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Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Ockendon review - the end of the cult of "natural" births?

143 replies

Frenchie8690 · 30/03/2022 10:47

Shocking findings from the report out today. Hopefully this will mark a sea change in how women are cared for during pregnancy
www.theguardian.com/society/2022/mar/30/baby-deaths-inquiry-shrewsbury-nhs-trust-condemned-for-repeated-failures?CMP=Share_AndroidApp_Other

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EarlGreywithLemon · 30/03/2022 17:43

[quote GinnyBee]@EarlGreywithLemon Yes I struggled to find any good statistics about c-section risks that didn't lump them all together. Such data probably doesn't even exist. What I did find though was that the risk of complications during a vaginal birth for first time mothers without specific risk factors is 43.4%! Did anyone think it could be that high?

www.bmj.com/content/371/bmj.m3377[/quote]
I saw that study. It's a staggering number, but it's entirely reflected in what I've seen in the people I know. Very few had no complications or interventions.

EarlGreywithLemon · 30/03/2022 17:48

I'm all for women's choice, but I think it's scary that women are indoctrinated to turn down necessary interventions - think inductions when going very overdue, or within a certain time of waters breaking.

And also epidurals - actually recent studies that reflect the current epidural dosages show no correlation with instrumental birth, or prolonged second stages. If you check the NCT website you'll see even they've removed that part from the epidural section. If in abject pain, it's upsetting to think some women have been scared into not accepting pain relief based on outdated evidence.

Celiamary · 30/03/2022 17:54

It really is about time some names were published.
Who were the Doctors and the Sisters in charge of these wards.
Let them answer publicly.
Do not allow the hospitals to collude in letting the guilty escape.

jenandberries · 30/03/2022 17:55

@EarlGreywithLemon but in this case a big part of the scandal was women not having a choice and not being listened to or having what they requested

oviraptor21 · 30/03/2022 17:59

@GreenOrangePear

I don't think it's helpful to make this about "natural birth" versus "c-sections".

I agree with the others saying the main issues are better funding, more midwives, continuity of care so that women feel supported and their wishes are respected.

Women should be able to choose a c-section, but also women shouldn't be pushed into interventions they don't want- or which aren't explained properly to them.

This. It would be a shame to throw out the baby with the bathwater in our rush to condemn what happened in Shropshire.

There is plenty of evidence to support natural childbirth, where possible, leading to better outcomes generally for both mother and baby. Which is not to suggest that a mother requesting ELCS should be refused, but there are pros and cons to both and mothers should be fully informed. Leaping to the conclusion that natural childbirth is inherently unsafe is not helpful for anyone.

MsTSwift · 30/03/2022 18:10

Dd1 would have died as a newborn if Dh hadnt been there. We both had mild after affects and would wake up in the night screaming. This wore off and I and dd1 survived so I can’t complain.

EarlGreywithLemon · 30/03/2022 18:12

@oviraptor21 the problem is, as several of us have pointed out, that the information women are given re vaginal re C section births is skewed. The risks of vaginal births are barely mentioned at all.

EarlGreywithLemon · 30/03/2022 18:14

@jenandberries but this was all done in order to promote vaginal births over c sections at any cost.

Theregoesmyhomebirth · 30/03/2022 18:18

@MsTSwift

Dd1 would have died as a newborn if Dh hadnt been there. We both had mild after affects and would wake up in the night screaming. This wore off and I and dd1 survived so I can’t complain.
You absolutely can complain. You had a traumatic experience. "Surviving" is not the benchmark we should aspire to. Thanks
OverTheRubicon · 30/03/2022 18:20

I'm supportive of women being able to have a c section if they wish, I've had 2 good natural births and still think its awful to force someone to go through labour against their wishes.

However I also think that this needs to be an informed choice. While higher numbers of women will have some level of complication following a vaginal delivery, the risk of 'serious' life threatening complications (such as haemorrhaging) are higher with a c section - but you'd never know that if you read most of the commentary here. Neither option is risk free, and pregnant women deserve to be better informed on both choices.

OverTheRubicon · 30/03/2022 18:22

*should add there - after the 2 'good' natural births, I had one very unfortunate one, that should have been a c section. So am truly on the fence about this, and think that the answer lies in real choices and better information, including that there's no 'safe' or perfect option.

ZoyaTheDestroyer · 30/03/2022 18:55

I had to switch off the coverage of this on the Today programme this morning as I found it so distressing, and very close to home after my own birth experiences - which had happy endings because I had good care from HCPs who listened to me.

What will happen to the individuals who perpetuated this scandal? Who has been struck off or faced criminal charges? I am beyond angry for the families of those hundreds of babies.

Lissiel0u · 30/03/2022 18:55

We have been involved in the report. DS’s birth was a shitstorm from early pg (heavy bleeding) right up to uterine group B strep being found 10 days later because they didn’t bother to swab his placenta. I have had 12 miscarriages and an ep. Their insistence that I not have a CS cost me my fertility and my sanity. DS has SEN. All to keep their stats on point. Fuck them all.

ZoyaTheDestroyer · 30/03/2022 18:57

Can we please also stop using the repugnant phrase 'natural birth'? As a pp pointed out early in the thread the most 'natural' outcome for many births is maternal and / or infant death. I've had a vaginal birth and there was nothing fucking natural about it, or the long-term birth injuries it left me with.

ThanksItHasPockets · 30/03/2022 19:08

@TheWayTheLightFalls

Everything *@Iwouldlikesomecake* said. Look up the Albany Practice in south London and what the midwives there achieved with continuity of care, before being shut down. Better for patients, better for midwives, better for outcomes and I suspect cheaper.

Fwiw I was pushed into a section in my last pregnancy and continue to resent my treatment - but every person I met in the hospital was horrified at the idea of a vaginal birth with twins and steered me off. And the hospital I gave birth at is actually very quick to recommend sections. In the horrifying cases highlighted by this report clearly it was pushing “natural” births which was the issue, but in general I’d say it’s a fundamental structural issue with maternity care in this country and what makes a (genuinely) good birth. It ain’t whale music and candles.

Albany has gone but there are still five caseloading teams at Kings. I had a baby with the Lanes in 2012 and many of that team have been redeployed to the new caseload teams.
Lissiel0u · 30/03/2022 19:10

@ZoyaTheDestroyer

Can we please also stop using the repugnant phrase 'natural birth'? As a pp pointed out early in the thread the most 'natural' outcome for many births is maternal and / or infant death. I've had a vaginal birth and there was nothing fucking natural about it, or the long-term birth injuries it left me with.
Yup to all this. It pits women against each other, the amount of “jokes” made because I was too posh to push were immeasurable. But my SIL haemorrhaged after DN was born “naturally”

Yep, Shropshire again.

MelCat · 30/03/2022 19:24

I agree the phrase "natural births" is unhelpful. My first came out my vagina, but dragged out by forceps with an episiotomy which has left me with permanent problems with my bladder and bowel - there was definitely nothing "natural" about it.

This should be the end to any culture of vaginal deliveries at all costs and respecting women's bodily autonomy.

Like many areas of medicine women aren't listened to. It's like as soon as you past through the hospital doors you are "hysterical", "emotional" be that in respect of your own care or your child. You would hope with increasing numbers of women in medicine, and also how female dominated midwifery, this issue would be improving, but sadly it seems if anything to be getting worse.

Peppaismyrolemodel · 30/03/2022 19:30

@MelCat

I agree the phrase "natural births" is unhelpful. My first came out my vagina, but dragged out by forceps with an episiotomy which has left me with permanent problems with my bladder and bowel - there was definitely nothing "natural" about it.

This should be the end to any culture of vaginal deliveries at all costs and respecting women's bodily autonomy.

Like many areas of medicine women aren't listened to. It's like as soon as you past through the hospital doors you are "hysterical", "emotional" be that in respect of your own care or your child. You would hope with increasing numbers of women in medicine, and also how female dominated midwifery, this issue would be improving, but sadly it seems if anything to be getting worse.

This. To add in- no woman is exempt, a friend is a midwife, birthed in ward she worked in, with women who knew her, and was denied her request of a c-section until it became an emergency csect. This is structural inequality.
GreenOrangePear · 30/03/2022 19:33

[quote EarlGreywithLemon]@jenandberries but this was all done in order to promote vaginal births over c sections at any cost.[/quote]
I've been reading the report (although not all the way through yet). It's horrifying. But what was happening doesn't really sound like promoting vaginal births to me. It sounds like lack of staff, poor staff morale/culture, not following guidelines, not listening, multiple failures of governance over years and years to address issues.

A hospital can and I believe should support (promote is not the right word) vaginal birth by providing enough staff, continuity of care and a non stressful environment to give birth in. And then they also need to have appropriate processes for when birth doesn't go smoothly, and also respect and listen to the women including those who choose a c-section.

What was happening in Shrewsbury and Telford was not that at all. It was neglect, poor care, not acting on issues, use of oxytocin outside of guidelines. There is an element of avoiding c-sections but the issues are much more than that.

I don't think it's fair to describe people who prefer intervention free vaginal birth as being part of a 'cult' - if it goes smoothly vaginal birth does carry the least health risks and there is evidence of benefits to the baby. I am pregnant and I hope I can have one because it sounds like the best option to me. If I have complications I may need to rethink. But I hope that if I do the risks/benefits are explained properly to me. Often I think they aren't and women feel disempowered.

I hope this report results in action to increase investment in maternity services and staffing levels, and to improve how women are listened to. Not this endless attempt at a narrative of "natural" v c-section etc which I think is mostly a distraction from the actual problems.

Lissiel0u · 30/03/2022 19:48

@GreenOrangePear I was specifically told that they needed to keep the CS rate low when I asked about an elective CS and that they wouldn’t even consider it. Trust me, the CSvVB culture was very much alive.

GinnyBee · 30/03/2022 20:06

Those of you sneering and blaming women who wanted a low intervention delivery... I have no words.

I've not seen any sneering at women wanting that, more criticism of healthcare providers and organisations that have been promoting that as the only 'worthy' option, not informing women about potential risks with vaginal births, and fobbing them off when they express concerns. It's gaslighting. And it's exactly what this report has found.

EarlGreywithLemon · 30/03/2022 20:30

@Lissiel0u I’m so so sorry about what happened to you - words can’t convey the horror Flowers

And yes, haemorrhage after a vaginal birth here too - 2.3 l. And yet there are no end of warnings about the risks of PPHs from C sections, but none about vaginal births.

I always said if forceps was needed, I wanted a c section instead. I asked at NCT if there was a risk it would be too late in the birth process to have a c section rather than forceps - I was told no. Well, in theory that’s true - I could have turned down forceps. But the baby was low in the birth canal, and pushing her up for a c section would have been risky. So I went with forceps because it was the safest choice for us both. I don’t blame the medical team at all - they were great and gave me the choice. But I do blame the misleading information I was given beforehand at NCT, and the fact that I couldn’t find reliable information elsewhere when I tried to research it.

GreenOrangePear · 30/03/2022 20:50

@Lissiel0u
Yes, it comes through in the report that a lot of women were told that that about c-sections and that was a factor. Also I'm sorry about what happened to you.

But what I am trying to say maybe not well enough is that whole one versus the other mode needs to change. Was really addressed at the title of this thread and some posters here e.g. the ones criticising 'cults of natural birth' I don't think that's helpful- and risks mocking/dismissing the feelings of women who want that.

cornflakedreams · 30/03/2022 20:56

Like many areas of medicine women aren't listened to. It's like as soon as you past through the hospital doors you are "hysterical", "emotional" be that in respect of your own care or your child. You would hope with increasing numbers of women in medicine, and also how female dominated midwifery, this issue would be improving, but sadly it seems if anything to be getting worse.

They go through the same misogynistic medical training and are inducted into the same misogynistic culture.

Medical training is still predominantly based on male medical science - research into male bodies, drug testing on male subjects, surgery outcomes for male patients. Viewing women as atypical men - which means drugs aren't appropriate for them, their biology is not properly understood, and worst of all their symptoms and presentations are not understood and are therefore missed or mistreated.

Typical female heart attack symptoms are totally different to male symptoms. Yet they are not taught, and when they are they are taught as "atypical symptoms" so HCPs are still not aware that a female patient needs a different approach from the beginning.

This applies to many conditions and many treatments.

For instance, female patients with IBD consenting to surgery to remove their rectum without being informed that the surgery would cause their vaginal wall to collapse as it would no longer be supported. And all the problems that then follow. Including with conceiving.

Why were they denied the opportunity to give informed consent to irreversible surgery that was going to cause life-changing consequences for them as women?

Because their surgeons were completely clueless about how the surgery they performed affected women. Because they had never been taught it.

Because women's bodies and women's outcomes are not studied or considered. The research and evidence and medical texts are all based on male bodies and male outcomes, with the assumption that it can be applied without adaptation to atypical men women.

Same as children used to be viewed as miniature adults by the medical profession and were treated the same as adults without any specific knowledge of or research. Then we wised up. We have yet to learn the same lesson about women's medical needs.

Every time you access medical care as a woman you are treated as an atypical man. Best case scenario you receive poor or ineffectual care, worst case scenario you die.

LittleGwyneth · 31/03/2022 11:16

I wanted to echo another poster who said they recently booked their ELCS without any push-back. I had one midwife who was vile about it (and then told me a long story about her hamster having a complicated and expensive to treat illness - wtf?) but otherwise I was able to request mine and get it booked without too much trouble. The consultant I spoke to was very reassuring, basically said that vaginal and c section births are both safe, it's a question of picking which downsides work best for you. And I really appreciated her honesty. It felt a lot more reliable than six weeks of Bump and Baby telling me that I could hypnobirth my way to a smooth and easy labour.