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.

Can I also put in a plug for AIMS here? www.aims.org.uk

I do like Walsh' original article but I do agree that if you have technocratic birth model in place that you can't simply withdraw the pain relief, and I don't really believe he is arguing for that.

I had two horrendously painful birth experiences where I used everything going, both ending in emergency cs followed by a co-erced cs followed by a home waterbirth. I chose,and eventually paid for an IM so I could try for, a birth without pain relief (other than birth pool which was actually brilliant pain relief). I didn't do it to feel superior but my belief system was that if I was supported well and in an environment where I felt safe I would not be in significant pain. That is not new research it has been around since NCT started fifty plus years ago, indeed formed the basis for its inception.

The scenario Walsh opens with is interesting and I think he does acknowledge the dilemma it raises for the midwife because at transition I think a lot of women would say/yell give me an epidural but there is rarely time and it could completely alter the course of the labour AND once in active second stage many women are then feeling back in control and don't want epidural. So is the midwife's role to rush out and get an anaesthetist knowing that this will double the mother's risk of needing forceps/ventouse? Or does he/she listen to what is behind the yell for an epidural? Does he/she reassure, help mum find a comfortable position, help her get thru what might be a difficult half hour but ultimately help her to a place where she no longer wants that kind of pain relief?

I think Walsh got well and truly done over by lazy journalists and I wish Mumsnet would invite him to a debate here.

I've taught antenatal classes for 10 years and most women I've met when they've looked at the evidence around pain relief when pregnant have wanted to avoid epidural. The problem is that we don't promote home birth nor have birth environments nor one to one midwifery care which would help put this into practice. Furthermore our culture constantly puts out the message that birth is always agonising, difficult, dangerous and we couldn't or shouldn't even think about doing it without help be it doctors, instruments and pharmacology.

I was just at NCT conference in Swansea where there was a midwife talking about how in her part of Wales they had increased the homebirth rate from 2% to 12% - their average labour for first time mothers at a homebirth or in midwife led unit was 8 hours!!! They weren't denying mothers pain relief, they simply didn't want or need it. NCT has campaigned, is still campaigning for that sort of care for all low risk women who want it but we would never campaign against pain relief for those who want or need it and if you are giving birth in a consultant obstetric unit on your own for hours on end or being induced then you probably are going to need it.

Walsh has been criticised for not being a woman and not understanding what it feels like but another problem with the whole debate is that everyone's experience is unique and we need to respect everyone comes to birth with different belief systems. What frustrates me most as an antenatal teacher is not the woman who makes an informed choice to have an epidural from the off but the woman who desperately wants to avoid one but cannot do so because the system won't support her to do so and who ends up with a whole cascade of interventions and then blames her own body for failing her when its the system that failed her.

Sorry, long and rambly musings.

Jenny

I found this really interesting if you can get past the fact that the reporter has grabbed part of his message to make a great headline out of it.

As I understand it, the pain of childbirth causes a massive release of endorphins. When the baby is born the pain is largely relieved, instantaneously, and so the body is left with astronomical levels of endorphins but no pain to counteract them, which contributes to euphoric feelings, and therefore aids bonding.

Pain is also normal, and as a senior HCP he's going to have the pressures of limited resources on him. The cost and logistics of having to provide the skills, facilities and drugs women are requesting in labour must be very challenging.

I think it is a woman's absolute right to know and to choose but I agree with his sentiment that there is an awful lot of fear and that's not constructive, it just means a lot of women want to be numb.

How many of you eat eggs, by the way?

TThis might be slightly off point but did anyone else feel loved up to the point of wanting to jump their partner during labour?? Or was it just an unnaturally high surge of hormones and endorphins while I in labour with DD??

No, definitely did not feel the love

MaternalTouch - "I do agree that if you have technocratic birth model in place that you can't simply withdraw the pain relief, and I don't really believe he is arguing for that." The trouble is, unbelievable as it seems, that is actually what he argues for.

I think that's what got this lecture so much publicity. He looks at first glance like an ally of the natural birth, low intervention movement (to which I'm very much signed up). However, when you look at what he's actually saying, he comes as much from a coercive, women should do what they're told perspective as the strap'em on the beds crew.

He uses all kinds of rhetorical devices, like the straw man of a mother at transition asking for pain relief and the idea that women are influenced by 'celeb' births, to belittle women's abilities to judge for themselves what they need.

I think the NCT, homebirth movements etc have come from a fundamentally different philosophical direction, which aims to take back decisions and control for birthing mothers.

No, no, can't say I felt the love, either.

loved up ? nope ,if my dh had so much as breathed hard in my direction he would be a dead man

NHS Blog Doctor has a piece about this. He doesn't attribute the quote to anyone in particular, just a generic "Mumsnet" and a link to this thread, including the immortal line:

And yet I still think the man is a twat.

Nope, didn't feel the luuuurve.

Would just also add that I'm a bit at the posts which suggest women who have natural births are gaia-worshipping lentil-weaving hippies. I have never met a woman who decided against an epidural because she worships the earth goddess. Most women I know who don't want them, choose to go without because epidural increases the risks of medical interventions for the baby.