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!

My Gran had a natural birth in a small village with dubious hygiene and no chance of medical intervention: she was completely traumatised and unable to ever contemplate another pregnancy. All the women in later generations of her extended family have given birth in hospital and we don't have a single instance of trauma. And most of us have gone on to have more than one child.

I don't think it was always better in the olden days.

Also, I think on MN we tend to hear very much about the interventionist, anti-breastfeeding etc hospitals. We don't hear so much about the ones that put women in the centre.

I gave birth at a teaching hospital which is well known in the region for their woman-centred approach, for their support of breastfeeding but also for being able to cope with extremely complicated cases.

I shared a ward with a woman who had already had to labour with two stillborn babies (knowing they were dead!) at a different hospital because they simply weren't up to dealing with her. She'd been told at her non-interventionist hospital that there was nothing unnatural in losing a baby and that there was no need for further examinations. She turned out to have lupus. Having listened to her sobbing through the night I went on to see her give birth to a healthy baby, not once but twice: we met up again on the same ward when I went in to have no 2.

So my local could certainly do extremely medical. At the same time, we had a very good hospital run ante-natal course, which focused on natural approaches and putting the woman in charge. We were encouraged to make informed decisions about pain relief. We were encouraged to move around in labour and there was no pressure for intervention until really needed. They apologised for giving me a caesarian when ds's heartbeat dropped- I was quite happy to get out of labour, but felt it would be churlish not to pretend disappointment lol. After the birth, I had a midwife round at every feed to help me latch on should I need it. When dd struggled with feeding, the hospital breastfeeding counsellor came to my house.

I would not have preferred to have missed out on all this.

I agree with ReallyTired.

Midwives are the experts in handling straightforward deliveries (ie the majority) of births.

Doctors/consultants are the experts when things go wrong.

I have been on both sides of the fence - normal delivery in a midwife-led unit first time around, and full scale C section to save my baby second time around.

The key issue here is when interventions happen which aren't a result of medical need, but as a result of management of the birth. Eg if a woman is feeling stressed out by being in a large hospital, with lots of shift changes and no chance to build a relationship with the midwife, and if she is confined to the bed and in a poor position for labouring, then she may end up more likely to have an epidural, not because there is any medical need but because she isn't coping well. This in turn makes other interventions more likely. This is the type of intervention which many people on MN are anti, not necessary life saving measures.

The added problem is that so many women these days seem to be almost encouraged not to have faith in their body to be able to have straightforward delivery - they start off with the assumption that they will need to be in a big hospital with doctors in attendance and all sorts of drugs. If you choose this route, then there's a greater chance that's how it will happen. My personal wish is that there were many more midwife units, like the one where I had my first baby. Small, personal, non-threatening environments where you have the chance to establish a relationship with the team of midwives, and where you have every chance of a really straightforward delivery.

It's not just surgical or monitoring interventions that save the lives of mother and baby - it's improvements in treating post-natal infection.

Personally I think the closest I would have come to dying in childbed was the infection I had after dd1's birth. Swiftly treated with antibiotics it resolved - without that treatment who knows? I'm sure treatment of infection is one 'medical intervention' we would all be happy to embrace!

Absolutely northern - anti biotics are probably the greatest medical advance.

I do sometimes worry about the tone of some threads - eg when a baby is breech and posters are encouraging the mother to have a natural birth. Now I have never delivered a breech baby myself (my one dc who was breech was turned by ECV) so I know I am not an expert and I am sure with the right care a breech baby can be delivered safely. However, I think there was a situation a few years ago where someone was expecting twins and at least one was breech. One of the babies was stillborn/died shortly after birth and I did worry at the time that the mother had been unduly influenced by other Mnetters. Of course I don't know the full story and maybe the outcome would have been no better with a c-section but it did worry me at the time

It's simply not true that all midwives are anti-intervention.

I had a midwife appointment at 40+5. First baby, no reason to think I was high-risk. Midwife didn't even look up from filling in the forms when she announced she was booking me in for an induction on Monday (four day's time).

She was really taken aback when I said: 'Oh no you don't. Is it necessary?'.

Same midwife gave me a sweep without even telling me, let alone asking permission. (I made a formal complaint and was promised they had investigated, discussed the case at a team meeting and changed their procedures - legally this was an assault.)

Gave birth on a midwife-led unit. Nice facilities but no ruddy midwives - one to seven women in active labour so I barely saw her. Very frightening. Thank God ds and I were OK because if anything had gone wrong, I doubt we'd be here. As it was, I got away with third-degree tear (no midwife in the room when I felt an overwhelming need to push - turns out it was a little too early).

That's shocking that the unit was understaffed edam.

Have to say, my experience was the total opposite - the midwife led unit had a brilliant midwife/patient ratio. I had my midwife allocated just to me, and she was happy to remain in the room while I laboured (and equally happy to leave me and DH to get on with it).

After my Csection (DC2) I also received a high level of care. However, this was at the expense of the care of women who had had straightforward deliveries. The post natal care generally in the hospital was shocking. I discovered this first hand when I had my DC3 and was not allowed to deliver at the unit so had to go to hospital. Even though it was a straightforward VBAC, no epidural and no hugely significant intervention, it was a horrid experience. Midwives and doctors coming and going, I don't even remember the name of the midwife who delivered me, and the doctors were desperate to monitor me non stop, I was in a poor position on the bed so tore badly etc.

Interestingly, when I had my first baby I spent a lot of time chatting to the midwives on the unit, while sitting breastfeelding at night (they actually made cups of tea and brought toast etc!). Working on the unit was seen as the creme de la creme of midwifery. Many of them had previously worked in large hospitals, and found the atmosphere impersonal and unsatisfying, and hated the fact that doctors would be all too ready to jump in and take things out of the midwives hands. I personally felt that the fact that the midwives felt so much better about where they were working, and the level of responsibility they had, made for a far better experience all round.

I probably felt more comfortable about my experience in the big hospital not only because it was a good big hospital (it is) but because I had spent a lot of time in the ante-natal ward, and felt I knew people, even the cleaners were excited when the date for my birth came round.

I suppose that's one of the very few upsides of a difficult pregnancy, Cory! I was admitted a couple of times while carrying ds but didn't get to know anyone involved in the delivery or post-natal care.

I was offered the oppportunity of a home birth with DS but turned it down immediately. I lived, at the time, in a very small cramped flat, no room for a birthing pool, nor did I want to have to clear up afterwards...
Also, being 39 at the time, with high blood pressure and a history of back problems, I wanted to be in a hospital thanks.
As it was, though I was induced (soaring BP) and had to be monitored, one midwife was nice enough to tell me I didn't actually have to lie flat with the monitors on, and could stand up, bounce a bit or pace (n admitteldy bery small circle cos of the wires). And I got through with G&A.
I am not anti-intervention, am more exasperated with the loony end of lentil weaving (freebirthers are fucking nutters).

greapefruitmoon, i doubt very much that a woman would turn down a life saving intervention on the basis of a thread on MN. sometimes babies are stillborn, sometimes there is a reason, other times, not. It is absolute tragedy.

I think there is a balance to be had between going on the conveyor belt of the hospital policy and burying your head in the sand as to any real and present dangers

i do also find the concept of free birthing paticularly if no ante natal care has been taken, frightening and selfish.

I am a big proponent of informed choice.. do some reading, do some research, you are allowed to ask questions, ask for compromise and discuss your care with your caregivers.

you do not have to have a sweep at term + 7 or have an induction at term + 10 without a compelling medical reason

you are allowed to say no. or maybe!

apologies to mspotatochip:

It really struck me after my unsuccessful induction for pre eclampsia at just gone 38 weeks that eventhough I lived in a country with a well developed maternity service, i could have died! The post traumatic stress which I suffered thereafter was less down to medical technology (treating pre-eclampsia and induction are v. low tech) and more to do with a lack bit of humanity in the system and too much of 'well we did everything within policy and you are still alive, so what is your problem' attitude. Focuses the mind!

so I informed myself and had a home birth the next time round. I refused an sweep at 40+7 and had a totally normal if fast delivery. DD2 arrived 5 minutes before that midwives. I would not do it any different again if I had my druthers.

Interventions when unnecessary are so disempowering to all women - as if it's been decided that no one can cope, and we all have to have medical help right from the beginning. Women are supposedly able to have a choice in all things, but are being scared into going with the highest amount of medical intervention whether needed or not.

Is it really so hard, Yellowspots and aBetaDad, to understand that intelligent women can be in favour of doing everything to help birth be the natural process it is when things go well, whilst still being incredibly impressed with modern science and very grateful of it when it is needed?

Blu - that's exactly how I feel.

What SoH said

I ahd interbentions with ds1 or we would have been dead- I ahd eclampsia (not even the pre kids)-scary,. But I ahven't needed intervention since and hence a HB was wonderful for me.

Which I had to fight for,mbecuase looking at goodr esearch showed me I was low risk.

'feel the same thing has driven the cult of organic food, cloth nappies, extended breast feeding (past 1 year)' I'll sign up to that cult then Surely waht moernity should ahve brought us is the right to choose? I want to choose these things, there is no isk to my DC's- why on earth not?

I had a hospital birth with ds1 - i was induced at 38 weeks for small growth - the delivery itself not too bad but the aftercare was horrendous.

DS2 was born at home but after advise not to HB - the Consultant lied to me several times and only backed down when i questionned her.

DS3 was also born at home - again advised not to - this time because i had gestational diabetes (apparently) but Consultant absolutely refused to listen to my point of view - told me i would be transferred to the high tech room - very likely on constant monitoring, and at 60% increased risk of CS - i had a 7lb 13oz boy at home with gas & air and we were all perfectly fine - i refused his intervention because i knew my body better and i did not trust them - they LIE to suit themselves and their own agenda. If there was not a complete lack of trust then maybe i would have gone into Hospital - but they refused to acknowledge anything i said to them and treated me as though i was stupid

Oh and as an aside I think there's a massive difference betwen olden days birthing with risk or puerperalfever so high / no options if problems and comfortbale, relaxed birthing in a minimum interventionw ay with the option of a 7 minute blue light trip to neasrest A&E unit with a scbu . When I ahd the exlampia ds1 showed worrying signs but they had lost my bloods, theatre and Paed were busy and it was mainly luck and a naturally rapid second satge that saved him (us?). I had been miosdiagnosed as 'anxious'as I had an atypical form of Pre-eclampsia. As a HB Mum I as monitored closely, had 2 dedicated MW's and a Doula (OK should have, best laid plans / rapid babies tec- wouldnt have made it to hospital anyway). So instead of being delievered in a ward with many women and few MW's, or more likely with ds4 in a layby outside Tesco garage, he was born athome with oxygen etc close by- for us it was the safest option.

I lost a baby shortly after birth last year. She collapsed and stopped breathing a couple of hours after she was born, was resusitated and taken to SCBU. When she was five days old, we had to make the decision to turn off her life support as she had sustained brain damage meaning she couldn't support her airway.
We never found out why. To all intents and purposes she was a perfect little girl. There was a full PM at the request of the coroner - nothing.
Despite all this I am still opposed to quite a lot of medical intervention. I would never be induced again (can't anyway in most places, my first was born by CS). I wouldn't even have a sweep. I reluctantly had continual monitoring during Caitlin's birth, but am glad I had it now, as it reinforces the fact it was 'just one of those things' and that it seems nobody could have helped it. But I can see quite clearly why people refuse it - I nearly did.
I was lucky to have good care throughout (and so was Caitie, for the short amount of time she was with us) from a consultant and midwife who were supportive of my desire for a VBAC and my refusing induction. If I have another baby, which I hope I will, of course I will be scared - but I will still think that waiting for spontaneous labour is best (I've had two post-42 weekers and most of my family are the same!)
I honestly don't think that anyone, in the heat of the moment, would turn down a potentially life-saving intervention on the basis that a bunch of strangers on the internet told her to.
Blu's post at 13.20 is one I agree with 100%.

Thanks for raising this. I had a high risk pregnancy due to type 1 diabetes and knew from the start that my hospital's policy was to induce at 39 weeks. I knew this meant my chances of a csec was raised. I called the nct to try and speak to other mothers with my condition because the major difficulties are more with coping during pregnancy rather than childbirth. They were unable to put me in touch with anyone but spent 10 minutes trying to convince me that it was my choice whether to be induced or not and I could refuse.

While obviously I could have said no to the induction it would not have been on the basis of one person who knew nothing about my condition and why it has been deemed by those with knowledge of it to require routine early induction.

Since giving birth and having a failed induction and csec I'm reluctant to go down the same route again. But the way I will play the system will be by trying to find the hospital whose policies allow the latest due date and the best chances of labouring naturally. Not by point blank refusing any intervention. Because at the end of the day what I want is a healthy baby and healthy mother and if there's a choice between the two I will take a risk of incapacitation on my behalf over the health of the baby.

Certainly there is an overreliance on intervention in certain circumstances because it's easier to cope with too many women if you keep them sedated and hooked to machines. That is due to the failings of the system and can only be resolved by more funding and more midwives. And post-natal wards are shamefully understaffed. But intervention when used correctly is a life-saver and just because it is wrong for one person it is not necessarily wrong for another. The difficulty is working out which person you are.

Some of the lives saved, were only at risk in the first place because of unnecessary medical intervention!

Right, now off to read the thread.....

I agree with the OP.

I was advised to be induced 'at some point over the weekend' with DD1 (it was Friday lunchtime) because she was

lulumama, in the case I'm thinking of I think the person was being advised to have a c-section by medical professionals but wanted to have a vaginal birth and was being encouraged to do so by other posters... it wasn't a case of turning down emergency intervention. I don't really want to say any more in case the person still posts and it upsets her...

I gave birth 11 days ago and probably had every drug they could throw at, plus was continuously monitored as meconium in waters and ended up with emergency c-section when ds's heartrate dropped.

TBH, I couldn't care less about the amount of intervention. Drugs made the pain go away, the staff were fantastic, keeping me informed and calm every step of the way, and despite it all going a bit 'ER' at the end I never felt frightened or out of control. And ds was perfect.

I'm afraid I've become rather pro-intervention now.....!