Chief midwife tells women that they should endure the pain of natural childbirth

[MissM]

Here.

It's too early in the morning to get my blood pressure up, but my response was off. Have you ever felt like you were going to split in two? No, because you're a man, and you've never bloody given birth!

Tosser.

I guess I think that the luck of the draw plays a bigger part in it than you do. I agree with you totally about the cultural norms that can make something like natural birth or breastfeeding harder (and broadly agree with you on both things about how to make it easier). But I still think that there is a huge amount of circumstance in any birth. I went into my first birth wanting a natural drug free birth, which I didn't have. Yet I feel I struggled and overcame more with that birth than my second, where I also wanted a drug free birth. Why should that one be celebrated?
If the same circimstances had arisen in that one, I would have had an epidural again.

It doesn't really matter anyway, because the most important part is that maternity services are improved in such as way that it does make it easier for drug free births, if that's what the mother would like to aim for.

Celebrate both your births, peppa, for different reasons!

I don't think the Walsh furore is about whether epidurals or gas&air or nothing are intrinsically the 'best' form of birth. Lots is known about the risks and benefits of all kinds of birth interventions.

It's about who holds the power in the birthing room. Pregnant and birthing women are vulnerable, physically and psychologically, and it's easy for non-sympathetic professionals to take control away from them.

Walsh's paper is couched in shadowy language, but the crux of what he's doing is questioning whether epidurals should be electively available. Saying the choice should not be ours. So midwives and obstetricians should choose when we get them, not us. In practice we know that's often what happens, because we're fobbed off or delayed, but Walsh says that should be the case.

There's always going to be a tendency for professionals to push their particular speciality. Walsh accuses anaesthetists of raising the epidural rate. You could argue that obstetricians have an incentive to increase intervention and caesarean rates to bolster their importance, get more posts, etc. And for midwives, decreasing epidural rates and increasing the numbers of midwife-led units are obviously advantageous. Walsh himself points out that one reason midwives don't like epidurals is that they reduce them to nurse status.

Of course good professionals manage to provide women-centred births. But the only people who are guaranteed to have the welfare of woman and baby as their only agenda are the birthing mothers. Into their hands the power!

Thanks again Tiktok - that's disappointingly reasonable! I have now found myself wondering how researchers would measure the degree of pain felt during labour, and degree of bonding experienced after birth...

Sounds like there is a degree of consensus that all options should be available.

I heard that services in Germany are very different, with no gas and air available and epidurals only available when other medical interventions were required. Is that true, and does anybody know what German mothers think of the system?

Very much agree with what umf said!

recommends Naomi Wolf's 'Misconceptions' v good book.

umf, I am with you there about women being at the centre of care...the Walsh stance is not mother-centric enough, but instead takes a philosophical view of 'this is how things are and this is why they are like this' and a good 'companion' paper could add to it, explaining how mothers and midwives could work together for a truly supportive birth context wherein the mother has trust in her care-givers, confidence they will listen to her and the consequent strength and power to work with her body...this will mean epidurals for some, but for others, it need not.

tiktok - yes!

tho think that Walsh paper is worse than not mother-centric, in that it attributes far too much blame for imperfect current situation to mothers.

also it scaremongers, eg by extrapolating rise in epidurals into future, when there is no reason to think that will be the case, especially with so many more women now choosing low intervention birth settings.

had better go and play with infant now.

LeninGrad - how stressful!! Fingers and toes crossed for you.

I had the VBAC thing in mind when first read this, because saw something else lately about the irony of women having struggled to be allowed VBACs a few years ago and now being forced to have them even when feel inappropriate.

And blamed in both situations, of course. First for endangering babies and being ideologically wedded to 'natural' ideal. Now for being too posh to push, selfishly using up resources, etc. So much easier to criticise mothers than to look at the structures and incentives in complex services.

Also very impressed with tiktok for responding so calmly throughout on this sensitive topic.

Oh naughty LeninGrad, fancy you thinking childbirth was an emotional experience. Tsk!

Really hope it all works out for you. It shouldn't be this hard!

Are there any organisations out there which are campaigning for better maternity services from an 'informed choice' perspective? Where 'better' means 'what mothers want' closely aligned with 'evidence-based'. With the underlying assumption that mothers are actually rational, well-judging and well-intentioned.

If not, anyone else want to start one with me?

NCT does great job with classes, meet ups etc, and I'm sure their services were the reason I didn't get PND. But they do have their own axe to grind about how births ought to be. And I'm not sure how engaged they are in critique-ing and improving actual services.

Helen, I don't always respond that calmly - got a bit cross last night with the ideas for torture .

umf - NCT is very engaged with improving maternity services. Yes, the axe to grind is that normal birth should be supported and that this involves a challenge to services, resources, training, attitudes. The 'axe' is that there are too many caesarean sections, too much interference, too many interventions. This is not controversial - even the conservative RCOG agrees.

AIMS is also a campaigning organisation that works very hard on behalf of individual women.

www.nct.org.uk/active/

Taster sessions

Well, it is the radical midwives, so presumably the taster sessions feature the oft-quoted eating of the placenta? Not sure I want to know about the orgasmic births - I had a sheltered upbringing!

Many thanks for the suggestions! Great to have constructive discussion.

I read some of the radical midwives' journal when pregnant - v useful. Didn't know anything else about them. Seem great - tho midwives' interests not always 100% aligned with mothers'.

Didn't know about NCT active. Might get involved. But concerned that it's when you move away from an individual informed choice perspective to targets that problems like LeninGrad's VBAC arise?

Well i still think Walsh is right in so many ways ,but then i will be having this baby in a feild in the middle of the night under a full moon ,with only my familiar for company ,and after i shall make a nourishing meal using the placenta of organic rissotto and to follow breast milk rice pudding