Pressure to Have the "Perfect Birth"

[satya]

Sorry to those who I seem to have offended with my comment about not understanding why anyone would want a drug free birth (it seems I did, I applaud your choice). If you had the birth experience that I did you would understand why I said that. Feel free to read my birth story. Had I not had the drugs I had and the interventions that I did I would never have given birth. The birth experience was not what I expected and it's still very fresh in my mind having only gone through it a month ago. I have not yet reached that place where you seem to forget the pain you went through.

I had originally planned to labour in a bath both at home and at hospital but that became impossible due to the amount of fluid in my feet and legs (could not get out of a bath as my ankles just couldn't take it about 2 weeks before the birth).

I think it's great if you can manage a drug free birth, but it's not always possible. I wish that had been my experience, but it wasn't.

I also think it's great that if you want to go into birth wanting every drug available then that's your choice to do it or if you want to just see how you go with pain that's OK too.

It's all about choice. I think the best thing we can do for our pregnant friends and relatives is to not put any expectations on them. That was certainly my experience and I'm very glad that's how it was for me.

[paradise lost]

Scooby big to you. I wasn't upset by your post, i was more worried i'd upset YOU. And i'm sorry you felt picked on on that other site and GLAD you felt able to vent about it here

Some general things i was thinking when reading:

The biggest drop in maternal deaths in the last 200 years came about with the introduction of soap not surgery. Childbed fever - postpartum infection - was what killed most women, not PPH, not tearing. During the widespread use of forceps about 80 years after their invention (they were a family secret for a good few decades) newborn deaths rose, because inexperienced Obs frequently broke necks and skulls. In the US, the country in which homebirth is illegal in many states, and where children can be removed by child services if a family choose to birth unassisted (not just the newborn, ALL children, even when the baby itself is healthy and no harm came to anyone), and where they have the 2nd highest section rate in the world mortality and morbidity for both women and babies has risen year on year for the past three years.

My cousin is now a hospital paediatrician. During her rotation in obs and gynae after graduation (when they are put to different places for 3-6 months while you decide where they want to make their career) in the first month she saw 49 c-sections, 4 vaginal births, and of those vaginal births 1 (ONE) woman only used gas and sintocin for the third stage. She saw no drug free births. Obs are NOT trained in normal birth the way midwives are.

I have major problems with elective c-sections. They are:

1. is it TRULY elective if the Ob has told the woman that her horrific 1st birth will surely be repeated if she doesn't opt for a section (this has happened to more of my friends than i can count).

2. why is it a woman can choose major abdominal surgery when i can't just walk into the doctor's and tell him i want heart medication, insulin and valium?

I have one friend who is an Ob. She's a great patient-centred doctor and if i was having a preemie, twins or some other more risky situation i would consider her care. She works about 60 hours a week, much of that in theatre. She has endless paperwork to do on top of pre-natal appointments, consultations with midwives on medium-risk patients, surgery, inductions and ward rounds. You might wonder then when she finds the time to read current medical studies to keep up to date on the newest figures, risks and findings... SHE DOESN'T. She has actually laughed at me before and said "You know more than me!" about Foley inductions because her hospital only uses medication for cervical ripening...

I support a woman's right to make her own choices, but "my Ob will know" is NOT a choice, it's a default. If it goes wrong it MIGHT be the ob's fault, but it is the woman and the baby who have to carry the consequences.

Bx

[Smoke Jaguar]

I wasn't going to get into the childbed fever/puerpal fever implication for neonatal death until clean communal (read: hospital) birthing environments could be achieved, but I'm so glad you did, Bec!
And I do know of OB's who are prepared to sit and support without doing anything...they are far and few between and all that I've heard of have been elderly, trained in bedside manner. It's not a new school trait, I"m afraid.
Anyway, I love the way MR put it

[Tobily]

And I do know of OB's who are prepared to sit and support without doing anything...they are far and few between and all that I've heard of have been elderly, trained in bedside manner. It's not a new school trait, I"m afraid.

I agree Mayaness. Every hands off OB I have come across (and I had one in the public hospital for my first birth actually) was very old school, trained years ago before all these interventions were commonplace, and have what is fundamentally a "midwifery" view of birth. But sadly, they are a dying breed. And those replacing them are being trained in a completely different way.

[AndiE]

Women preparing to birth their babies should be as informed as possible about their choices, and then "back" themselves in their decision. I'd also suggest that some women preparing for labour should cover their ears with their hands and loudly sing "la la la" whenever birthing opinions are offered. Where birth is concerned, anyone who's done it has got an opinion, and if you don't want to hear it ... well, I've offered my advice on what to do.

IMO not enough women trust themselves in their decisions where labour is concerned. But I think that any woman who "goes with the flow" and relies on the Ob to do the right thing, is doing herself a disservice. Obs are great whenever there's a problem with birth, but they're a bit too handy at offering alternatives to a natural birth too. I think Obs are valued people in the medical profession, and God knows they have saved many mums and babies (ditto c-sections) ... but how many Obs are happy to sit back during the birth of a baby and let mum take control of her birth? Not too many, I'd suspect. They're paid lots of money, so it stands to reason they want to DO something during a birth. My Ob was a lovely person and did show support for my drug-free, intervention free plan ... but she couldn't help but add her medical two cents worth during our consults - and why shouldn't she, it was what I was paying her for. I decided to keep on going to my Ob, but realised early on that I had to stick to my guns and follow my head and heart where my intention for a natural birth was concerned. And yep, there was a bit of ear covering and "la la la" going on for me.

As the thread has gone beyond the questions posed in the OP, I'd like to add my experience. I was adamant I wanted a drug-free, intervention free birth. For whatever reason, Dh and I chose to go with an Ob and a private hospital (mainly because of the years I've been paying into priv. health insurance). Yes, some women at work said "go with the drugs blah blah" ... you can imagine what I did (hands on ears, etc). Anyway, to achieve the birth we wanted, DH and I did our best to inform ourselves, including a hypnobirthing course and lots or reading on natural birthing. The night I birthed my son, I went to hospital for a check after my waters had broken, and ignoring advice, I went home again to establish labour (at the time I was less than 2cm dilated but all was perfectly A-OK with bub and I). Just three hours later I returned to hospital and within 90 mins DS was born - no drugs, no intervention. All the Ob did was tell me how to push properly (in that, she did me an excellent service!). My point ... I backed myself. I felt if I'd stayed in hospital at less than 2cm dilated, I was in "their" hands ... not mine. As it happened, my son's heart rate dropped a bit during contractions, if I'd stayed in hospital and been constantly monitored, I honestly think I would've ended up with intervention - much against my better judgement. I heard afterwards that it's perfectly normal for bub's heart rates to drop during contractions.

My natural birth was a wonderful experience and I'm forever amazed that I was up and walking around just a half hour or so after the birth. Trusting my body, and going home to establish my labour helped me achieve my aim. Look, there is a place for intervention, drugs and c-sections ... of course there is. But the vast majority of we women were built to birth babies. Not all, but most. Unfortunately a large percentage don't trust their bodies to birth effectively.

Sorry, I've written a thesis. This is such an emotive topic, but I personally feel there are too many stories of horrid birthing experiences, birthing "pain", the need for drugs in birth etc etc. No wonder it scares/unnerves many women. Those of us who have had a good, natural birthing experience are keen to shout it from the rooftops in the hope that we can empower other women to give natural birthing a red hot shot.

To Sophiebear ... you're probably exasperated and maddened by the controversy your OP has caused on BB. However, your curiosity should be appeased to some extent. But if nothing else, I hope you can understand why so many have chosen to comment. Natural, drugs, c-section ... whatever the case, make your birth yours and own it.

Andie

[Steffi]

Hi Natty, after reading your posts it sounds like your my type of gal
Thanks for making me feel that it's ok to choose a priavte hospital and an ob. I am most comfortable with that especially for my first baby and believe me i have taken many years to decide which path to take so i believe it's an informed decision. I would like to have a doula as well and thanks for everyone's advice i will interview some others and see if i can get one i gel with better. I think i can probably guess which hospital you work at and i would love to know more about what it's like to deliver there, just excited about when i do. I think i am definately going to try to go with Dr Gubbay, do you know much about him???

[MantaRay]

I'd also suggest that some women preparing for labour should cover their ears with their hands and loudly sing "la la la" whenever birthing opinions are offered.

I'm not sure I agree with this. People who have experienced something we haven't experienced yet should be a good source of information for us. That used to be the only way people learnt about things. I think the thing is that those of us who have BTDT need to ensure that we share our experience in a postive and supportive way, and understand that our values and desires might not match those of the person we are talking to. And the person who is listening needs to filter the information, to try and understand the facts and important bits of what is being said, while discarding any emotion or persuavisness that is clouding the issue.

Sadly, the "advice offering" is only going to continue once the baby is born, so it doesn't hurt to learn early that "hmm interesting" is a suitable response whether you totally agree or not.

[Tobily]

I have one friend who is an Ob. She's a great patient-centred doctor and if i was having a preemie, twins or some other more risky situation i would consider her care. She works about 60 hours a week, much of that in theatre. She has endless paperwork to do on top of pre-natal appointments, consultations with midwives on medium-risk patients, surgery, inductions and ward rounds. You might wonder then when she finds the time to read current medical studies to keep up to date on the newest figures, risks and findings... SHE DOESN'T. She has actually laughed at me before and said "You know more than me!" about Foley inductions because her hospital only uses medication for cervical ripening...

Bx

And this is where alot of the temptation for inductions and caesareans comes into play with OB's as well. They don't have the time anymore for the unexpected, and they don't have the energy to be out of bed all night at a birth - and front up to their office for consults in the morning.

I'm not a fan of OB's but working with birthing women myself - going out at all hours, not knowing when I'll be home, not knowing when the phone is going to ring - I do understand where this need to schedule things and put some predictability into what is essentially the most unpredictable event there is, comes from. I only work with a couple of women at a time, doing a couple of births a month and sometimes it turns my life upside down for days at a time. I just had a birth last week where I was back and forth between the mother's home, the hospital and my house around the clock for 4 days. I can't imagine how it must be for them, working in the office all day and being on call for dozens of women at any one time.

BUT that is no excuse for the situation we find ourselves in now - too many caesareans, too many inductions and too much intervention in general. If obstetricians only had to deal with the small number of women who need their skills - they could manage the load better, balance their lives better and women and babies would be better off to boot.