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.

AND I had an epidural and still had to endure a huge amount of agony. People need to know that ofren epidural doesn't = pain free!

Pain relief is clearly needed for many women giving birth, in particular when the birth is induced or when the labour and birth are not going as well as it should - because we are all different and some women will have more difficult, longer, more dangerous labours then others. The human body does not always get it right, maybe for most births it will, but not all.

I was lucky in that my body knew what it was doing, and I had good support, and when that happens, a drug free delivery is imo, the best way to give birth. This is not the case for every women, and we would be ignorant in thinking it was.

Like PinkTulips, giving birth naturally did help me bond immediately with my babies, it did prepare me for the pain of breastfeeding which was perhaps worse then giving birth. I didn't need an epidural for the births, but I could have done with one for the after pains and the breastfeeding!

Another natural process, of course, is that of dying. In the olden days it used to be thought that the pain involved was an essential part of the experience, preparing the patient for the other side; any attempt at palliation would therefore be frowned upon. Perhaps the chief midwife would like to go back to that when his time comes. You can't deny that dying is natural, can you?

Again, you can see that with proper support, dying patients can no doubt get through with fewer painkillers. But I'd like to see him argue the case for the benefits of pain in this case.

monkeytrousers - having seen an epidural birth where the woman was scared, exhausted and still in pain, I was put off epidurals.

Let's cut to the chase, shall we?

Epidurals cost more money. Therefore the NHS's agenda is to cut down on them.

I don't mind a bit of honest cost cutting. I do mind being force-fed some hypocritical cant with the objective of persuading me that 18 hours of agony is in my own best interests.

I find myself feeling more and more alienated from midwifes the more they push this romanticised idea of childbirth.

Things have changed so much in hospitals in the last 20 years. I wish they would stop pusing this midwife/obstetric dichotomy. Its just not good for women or babies.

His theory is fine if it is a trouble free labour and birth, but I had no choice, I had a spinal with DS1 as they thought I was going to have an em c/s (a ventouse worked in the end)and an epidural with DS2 (which they stopped at point of pushing) as he was also stuck.

Some women can have natural, drug free labours without intervention, some can't. It is not simply a case that I was a big fat wuss, I needed help.

I never planned on having a ventouse, I wanted a natural,water birth (which didn't happen in the end) and was happy on gas and air.

Normal, natural childbirth cannot be compared to the pain experienced by people who are ill, having surgery or dying. It's not the same thing. If there is such a thing as positive pain, then normal childbirth is an example of it.

What's that Belgo? You have seen "an" epidural birth?

I would also question this idea about bonding and BF. I have had an emcs and elcs and bonded and BF my babies quite happily.

I thought the low BF rates were due to women not being well supported when they started BF/first encountered problems - often on the postnatal wards - not because of pain relief...

There are also plenty of stories on here of women who have been so traumatised by their natural pain relief free births that they have suffered PND and had problems bonding.

The thing he doesn't mention (and that so many natural birth advocates don't mention) is that natural child birth can go horribly wrong and can have consequences for the woman after birth (really bad tears etc) which do nothing to add to the woman's "birth experience".

For people who don't want pain relief, great. Why remove the choice from those who do. When the removal of that choice will likely make them even more scared and thus make their experience of labour worse.

my point, belgo was that dying used to be seen as a positive pain - people wrote instruction manuals on how to die well and make the most of the experience

not all dying is unnatural; when my FIL died in hospital aged 93, it was as natural as you could possibly expect- his body was just giving up, it was clearly what Nature intended- yet they still gave him drugs to help him through the last few days

but 500 years ago, that would have been considered very shocking, that anyone would opt out of the whole death experience

Endure the pain of natural childbirth - I don't think so! I had a planned emergency Caesarean with my first child and was up and about the following day with little pain. Infinitely preferable to second time around when I went into labour and found the pain so excruciatingly awful that I was screaming for an epidural after two hours of contractions. It was the worst pain I've ever experienced and all the active birth classes I took and yogic breathing I practised didn't help me overcome the absolute horror of it. Once the epidural was in I was calmer and happier and, when, in the end, I had to have another emergency Caesarean, I was frankly glad I hadn't gone through six hours of pain-riddled hell all for nothing. I salute all women who can manage intervention-free, drug-free labour, never mind enjoy it, because it was certainly beyond me, but it should be the choice of every woman to go through labour as she wants, not as dictated by fashion, militant midwives or government targets.

I would also question this idea about bonding and BF. My best friend had a TERRIBLE birth, no epidural as it was so busy, forceps, extensive tearing into her bottom. She was in a terrible state, now seeking compensation. She had a very tough time bonding and BF mostly because she was in so much pain months after the birth. I would like to add that she was an A&E nurse working in the same hospital.

I don't think the Prof. was advocating the removal of all pain relief so let's not make wild assumptions about what we think he said. I also agree that intervention leads to more intervention and the whole process then becomes a continuing spiral of drugs and procedures.

However, it needs to be remembered that everyone's pain threshold is different. What might be described as extremely painful but bearable by one woman will be considered agonising by another. I also wonder if what we hear from our female friends and relatives engenders a fear about the pain of childbirth. I can remember being told about the awfulness of various labours and the agonies that were suffered.

When it came to it - I went for a home birth. I swam a great deal while pregnant did regular Pilates/yoga exercises and, during labour, kept upright and mobile although I did use some gas and air towards the end. I'm not claiming to be better or braver than other women but I accepted that giving birth was going to be decidedly uncomfortable and painful. Luckily I had no complications so no life-saving interventions were required.

I'd like to read his original report rather than the second hand reporting of it in this article. The one point I noticed which was almost lost amidst the bobbins, was that he believes 20% of epidurals are unecessary, by which I understand him to mean that he accepts that 80% are necessary interventions. I'm prepared to keep an open mind on that statistic.

My own experience was that I was fully clued up on the benefits of natural childbirth, to the extent that I planned a home water birth with only gas and air, and a doula to help me. However 36 hours after my waters broke, after 24 solid hours of contractions coming at consistent 3-4 minute intervals, I was still only 2cm dilated and subjected to bullying from the midwives to get into hospital to get the baby out, and I utterly lost my ability to continue labouring as I had been. Once in hospital I resorted to yelling at the top of my lungs at the midwife who was refusing me an epidural because I hadn't progessed enough. I did eventually get an epidural, but paid the price for it by then receiving every possible intervention I had wanted to avoid.

So, mixed feelings. I fervently believed in natural childbirth, but absolutely could not go on without help. My body could no more cope with the prolonged labour and failure to progress than it would have been able to run a marathon without training. Epidurals have their place. I for one would like to see the medical teams better educated to be able to use them and yet still assist a woman to be mobile and deliver in a more natural position than on her back with stirrups and then the inevitable ventouse/forceps/CS outcome.

His presentation is interesting
for some of the ideas brought up: eg his rational for experiencing labour pain includes suggestions of benefits for seeking saftey etc which seem fair enough but also such gems as

?Marking the occasion
?Heightening joy
?Catalysing the transition to motherhood
?Generating triumph
?Healing past birth experience
?Awakening spirituality

Do people actually demand these things of childbirth? Do many women just want to have a baby and end up with both as healthy/untraumatised as possible so they can get on with the important business raising and enjoying raising that baby?
Or am I just spiritually dead?

Second point I'll pick up is this one from the slide contrasting the concepts of 'pain relief' and 'working with pain'
Under pain relief we have 'informed choice means all options must be presented' while under the idea of working with pain we have 'informed choice within context of birthing plan and philosophy'
I have so many problems with this: Its essentially paternalistic (or is it maternalistic when done by midwifes?) , we know best, we chose what you need to know, you follow our philosophy.

I think thats what annoys me about him: I get the impression its essentially about not trusting women and their choices: many women, shock horror! might when presented with all the facts make a different choice to the 'philosopy'?. By all means fight for better choices and resources, one to one etc support but please stop pushing an agenda that may not meet the needs and wishes of many.

Oh, and the little note that medicalization of birth stops midwives using their intuition: I personally would rather they were using their skills, intelligence and critical reasonong abilities in the first place!

I am sure there are many who will disagree with this hard line on his presentation and I look forward to their views.

vlc, his presentation (this was from a lecture not an article) is here. I'll stop posting this now. I feel I have stood up for him enough

It's highly likely that some sound judgements by this doctor have been dressed up and messed about with in the name of journalism. So I think we need to take that into account rather than just react by jumping up and down and saying 'ooh he's a man, he doesn't know what it's like!'

The bottom line is, there are increased medical risks with having an epidural. (And it is epidurals he is focusing on). That's not to say a woman shouldn't have one, if she weighs up the risks and decides she still wants to take that route, of if she can't cope with the level of pain. It's a choice. But the statistics show that the use of epidurals has increased hugely over recent years - I was actually quite surprised to see that one third of births are with epidural - I just didn't think it would be that high. And just as with the increased incidence of Csections, surely that's something that's worthy of honest and intelligent debate?

to me childbirth is about getting baby born as safely as possible.

If that can be done and allows mum to have a lovely experience then great but its just not the be all and end all.

safety is the priority.

As for him, someone should stick a grapefruit up his arse, dry, and then ask if he'd have preffered pain relief

I've had two drug free labours (1 hospital birth and 1 homebirth) and i am planning another homebirth in a few weeks.

My first labour lasted 2 hours and the only reason i didn't have any pain relief was because i turned up at the hospital and had my DS 10 minutes later. The second time i had a homebirth and thought i'll see if i can do it again. It lasted 2.5 hours and i managed it.

This time i have got a meptid in the bathroom cupboard and will use it if i feel i need to. I feel i managed without pain relief because my labours were so quick. The pain felt purposeful but only bearable because i knew it would be over quickly.

My recovery was very quick, i had no stiches and was able to breastfeed and bond with my baby. Obviously having no pain relief aided this but i think women should have whatever they need to get them through. I also strongly feel that in both labours i was able to let my body tell me what to do with no interference from anyone else, and had minimal intervention. Despite having two very textbook labours i am still scared to death at the thought of doing it again.

It always amazes me that the top jobs in nursing and midwifery are held by men when the professions must be 90% plus women. I do understand what he is saying and in an ideal world where maternity units had an adequate number of midwives etc it might be more realistic. The truth is it bloody hurts and women should be able to get whatever they feel they need.

just to counter the 'it's all well and good if nothing goes wrong' arguement...

with dd the cord was around her shoulder and her heart rate plummeted, doctors were rushing in and i was told to push before having the urge to do so to save her life. because i could feel everything and my mind was clear i got her out in less than 10 mins from first pushing and her life was saved, any longer might have cost her dearly. i had tiny cuts on my labia, nothing worse.

with ds1 he was back to front, i pushed him out still facing the wrong way with only 3 pushes as i could feel everything and could work with my body. again, only labial grazes.

both those labours were 18 hours long so i was exhausted and by no means had an 'easy' time of it, i'm convinced if i'd had pain relief both those outcomes could have been drastically differant, dd a crash cs and ds1 forceps most likely.

with all three births i went from 5cm to baby out within half an hour as i could feel what my body was doing and work with it.

i think epidurals have a place in cetain circumstances, as do all medical interventions, but they are massively overused as women have been told labour is so painful and terrifying and all control is lost that they are petrified of having to go through it with nothing. however if a woman is taught how to cope with pain then she can make a much better choice during labour about her own personal requirement for pain relief, rather than like so many women i know who decided before they ever got pregnant that they'd need every painkiller going to endure it.

as an aside... birth is not a 'medical procedure', it is a natural process.. granted a painful, messy process but then so are many things in life... it has been turned into a 'procedure' by years of medical over intervention at the cost of the physical and mental wellbeing of mothers and babies.

pingvinger, I've always thought these nursing/midwifery theories sound a bit wnaky, but as the idea seems to be that you should think about what you're doing rather than just doing it because that's the way it's always been I suppose they're a "good thing".

Not sure I agree with paternalistic.

thanks SS, I'll take a look

I agree (having had my mind changed on a recent thread about this) that women should have unfettered access to the pain relief of their choice, so long as there are no compelling medical reasons why they shouldn't.

But, pingviner, I must say that, of the list you transcribed, I definitely experienced the first four (marking the occasion, heightening joy, catalysing the transition to motherhood and generating triumph).

I'm not saying that women can't experience these things if they have epidurals, or CSs, or any other sort of intervention. But I definitely experienced them in spades after my births - which rank as two of the best experiences of my life.

Open the link supplied by shona. Read it in context - not just the newspapers slant on it. It is really interesting and quick to read in the format it's presented in.
He is talking a lot of sense. Definitely not being vindictive, suggesting that women should 'just suffer' etc (unlike the vindictiveness displayed in some of these posts!)
Epidurals carry risks to baby and mother. That's a fact. If you still want one, knowing the risk factors, then that's an individual choice.