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.

Well whatever he meant to say I don't think he's put it across very well.

"A large number of women want to avoid pain. Some just don't fancy the pain [of childbirth]. More women should be prepared to withstand pain," he told the Observer. "Pain in labour is a purposeful, useful thing, which has quite a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby."

Is it odd to want to avoid pain or not fancy it?

While pain in labour might be useful/purposeful (debatable)I can't see how it's useful for preparing a mother for the responsibility of nurturing a newborn baby.

I would imagine (or hope anyway!) that someone in such an eminent position and obviously intelligent would know better than to make those comments Thursday, so I would imagine it's a typical case of journalism. Bend what's been said a bit, and you whip up more of a story!

As I've said, juule, I think the idea of pain preparing you for nurturing an infant is questionable. But there can be no doubt that the pain of childbirth is purposeful - the purpose is that the muscles need to contract to push the baby out! Many women who go without epidural do so because they want to be able to feel properly to actively push the baby out, and thereby minimise the risk of forceps, longer labour, risks to baby etc. That's quite straightforward. Doesn't mean they enjoy the pain, or want it. I would have preferred labour and birth to be an entirely painless procedure, languishing on my bed for an hour or so before popping out a perfect newborn! But it ain't like that! So, like many other women, I weighed up the pros and cons of various forms of pain relief, and decided to try for a natural birth.

I don't agree that the pain is purposeful at all! The pain simply coincides with childbirth (for obvious reasons) but that does mean we NEED the pain to give birth. Our bodies could be designed in such a way that we could push babies out without pain. It is just a shame that they are not.

Some women do have painless childbirth (without pain relief),don't they?

Interestingly every woman I know who either works as a nurse/midwife or whose partner works as a medic have had either epidurals (planned befoehand)or a planned C-section.

The last thing I wanted was an epidural tbh, the very thought freaked me out, with DS1 after 48hours of labour and 4 hours of pushing going nowhere fast I quickly got over my fear of needles into my back.

I find that odd too lizzy - it's also my experience that medic I know tend to have the most medicalised births!! But then I guess they have seen more women in extreme pain than most of us have, and don't want to go through that!

I'm not really sure why in order to 'mark the occasion' or experience a 'rite of passage' or 'heightened spirituality' childbirth has to happen without epidural or other pain relieving drugs? It seems dangerously close to saying that women who have pain relief are missing out on some part of the process which is essential to their or their child's wellbeing.

And for those who have talked of not wanting to give birth in a 'fog' of drugs, having had two epidurals myself I can assure them that my mind was beautifully clear after the epidurals, and I have the most wonderful clear memories of both my DSs being lifted out and meeting them for the first time (two EMCS). The bit before the epidurals though, is a fog of pain in my memory.

Or perhaps, as my paediatrician friend says, they have seen many many births go wrong, and have decided that epidurals are the safest/least traumatic option?

It's all very well saying that epidurals carry a risk for the mother and the baby, of course they do. Birth is dangerous in general. Incontinence, loss of sexual function, haemorrhaging, permanent pain, etc etc, and that's just for the mother. 'Natural' birth is not risk free, let's face it.

Give people all the information they need to make an informed choice, and then let them get on with it, without patronising us or telling us what we can and can't cope with.

"there can be no doubt that the pain of childbirth is purposeful - the purpose is that the muscles need to contract to push the baby out"

I would say that is doubtful. Do other animals experience such pain as humans do giving birth? Having watched a friend's cat deliver 5 kittens and remain purring throughout, I don't think so. When other muscles contract it doesn't hurt. The pain is unnecessary from that point of view.

Of course there is a risk with all births. But the information shows that all things being equal (ie no medical issues which would indicate an epidural is preferable) then natural childbirth is safer. You can't deny that fact. We may all have anecdotes about the people having dreadful natural births and haemorraghing, or people have wonderful medicalised births, but the statistics indicate that overall, natural birth is safer for baby and mother.

Incidentally, I've never heard anyone say that having an epidural creates a 'fog' or 'fuzziness' - I've heard that of other drugs like pethidine, but as far as I was concerned, my main reason for avoiding an epidural was nothing to do with fugging up my brain. It was about not wanting to be numbed up and unable to feel the contractions and increasing the risk of interventions.

Soupdragon - whether or not other mammals feel pain in the same way is beside the point! (Though I have seen a few animals give birth and they appeared to be in some pain). The fact is, humans do feel pain during childbirth. Yes, we'd all like it not to hurt, but the reality is that it does, because of the muscles contracting. Uterine muscles contracting does hurt. A baby descending into the vagina does hurt. And a baby exiting the vagina hurts most of all! I think it's unhelpful for people to assume that hordes of women really somehow 'enjoy' the pain, because in all honesty I have never met anyone who does. I have met a few, and I mean a very few, who say afterwards that they didn't find it as painful as expected, but most women I know (myself included) would say it's the most extreme pain they've ever been in.

I chose not to have an epidural due to hearing there was an increased risk of intervention and also because, being a worrier, I knew that every ache and pain in my back or every headache I ever had after I would probably worry was caused by a needle into my back.

And for some of my labours/deliveries I have definitely been in worse pain (uveitis and dental problem)

Put that wrong. Meant to say that the labour/deliveries were less painful than the uveitis and dental problem.

There is no need for it to hurt though. Muscles can contract without pain so what is the purpose? Having skin cut hurts but no one suggests that you have surgery with no anaesthetic.

I've never had an epidural (did need with ds1 but no anaesthetist- need from a medical perspective as much as want, didn't need or want with subsequent births).

And yet I still think the man is a twat.

What prepares women best for the first few months of parenthood- where bonding vies for equalpalce with sleeplessness, nappies and a whole new life- is being able to face that without having to also deal with severe PTSD, and the resultant possible post natal stress. It's not soemthing all women experience but is is what some poeple do (a browse through birth stories on here can make for enlightening reaidng if you've been as lucky with your births as I have been).

Absolutely women who want and are able to go without meds should be supported but taking the option away is mysogynistic crappery at its nest. Woulod he ahve a vasectomy sans pain relief? Would he even have a headache without an aspirin FFS?

Agree Soupdragon, there is no apparent purpose to the pain.

I would be too frightened to have an epidural-you hear terrible stories about them.

" I think it's unhelpful for people to assume that hordes of women really somehow 'enjoy' the pain". I admit that I didn't enjoy the pain, and that I most certainly wanted it over. But I can honsetly say that the pain was not something I felt I wanted taken away from me completely - because to me the pain was telling me what my body was doing. Lessened maybe (by use of Tens and "mild analgesiscs - paracetamol and codeine"), but the pain actually enabled me to stay in control IMO.

I didn't enjoy it, it was painful, but it was just a necessary part of labour and childbirth for me. And I acknowledge that is my opinion and for others an epidural is a necessary part of childbirth for them.

I think 'purposeful' issue is a question of semantics now! Yes, in an ideal world, the uterine muscles would contract painlessly, and the vagina would expand painlessly and then snap back instantly! But that's not the reality. The purpose of the muscles contracting is to push the baby out. Unfortunately, that's a painful process. So, the pain doesn't serve a purpose in itself but the muscles contracting definitely does.

This seems to have turned into a debate about whether women should be allowed to have pain relief if they want it, which wasn't what the OP was about. If women want an epidural, they should be allowed to have one. The fact remains though, that two thirds of births are without epidural, and many women have strong feelings about not wanting one due to the risks involved, and I'm entirely in agreement that women should be supported before and after birth to achieve a natural birth if that's what they want.

soupdragon... cats have a shockingly high pain threshold, i held my cat in my arms while the vet rooted around pulling out stitches and hauling out clumps of fur with them. i've gone at other cats with tweezers for various reasons and none of them have reacted much to it.

yet that same cat who barely reacted to a vet tweezering stitches out, who woke up from being spayed and jumped out of a travel cot, climbed on a couch and lay on her open wound (any c-section ladies that were that active 4 hours after the op?) yowled and hissed and was in obvious pain while giving birth... in fact her behaviour was much like mine during birth... lots of moving around and repositioning and groaning and straining

i don't think animals have pain free births, i think they simply do not become completely petrified when dealing with pain like most humans do. i've seen cats with legs smashed to pieces by cars that merely hissed at anyone who came close... most humans would be screaming in agony from similar injuries.

i think acceptance of pain brings alot of relief in itself... i've suffered life long chronic migraines that painkillers are completely useless against... i learned by about 4/5 years old that the easiest way to cope was simply to let the pain envelope me (that either makes sense or it doesn't, i can't explain it any better)

I do know what you mean, pinktulips. When I hit the excruciating, wanting to die, phase of contractions, I kind of 'went in on myself', found a space in my head, where I wasn't trying to resist the pain any more, but accepting that it was there, it was real. Animals often physically find a space they feel comfortable and safe in if they are in pain. They shut themself off. That's why I'm not a fan of large hospitals for giving birth. To me, the idea of lying on a bed in a huge impersonal building with various medics who you've never seen in your life before, coming and going... it's just not conducive to a positive birth experience in my opinion.

Well, I've read his presentation (but bearing in mind that it was bullet points and not the text of his speech that went with it. Even if the quotes by the paper were taken out of context, some of them are pretty (such as the pain helping with bonding etc).

Much of what he presents makes sense, and in an ideal world of course we'd love better access to natural ways that help deal with the pain. And yes, there probably is a worryingly high number of epidurals compared to however many years ago.

He's entitled to his opinion, but I'd be pretty annoyed if a woman made these same comments to be honest, the fact that he's a bloke does diminish his argument to an extent as someone has already said.

I weighed up the pros and cons, opted for a natural birth, but circumstances dictated otherwise. I have never had a problem bonding with my children and I was fortunate enough to not find breastfeeding difficult. So I do resent a lot of his implications, yes.

I don't like the way 'bonding' is presented as if it's some task a woman has to achieve - as if the midwife is going to come round with a checklist:
Is baby alert?
Is baby feeding well
Has the mother bonded?

Seems terribly reductionist and patronising. A traumatic birth where a woman is let down by the midwives and medical staff, can, of course, affect her experience of early motherhood. But it's patronising in the extreme to talk about 'bonding' as if it's an order.

I agree with that edam. I think bonding is something that's impossible to measure anyway. A woman knows how she feels, it's a subjective thing.

I would feel far happier tbh if the article stuck to the purely medical issues, which can be measured.

IME, women don't tend to think 'Ooh I'll go without epidural because I'll bond so much better with my baby.' They choose to go without because of the associated medical risks.

The title of this thread does not reflect the views of this leading midwife.

With more support, better staffing, and better listening to mothers, more mothers would manage to give birth without, or with less, pain relief. This would be a good thing as recovery is likely to be quicker and the risk of interventions is lessened.

Of course pain relief is necessary, and in fact in some cases, pain relief makes recovery quicker as the mother is not having to get over an unbearably painful experience.

But speaking generally, better midwifery and peri-natal support will reduce the need for pain relief.

Giving birth was excruciatingly painful for me twice out of thrice (third time, home birth, was not as painful). The worst pain I have ever experienced.

But my choice was to deal with this without drugs as I did not want the lack of control and the risks that come with any form of pain relief beyond gas and air. I don't think I am superwoman or better than anyone else or braver - not at all. I know there are births that are a lot more painful than mine, too.

But I want that choice to avoid drugs preserved for my daughters and for other women, and it won't be if epidurals become more and more normal