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The dangerous cult of natural childbirth Doctors stereotype midwives as sadistic ideologues and midwives condemn doctors as arrogant brutes

We are failing new mothers. Credit: BSIP/Universal Images Group via Getty Images

We are failing new mothers. Credit: BSIP/Universal Images Group via Getty Images


December 16, 2020   7 mins

“One of the most disappointing and deeply worrying themes that has emerged is the reported lack of kindness and compassion from some members of the maternity team.”

This is perhaps the most disquieting sentence to be found in the first report into failures at the maternity services at the Shrewsbury and Telford NHS Trust between 2000 and 2019, published last week. The report is critical of many of the practitioners involved in delivering maternity care, but it is the Trust’s midwives that are criticised most of all.

This profession, usually associated so strongly with “kindness and compassion”, is here associated instead with cruelty and tragedy: 13 women dead in childbirth, hundreds of babies dead, and many more left disabled after traumatic births. Speaking to MPs on the Commons Health Select Committee, Donna Ockenden, who is leading the independent investigation, described a legacy of “broken families and women who carry guilt on their shoulders for many many years”.

It seems now that many of these tragedies were a consequence of a dogmatic opposition to performing c-sections. While the national c-section rate averages 24% to 29%, at the Shrewsbury and Telford Trust it was between 8% and 12%, apparently due to a widespread belief among midwives that a low rate was a sign of good maternity care.

In fact the opposite proved true, since the report concludes that in many cases earlier recourse to c-section would have avoided death and injury. And some midwives’ single-minded quest for natural (i.e. vaginal) births at “almost any cost” was often achieved through unnatural means, including the injudicious use of forceps and hormonal induction, causing additional harm. Worst of all, when babies died during these protracted and agonising deliveries, patients’ pleas for c-section having been ignored, some of these grief-stricken women were then told that they themselves were to blame for the disaster.

When news of this scandal broke, my Twitter feed was immediately filled with women recounting their own experiences of bad care at other NHS Trusts. Most mothers have some sort of horror story to tell — either their own, or that of a friend or family member — and most of these stories include some kind of error on the part of a medical professional. Usually these involve a lack of intervention, or an intervention of the wrong kind, and women almost always report a feeling of not being listened to or cared for — of being treated like rag dolls, passive and mute.

I’m now 18 weeks pregnant with my first child, and I’m in the unusual position of knowing that I will be having a planned c-section for medical reasons. There’s no debate to be had about how the birth will go — I know exactly what’s in store for me come May. And am unlikely to experience the subtle or not-so-subtle pressure often put on pregnant women to stick as closely as possible to the natural childbirth ideal.

Of course, some women are enthusiasts for natural childbirth, and personally fare well by it. But it’s important to recognise that there is a heavy dose of ideology at play here. A woman I used to work with was evangelical about homebirthing, despite the fact that both of her babies had been rushed to hospital in ambulances when their births went wrong. But when telling her birth stories she would include that detail only in passing, focusing instead on the “energy” and “joy” of the experience. The natural approach all too often requires its adherents to gloss over pain, injury, and danger, repeating again and again “pregnancy is not an illness” (then why do I feel so ill?).

There is a reason why the God of the Old Testament punished Eve by condemning her to bring forth children “in sorrow.” The writers of Genesis were no fools — they knew what childbirth was like, and no amount of New Age woo can ever quite conceal an ancient truth: that while this form of human experience may be wonderful, it is also terrible, and even in the modern world still carries with it the stench of death.

The immense importance of childbirth means that power over it has always been contested, just as it is today. When the ‘man-midwife’ first emerged in the 18th century, this progenitor to the obstetrician was viewed with hostility by the female midwives who traditionally had sole control over the birthing chamber. For a period, the fashionable choice for wealthy British women was to employ a man to attend the birth, and he would arrive in a smart coat and carrying a bag containing the latest in medical technology: a pair of forceps. Poor or unfashionable women continued to rely on their local midwife, until gradually childbirth became more and more medicalised and power over this female domain was passed to male hands.

This centuries-old rivalry between midwives and obstetricians still persists, despite the fact that UK medical graduates are now majority female. Conflict may have been particularly acute at the Shrewsbury and Telford Trust, but it was far from unique. Doctors stereotype midwives as vain ideologues who put women through hell for the sake of their egos (“sadists” is the word used by one of my doctor friends). In turn, midwives condemn doctors as arrogant brutes who see a scalpel as the solution to the slightest complication.

There is some truth to both of these perspectives. A remarkable episode in the third season of Mad Men provides a graphically accurate illustration of the over-medicalisation of hospital births in the 20th century. Betty Draper is shaved, sedated, given an enema, and has her legs placed in stirrups, a birth position that provides better visibility to practitioners, but forces the labouring woman to work against gravity. Frightened and isolated, Betty sobs for mercy and goes uncomforted. We’ve since made progress, but this sort of once typical hospital experience couldn’t be further from the ‘woman-centred care’ that the midwifery profession tries to promote.

Nor do hospital births have an unblemished safety record. Igaz Semmelweis, surely one of the most tragic figures in the history of medicine, realised in 1847 that the high maternal mortality rate in his Viennese hospital was an accidental consequence of doctors’ physical contact with women in labour. Ignorant of germs, doctors would go straight from the dissection lab to the maternity ward without washing their hands, bringing deadly infections with them.

The desperate Semmelweiss tried to alert his peers to the harm they were inadvertently committing and found himself ostracised. He suffered a nervous breakdown, was admitted to an asylum by his colleagues, and died shortly afterwards, with the truth of his theory still unacknowledged. More than 20 years later, Louis Pasteur finally convinced the medical community to accept germ theory and wash their hands before examining patients. We have no way of knowing how many mothers died needlessly in the interim.

Yes this is history, but my point is that sometimes doctors make things worse, and sometimes midwives do the same. Errors made by both ‘sides’ have been used down the ages to bolster the case for either natural or medicalised childbirth, with feminists generally taking the midwives’ side. Classic second wave texts like Witches, Midwives, and Nurses present a highly politicised historical narrative of feminine knowledge wrested from women by men envious of the power of the female body.

Some proponents of the natural approach are so resentful of this male incursion that they go further even than homebirthing and choose to ‘freebirth’, with no medical assistance at all. With lockdown restrictions limiting access to NHS midwives at home, more women are opting to freebirth illegally, with some reported to social services as a result.

Maybe it’s because I wrote my Master’s dissertation on the grisly history of childbirth, or maybe it’s because I did part of a medical degree and so have some bias towards the doctors’ ‘side’ of the debate, but I’m afraid I can’t see freebirthing as anything other than stupidly reckless. But then again, I do understand the fear women have of giving birth in hospital without their loved ones, as nearly 2,500 women have been forced to since the start of October. The feminist writer and campaigner Caroline Criado Perez has written about her own awful experience of miscarrying in hospital without her partner present. Lockdown adds a new form of suffering to an experience already replete with it.

More from this author
The dangerous cult of natural childbirth

By Louise Perry

It does remain thoroughly baffling that the suffering remains, and that the pace of development for obstetric technology is so oddly slow. The maternity team at the Shrewsbury and Telford Trust have been criticised for misusing an implement that has hardly improved in several hundred years: forceps. There is still no good form of pain relief available in labour, it is still common for women to suffer tearing, prolapse, and incontinence and, even in the West, women and babies still die far too often, particularly black women. Our species has been to the moon and built nuclear weapons, but we haven’t yet managed to remove agony and risk from one of life’s shortest journeys.

The mistakes made at the Shrewsbury and Telford Trust show us what happens when the ‘natural’ is fetishised. But, at the same time, we can’t avoid confronting the fact that medicalised childbirth is hardly much better. The Trust’s midwives were not wrong to consider c-section an undesirable option, given that surgery and recovery carry their own harms and risks. What they were wrong about was to assume that denying patients a c-section was a better option.

There are no desirable options when it comes to childbirth, only relatively worse ones, and there is no way through it without pain. I do realise that this isn’t an easy problem to solve. Childbirth is worse for us than it is for other animals because of the trade-off that Genesis describes in metaphor: we stood up to free our hands, and we developed large brains, and in doing so we narrowed the pelvis and enlarged the infant head.

But I look at what happened when the entire world was focused on just one medical problem — producing a vaccine for Covid-19 — and the astonishing speed with which a solution was found. And then I look at what happened at the Shrewsbury and Telford Trust, where patients were denied access to a routine form of lifesaving treatment. Not only do advances in obstetrics lag behind other areas of medicine, it’s also the case that, even when the technology does exist to reduce injury and suffering, it often goes unused, and without even the cheap and simple application of “kindness and compassion” to soften the blow.

A GP that once mentored me used to tell her anxious patients at the antenatal clinic “it’s only one day of your life,” and I thought at the time that a prisoner in fear of the torture chamber would hardly be comforted by such a statement. In our safe and affluent society, we don’t usually tolerate pain and danger, but we do in this case, and the nature of the burden means that it is only women who are asked to bear it. Can that be a coincidence?


Louise Perry is a freelance writer and campaigner against sexual violence.

Louise_m_perry

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bootsyjam
bootsyjam
3 years ago

This article has made me realise that I will contact our local hospital to complain about my partner’s childbirth experience.

It was lockdown and I was not allowed to be in the ward. My partner had high blood pressure and our baby was dangerously underweight as it wasn’t getting enough nutrition so she was brought in to be induced. So far so good.

The inducement process/drug led to our unborn bay’s heart rate dropping as it was clearly in distress. My partner was alone and had no one to act for her whilst this was happening. The heart rate dropped 4 TIMES and on the 5th time all hell broke loose and corridors were cleared as she was rushed off to the operating theatre in true Casualty/ER style, with people shouting to get the hell out of the way as she was run through corridors and bouncing off walls in her bed. She was scared as hell. She had been told that they always wait 4 times to see if the heart rate normalises or whether it will continue.

If I had been there then there would been absolutely NO CHANCE that it would ever have gone this far. After the second or third time I would have insisted on a c section using simple logic. What if we go through with the labour and the heart rate of our baby drops during the labour and the baby is no longer in a position to be removed via a c section. What then? Logic dictates that after the heart rate has dropped 2 or 3 times then it’s going to keep on happening.

So they waited until it happened 5 TIMES, and then they panicked. Their reaction on the 5th time shows just how wrong they were, and how common sense had left the building a long time ago. It appears that the things being described in this article were happening at my hospital too.

Damn, I forgot how angry I was about this.

Helen Barbara Doyle
Helen Barbara Doyle
3 years ago
Reply to  bootsyjam

I doubt they would have listened to you

Deborah Short
Deborah Short
3 years ago
Reply to  bootsyjam

So sorry you had such a traumatic experience

bootsyjam
bootsyjam
3 years ago
Reply to  Deborah Short

Thanks. I’m over it but now realise I should complain to make sure no one else is in the same situation.

bellonaregina
bellonaregina
3 years ago
Reply to  bootsyjam

Thank you for deciding to speak up! They can’t simply brush off your concerns as the complaints of a fussy laboring woman! We all need to make ourselves heard on this issue, this treatment is absolutely barbaric and lacking in all humanity.

Michael Cowling
Michael Cowling
3 years ago
Reply to  bootsyjam

They would have waited until the fifth time because that is what the rules said.

bellonaregina
bellonaregina
3 years ago

And we all know that humans are exactly 100% alike and we should apply the rules very strictly with no room for nuance, common sense, or reason.

Joe Blow
Joe Blow
3 years ago
Reply to  bootsyjam

A grim experience, and I am sorry you and your partner went through it.

You should complain, and you should consider getting legal advice. I am not a lawyer, but it may be that as you eventually had a “good” outcome, there is nothing to be done. I would expect that most solicitors in the field would speak to you for free to start with.

However, a simple letter of complaint to the hospital is unlikely to go anywhere useful, I fear. Consider writing an article on your experience in the local paper. Write to your MP. Write to the chairman of the trust board.

L H
L H
3 years ago

Yes for most women, dental pain or an ear ache may well have been the worst pain ever experienced prior to natural childbirth. For my first child I was wildly positive and went along diligently to antenatal classes, where the midwives argued strongly for completely natural childbirth and strongly against medical intervention. I opted for completely natural childbirth and of course when the moment arrived the pain hit me like a ton of very surprising bricks. Nothing can ever erase my memory in actual birthing that I was facing actual death – being split in two – while relations took uninvited photographs of my nether regions. The experience affected me very deeply. Months after I was still wondering why I had been through that incredibly lonely fear and pain and why weren’t there better options for women.
In Australia the attitude seems very much ‘at least you have a healthy baby’. No one seems to prioritise the recovery of mum as long as she is not grossly depressed (and neglecting Bub).
After my second birth my perineal cut / tear was stitched incompetently, far too tight, and swelling against the stitches was horrendous. In spite of bitter complaints, absolutely nobody wanted to take a proper look and so I literally could not sit straight for two years. The pain was breathtaking, like being raped with broken glass. My muscle tone was completely shot for years and only after a decade I started to feel somewhat normal with full feeling again. My third childbirth I felt competent enough to do the whole thing standing up on my numb wooden legs – so scared I was of tearing once more. So I guess i did make a type of progress in terms of natural birth.
The knowledge of natural, completely drug free birth is important but should it be relevant to every mother as the norm?
Midwives here actually attempted to make non-medical Caesarians ILLEGAL in my Australian state. Thankfully they were knocked back.
When I saw a French documentary on television, featuring a women labouring with an epidural, I felt angry about my own primitive and terrifying experience. And I had quite good care by my local standards.
Natural birth is a wonderful ideal and can provide an incomparable ‘I climbed a mountain’ feeling. (‘I lived!’ )
But not every woman should be expected to climb mountains, performing to a fairly indifferent audience of community and in-laws.

Blue Tev
Blue Tev
3 years ago
Reply to  L H

That is terrifying.
And makes me really angry, normal human weakness, greed, etc is fine.
Subjecting someone to pain just because of politics or tribalism is unforgiveable

Drahcir Nevarc
Drahcir Nevarc
3 years ago
Reply to  L H

“while relations took uninvited photographs of my nether regions.”

This phrase leapt out at me. Truly shocking behaviour by people you’re supposed to trust.

David Morley
David Morley
3 years ago
Reply to  L H

“When I saw a French documentary on television, featuring a women labouring with an epidural, I felt angry about my own primitive and terrifying experience.”

This ties in to the point the author makes about “ideology”. The french tend to be more critical of a philosophy they call “naturalism” a belief that what is natural is best. It’s a quite marked cultural difference with arguably good and bad consequences.

bellonaregina
bellonaregina
3 years ago
Reply to  David Morley

Really? In my experience the French have embraced naturalism, especially in a way that’s pretty distinct to non-French travelers, aka their rejection of deodorant in favor of “natural” body smells.

It certainly was an interesting trip! The cheese wasn’t the only stinky part, haha!

David Morley
David Morley
3 years ago
Reply to  bellonaregina

If you go to some rural areas I’m afraid it’s not just lack of deodorant it’s lack of soap and water. Sometimes the smell of stale sweat is overpowering. I don’t think there is any philosophy behind that though.

David Morley
David Morley
3 years ago
Reply to  bellonaregina

This is worth a read. In writings in french that I’ve read she very much associates “naturalism” with Anglo Saxon culture.

https://www.theguardian.com

David Morley
David Morley
3 years ago
Reply to  bellonaregina

The bottle (for feeding babies) was initially seen as a means of liberating women, and in France this is still far more the case than it is in the U.K. In France I think this is also seen as a liberation from animality. In the U.K. and US this was followed by a natural turn.

The french are more dualist in their attitude to mind and body than people in the U.K. and see a greater distance between humans and animals. In many ways they are pre Darwinian, in that they see Darwin as applying to animals only (it’s something Chomsky has picked up on). I think it’s also why vegetarianism and veganism were slower to take off in France, and why they were very slow to protect animals in law. They just see animals (apart from pets) as outside the moral realm.

The whole human/animal nature/culture thing is just far more binary in France, far less fuzzy. It’s quite a marked cultural difference. Part of the cultural background.

Joe Blow
Joe Blow
3 years ago
Reply to  David Morley

Tuberculosis is completely natural too.

David Morley
David Morley
3 years ago
Reply to  Joe Blow

You’re committing a fallacy, but I get your point. It doesn’t follow automatically from something being natural that it is good.

David Goldsmith
David Goldsmith
3 years ago

As this posting column is moderated, I cannot actually articulate my views on this topic, both as a doctor for over 30 years, and, as a father of two children. I enjoyed reading Louise’s viewpoint, and find myself agreeing with much, and understanding and respecting the opinions presented. There are other horror stories: medical students – (encouraged indeed directed to attend, and watch, births in hospital) right up until say 10 years ago (and certainly in the era when I was one)) – would routinely be made to stitch up any perineal tears or other nether-region damage – unsupervised – thereby putting the future sex life and possible reproductive capacity of the mothers at risk. I agree, the professional chasm between the viragos and virgins in this most curious profession put children and mothers’ welfare very low down in their list of priorities. No medical regulator or professional body comes out of this situation smelling of roses.

bootsyjam
bootsyjam
3 years ago

Hi David, have a quick story that might put a positive spin on what you have mentioned. It was of great comfort to myself and my partner that our mutual friend had undergone a c-section a few months earlier (pre-planned as she had a bad back).

There were (non-participating) students in the room and the doctor/surgeon turned round and apologised to them, saying something along the lines of “I’m sorry that you have to watch another one of these. It’s a very simple operation and it must be quite boring for you to have to watch another one.”

We could debate the merits of his bedside manner, but for people on the other side of the profession, it was lovely to hear an inadvertent slip by a professional that what looks very serious and frightening is actually pretty easy.

When my partner went in a for an emergency c-section I recounted this story to her numerous times, and it kept our anxiety (just about) under control as a result!

A Woodward
A Woodward
3 years ago

I put my foot down and demanded a planned c section. After threatening to walk out and find another hospital which would give me what I wanted the obstetrician relented and we cooked up a vague line of reasoning between us (geriatric mother and IVF pregnancy) to justify it. Best thing I ever did, apart from the IVF. You have a full surgical team around you, no p**ssing about being left in a corridor. Recovery was a doddle.

Don’t listen to the stats they present to dissuade women either. My favourite was that in terms of post pregnancy incontinence there’s no difference in the rates between women who have given birth naturally and those who have c-sections. Ha! They include the emergency c-sections in with the planned ones of course, thereby combining one of the most dangerous and most safe delivery methods in one obfuscating category. Most people who end up with an emergency c-section have been through hours and hours of labour and it’s not surprising that they would be a risk for long term incontinence. Having an operation when your muscles are in contraction is not ideal either.

Anyway, ladies stand up for what you want and refuse to accept anything less. And do make sure you know what the options are before you give birth, especially the options on offer if things go wrong. You don’t want to find out at that point that there’s no surgical team around and the midwives are opposed to calling them anyway.

bellonaregina
bellonaregina
3 years ago
Reply to  A Woodward

Honestly I’ve heard nothing but good things about planned c-sections. Every women I know that’s gotten one had been extremely pleased with her delivery experience. They don’t have that cold, dead, hollow, 1,000 yard stare that many new “natural” mothers have. The horror stories I’ve heard about natural labor bring me to tears. I can’t understand why we allow woman to suffer such an unimaginable level of trauma. The author is right: there’s absolutely no good reason to let laboring women experience such a traumatizing level of pain when that isn’t expected in literally ANY OTHER CONTEXT.

Joe Blow
Joe Blow
3 years ago
Reply to  bellonaregina

I remember the “training course” that my and I had to sit through from an arrogant midwife, smugly instructing us – right at the start – that pain is unavoidable. I am a doctor; her attitude was from 75 years ago. Unconscionable.

Susie E
Susie E
3 years ago
Reply to  Joe Blow

The pain is unavoidable if you choose a natural birth (which many women do). The point is to change your attitude towards it and use it to guide you through the process. There are many natural ways of reducing the pain such as water birth. I’m not saying women should be forced to go through a natural birth, but the attitude that pain is always bad needs reconsidering in this context. Ask any elite athlete if they endure pain to reach their goals… I’m sure many do.

Joe Blow
Joe Blow
3 years ago
Reply to  Susie E

I wouldn’t consider myself an “elite” athlete, but I have at times in my life been at fairly good levels of fitness, and yes, it takes pain to get there. But, if you get to that state, you also know that there are different types and qualities of pain. Pain associated with rehabilitation is different from the slight (and pleasant) soreness from a hard workout which is different from an injury. This is not just attitudinal.

It is also all voluntary. And women should not be expected to listen to some ideologue midwife droning about the unavoidability of pain in the 20th Century (which is when this was). I don’t know if it is better today – I doubt it.

bell.mariana
bell.mariana
3 years ago

I was given a “trial of labour” in spite of my wishes ( I was 37 and my baby was huge), it did not work but caused me a lot of pain. The doctor’s idea, the midwife muttered under her breath: “it will be a c-section in the end”. Twenty hours later when it was clear that the “trial of labour” will not allow my 12-pound daughter to come out, I had that c-section. Unfortunately, I was exhausted by then. I find it horrendous that I was denied any opinion or any choice in my care.

Jo C
Jo C
3 years ago

I had an opposite experience. I believe in intervention only when necessary and opted for a natural childbirth. I was booked in for an induction without discussion (left me a voicemail to tell me) this was to occur at 41 weeks (2nd pregnancy zero risk factors). When I declined I was given an appointment with a specialist who basically said I was risking killing my baby by not inducing and she would have induced at 40weeks. Natural childbirth is anything up to 42 weeks. There were no issues with me or baby, just a belief that it was better to resolve medically instead of naturally. As this article mentions inducing then relying on forcing the baby out does no good either. In the end I booked for an induction at 42+1 and baby appeared 4 hours before the appointment. Answer is listen to mothers- vast majority understand what they are doing and know when something is wrong.

Susie E
Susie E
3 years ago
Reply to  Jo C

I have a very similar experience. First child I reluctantly agreed to be booked in for a sweep (start of the induction process) at 42 weeks. I think they let me get that far because I was only 24 with no complications and I’d already cancelled an earlier sweep. My son was born at home (as planned) the same day as the appointment.
With my second son they were keen to induce me at 39 weeks because they had been monitoring me for various reasons and were convinced he was going to be small so they had to get him out. Surely best to leave him in to get a bit bigger and let his lungs develop further (whilst monitoring me for any actual signs that my placenta was failing, rather than just assuming it would)?! Any way… he was born at home as well and was a normal weight.
The home birth midwives would attend some of my consultants appointments with me as back up (also – surely good practice for medical teams to speak to each other!) and the consultant was always on best behavior when they attended. If I went on my own she was very dismissive and tried to scare me. I’ve asked for a different consultant this time round.
I definitely think there is a culture of over medicalising births (even from midwives themselves). Everyone I know who has been induced has horror stories to tell and I’d rather have a c-section. Much safer and less stressful for everyone involved – especially the baby and mother.

bellonaregina
bellonaregina
3 years ago
Reply to  Jo C

“Answer is listen to mothers- vast majority understand what they are doing and know when something is wrong.”

Yes! EXACTLY! We’ve been having babies for hundreds of thousands of years, our lizard brains know what they’re doing. I mean, sometimes things go wrong, but a mother’s intuition has been finely tuned over the eons. Trust her gut, it’s what’s been keeping the human race alive since we existed. Trust mothers.

CJ Henderson
CJ Henderson
3 years ago
Reply to  bellonaregina

“Answer is listen to mothers- vast majority understand what they are doing and know when something is wrong.”

That, Bellona, is exactly and dangerously wrong. Women have been dying in childbirth for hundreds of thousands of years, and, sadly, damaged and disabled babies have survived as a result of ‘letting nature take its course’.

‘Trusting your gut’, or a ‘finely tuned mother’s intuition, makes no sense in the light of modern knowledge of childbirth. Things do go wrong, and the problem is nearly always because of failure of the system – I’d push for higher standards and oversight if you really want to make a difference.

Helen Barbara Doyle
Helen Barbara Doyle
3 years ago

The medical profession never listens. I had a 42 day cycle, I told the doctors this, they ignored me and calculated my due date on a 28 day cycle, thus determining my babies were overdue when they were not and inducing me both times.

I also had a male midwife the second time around who spent most of his time chatting to hubby.

I eventually had two healthy boys but also a lot of internal damage as although son 1 was presenting the wrong way I had been induced so had to go through 30 hours of excruciating Labour on my back so his heartbeat could be monitored. This finally ended in an epidural and Keillands forceps as a last throw of the dice.

Would that have been avoided if they had listened to me 8 months earlier and he had been allowed to come in his own time, I think probably yes.

bellonaregina
bellonaregina
3 years ago

I had a very similar situation (for a different reason, tho). My cycle is VERY irregular, sometimes I go months without anything at all. Back when I was young and naïve I fell pregnant at a time that would have been disastrous for me, so I decided to terminate.

The clinic I rung up wouldn’t listen to me **at all**, they insisted I was 3 MONTHS ALONG because the date of my LMP was so far back. The woman got an attitude and kept repeating “we don’t do late term abortions here” and I kept saying “there’s absolutely no way I’m further than 8 weeks. I don’t normally throw up 300 times a day until my throat starts bleeding, that’s not a daily thing for me, I would DEFINITELY know if I was 3 months pregnant… because of the non-stop throwing up… for 3 whole months…”

I called a few more clinics and got the same exact responses, NONE of them were willing to believe my periods were that irregular and I could still fall pregnant. They wouldn’t even let me come in just for an ultrasound to prove it, I’m thinking they didn’t want to be seen “encouraging” late term abortion 🙄…

In the end I was forced to see my normal GP to get proof of the pregnancy and the correct date, and I WAS RIGHT. I was only 4.5 weeks along!!! I had to basically trick the other clinic by making an appointment to talk about “options”, then I brought the paperwork to smugly show them how wrong they were, and their stubborn stupidity almost prevented a woman from getting a much wanted termination (seriously, turned down from several clinics just because they don’t understand irregular cycles).

Women’s health care is still in the dark ages…

Adrian
Adrian
3 years ago

I blame the Natural Childbirth Trust, who, to this day, provide virtually all of the ante-natal education in Britain.

And no, I didn’t get the name wrong.

sarahcynthiajohnson
sarahcynthiajohnson
3 years ago
Reply to  Adrian

You did, because the name changed a very long time ago and the NCT encourages informed decision making, which the NHS is supposed to be in favour of.

Ray Hall
Ray Hall
3 years ago

I wish the author of this article all the best for herself and her baby .

Jane Marple
Jane Marple
3 years ago

A good article, and the author says many things that must be said. There is sometimes a lack of concern and empathy in the way that both doctors and midwives have treated women, both in the past and the present.
However, I feel that, if one can judge by her final comment, Louise Perry is in danger of being swayed by the prism through which she views the situation. This is not just about women being the victims of the system as in previous years.
I am sorry to say that the shortcomings in this service, as with so many in the NHS has become a major problem for patients. Patient centred care, and nursing care plans are laudable ideas that are often not carried out in practice. I have seen for myself, and heard from others, how the standard of care on our hospital wards has deteriorated over the past few years. Over 30 years ago this was predicted by older nursing tutors, who feared that the emphasis on theory and the lack of emphasis on practical training in hands on care would produce this sad result. A lot of nurses and doctors are wonderful, and deserve our thanks and support. But there is a culture where a failure to care properly for patients is often not detected, nor is it corrected. The NHS needs to be properly patient-centred once more.

David Morley
David Morley
3 years ago
Reply to  Jane Marple

“Over 30 years ago this was predicted by older nursing tutors, who feared that the emphasis on theory and the lack of emphasis on practical training in hands on care would produce this sad result.”

I don’t suppose there is any written evidence of this – it would be interesting to hear what they said. It’s certainly what many of us feel has happened – perhaps in a desire to raise the professional status of nursing.

Kevin Ryan
Kevin Ryan
3 years ago

“There is still no good form of pain relief…no way through it without pain”

Is that true? I had an epideural for a knee operation last week. I was wide awake but they could have sawed both legs off without me feeling it.

Adrian
Adrian
3 years ago
Reply to  Kevin Ryan

You weren’t trying to push on the foot though.
And falling asleep due to a bad fentanyl reaction wouldn’t have complicated the process.

Helen Barbara Doyle
Helen Barbara Doyle
3 years ago
Reply to  Kevin Ryan

I had an epidural after 24 hours of Labour and promptly went to sleep!

Susie E
Susie E
3 years ago
Reply to  Kevin Ryan

Epidurals don’t always work as intended… sometimes only half the body gets relief. Depends how well it was ‘installed’ and with a wriggly mother in pain that could be difficult. I know id rather give birth again that put up with needles.
The pain of birth is also important because it tells you when to push and when to rest between contractions.
If the epidural is too good, then how do you know when to push?? Maybe this results in more birth trauma (horrific life altering tears) than if you can feel whats going on.

Annette Kralendijk
Annette Kralendijk
3 years ago
Reply to  Susie E

In childbirth only half the body needs relief. Millions of women give birth, including pushing, with epidurals. If you’re on a monitor, it’s pretty clear when you’re having a contraction.

bellonaregina
bellonaregina
3 years ago

Not true at all! It’s definitely a whole body experience.

Annette Kralendijk
Annette Kralendijk
3 years ago
Reply to  bellonaregina

The pain of childbirth? No it’s not a whole body experience. If it was, an epidural wouldn’t be enough. I’ve done it several times.

Susie E
Susie E
3 years ago

I meant that sometimes only the left or right side gets relief due to a badly installed epidural. I’m sorry I didn’t make that clear!

I personally would not choose to have one, but think it should be an option for those who want it.

The pain is there for a reason and I think we need to learn to not fear it, but use it! Just the way I approach things anyway. Obviously it’s incredibly uncomfortable, but it’s only temporary.

Annette Kralendijk
Annette Kralendijk
3 years ago
Reply to  Susie E

Competent medical care includes epidurals. If you can’t get them you have a medical competency issue.

Every woman should have the choice about epidurals. The pain is not there for a reason in my view anymore than the pain of arthritis is there to make you sit down all the time. I so enjoyed every birth experience I had with very little pain except the first one. Some women have such horrendous experiences that bonding after birth is an issue. Women should be free to make their own choices.

jonathan.simon2020
jonathan.simon2020
3 years ago

There has been a battle between midwives and medically qualified practitioners since the 1980s when induction was in fashion with the medical profession.
The midwives reacted by ‘natural’ childbirth.
The pregnant women and their babies in the middle of this conflict were the victims.
In healthcare delivery outcomes are difficult to measure in every area apart from Maternity services.
The outcome is a fit mother and baby; anything that deviates from this can be measured.
It is incomprehensible that it has taken so long to detect these problems that exist in many maternity units across the UK and overseas.
There has been a timidity in confronting the midwives with their obstructive behaviours. I suspect the politic of childbirth has inhibited the questions.
The results are maternal and foetal deaths and brain damage of many infants.
The affected unit should be shut down and recreated with a culture that cares more for the patient and is guided by outcomes not useless, dangerous ideologies.

Susie E
Susie E
3 years ago

I suspect induction causes huge amounts of trauma (increased use of forceps or exhausted mothers finally being taken for c-sections). We need to get the balance right between natural birth (worked fine for me each time) and c-sections. It’s all to easy to just go for the middle ground which is induction. Every person I know who has been induced said it was horrific and many ended up with tears etc. There has to be something were all missing…?

Susie E
Susie E
3 years ago
Reply to  Susie E

By the way, I think the behavior of the midwives at Shrewsbury and Telford is disgusting and they got it very wrong. Most trusts do not operate like that and their results reflect this. We must be careful to not tar everyone with the same brush.

jonathan.simon2020
jonathan.simon2020
3 years ago
Reply to  Susie E

There is evidence about maidstone and suggested 38% of other maternity units that have issues. This is also true in New Zealand. There is a cultural war between the idea of natural birth and interventions. The LSCS rate is an indicator in S&T 11%, nationally 24-29%. My daughter at Kings College hospital has a very poorly managed delivery due to delay in decision making.

Susie E
Susie E
3 years ago

Thanks for sharing the stats. I agree that the c-section rate was too low at S&T. I’m sorry about your daughters delivery.

Annette Kralendijk
Annette Kralendijk
3 years ago
Reply to  Susie E

I had several inductions and they went just fine. Plus you’re overlooking the fact the sometimes induction is the safest way to go. For example, a pregnant woman with pre-eclampsia.

Richard Spicer
Richard Spicer
3 years ago

You are right.
Vaginal delivery is a bit of a design fault in humans. It sometimes goes ok but often does not. Oviparous creatures and marsupials have a much easier time but these options are unfortunately not available to homo sapiens.

‘Natural’ childbirth is fine if you are prepared to accept maternal and neonatal death just as it is natural to die of bacterial infections if you decline antibiotics. Anyone who puts herself under the care of a department in which doctors and midwives are not cooperating colleagues is running a significant risk.

Why is it that in departments other than obstetrics one very rarely sees such conflict between doctors and nurses? I think the answer is self-evident is it not?.

Helen Roberts
Helen Roberts
3 years ago

This strikes a chord….having been indoctrinated into why natural childbirth was good & c-section bad, terrifying, unnatural, etc, I then had the experience of two midwives who were “determined” that they would be able to deliver our second son naturally, despite him facing the wrong way but turning as he came out, and my sheer exhaustion having suffered hyperemesis throughout the pregnancy (and having lost 4 stone whilst pregnant). And don’t get me started on the hyperemesis treatment……

bellonaregina
bellonaregina
3 years ago
Reply to  Helen Roberts

I’m so sorry to hear you had HG. I chose to terminate because of it. Many, many people underestimate how difficult and traumatic it is”I have PTSD related to it now. I hope you’re doing much better, HG is a nightmare and I’m glad you survived.

G Jones
G Jones
3 years ago

There is a factual error in this article. Freebirth is absolutely legal in the UK not illegal as stated above.

Judith Cameron
Judith Cameron
3 years ago
Reply to  G Jones

Absolutely – it does annoy me when such nonsense is written and ignored by editors in a supposedly serious publication.

Susie E
Susie E
3 years ago
Reply to  G Jones

Totally agree. The article should be corrected.

Annette Kralendijk
Annette Kralendijk
3 years ago

I’m not a religious person, so I’ll skip the section on the Bible and genesis, but there is very much a way through childbirth without pain. Proper medical care can relieve childbirth pain if not every discomfort as you’re long past comfortable at nine months.

I couldn’t have cared less whether my OB/GYN was male or female, I wanted the doctor I felt most comfortable with and experience mattered to me. As it happens I was very lucky as one pregnancy required a very skilled physician (more than one, in fact).

In my view, all pregnancies require the attention of a medical doctor for at least some appointments. While midwives are fine for some routine appointments (as are nurse practitioners) you don’t always know you’re going to have a complication until quite late in the pregnancy. I understand that the NHS does not offer all patients ante or post natal physician appointments and that most will be scheduled with a midwife. This would not have worked for me.

One of my daughters just had her first child at 37 weeks and she too required and had the attention of a team of physicians. Yes, this care is expensive but sparing expense on maternity healthcare is foolish in my view.

Jo C
Jo C
3 years ago

I do think though it can be forgotten that pain is for a reason. Pain during childbirth focuses you and drives you to pass a large object through a small space. We should never use medical interventions unless they are necessary (and there are lots of reasons for necessary).

Annette Kralendijk
Annette Kralendijk
3 years ago
Reply to  Jo C

In my case, pain wasn’t a point of focus for me. It was simply pain that could be alleviated. And yet large objects were still driven through a small space. “We should” is an opinion in a childbirth context. Every woman is different, every birth experience is different. Every woman, in consultation with her physician, gets to make her own choice.

sharon johnson
sharon johnson
3 years ago

I was absolutely 100% determined to have ‘natural’ childbirth. My husband and I went to all the breathing classes . . .pant pant blow is etched into my brain . . . and were excited about our firstborn. On a Friday evening, two weeks short of due date, I was planned for an evening out, but felt not quite right. Shortly before midnight I thought I was about to give birth. My husband rushed me to the hospital. While he was doing the paperwork I was put in a chair and wheeled to the maternity ward. My vitals were taken and before my husband appeared I was in the delivery room and a fat baby girl was quickly brought into the world. I held her for a minute. The doctors were concerned and put her in an incubator for close monitoring. I was wheeled to my room, my husband saw baby Jane in the special care section. She was hooked to several wires measuring all aspects of her system. Early morning a doctor appeared to tell me she might have trouble with her heart, but two weeks earlier the hospital had purchased a special monitoring system so she was getting the best care available. I shuffled into the ‘early bird’ room to see my newborn. She weighed 11 pounds, had red hair, and looked hardy to me! My parents arrived, my sisters, flowers, and we all waited while the doctors hovered over her. Late in the day my obstetrician said she would have to stay in special care for a few days. We went home and visited her for the next five days when she was declared fit to leave. Her pediatrician wanted to see her in a month. He played with her and checked her responses. He said reading her file indicated her oxygen level was low after birth, but she showed no ill effects. He added that things could have gone very badly, but fortunately we could get to the hospital in time. Jane is an attorney in San Francisco now. Married to a physicist. She still has red hair.

Joe Blow
Joe Blow
3 years ago

“Yes this is history, but my point is that sometimes doctors make things worse, and sometimes midwives do the same. “

But this is not a particularly trenchant observation. Of course they make things worse sometimes. Sometimes, what science today tells us is best turns out on further study not to be for the best after all. The question is, are they acting with the best intentions, with the best interests of the patient first and foremost in mind, at the time? Are they making use of the best available evidence of what constitutes good practice? The horror stories presented from the 1960s and earlier were almost certainly a consequence of people acting with good intent.

The question that arises from today’s report on the ghastly treatment of women during childbirth is whether the aspirations to greater professional status and independence among midwives has been placed above maternal and baby wellbeing in the hierarchy of motivations.

It seems that it has.

Mark H
Mark H
3 years ago
Reply to  Joe Blow

Yes, our experience of British midwives was that they were more interested in persuading my wife to have natural childbirth at home despite the fact that she had had an emergency c-section 15 months previously (thankfully she had been in hospital intending natural birth of our 1st child so when the c-section turned out to be necessary she was already in the right place).
Great professionalism was demonstrated by the doctors, from the consultant (Egyptian) to surgeon (Polish) and anaesthetist (South African).
In our experience this tension between doctors and midwives exists to some extent in South Africa and not at all in Brazil.

carolstaines8
carolstaines8
3 years ago

It remains that childbirth in 21century is still a dangerous, traumatic experience for women. The saving grace in this experience is the flood of “parenting” hormones that, if you are lucky, blocks out the horror of what you have just gone through. I don’t know how medical progress can soften the negative side, but there is scope for improvement in how some women are managed and related to through this time. There are two lives at stake throughout and whilst most midwives, obstetricians are sensitive to this, there are some who are bordering on brutal. The good ones must blow the whistle on the bad ones….. We must progress.

Elizabeth Ward
Elizabeth Ward
3 years ago

My mother was a midwife for many years and she brought hundreds of babies into this World in a range of the most astonishing situations and conditions. She always maintained that maternal health before and during child birth required really good monitoring throughout pregnancy and labour. Not that she relied on machines – on the contrary, she felt they weren’t accurate and were overly relied on. They were a short cut to good care for the lazy or unskilled. However, were she still alive, she would say that what both sides of the debate misunderstand is that you must closely observe and listen to your patient at ALL times. You can strap on as many devices as you like, if you do the routine checks (heart rate, blood pressure, dilation, breathing, observation etc) and listen to what your patient is actually saying, you won’t go far wrong.

It strikes me that today’s midwives and doctors are unable or unwilling to do is to commit time to patients in this way. My mother was an avid knitter. Once labour was underway, she committed to being with her patient throughout, talking to them, watching them and filling the time in between with an activity which both parties enjoyed. No dashing off to monitor other people, or relentless form filling, or even leaving their bedside because the shift was finished. No Sister Marion Ward was the ultimate patient’s champion. Midwifery is a calling – it is not the faint hearted or those who can’t provide 100% to their patient. In 40 years of being a midwife, she never lost a Mum or a baby, despite working in conditions, many people now would even recognise.

Susie E
Susie E
3 years ago
Reply to  Elizabeth Ward

We need more midwives like your mum, and those midwives need more time with their patients! This is one of the reasons I opted for home births – having at least one midwife all to my self, 2 for the pushing stage. I ended up with three, the third being a student, for my second home birth. Who would get that kind of dedicated attention in hospital!?

Alison Houston
Alison Houston
3 years ago

I have had four children, three of them were intended to be born at home, two of them were actually born at home, the last born naturally in hospital. I went into hospital because my youngest was face to pubis and I had been in labour for a long time while she tried to turn herself the right way round.

Firstly the pain of labour is not unbearable pain if you stand up or crawl on hands and knees. Once labour is properly underway the pain is unbearable if you sit down, even on the loo, or if you remain lying down during strong contractions. If you are allowed to follow your instincts, the pain is bearable because your body guides you as to how to bear it.

The second stage of labour is not painful. The one thing women don’t tell each other very often is that the second stage is orgasmic. You have wave after wave of pleasure along with the feeling of the baby pushing its way to freedom, leading to high levels of oxytocin and love. Having said that I used gas and air for the final few contractions and for the birth of the afterbirth and I was pleasantly stoned, too.

I didn’t tear with any of my natural births, only with my epidural, drugged up hospital birth, which was still a vaginal birth, only I couldn’t feel any contractions.

My GP was horrified that I wanted natural childbirth at home, she said “there are no Brownie points for putting up with pain”.. My in laws were both GPs, who had specialised in obs and gynae and my mother in law ran the family planning clinic (needless to say my first pregnancy was an accident). But it seemed to me that I heard the voice of God telling me my second child would be born at home and I had no means of resisting. This was the first time I had a religious experience. I realise now God often comes to unbelievers in the form of a little child, but also after periods of intense depression and I suffered terrible antenatal depression in the early stages of pregnancy with my second child.

Laura O
Laura O
3 years ago
Reply to  Alison Houston

I think I missed out on the waves of pleasure…only excruciating, breathtaking pain. It took me months to get over the pain and trauma of childbirth, despite having a beautiful baby who I was full of love for. Please don’t make generic statements like ‘The second stage of labour is not painful’ when you can only speak to your own experience.

Juilan Bonmottier
Juilan Bonmottier
3 years ago
Reply to  Laura O

No need to censor or silence her like that. I think she was pretty obviously speaking to her own experience
throughout, as you are speaking to your very different one.

Alison Houston
Alison Houston
3 years ago
Reply to  Laura O

I’m sorry your experience was not good. None of us can speak about pain or pleasure as others experience it, its reality is unique to ourselves.

You don’t say that you had subsequent children, perhaps your experience put you off. But if you are an age and minded to have others I can assure you that the first experience need not set the template for others.

Going through the first stage standing up and doing the deep breathing exercises for hours does prepare your body for the second stage. I would not have borne the internal examinations without a whiff of gas and air which I realise I did not mention in my initial remark, I do realise how terrible the experience could have been, if the whole of it had taken place flat on my back with no kind of pain relief at all. But what I experienced is how it is meant to be at its best.

On the day after giving birth to my second baby my bossy GP called round in the morning. I was determined to show her I was in good form, so I put my daughter in her cot and was practising a rather taxing violin sonata when she knocked on the door. In the afternoon after the birth of my third daughter at about 10 am I took the first two children to their ballet exams. But after the fourth I decided, although I was perfectly fit I would have an old fashioned lying in and do nothing.

Susie E
Susie E
3 years ago
Reply to  Alison Houston

I’ve had two home births and I wouldn’t describe either of them as orgasmic, but the pain was more than manageable with breathing, a pool (didn’t need it for my second baby) and some gas and air… I would highly recommend it to those who are medically able to birth at home and think it will suit them.
I’m sorry you had a traumatising experience, Laura. I don’t know why some women’s outcomes are so different from others and I think its something which should be a serious area of study… I think were treated as the same by the medical professions, when really were all built very differently and have different histories.
My own mother had three very straightforward births (including the third at home) so I was confident I would be fine. I do, however, know of someone who’s doctor said if I’d of known you were short, have size 5 feet and large headed babies I’d have booked you in for a c-section straight away! (this was 40 years ago). The point being her body shape indicated she had a small pelvis so would struggle to give birth to larger babies. She only had 2 children because her husband couldn’t see her go through it again.
The point being, surely a woman’s bone structure should be considered as part of her risk assesment and a scan offered at 35 weeks or so to try and work out how big the baby is going to be (more accurate than the bump measurement I suspect). Then an appropriate plan can be put in place and advice on body position during labour can be given – or a c-section booked if necessary. Being induced sounds like a special form of torture and I think their use needs to be more carefully considered. I suspect they cause more (or at least different) problems then they solve.

Anna Norman
Anna Norman
3 years ago
Reply to  Alison Houston

I’ve had three vaginal births and all were horrifically painful; there was nothing pleasurable about them except the huge relief when they were over.

The first was the worst; I was induced and the midwife had the monitor on incorrectly, so she didn’t believe me when I said the contractions were extremely painful. When she realised it was in the wrong spot ‘oh that must have been quite intense’. What a euphemism for pain that caused me to leave my body and watch the scene from above ( I assume this was the pain or trauma?).

In each labour, my requests for an epidural were fobbed off – either it was too soon to call the anaesthetist and then it was too late. I was allowed some gas with my third child.

Yes, it is just one day in your life but even if you have a good outcome, as I did, the effects of the trauma linger. This is also the start of your parenting journey, and a better birthing experience is better for those crucial early years of a child’s life.

I agree Susie, I don’t think enough consideration is given to the shape of a woman’s pelvis. I have read that a narrow pelvis corresponds with a narrow jawline and I have quite a narrow face (braces as a child), so I presume I have a narrow pelvis too, I was never going to have an orgasmic birth.

Deborah Short
Deborah Short
3 years ago

I was lucky enough to have supportive .midwives with both pregnancies. They encouraged me to trust my body and the natural process of birthing while reassuring me that if we ran into complications at home, we could transfer to hospital, under a blue light if necessary. Both deliveries did indeed end up being in hospital, not due to medical emergency but due to my long drawn out ‘failure to progress’ labours. Happily they were both vaginal deliveries with minimal intervention other than pain relief. I’ve always been grateful to have been able to labour at home though.

David Morley
David Morley
3 years ago

A woman I used to work with was evangelical about homebirthing, despite the fact that both of her babies had been rushed to hospital in ambulances when their births went wrong.

This perhaps gets to the heart of the issue. As human beings we seem to struggle accepting evidence that goes against our beliefs. And this applies to professionals and groups as much as it does to anyone else.

The situation is made worse by professions closing ranks and resisting external monitoring, even management. In many cases, a quick examination of the statistics would soon have shown there was an issue.

stephen f.
stephen f.
3 years ago

I am the first person in my family born in a hospital, and my mother chose to go through it without pain killers or anesthesia. She chose to be out for my sister’s birth…that’s all that I have to contribute.

repk205
repk205
3 years ago

This was a very interesting article and I definitely agree with the author that there does seem to be a drive for having a “natural birth experience” generally. However, I gave birth to my second daughter this October and was supported by the wonderful midwives at the hospital in Bristol.

The day before my baby was born I was given the terrible news that my father had terminal cancer (he died only a few days later) so I did go into shock as I started labour. It was therefore far from the situation I had wanted, but the midwives I had with me were very sympathetic and caring. I truly felt safe giving birth with them there. I had a “natural birth” but I would have opted for a c-section if the situation had required it.

I hope the author has a positive childbirth experience next year.

Susie E
Susie E
3 years ago
Reply to  repk205

Sorry about your father. Sounds like you had excellent care.

Laura O
Laura O
3 years ago

This is an interesting article which covers various aspects of this debate. I’m glad you mentioned the freebirth movement – it’s a concept which makes me feel physically sick, stemming from western privilege and an insane idea that ‘natural’ must be ‘better’. Natural childbirth in many parts of the world is still extremely dangerous for both women and their babies, and these women do not have the luxury of knowing that, if their freebirth plan goes tits up, they can call an ambulance and be rushed to a modern hospital.

I’ve had three children by vaginal delivery. The first was incredibly long, painful and traumatic, but would be categorised as ‘low risk’ as everything went to plan. All of the midwifery care I’ve had in labour and birth has been excellent. My sister, on the other hand, has had 3 c-sections, and both her and her third child would almost certainly be dead if it weren’t for the emergency team at an NHS hospital, as well as the NHS Blood service. What’s right for one women is not going to be right for another, and ‘natural’ birth is definitely not right for many. We don’t question the ‘naturalness’ of other forms of healthcare, so why is it such a big deal in maternity care? The human race has amassed enormous scientific and medical knowledge to make us healthier and less likely to die, we need to make sure that women understand what is happening to them and be able to make informed choices when it is safe to do so.

Susie E
Susie E
3 years ago
Reply to  Laura O

Your point about every woman being different is key. As far as I can tell (had 2 children bring at home, no 3 due in May – hopefully at home all being well) at no point in the process is each woman’s body shape and bone structure (specifically pelvis) looked at as an indicator of how easy or difficult it will probably be for her to give birth naturally and whether she is at increased risk of needing intervention. I also don’t understand why women are not routinely given a third scan close to their due date just to check the size of the baby. If it’s a big one…. time to think of alternative plans?
I have always had extra scans during my pregnancy and having all that information has given me the confidence to have two homebirths so far, but maybe with this next one it’ll help me decide to be in hospital… information is key!!

Robert Malcolm
Robert Malcolm
3 years ago

In 2015, much as in previous years, caesarean section rates were lowest in Nordic countries (Iceland, Finland, Sweden and Norway), Israel and the Netherlands, with rates ranging from 15% to 17% of all live births.
Perhaps rather than worry too much about rates, it might be better to look the underlying economic and social reasons why so many women leave childbirth so late in life these days, why so many mothers in the UK are obese, and also encourage societal changes such as a universal basic income and better maternity/work rights?

Thomas Laird
Thomas Laird
3 years ago

Is this the same hospital that took an extra 50,000 pounds allocated to it by government and spent it on a Diversity & Inclusivity officer as well as a multi-faith (mosque) contemplation room.?

Jacquie
Jacquie
3 years ago

Louise Perry is quite obviously wrong when she referes to “more women opting to freebirth illegally …” Women had a legal right to freebirth! The very Guardian article she refers to states:

“It appears many maternity staff are not aware that women have a legal right to freebirth,” says Nadia Higson of the Association for Improvements in the Maternity Services. On 30 April, in response to reports that some women were removing themselves entirely from NHS perinatal care because of a reduction in birthplace options, the Royal College of Midwives issued guidance to members on how to support women. This made clear that it was not appropriate to refer a woman to children’s services solely because of her decision to decline medical support. “Despite this, we continue to hear reports of women being threatened,” Higson says. “It causes huge anxiety for couples. While common sense usually prevails, we do hear of some families being monitored.”

Seems Louise is as uninformed as maternity staff.

Zhirayr Nersessian
Zhirayr Nersessian
3 years ago

In our experience birth through public health care has become a productionized process. One of the the most, if not THE most important factor for a successful birth is time. Next is the environment- the body requires absolute focus on what IT needs to do. We are living in a world where we underestimate the capabilities of our bodies – and that topic also applies to ahem, viruses. We are becoming dependants on systems designed for efficiency, not for the individual. Therefore the individual must understand their rights during these processes.

Hospitals no longer have the capacity to give mothers all the time they need to give birth, nor are they the best enviroment to do so with trainees surrounding you and surgeons constantly hounding you to opt for assistance. OInce the mind becomes focused on dealing with these externalities you can forget about a comfortable, natural birth. All this has resulted in an insanely huge increase in assisted birth, a great number of them IMO totally uneccessary if TIME and ENVIRONMENT were appropriately allocated. Our first experience at a ward was horrendous and so we opted for private midwives to help push back on our second. I also highly recommend hypnobirthing courses..

Susie E
Susie E
3 years ago

Totally agree, especially about hypnobirthing. Hospitals should be set up like homes so that women who can’t or don’t want to birth at home can at least have a good chance at a straightforward birth. The production of Oxytocin is extremely important in ensuring the progress of a birth and this must be difficult to produce in a hospital ward.

Hilary Arundale
Hilary Arundale
3 years ago
Reply to  Susie E

I think you mean oxytocin

Susie E
Susie E
3 years ago

Yep! Oops

Tino Joseph
Tino Joseph
3 years ago

My wife gave birth naturally to our son at 10lbs. It was pretty traumatic (forceps, lots of blood, stitches ..and an infection) but it turned out ok. Everyone (midwives, nurses) were pro natural birth including my wife but to me the whole thing was just brutal. I’d persuade her to have a c section next time unless it’s a much smaller baby!

Susie E
Susie E
3 years ago
Reply to  Tino Joseph

I gave birth to a 9.5lbs at home in a pool. No stitches required. Just to give the other side of the story.

Sorry your wife had a bad experience. I think a lot of it is down to pelvis shape – which never seems to be taken into account! If I were in her situation I would also be opting for a c-section next time around.

simon taylor
simon taylor
3 years ago

When my wife gave birth to our son 18 years ago, the mid wife, who looked like a denizen of middle earth, and really needed a shave) point blank refused to give her an epidural and then became verbally and physically obstructive. Eventually, a lovely medic with a drugs trolley threw her out.

sarahcynthiajohnson
sarahcynthiajohnson
3 years ago

If there is a “cult of natural childbirth” gripping the land, why are caesareans and inductions rising year on year?

bellonaregina
bellonaregina
3 years ago

Because people are finally regaining their senses.

Hilary Arundale
Hilary Arundale
3 years ago

A good, balanced article. My daughter is being encouraged to “book” an induction as her due date was yesterday and Christmas will mean fewer hospital staff. Now that I’ve read all the comments, I’m very worried about this.

Amy Blakeney
Amy Blakeney
3 years ago

I was coerced into an induction with my first and it was a very traumatic experience. It is a big intervention for both mother and baby so is NOT a natural birth even if it leads to a vaginal delivery. Induction rates all over the country are sky high, often for very spurious reasons. And a baby isn’t ‘overdue’ until 42 weeks. Unless there are compelling medical reasons it is far better for mother and baby to wait for spontaneous labour. The hospital have a legal obligation to provide care, and in terms of staffing issues an induced birth would usually be a much longer process (up to several days) than a spontaneous delivery. There’s also a much higher chance of ending up with an emergency c-section which would require a longer hospital stay afterwards. I hope your daughter has a great birth whatever happens, be sure to ask questions and don’t let them force their will if it’s going against her instincts.

Hilary Arundale
Hilary Arundale
3 years ago
Reply to  Amy Blakeney

Thank you, Amy. Her instinct is to follow the midwife’s guidance at the moment. But we have a few days. I hope very much that induction won’t happen but it’s not up to me!

Annette Kralendijk
Annette Kralendijk
3 years ago

I had a December induction with a second baby and it went just fine. She was three days early. I wanted to be sure that my doctor would be doing the delivery rather than whatever physician was on call. An induced birth can actually be quite short, mine was less than 7 hours. If you’re allowed to go days in labor with an induction, that’s malpractice. But if you’re already past your due date, that’s unlikely anyway.

If you have a hospital and a doctor you trust, which every woman should, you go with the best medical advice.

Hilary Arundale
Hilary Arundale
3 years ago

Thank you, Annette. This is very reassuring.

Susie E
Susie E
3 years ago

Help your daughter do her research and make an informed decision… and it is HER decision – don’tlet the midwives push her around.
I would personally avoid any intervention unless it is medically necessary, not to help make the midwives Christmas rota a bit more relaxed!! I wish your daughter all the best.

Amy Blakeney
Amy Blakeney
3 years ago

There’s nothing ‘natural’ about sweeps, ARM, prostaglandin pessaries and syntocinon infusions, although they are pushed onto women all the time and often lead to a cascade of interventions and assisted delivery or emergency C-section. Spontaneous delivery and birth is not ‘New Age woo’ and given the right conditions we afford other female mammals (dark, quiet, calm, familiar environments and companions) the natural hormones of oxytocin, endorphins, prolactin, epinephrine, etc will do their job.

The problem is that very often a woman isn’t listened to and is infantilised by HCPs who ignore her own instincts and observations. I am very much in favour of truly natural delivery but honestly think if problems arise it’s easier to go for an elective C-section as soon as possible and retain a sense of control. Birth trauma from my eldest led me to seek out groups of women with similar stories and almost all reported that it was dismissive, even cruel, treatment from HCPs that made it so dreadful.

Maybe my view is tainted by bad experience but it’s something that stays with you for the rest of your life. Incidentally, this is also why some women choose to freebirth, which is NOT illegal in the UK (https://www.aims.org.uk/jou….

Susie E
Susie E
3 years ago
Reply to  Amy Blakeney

Completely agree!!

Robert Cannon
Robert Cannon
3 years ago

“While the national c-section rate averages 24% to 29%, at the Shrewsbury and Telford Trust it was between 8% and 12%, apparently due to a widespread belief among midwives that a low rate was a sign of good maternity care.”

There is a problem with midwives in the NHS. Quite simply they do not want doctors routinely involved in the birth process because they do not want a reduction in status and autonomy. Politically, the Conservatives have supported this because having midwives deal with births keeps NHS costs down and Labour have supported it because traditionally midwives were more Labour voters than obstetrician as well as an inverted snobbery.

When my wife was pregnant with our first child we went to our GP practice in East London. The GP wanted to refer my wife to a local birthing clinic which had no doctors present on site. My wife, through research, found that more than 1 in 4 women giving birth at the birthing clinic ended up being taken by ambulance through congested roads to the Royal London Hospital. As you might expect, almost all of the women attending the birthing clinic were low income immigrants or children of the same – mostly of Bangladeshi origin. None of the City workers living around us were using it. Many of the scandals reported regarding maternal deaths in England have involved mothers who were immigrants.

The NHS, the education system, and most of the British public sector, has a problem: they’re run to generate jobs without paying those jobs particularly well. In many cases outcomes for service users would be significantly better if the same money was spent employing a smaller number of more qualified people and paying them more. That’s certainly the case with NHS midwives and obstetricians. The average midwife salary in the United Kingdom is over £39k per year.

Another example is teaching assistants – low paid adjuncts for qualified teachers which have been around for 20 years but which studies show add absolutely no value at all in terms of average educational outcomes. Even worse, teaching assistants have widened the educational attainment gap between children from low income families and those from high income families. In short, schools in low income areas get teaching assistants of low educational attainment (many cases of teaching assistants teaching children the wrong spelling or grammar because they do not know better) whereas schools in high income areas get teaching assistants educated to degree or postgrad level who are looking for very much a family second income and a job where the days and hours of work match their children’s school terms and days. The money spent on teaching assistants would be much better spent giving higher salaries to teachers who have top degree results themselves, as is done in Finland with very good outcomes.

Because the NHS is a top-down monopoly there is no evolution of structures towards those that are more efficient or generate better outcomes. If the UK had a less statist healthcare system and instead something more like that of Germany or France then the issue with mothers getting appalling care in pregnancy would not arise to the same extent.

Unfortunately, the U.K. is now locked into politics where decisions on public services are driven by the outlook of those who, because they pay so little tax themselves, treat the NHS and the state education system as cargo cults.

Carl Goulding
Carl Goulding
3 years ago

Surely the tragedy here is the abject failure of the NHS and not that women (especially black women) are putting themselves at risk of pain, suffering and death during pregnancy and childbirth?

David Goldsmith
David Goldsmith
3 years ago
Reply to  Carl Goulding

Yes Carl, it is certainly so. The NHS is a national disgrace in this, and so many other ways.

Last Jacobin
Last Jacobin
3 years ago

Obstetrics, worldwide, is the single largest cause of medical claims. Since, as so many people in these pages point out, no other country has a system similar to the NHS it can hardly be an NHS specific problem.

bootsyjam
bootsyjam
3 years ago
Reply to  Carl Goulding

Well done for shoe horning race into this. Top marks.

Carl Goulding
Carl Goulding
3 years ago
Reply to  bootsyjam

Read the article and hopefully you will realise the reason why I chose to.

Judith Cameron
Judith Cameron
3 years ago

This is a dreadfully biased article and it is no surprise to have been written by a purported academic who didn’t actually become a doctor and hasn’t ever given birth. How she can claim to be qualified to write about such an emotive subject because her Master’s essay was on the history of ‘grisly’ childbirth is both shameful and disquieting in its ignorance.
The unnecessary deaths at the Shrewsbury and Telford Trust are very sad but to suggest that a quarter of births should be through surgery is irresponsible – and it’s also irresponsible to suggest that any surgery doesn’t carry its own risks. Why was there no mention of baby laceration, consequential allergies or even hospital infections only associated with C-sections? The UK high rates of C-section are not in line with many other western European countries, most of which have better neonatal survival rates than the UK. Indeed, the Netherlands, a country that encourages home births wherever possible is placed 13th against our 19th position in the most recent European neonatal mortality figures.
Getting onto the personal, I was butchered by a male obstetrician during my first birth resulting in a cut from vagina to a**s that was so badly sutured that it took more than a year to heal. Following subsequent healthy pregnancies, my younger children were born at home with my GP and midwife present but if that had not been possible, I would have chosen to free birth rather than return for further physical harm. And again the writer is wrong to state that giving birth alone at home is illegal in this country.

vince porter
vince porter
3 years ago

As our sciences become more robust, the tendency to deny their truths with ideological nonsense becomes more strident.

Meghan Kathleen Jamieson
Meghan Kathleen Jamieson
3 years ago

The pendulum seems to have swung back to high levels of intervention at the moment, but people seem to forget that the push toward natural childbirth came from high levels of c-sections that which are more dangerous for mothers and babies, doctors who would not listen to or respect mothers, and a host of bad practices.

The author has been a little selective in going back a hundred years or even 70 years for her examples of how medicalised births can be negative. On the other hand she doesn’t mention that high c-section stats indicate that mothers and babies are being put in unnecessary danger, and “high” means over 10 – 15% depending on the type of hospital involved. Nor does she mention that generally the studies show that outcomes for low-risk births are better with midwives than doctors, and better with GPs than OB/GYNs.

It’s a very superficial article all round.

Alan Thorpe
Alan Thorpe
3 years ago

I am pleased that I don’t have to go through this, but it sums up all the health services. The staff think they know what is best for us and that they don’t have to explain anything or give us options. My body, my choice should certainly apply.

Katie F
Katie F
3 years ago

I would agree with several of the commentators that the best route to an easy birth is through a good relationship with a competent birthing partner – the midwife relationship of old. I’ve had four children; the first was a planned home birth that for various reasons, mostly the feeling of being ‘on the clock’, and a multi-day labour, turned into a (non-emergency) hospital transfer, epidural, and double episiotomy, followed by an MRSA infected breast abscess leading to readmission at 5 weeks. I cannot fault the midwives I saw through the early parts of labour but it was a succession of strangers and the hospital experience was not conducive to anything pleasant, frankly.

My other three children were birthed at home in a pool, with no pain relief and no significant tearing, under the care and supervision of an independent midwife – someone I knew and who knew me through time spent together at our appointments (and knew my other children, all of whom were present for all the births), and the experiences were worlds apart. It’s still not a wholly pleasant experience; but it can certainly go better or worse.

C-sections are right in some circumstances; hone water births in others. Personalised and personal care seems right in every case.

An aside – those three births with an independent midwife would otherwise all have been under the care of Shrewsbury & Telford trust during this period (and would have if I had required a hospital transfer). When my second child was six weeks old we stayed in a rental cottage of a house near Shrewsbury and were given a brand new cot for her to sleep in. It transpired that the cot should have belonged to the grandchild of the home’s owners, who would have been the same age as my baby but had died at birth, presumably in Shrewsbury hospital. I have never forgotten her understated “we’re all very sad”.

Jeremy Reffin
Jeremy Reffin
3 years ago

Thank you for an interesting article on a very important issue. As a husband and father-to-be 22 years ago (where does the time go?) I felt acutely aware of how dangerous it was to give birth to a child. We went through and enjoyed the NCT courses together, my wife having booked a total of 22 hours of instruction for the two of us. Coming out of that, and after doing a certain amount of reading, I was clear on one thing – it was perfectly safe to have your first child anywhere so long as it was within 100 feet and three minutes of a fully fitted and staffed c-section suite.

The maternity mortality data and trends are at least slightly encouraging for the UK. Since 2010 the UK has trended down from an alarming 11/100,000 to 7/100,000 in 2007 which is at least approaching the level (about 6) for most EU nations. So apparently something has been done to start making amends for the UK’s poor record. According to this data (World Bank) the USA has headed in the opposite direction going from 12/100,000 in 2000 to 19 in 2017, presumably because of terrible outcomes for the uninsured.

https://data.worldbank.org/

Peter Kriens
Peter Kriens
3 years ago

It might have been mentioned that in the last 40 years this has been a discussion exclusively among women. No modern man would have the balls to interfere. For quit some time all sides are fare majority female.

Instead this article, as usual from Perry, goes out of its way to put the blame at men. If the situation had been reversed I’m sure women would’ve suffered worse because they had had to watch the agony.

Hadyn Oriti
Hadyn Oriti
3 years ago

And where do Midwives see the Child in all of this?

A Bcd
A Bcd
3 years ago

I thought at the time that a prisoner in fear of the torture chamber …

This is an obscene comparison. With our large heads and narrow hips, human childbirth is uniquely difficult, painful, and risky. Also difficult, painful, and risky is what elite athletes endure pushing their bodies to the limit.

Both are in service to an exhilarating objective. Neither is in the same realm as an activity in service to a cruel and dehumanizing objective.

Simon Renouf
Simon Renouf
3 years ago

I was quite surprised by the lack of science in this article. Some interventions, for example unnecessary inductions, can lead to increased likelihood of cesarian, with all the risks associated with abdominal surgery. Cesarean delivery for low-risk pregnancies is associated with worse health outcomes for infants and mothers. This article appears not to recognize that science.

john freeman
john freeman
3 years ago

I was sorry to read the last two sentences. Give it a rest, will you?

larry tate
larry tate
3 years ago

You said it at the beggining of your article: God had to punish women for her transgression. It´s a methafor, of course, but one that makes sense, considering the size of the sin. You now ask if this burden is a conicidence. There are no coincidences, you get what you deserve, from God´s hand.
Should have listen to the advice and refrained from biting the fruit of knowledge. Now look at the mess we´re in. Take the punishment honourably and with grace.

simon taylor
simon taylor
3 years ago
Reply to  larry tate

I sincerely hope your post is supposed to be satirical, in which case I do not share your sense of humour. If not, you need sectioning.

Hilary Arundale
Hilary Arundale
3 years ago
Reply to  larry tate

Are you mad?

Alex Mitchell
Alex Mitchell
3 years ago
Reply to  larry tate

Nothing like a bit of religious fundamentalism to blame people for something they didn’t do. The sole area of overlap between religion and wokeness.

Daniel Björkman
Daniel Björkman
3 years ago

In our safe and affluent society, we don’t usually tolerate pain and danger, but we do in this case, and the nature of the burden means that it is only women who are asked to bear it. Can that be a coincidence?

But you’re not asked to bear it. You volunteer. In fact, you go to extraordinary lengths for the privilege. It’s not even that you’d crawl over broken glass to get to give birth, it’s that you choose to give birth even though it’s commonly known that it’s like crawling over broken glass.

I mean, any woman who wants to opt out of this horrifying thing has my full understanding and support. But few if any are doing that. If you refuse to go on strike, don’t be surprised that the working conditions continue to suck.

Drahcir Nevarc
Drahcir Nevarc
3 years ago

Weird.

Adrian
Adrian
3 years ago

I think you may have missed that the choice of words “burden” and “bear” are cognate with “birth”, “born” etc.
Just thinking that.

Laura O
Laura O
3 years ago

I’m sure it would go down well with the rest of the human race if all women decided to go on ‘strike’ and refuse to bear childbirth (that was sarcasm).

Blue Tev
Blue Tev
3 years ago
Reply to  Laura O

Sometimes, looking at the world around us, I wonder if that wouldn’t be the better option.