterine rupture?
Ninety percent of uterine ruptures happen at the site of a scar from a previous c-section. And ruptures are most likely to occur during labor because a scar is more likely to give way under the stress of contractions.

If you've had one c-section with the typical low-transverse uterine incision and are considered a good candidate for VBAC, most studies estimate the risk of rupture during labor to be less than one percent. On the other hand, if you've had a "classical" c-section, in which the incision extends vertically to the upper, more muscular part of the uterus, you have a much higher risk of rupture and should be scheduled for c-section before the onset of labor. The same is true for women who have had other kinds of uterine surgery, such as an operation to remove fibroids or to correct a misshapen uterus, or repair of a previous rupture.

It's possible for an unscarred uterus to rupture, but that happens in fewer than 1 in 15,000 pregnancies, almost always during labor. Risk factors include having had five or more children, a placenta that's implanted too deeply into the uterine wall, an overdistended uterus (from too much amniotic fluid or carrying twins or more), contractions that are too frequent and forceful (whether spontaneous or from medication such as oxytocin or prostaglandins, or as the result of a placental abruption), and a prolonged labor with a baby that's too big for the mother's pelvis.

Trauma to the uterus, from such things as a car accident or a procedure such as an external cephalic version or a difficult forceps delivery, may also cause a uterine rupture, as can a difficult manual removal of the placenta.

mummc2 you must of had a really good hospital to birth in. I have noticed on here 'it doesnt always go the way you want' when staff interfere.

Chellesgirl · 16/03/2009 10:41

traffiwarden what made situation2 haemorrhage? Did you find out?

You havent mentioned any births that were purely VBACs without the first being a CS.

And also the ruptured uterus:"A uterine rupture is a tear in the wall of the uterus, most often at the site of a previous c-section incision. In a complete rupture, the tear goes through all layers of the uterine wall and the consequences can be dire for mother and baby. Fortunately, these ruptures are relatively rare events ? exceedingly rare for women who've never had a c-section, a previous rupture, or other uterine surgery. The vast majority of uterine ruptures occur during labor, but they can also happen during pregnancy.

The first sign of a rupture is usually an abnormality in the baby's heart rate. (This is why a woman attempting a vaginal birth after cesarean, or VBAC, needs continuous fetal monitoring.) The mother may have symptoms such as abdominal pain, vaginal bleeding, a rapid pulse, and other signs of shock, and may even experience referred pain in her chest caused by irritation to the diaphragm from internal bleeding.

What causes uterine rupture?
Ninety percent of uterine ruptures happen at the site of a scar from a previous c-section. And ruptures are most likely to occur during labor because a scar is more likely to give way under the stress of contractions.

If you've had one c-section with the typical low-transverse uterine incision and are considered a good candidate for VBAC, most studies estimate the risk of rupture during labor to be less than one percent. On the other hand, if you've had a "classical" c-section, in which the incision extends vertically to the upper, more muscular part of the uterus, you have a much higher risk of rupture and should be scheduled for c-section before the onset of labor. The same is true for women who have had other kinds of uterine surgery, such as an operation to remove fibroids or to correct a misshapen uterus, or repair of a previous rupture.

It's possible for an unscarred uterus to rupture, but that happens in fewer than 1 in 15,000 pregnancies, almost always during labor. Risk factors include having had five or more children, a placenta that's implanted too deeply into the uterine wall, an overdistended uterus (from too much amniotic fluid or carrying twins or more), contractions that are too frequent and forceful (whether spontaneous or from medication such as oxytocin or prostaglandins, or as the result of a placental abruption), and a prolonged labor with a baby that's too big for the mother's pelvis.

Trauma to the uterus, from such things as a car accident or a procedure such as an external cephalic version or a difficult forceps delivery, may also cause a uterine rupture, as can a difficult manual removal of the placenta."

mummc2 you must of had a really good hospital to birth in. I have noticed on here 'it doesnt always go the way you want' when staff interfere.