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 think the bonding idea is poor, too, violet.

A very painful labour, unrelieved and endured, could affect bonding negatively, anyway.

I don't think we have much evidence to place bonding anywhere in the argument.

I had an epidural 13 years ago and the aneasthetist who administered it was able to gauge the dose such that I was able to feel the contractions and know when to push, but not to feel any pain.

Surely the expertise in administering aneasthesia hasn't regressed in the intervening years? It should be possible to have both effective pain relief and retain awareness and control of the physical process during birth.

In my case an absence of pain relief would have made forceps or more extreme intervention a more, not less likely outcome as I would I would have been in no state to push the baby out "naturally" without the epidural.

The purpose of pain, such as it is, is to tell us when we're in danger of damaging ourselves, or that there's some problem that needs addressing. In the case of childbirth we already know what the problem is - we don't need further pain to alert us to what's going on with our bodies. Therefore the logical response would seem to be to moderate the pain as much as possible. Childbirth does not need to be as painful as it is for many women.

I might add that I went on to bond with my baby and breastfeed up to eight months - despite having a further procedure to remove my placenta followed by a major blood transfusion which meant that she was cared for by the nursing staff for the first 24 hrs or so.

Some women may attach a sense of rite of passage (and no violethill, a rite of passage is not any transition from one phase of life to another, its the formal ritualisation of such a transition - hence "rite") to childbirth for whatever personal reasons - and for these women it may be that endurance of unnecessary pain is associated with the idea of personal accomplishment - but for many of us its just a bodily function, albeit a hugely intrusive and still hazardous one, necessary for bringing children into the world, one which we aim to execute with the minimum possible fuss, bother, pain, discomfort and risk.

The job of medical professionals is to facilitate that process - not to make pronouncements about how the nature of it may affect our future experience of or attitudes to parenthood.

Anyone who openly admits to believing that women in childbirth should ever in any circumstances be subjected to pain and suffering that is at all preventable has no business practicing as midwife

Good post, Zimmy.

However, I agree with Tiktok
"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"

Only because I 'enjoyed' most of my labours and deliveries and would want it to be an option for my daughters. I'm glad that I didn't miss out on such a fantastic experience. And no I'm not a sadist/masochist

If the m/w in the op was advocating more support for women to enable them to do without epidurals then his message was spoiled by the other rubbish he spouted.
It's difficult to take someone seriously who appears to say you need the pain of labour to be able to deal with parenthood.

put him in a corset two sizes too small. Tighten mercilessly each 3 minutes or so whilst simultaneously kicking him in the balls repeatedly. Repeat for 10 - 20 hours. What? It's good for him to experience pain for some spurious made up reason that I haven't thought of yet.

Fuck sake. It doesn't matter how the baby gets out, the important thing is that the mother's wishes are followed as much as possible. A woman will be more likely to be traumatised by a forced natural birth, thereby affecting bonding, rather than a pain managed birth that was her choice.

When he's had teeth out with no pain relief, his balls stretched until they rip and his back pushed into extreme positions then he can say women should give birth with no pain relief.

It's worrying that someone so stupid is a head midwife.

But he's not saying that women 'should' give birth without pain relief or that unbearable pain should be left undealt with.

I heard him on the radio and it was very clear he wasn't saying that.

He is actually being really uncontroversial. More one to one support from midwives, more listening to women, an acknowledgement that pain relief, including epidurals, may have negative consequences, and fewer assumptions about what women 'need'....if we had all that there would be fewer epidurals. Of course there are some labours, and some women, for whom 100 per cent pain relief is essential. And some labours, and some women, for whom 100 per cent pain relief gives a better and far less distressing experience.

But doing without has its own positive side, too.

It seems impossible to have an adult debate about this - dreaming up tortures for him because he is a man and somehow therefore not entitled to a view is juvenile.

And please - no more comparisons with anaesthetic-free dentistry.

It's not the same.

It only serves to make the discussion even more difficult.

Whether people agree with what he's really? trying to say the following don't really help his case though do they, Tiktok

"It's good for women to suffer the pain of a natural birth, says medical chief"

"More women should endure the agony of labour"

"Pain prepares women for the demands of motherhood"

"Patients should be told that labour pain is a timeless component of the "rites of passage" transition to motherhood,"

What a GREAT post Zimmy. You express exactly what I would like to if I had your eloquence.

He was only saying that epidurals aren't a universally good thing. We don't know the long term psychological and physical impact of epidural in childbirth. He wasn't saying that all women should forgo epidurals. Nothing to get worked up about IMO.

The bonding thing is different....we have evidence of the effect of the childbirth experience on bonding and (very much linked) the mother's mental and emotional well-being postnatally.

Basically, a frightening birth experience where the mother was unsupported for a long time, or felt things were 'done' to her, increases the risk of PND and PTSD with consequent negative effects on bonding.

Epidurals do have an effect on the parts of the brain which do the bio-chemical, hormonal support 'bits' of bonding. So giving an epidural might well, in theory, affect this. I don't know of any research that shows this happens in practice, and it would be very hard to demonstrate it. It's going to be massively influenced by other confounding factors, isn't it? I mean, if a woman has an epidural because she has gone beyond the levels of her own ability to cope with the pain, refusing her this choice because of theoretical ideas about bonding is cruel - and her anger and pain might interfere with bonding as well.

Although I think the comparison to dental surgery is possibility misleading, I think a good comparison would be to death. Death is a natural process. People have been dying for thousands of years. It is a transition to a different phase of "life." But we would never expect a person to die without pain relief because it is somehow better for them, pain serves some purpose (ie: to let you know you are dying), and our bodies are well equipt for the pain of death.

The 'pain prepares you for motherhood' is very, very flaky, too, I agree, LeninGrad.

But there is a sliver of truth in it - buried deep.

Giving birth the way you want to, coping with the pain in the way you want to without an epidural so you feel in control in a good way, feeling supported and not 'freakish' in doing what you want to - all that is empowering and good for you. By extension, that's a good start to being a mother.

chaya, poor analogy, sorry.

Childbirth is no closer to the experience of dying than dentistry is.

You might as well say 'you wouldn't expect someone to endure the pain of amputation, so why expect someone to endure the pain of labour?' or 'we don't ask people to cope with heart surgery without anaesthetic, so lets make sure no one has to manage labour without it'.

I agree that the 'pain prepares you for motherhood' line was inappropriate in the context of a policy discussion and undermined his very good points.

But I agree also that there is at least a sliver of truth in it. It is very important to frame pain positively -- that's how we deal with it. and in an ante-natal conversation I want to speak in those terms about the significance of pain. It is disempowering to me as a mother to think of all the tools of pain management being external and medical.

But in a policy conversation with the nation at large it was a little glib and lecturing, and seemed (wrongly) like an underplaying of the need for medical pain relief in some cases.

When I had DS#1 there was a poor woman in the ante-natal ward with the most agonsing headaches and back pain due to a misplaced needle. She was in so much pain she couldnt' deal with her newborn and didn't want painkillers because she was trying to bf. It was terrible. And whilst I appreciate that shouldn't have happened, it just points up the fact that things can go wrong and epis shouldn't be seen as the default setting for normal labours. And that was what he was saying.

I don't think I have ever been so angry when reading a newspaper article before. I kept reading parts out to my DH and nearly exploding with rage.

I thought the worst piece of misogynist s**t (and there were many to choose from) was when he said women need to endure the pain of childbirth as an important "rite of passage" preparing them for motherhood.

I would like to see some actual data on this, but I suspect that if there is a link between going through the worst, most beyond description pain, and feeling love for the little creature thaat caused it, it is more likely to be the other way around. PND and lack of bonding is, as I understand, more likely to be associated with traumatic births, isn't it? And if it is so important to endure this sort of pain in preparation for being a parent, what torture will we now need inflict on the fathers?

His attempt to say more women should use hypnobirthing and other natual pain relief methods was illogical, because his underlying premise is that WOMEN MUST GO THROUGH PAIN DURING CHILDBIRTH. So he doesn't actually think that a calm, pain free, natural birth is the ideal either. Does this mean he wants midwives to ensure that women have some ideal minimum amount of pain during childbirth? And if it seems to be going too calmly they need to ramp it up a bit with a random episiotomy or something?

Why is he not recommending the one most basic thing which would improve childbirth experience in Britain: one consistent midwife throughout pregnancy and labour? And he seems so ill informed! When did you ever hear that there is an "epidural epidemic", with NHS staff freely offering epidurals? More likely you're asking for one and are told you can't have it!

Honestly, I am just so angry about this. Is this person actually in a position to influence policy in this area? If so he should be removed from his post. His views are dangerous and he is ignorant. Did he just want to get his name in the paper or something?

I'm with showofhands. Please do tell us about lots of methods of pain relief, but FFS don't take away the choice.

Why is the Chief Midwife a man, btw? And how do men get prepared for the "responsibility of nurturing a newborn baby"? They're not experiencing any pain, are they?

Hypnobirthing and other self-managed techniques don't stop labour being painful, though, Ponymum.

They use the mother's own strategies to bring on her own endorphins which change her perception of the pain and her ability to manage it.

They don't have the same effect, or work in the same way, as pharmacological methods.

They also have no side-effects to be wary of, and you recover from their main effects instantly.

That's the difference.

"Childbirth is no closer to the experience of dying than dentistry is"

Not a poor analogy at all when people keep talking about how we should endure the pain of childbirth because childbirth is "natural", people have been going through it for thousands of years, and the pain serves some purpose. We could say exactly the same thing about death.

Dentistry, on the other hand, is a poor analogy because if you need oral surgery something has gone wrong and people haven't been enduring it for years.