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!

OK i didnt mean I was calling you a 'bitch' just the investigator. The sacarsm i felt in your words but if not then fine.

Alot of us on here beleive what I said. We are talking about the simple interventions such as a midwife putting her fingers inside you when you dont want her to, a docotr putting you on a drip when she wasnt meant to, the fact of monitoring when not necessary etc...
Were not talking about the life saving interventions whic you seem to have described.
I'm talking about the things peads/consultants/midwives do or say when you i.e you havent asked them too or told them. They feel that because we birth in a hospital that they have the control over our bodies and the fact women are 'unable' to cope with labour and labour without some intervention.Which means us mums get left with PND or scarring which wasnt necessary. Thats all, not the fact that one or two of us had to have life saving operations to save us or our baby. Obviously we all feel that necessary.

And you are going to defend midwifery on the NHS, its your job too.

I dont mean to be offensive here but...
I bet its in your contract that you cant talk about the bad things that go wrong when (some) midwives/doctors etc...are at fault and have misjudged cause thy didnt listen to the mother. ( Ive had it in my contract when I was working for a massive company) So were not going to get a story where by which a midwife did something unecessary and this resulted in mum and baby dieing/baby/or just mum.?

Chelles, reading your posts I wonder whether it is PND you are suffering from or whether you have Birth Trauma.

I think you have been unfair on traffic, she's not the only MW on MN and I've seen a few that have spoken about bad things they've seen or heard at work.

TinkerBelleIt was def PND as the actual birth was fine. Its just the afterpart. I sunk into massive depression and not only because of having DD but other things in life too. I aslo have an anxiety disorder related to the PND now and I know only counselling will help just cant get a GP to refer me as I never told them about the PND. Ive managed to cope so far. It was like baby blues but never went away. Up until about 2 months ago. Aint gonna pour my heart out on MN anyways.

Isnt this what this post is about anyway. I dont feel im being harsh to traffic as I said I didnt mean to cause offence. I just feel that she think Im the only one on here that dislikes the care they received through the NHS.

Im not picking on traffic at all,not by a mile and sorry traffic if ive hurt you in any way. I just blame the system really as well as the health minister! As well as some staff. I know I sounded a little harsh when I said "The sacarsm i felt in your words but if not then fine" I didnt mean to sound so horrid. And I wasnt aiming it at you either, it just reminded me thats all.

Tink about the Birth trauma thing, ive just read up on it on the Birth trauma Ass.website. I think you maybe right. Thank you. It always gets misdiagnosed as PND and sufferers can have depression too. Thanks again...No i can move on and try get some real help from someone who will listen.

I am so glad that someone finally brought this up. Only a couple of decades ago 1 in 10 women died in childbirth so basically without the miracles of modern medical practice and yes medical intervention, obviously childbirth is of course dangerous! Many home births (about 40%) end up in hospital because of complications so statistically they are hospital births. I would have been a perfect candidate for a home birth as I had the perfect pregnancy but thank God I didn't because my baby needed immediate paediatric attention when she was born (without any forewarn) and I dread to think what would have happened if I was at home. I'm not against home births if that's what people want. I understand it can be a lot more comfortable for the Mum (although am not sure of the advantages for the baby) but would question the statistics.

Also, I think way too much importance is given to birth stories on MN. It's great that women discuss them as this can help against post natal depression etc. but it has become almost competitive in that if you have a birth without an epidural or any intervention, then you have had a great birth. But if for example you succumbed to an epidural, then you are weak. This is just total BS. The thing that matters is having a happy healthy baby and a Mum who shouldn't feel that her birth was some kind of test. Ok, I'll stop ranting now

Mollyflossadvantages
read this study

"Advantages

You can labour and give birth in familiar surroundings. You are likely to be more relaxed and this can help your labour to progress

You don't have to make a decision about when to go to hospital or interrupt labour with a journey

You will probably be looked after by a small team of midwives who will have got to know you during your pregnancy, and they will also look after you in the days following the birth of your baby

You may find labour less painful and are less likely to want strong pain-relieving drugs6

You are less likely to have medical interventions. (One study showed that planning a home birth halved the incidence of both assisted delivery and Caesarean birth6)

You won't have to be separated from your partner after the birth

If you have older children, you will not need to leave them"Birthchoice

"But if for example you succumbed to an epidural, then you are weak."

I have never ever heard anyone say this on MN or anywhere.

I don't think 'weakness' is the issue at all here. What is the issue and what is being discussed is unnecessary intervention.

They are similar enough to get misdiagonsed but need different treatment, PND treatment can make birth trauma worse but your first post demonstrates why it often is. Do tell your doctor, it won't go away on it's own.

Molly, I know it's long but have you read the thread? Noone has said intervention is wrong, just unnecessary intervention and statistics prove that there is a helluva lot of that. I had two generals, what does it make me? Strong for not having an epi or weak for the same reason?

Thanks Tink. I will speak to someone.

"Second time round though the pain was excruciating! I was induced and the midwife accidently broke my waters when I was 1cm dilated, within minutes I was almost screaming because of the pain. I didnt feel like I was panicking (until i felt the pain!) 5 hours later I was rushed down to have a emergency caesarean, the baby was very distressed and even though I had been fully dilated for a while her head hadnt come down at all.
I think if you do panic then you have a harder time, but anyone whos had a baby will no how hard it is not to panic! " Keels26

Keels I hope you dont mind me using this from another post its just it seems to be exactly what were al talking about.

Would she have needed the C-section if not being induced or midwife breaking her waters?

And we're not talking about what Mum wants. We're talking about medical staff saying "now it's time to..." "you're not progressing fast enough so we're going to..." with no discussion with the mother (and you only don't have time to discuss it or "use you T-BRAINS" when it's a crash situation and you will know when you're in one of them!) and often impatience.

Thats fine chellesgirl! Had a 'normal' birth first time round and was induced second time because of pre eclampsia. They induced me when her head was so high up that I had to have a scan to see if she was breech!
The midwife was giving me an internal to see if the induction had worked and broke my waters with her finger.
Obviously I dont know what would have happened if I had been left to go into labour naturally but I do think the intervention was done before the baby was ready to be born and this is why she got distressed.

Many Thanks Keels for your reply to this thread!

Hello,

Yes, I've read the thread and I wasn't suggesting that on this thread anyone was saying women were weak when having an epidural. I was just trying to highlight that these days there is often a lot of pressure on people to do everything as natural as possible and I sometimes get this feeling from MN (which I think in general is really supportive by the way). If noone else has ever felt it then my bad...

Regarding the debate being on necessary and unnecessary intervention, there is sometimes a fine line. I know there is a ton of unnecessary intervention and because of this some women want to completely disregard medical advice which is dangerous. I have a friend who recently refused a caesarean as she thought it was unnecessary and the baby ended up in hospital for weeks and they don't know yet what the long term effects are. I also have a friend who wanted a home birth despite a bunch of complications. It was bordering on madness and she had to be told in no uncertain terms that it would be insane before she saw the light.

Regarding the research and statistics on home births:

Saying women are more relaxed at home - well of course they are because they specifically choose the home birth presumably for that reason, but this would not be true of the general population.

Regarding familiar midwives, I'm not sure how probable it is that you would have got to know them in advance. Also, what if you really hate the midwife you're sent? In the hospital you have the right to demand another one - it might take a while for another one to arrive at your home.

I'm not sure why you would find labour less painful at home. I guess it psychological for some people. I think the pain would have been exactly the same wherever I was.

The reason you are less likely to have medical intervention at home is quite simply because it is not available at home and in choosing to have a home birth you are the kind of person who has decided in advance not to have an epidural etc. If you are in hospital and pain relief is on offer, you are more likely to get it than at home where it is not on offer.

If you have older children, I'm not sure how much of an advantage it is to have them around but that is personal.

Anyway, I am not trying to deny the advantages of home births. Those who want it feel very strongly that way and I respect that. I'm just trying to point out how the statistics can be misconstrued. I also am wondering what you do at home if suddenly something is very wrong with you or the baby. I know it is rare that something can go wrong so suddenly that you wouldn't have time to go to the hospital but it is a possibility.

Voila, that's it. I don't want to ruffle any feathers. I'm actually a pro-natural birth, long term breast feeder, etc. but just worry sometimes about the some of the ugly side effects of the 'pro-natural movement' if you could call it that.

MollyFloss - 40% of homebirths to first time Mothers transfer to hospital - this isn't necessarily because of complications but because these women choose to transfer, for example because they want additional pain relief. The figure is just 10% for births to Mothers of subsequent babies.

'Only a couple of decades ago 1 in 10 women died in childbirth'

I'm pretty sure this isn't true (not in this country anyway). Where does this statistic come from? Anyway, as has been mentioned on this thread before, improved hygiene, antibiotics and better antenatal care are largely responsible for the improvement in maternal mortality. Not to say that appropriate intervention hasn't saved many lives.

"I also have a friend who wanted a home birth despite a bunch of complications. It was bordering on madness and she had to be told in no uncertain terms that it would be insane before she saw the light".

I had a 'bunch of complications' and had a homebirth. I was told - very strongly - by my obstetrician and my community midwives that I should give birth in hospital. My independent midwife (after speaking to a consultant midwife at a large teaching hospital) advised me that it was reasonable for me to attempt a homebirth. Who should I have listened to? My obstetrician had never attended a homebirth. My midwife had attended hundreds. Was my decision 'insane'? Even though the outcomes were excellent for me and my baby?

Regarding the research and statistics on home births:

"The reason you are less likely to have medical intervention at home is quite simply because it is not available at home"

No - this is not the case. You have argued previously that interventions are not offered if they are not necessary. Women labouring at home by your logic should be just as likely to need intervention as women labouring in hospital. The fact that they don't is testement to the fact that women at home are more likely to have physiologically normal labours - the hormonal cascade which underpins the process is not disrupted in the same way it is when women are labouring within a large institution.

~"I'm just trying to point out how the statistics can be misconstrued."

Which statistics are you talking about? Have you read any good quality research into place of birth?

"I also am wondering what you do at home if suddenly something is very wrong with you or the baby. I know it is rare that something can go wrong so suddenly that you wouldn't have time to go to the hospital but it is a possibility."

Yes - sometimes things happen at homebirths that, had they happened in hospital would have been better dealt with. Sometimes (rarely) babies born at home will die or be damaged because they weren't born in hospital. But the research suggests that the reverse also happens: that some babies who die or who are born damaged in hospital may have escaped this fate if they had been born at home. This has to be the case if the infant mortality/morbidity rates are pretty much the same for home/hospital (they are).

"but just worry sometimes about the some of the ugly side effects of the 'pro-natural movement' if you could call it that."

You'd do better to worry about the overwhelming dominance of medically managed births in this country. The 'ugly' side of this is one in four women starting their lives as mothers while recovering from major abdominal surgery, widespread problems with breastfeeding and surging rates of postnatal depression. The natural birth movement is the least of our problems.

"Many home births (about 40%) end up in hospital because of complications so statistically they are hospital births"

No - in a lot of research currently being used to assess the safety of homebirth, tranfers (both before, during and after labour) are included in the 'homebirth' arm. This sometimes distorts the findings against homebirth because the outcomes for women who switch to hospital because their pregnancies have become comlicated may still be included in the figures for homebirth, despite the fact the mother didn't labour or birth her baby at home.

I do think Mollyfloss that it's good form to read the research before commenting on it.

standanddeliver: You can choose to listen to whoever you want to. An obstetrician is medically more qualified than a midwife but yes he hadn't been to a homebirth but he knows what medical intervention is available rapidly at a hospital compared to at home, hence presumably why he advised you so. I'm glad you were so happy at the outcome, obviously a homebirth was something you really wanted. Does it make you insane? No, but in some people's eyes it means you took some risks, risks you either believed were worth taking or weren't really risks at all.

The funny thing is that I have read the research and am pointing out how the stats can present the argument pretty much either way but I knew if I started talking about any minor downside to homebirths at all I'd pretty much get the head bitten off me. How is it if infant mortality is the same for home and hospital births but here it seems that there are only downsides to hospital births? Are there no downsides at all to home births? (such as the tiny risk that you won't the same medical help at hand if an emergency) I have a masters (quantitative and qualitative analysis) in analysing this kind of research so II do have some idea how to examine stats, thanks.

because the general population of women don't choose a homebirth and therefore presumably choose a hospital birth because they are more comfortable with that choice (aside the few who want homebirths but decide not to have them for medical reasons only)