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.

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

Interesting. These things happen with or without pain relief - or certainly they happened to me. And I had an epidural.

This piece probably has been misrepresented by the media (oh, what a suprise) but there are enough direct quotes like the one Soupy has added that are enough to make you go .

Like I said, I was at a conference last week talking about pain, with the leading scientists there. The idea that pain in labour has a purpose rather than simply being a biproduct of the process is highly questionable. And suggests to me that this is a statement of his opinion which he is representing as medical fact. That is unacceptable for someone at such a level of inflence and responsiblity.

I will have a look at the paper proper when I get the time, but I am running up against a deadline myself.

Violethill, I have read the whole presentation. And while I think it tackles some important issues, such as proper support so that more women don't reach the stage where an epidural is necessary, I dont feel at all that it's 'a superb presentation, which looks honestly and openly at all aspects of giving birth'. Where is the evidence that women are more afraid nowadays of giving birth than they ever were? Maybe I'm wrong, but I'm not aware there were any large-scale studies in Victorian times or in the early 20th century on women's attitudes to giving birth. In the absence of these, I've just reached for my copy of Lewis Grassic Gibbon's 'Sunset Song', which was published in 1932, during that golden age when women were less afraid of giving birth than they are now. And yes, this novel is just based on one person's opinion, but it deals in depth with issues surrounding childbirth and its effects on the main protagonists and their relationships in rural Scotland in the 30s. And it seems to show that childbirth was a major fear for at least some women. Towards the start of the book, Chris's mother kills herself and her baby twins on realising that she's pregnant for the sixth time. Later on, Chris's own fear of childbirth is a factor in the breakdown of her relationship with her first husband. In the 1930s. Yes.

I also don't think that quoting one woman on her experience is being 'very honest about the pain' - he could at least have balanced it out by quoting several different experiences, including perhaps someone who was left with PTSD and/or severe injuries and someone who experienced very little pain at all.

I have 15 years of experience of pain myself, mainly due to medical conditions and extensive surgery. It's my (subjective) experience that often people who are very used to dealing with pain themselves, even if they themselves cope well with it, will be very wary of wanting to dicatate to others exactly how much they should suffer and what sort of spiritual experience it should be for them. Conversely, those who don't have to cope wiith it regularly are sometimes more blasee (sp. without accents?) about what they think other people should be able to cope with. That's not to say that all people who don't regularly experience pain can't empathise. And if it's a spiritual experience and a rite of passage for some people, then I'm very pleased for them (hope that doesn't read as sarcastic, because it's not meant that way!) But personally, I can't believe that this man has much personal experience of pain, otherwise I think he would have worded his presentation a bit differently.

I also don't buy the rite of passage thing - in some cultures circumcision without any sort of pain relief is an essential rite of passage for both boys and girls.

Again, I think the presentation raises some valid points. But it would be far better to concentrate on appropriate, one-to-one support and assistance for all women, to maximise the number who can give birth without needing extra intervention, rather than making subjective (and in some cases offensive) judgements on what people should or shouldn't be able to endure.

I have two children both given birth to without so much as a paracetamol, my birth plan said "give me drugs drugs and more drugs" but kids had other ideas ds1 15 minutes to be born DS2 I walked in to the hospital at 8.30 am he arrived at 8.49am

i think the issue of cognitive male perspective bias is crucial here.

Dr Denis Walsh, for example, is a twat

Rather than improve the quality of midwifery care and so improve womens experiences in childbirth, he's basically suggesting women put up and shut up. Do you think he's been pushed to reduce intervention without the necessary budget to actually achieve that?

Is there any other occasion where people are meant to deal with so much pain without resorting to the best drugs you can get?

Great post, Vigilante!

I agree, MT.

This chap's never even gone through the pain of a very bad period, much less childbirth.

Would you buy a car from someone who doesn't even know how to drive?

absolutely agree with everyone who is saying that the NHS needs to get its house in order regarding maternity services, midwife ratios, proper support in labour, before they start denying women pain relief. personally i think the system would almost collapse without epidurals, pethidine etc as they tend to keep a labouring woman quiet and comfortable while the midwives attend to their other patients.

and i speak as someone given diamorphine to basically shut me up as i laboured on a packed ward during visiting hours - i was upsetting the other patients!

I think a suprising number of midwives are childless, apart from anything else it's a hard job to fit childcare round. Out of all of my NHS midwives only one had children and they were grown up, the rest were childless.

My independent midwives all had children.

I wonder if we have all lost sight of the natural world..
Everything seems so medical these days, we can choose to look after ourselves diet, exercise, not smoking/drinking etc. during pregnancy. Keeping the birth as natural as possible, breastfeeding, etc.
but not all women choose to do this, when things go wrong it seems they are eager to blame someone other than themselves.

Childbirth is a natural process, bodies know what to do , there are sound reasons for vaginal births & breastfeeding not only for the infant but for the mothers too..

We are fortunate in this country to have medical interventions should the need arise & sometimes this may be the case.

He's NOT the Chief Midwife BTW. The Chief Nursing Officer is Christine Beasley, who covers maternity.

I read the presentation. I mostly agree with him. It would certainly give his argument more credibilty if it written by someone who had actually experienced childbirth, though.

Observer piece is not good though, some of the quotes here are really silly and guaranteed to infuriate lots of women. As indeed they have. 'Some just don't fancy the pain' Silly, silly.
"In the west it has never been safer to have a baby, yet it appears that women have never been more frightened of the processes," sounds like nonesense to me, I would think women were more frightened of childbirth when they were very likely to die from it.

sigh.

I used only a little bit of gas and air in both my labours as I was keen to avoid anything stronger and the associated risk of further intervention. That said, I was roaring for an epidural just before each of them were born, at which point it was obviously too late.
I realise I am very very lucky to have a high pain threshold. If some women feel the level of anxiety and pain that I felt in those final moments at the beginning of their labours, the thought that they could be refused adequate pain relief is barbaric.

It's not his fault that he's male and can't experience childbirth though! It's a cheap shot to use that against him. Fair enough if you disagree with some aspects of what he says, but don't berate him for being a man.

I agree with lockets post. I think the idea of pain being helpful to prepare you for the reality of caring for an infant is questionable. IME most women who feel strongly that they want to go for a natural birth if possible, the main factor is the increased risks of epidural to baby and mother, which the doctor describes. That was certainly my experience. I didn't choose to go without epidural because I have some kind of pain fetish, or because I wanted to try to have an orgasm during birth (believe me, that would have been the last thing on my mind!) or because I thought it would better prepare me for sleepless night. I went for natural birth because I wanted to reduce the risks of medical intervention as far as possible.

The rite of passage aspect is interesting, but I think you need to see it for what it is. A rite of passage -the transition from one phase of your life to another - is absolutely what childbirth is. Don't confuse that with the traditions, such as circumcision, which some cultures use to mark some rites of passage.

Maybe this is a little off point but perhaps someone can help me. Ideally, I would like to not have an epidural if I don't need one. But I have been told that once you desperately need one sometimes the anaethetist (sp?) can be so busy that it takes hours (my friend waiting 3.5 hours!) to get one by which points you are almost dying from the pain. So I have been advised to ask for one early so that I get on "the list." Do you think this is why so many women have epidurals when they may not have needed them?

Also, where are these hospitals you speak of that practically force you to have them? I have heard only the opposite from my friends who have given birth. And indeed, my midwife told me that the midwife on duty might use "delaying tactics" to avoid me having an epidural.

"It's not his fault that he's male and can't experience childbirth though!"

No it's not but he should shut up about stuff he simply can not understand. He can never have any idea what the pain of childbirth is like so he really shouldn't be commenting on it. Ditto child-free MWs - they may be fabulous at their job but they don't have any idea of the pain.

I think it detracts from the credibility of his argument that he hasn't actually experienced childbirth.

It's because pain is a very personal thing and impossible to quantify to someone else that makes him lack credibility in that area - a person doesn't need to have given birth in order to be a damn good midwife but they do need to have done it in order to comment on the pain and how to deal with it.

I think we're going down a very dangerous route if we're saying people should only be 'allowed' to comment on things they have experienced first hand. Yes, sure, he might have a different persepctive if he was a woman who had given birth. But even then, his experience would be a personal one. It might be hugely different to other peoples. If he was a woman who had only given birth with epidural, would you say he can't comment on natural childbirth? Can only a female surgeon who has had a Csection herself have an opinion on csections? I think you have to respect the fact that this man is a specialist, he has researched this issue extensively, and has concluded that women should have far better support antenatally and during labour to help them to achieve a natural birth in the cases where this is possible.

Of course, there will always be some women who opt for a medicalised birth, not out of medical need, but personal preference. And I don't think anyone is saying they should be denied the choice.

chaya5738 - I think your post may get lost on here. Perhaps start a thread, i'm sure you will get some advice and support.
Congrats on your pregnancy.

'There is no tyrant as merciless as pain . . .'

-Stephen King, Duma Key (I daresay Mr King learned this the hard way)

Of course he's 'allowed' to comment on things he hasn't experienced, but experience can be helpful. If is his ultimate aim is to encourage and support women to have a natural labour without epidural where possible, then his point would be much better made without ridiculous comments such as 'some women just don't fancy the pain' in the national press.

Oh I entirely agree with that last point Thursday. But then I'm absolutely sure that he had no control over the that riduculous phrase.

Bottom line is, epidural is an invasive, medical procedure which carries risks to baby and mother. In some cases, there is a medical issue in favour of having an epidural which outweighs those risks. In some cases, a woman weighs up the risks and decides she wants an epidural anyway. In some cases, the woman intends to have a natural birth, but cannot cope with the pain so opts for an epidural. These are personal situations, and it's not about attaching a value judgement to them. The doctor is simply suggesting how an improvement in the level of support and care before and after birth could maybe enable some of those women in the last group to achieve the natural birth they hoped for. It's not about denying choice to women who don't want to try for a natural birth in the first place, it's about supporting those who do.

violet, do you think the direct quotes in the Observer are not accurate, or are they probably just out of context? Because if they are accurate but out of context, then I still think he should know better. It's potentially counterproductive.