Is there a casual and callous attitude towards pregnancy and childbirth in society?

(385 Posts)
PeaceAndHope Tue 17-Jan-12 22:43:23

Hello everyonesmile

I'm sorry if I have posted my question in the wrong section but since I am a newbie I hope you'll all overlook it.

I have spent a lot of time recently wondering about the varied attitudes to childbirth and pregnancy and the lack of proper information regarding the process amongst most people.

I do believe that with the advancement of technology and better care we have been able to make the process a lot safer than it was in say the 1700s when the maternal mortality rate was 35%. However, it is my observation that people tend to take the whole thing for granted and assume all will be well because "women have been doing this for millenia".

I have keenly researched this subject and I have noticed that whenever I point out the risks associated with pregnancy and birth the reactions are those of disbelief and annoyance. I once brought up the possibility of fecal incontinence post childbirth and was admonished (by a man) to stop 'scaring people'.

I recently read a comment on a men's website that said "Pregnancy is the safest thing ever. It's not dangerous-to say that it is dangerous is misleading".
I certainly agree that the mortality rates in the developed world are rather low, but death is not the only thing that makes a process risky.

Pregnancy comes with superficial risks like permanent body changes to more serious ones such as permanent incontinence, diabetes, hypertension, uterine prolapse, obstetric fistulas (although these are rare), and even a permanent colostomy. Even in the developed world women still die of haemorrhage and aneurysms while giving birth.

Why is it that bringing this up tends to anger most people? Why do most people deny that these complications exist despite clear cut medical evidence that they do?

Is it traditionalism by virtue of which women are "meant" to bear children and therefore how can the process not be safe? Or is it just a paternalistic refusal to acknowledge that women do put themselves at risk for a series of complications (irrespective of whether they occur) when they have children?

I am not trying to imply that pregnancy and childbirth are horrible, evil things but I do believe that the attitude towards them is a bit casual and ignorant.

Your thoughts please?

QTPie Wed 18-Jan-12 15:01:38

SardineQueen, was it NCT? If so they do tend to er on the side of "VB good, CS bad", but it can vary quite a lot from instructor to instructor.

If you are going to tell people the full gory details, then antenatal classes (had mine at 26 weeks plus) is really a bit late and would probably really panic every pregnant woman there.... Unless people can truly have a choice of VB/CS.

I guess that there is a trade off between knowledge and being relaxed and calm. Really you want to know enough to be able to do everything practicable to reduce the risks of hazards happening to you without scaring yourself into a rigid ball of tension who them fights the whole process of birth....

QT

OrmIrian Wed 18-Jan-12 15:03:04

"people are often told that their experience of it doesn't matter because the baby is healthy"

I agree with that. When my babies were small i wanted to talk about my experience but felt that no-one would be interest (they probably wouldn't!). i was off the end of the production line and back to normality. I do think there is an argument for having an old-fashioned 'confinement' when the mother was allowed to do nothing, to truly rest and enjoy getting to know her baby. But that lack of space and time to just be is missing from our culture as a whole - not just after childbirth.

suzikettles Wed 18-Jan-12 15:08:44

Yes, I remember being quite overwhelmed (in shock in a way I suppose) in the immediate aftermath of ds's birth. I wanted to tell my birth story to everyone - I think telling it a few times helped me process it, and I had a pretty straighforward experience - successful induction, quick (5 hrs), g&a only, episiotomy.

Anyway, I remember my mum being very disapproving of me telling my childless friend about it. Like it was something you shouldn't talk about with people who hadn't been through it, in fact you should brush it off and be grateful that you had your baby.

I would say within a fairly short time though the memory had almost completely faded. I did forget about the pain, and I'm lucky to have no lasting sequelae (except for not bouncing on a trampoline tbh). I think talking about it was a good thing though.

shagmundfreud Wed 18-Jan-12 15:13:13

"If you feel that pregnancy is overmedicalised you can refuse scans, fetal monitoring etc. and opt for a duola and home birth"

The point I was trying to make was about the culture surrounding birth, which all of us are prey to. Women are very unlikely to opt for a homebirth, or to reject antenatal testing when the prevalent cultural climate around pregnancy and birth is one of fear, no matter what the actual medical evidence tells us about the efficacy of antenatal testing or the safety of out of hospital birth.

The simple fact that 98% of women opt to give birth in hospital in the UK despite the option of a safe home birth service suggests to me that most women do actually see birth as being a possible medical emergency, necessitating immediate access to doctors and operating theatres

"I'm talking about the denial amongst people and a failure to acknowledge that while being a perfectly natural process pregnancy and childbirth does come with a set of risks and possible complications. "

Where is your evidence that people are treating pregnancy and childbirth 'casually'?

I see the opposite: unprecedented levels of fear and anxiety about poor outcomes.

"As for why they have their babies in hospitals, well some people just like to be on the safer side. And remember that a low risk pregnancy doesn't always imply uncomplicated birth. Some prefer not to take risks and I respect that."

Are people who give birth out of hospital taking risks with their health and that of their baby? hmm

"I think you view the process as inherently safe, whereas I view it as inherently risky!"

No - not at all. There is no denying the 1 in 200 babies who die shortly before or during labour in the UK. Or the two or three dozen women who die in childbirth every year. Childbirth is not completely safe for mothers or for babies. I'm very keen that it should be made safer. I think we just differ in how this issue should be approached. I'm interested in the practical things we can do as a society to make birth safer. I'm not quite sure what would be the purpose of a campaign to tell women how dangerous birth can be.....

PeaceAndHope Wed 18-Jan-12 15:14:04

OrmIrian:

What is your definition of "minor damage" and "minor discomfort"? And how did you come to the conclusion that most women experience 'minor damage'?

What I expect wider society to do is to not dismiss the risks and complications that are associated with the process, or worse yet deny that they exist despite evidence to the contrary. I expect them to have a little more respect and sensitivity towards the women who go through it.

CailinDana:

exactly
If a woman has a fourth degree tear and incontinence but her baby is healthy nobody would care much about her condition.

TunipTheVegemal Wed 18-Jan-12 15:14:34

Another thing that might be relevant is when people who are suffering badly with horrible-but-not-dangerous pregnancy complications such as SPD or severe NVP are told 'You're not ill, you're just pregnant.' Not just by relatives/colleagues/bosses, but medical professionals too.

WidowWadman Wed 18-Jan-12 15:18:07

Lying to women and withholding information about the risks of vaginal birth as not to scare them away from homebirth is the opposite of enabling informed decision making. It's patronising and dishonest.

OrmIrian Wed 18-Jan-12 15:20:22

Minor damage is what I consider I had - an episiotomy first time round, tears second time around, weakened pelvic floor (9 years after my last baby), not to mention droopier boobs, flabbier tummy etc that took a while to get back under control. My evidence is purely anecdotal - ie all the women I know who have had at least one baby. And I know quite a few. But if you have evidence to say that that isn't the case I'm quite happy to beleieve you.

I still don't know exactly what you want society to do though. It sounds a bit vague TBH.

FWIW I am perimenopausal atm and to be honest i feel infinitely worse, emotionally and physically, and more disregarded now than i ever did when I was pregnant and bfing.

CailinDana Wed 18-Jan-12 15:23:04

In our NHS antenatal class the midwife wouldn't show us the forceps as she "didn't want to scare us." I think that about sums up the attitude of some people - the idea that keeping you ignorant is the best way to keep you calm.

I do think girls should be taught all the ins and outs of pregnancy in sex education, after all, it's all part of the experience and they should know about it beforehand. I think it's quite sad that women have to seek out information online about things that will be happening to their own body.

PeaceAndHope Wed 18-Jan-12 15:25:12

Shagmundfreud:

No, I didn't say people who give birth at home are taking risks with their health. I fully support home births.
However, you must understand that some women prefer to be in an environment where emergency help is available such as a paediatrician for the newborn if required. Others don't feel it's necessary. Neither approach is wrong. While birth is not necessarily a medical emergency, I'm sure you're aware of complications such as asphyxia, hypoxia, shoulder dystocia, post partum haemorrhage and cord prolapse which could very well result in an emergency situation. Sadly, there is no way of predicting who will experience these complications so one cannot be prepared in advance. Unless you can predict who will suffer these complications, you can't give anyone a 100% guarantee that they don't need to be in a hospital.

I think you're deliberately misunderstanding me. I'm not wanting to start a campaign telling women about the dangers of pregnancy, I am simply questioning the attitude of denial and casual dismissal which exists in society regarding pregnancy and birth related complications.

Yorky Wed 18-Jan-12 15:29:49

I think people like me are part of your problem - my 1st pregnancy was easier than easy, I had no morning sickness (major blessing as I was working in catering at the time!), no blood pressure problems, no SPD - I had a home water birth, the MW arrived 45mins before our son, the placenta arrived without injectino or difficulty, I had no tear that needed stitches, he fed easily and happily
And while people can do it like that, it always more comfortable to turn a blind eye to faecal incontinence, emcs, 4th degree tears, sore/blistered/cracked nipples, GD, PE, BP complications etc and say well, 'it may not happen to me'

For what its worth I am on pg#4 now and they have got progressively harder work (but no more medically complicated on my notes) - not sure if thats due to having toddlers to run round after as well as a bump, or my body feeling the cumulative effects of 4 pregnancies in 6yrs

I remember when I restarted my yoga classes after DS1s birth, when he was about 2months old, and my yoga teacher specifically told me not to try and stretch as I still had the hormone relaxin in my system and my body would be able to stretch further than was good for it, causing problems later. She said she would consider me a postnatal yoga student for 2yrs, but before those 2yrs were up I had a 2nd child (and we'd also moved so I didn't have the benefit of her advice sad ) My MW/HV had never mentioned this as a possibility, and I find being considered post natal for 2yrs quite extreme, but it does make me wonder about attitudes to new mums - not just the pressure to get back into your pre-pg jeans - would love to be part of those cuktures where mums are waited on, or kept to bedrest for a period after the birth (although I do think I'd go spare, the thought of a section and not being able to drive for 6wks terrifies me!)

Sorry this is so long and more about postnatal then preganancy, but I do think similar attitudes prevail

NeedlesCuties Wed 18-Jan-12 15:31:45

This is a really interesting OP and discussion.

Not sure what is 'right' or 'wrong' but from my own experience I feel that the shiny sunny happiness of adverts for baby items and pregnancy magazines really give a rose-tinted idea that isn't what happens in real life.

Either the magazines mainly focus on prams, maternity wear etc rather than health, issues, real experiences in order to sell more products or that is what sells because people want to see the sunny side of life.

The general ignorance in society about fertility rates and ages astounds me, never mind the ignorance about tears, pain relief, pregnancy issues etc.

PeaceAndHope Wed 18-Jan-12 15:34:42

OrmIrian:

What you consider minor damage might be more problematic for others. I know many women who would find their quality of life severely reduced by a weakened pelvic floor and self esteem a bit damaged by a body that changed for the worse.
However, these women are dismissed and told to get over it. That is the attitude I abhor.

I didn't understand what evidence you're asking for exactly?

FruitSaladIsNotPudding Wed 18-Jan-12 15:34:58

I agree with those who say there is a culture of fear surrounding childbirth, if anything.

Increased intervention in a double edged sword as well - it certainly isn't true that hospital and doctors = safer. Although that is the common perception, as the op is showing!

CailinDana Wed 18-Jan-12 15:36:02

From a feminist point of view I think some women downplay pregnancy and birth because they feel under pressure not to appear "weak" and "womanly" - they feel they should just get back on their feet and be ready to go as that is what successful go-getter women do. My greek friend assumed I would have 40 days in bed after the baby was born, as that's what they do in his home town. He was really surprised when I said I was in the pub three days after DS was born! (not drinking, just for a coffee, honest!). I didn't need the time in bed as I'd had a straightforward birth but I could see why a lot of women would.

The fact is, having a baby is a massive experience, whether you have an easy or difficult birth. Yet there seems to be very little acknowledgement of that fact. The media celebrates women who get back to "normal" (ie skinny) in double-quick time and PND is talked about very seldom. Even though DS is a year old and his birth was fine, I still sometimes have flashbacks to labour and I can't believe it all actually happened. I mean, I grew a person, and then he came out of me!! WTF!!

PeaceAndHope Wed 18-Jan-12 15:37:18

NeedlessCuties:

YES. I wish that these mommy magazines would focus a bit more on real issues instead of painty a romantic notion of motherhood.

I am like you in the sense that I'm constantly astounded by the ignorance regarding these issues and the insensitivity towards them.

PeaceAndHope Wed 18-Jan-12 15:41:58

FruitSalad:

Is it possible for you to clarify how my OP implies that hospitals=safer? That wasn't even really part of the actual discussion.

If you judge women who prefer hospital births, you're no better than those who judge home births. Perhaps if there were better information and more honest opinions available to women they would make decisions based on personal preference and not fear or alternatively an overly positive view of the outcomes.

shagmundfreud Wed 18-Jan-12 15:46:11

"However, these women are dismissed and told to get over it."

Who exactly is telling these women to 'get over it'?

Who exactly is dismissing women who have medical problems following childbirth?

PeaceAndHope Wed 18-Jan-12 15:47:06

CailinDana:

That's an interesting point. I think you can look at it the other way as well. Some women downplay the risks and complications because they feel like less of a woman if they have complicated pregnancies or deliveries. I think the common perception is that our bodies are meant to do this. Complications often result in women blaming themselves and feeling like failures.

PeaceAndHope Wed 18-Jan-12 15:49:30

Shagmundfreud:

Do you want names? Addresses? Phone numbers?

It's a general attitude I've noticed in my 31 years on the planet. I don't know why your attitude towards this discussion is so hostile, and I'm confused as to what point you're attempting to make.

shagmundfreud Wed 18-Jan-12 15:55:05

"If you judge women who prefer hospital births, you're no better than those who judge home births"

I don't think there is any moral judgement going on here.

I assume that women who choose a hospital birth do so because generally they believe it's the safest and most appropriate place for them to give birth.

Is it unreasonable or unpleasantly judgemental to assume this?

"YES. I wish that these mommy magazines would focus a bit more on real issues instead of painty a romantic notion of motherhood"

Have you got any of these magazines to hand, so we could discuss the actual content?

March's edition of Mother and Baby magazine carries an article on postnatal depression.

Other issues I've seen have had articles on special care babies, baby loss, pre-term labour, emergency caesareans, etc.

Although I will give you that primarily they seem a vehicle for flogging products, particularly formula milk, adverts for which (and for bottlefeeding equipment) seem to form the bulk of their advertising revenue.

NoWayNoHow Wed 18-Jan-12 15:59:32

This is a really interesting op, OP.

I tend to agree with you - I do feel that we downplay the potential complications with giving birth. 4 years down the line, I'm still traumatised by the whole thing, mainly because nothing that happened to me was even discussed in my NHS ante-natal classes.

In fact, the presiding messages were as follows: don't bother us until your baby is crowning; if you have an epidural, on your head be it, they cause delays, are only for sissies and will make your labour horrible and long if they don't stop it altogether; VB is textbook and standard and straightforward, this is what happens, and then you go home (unless you have an epidural, in which case meet my friend the forceps).

No mention of episiotomies, tears, ventouse, etc. I was just poorly informed, and being poorly informed left me badly prepared, and being badly prepared left me in a situation where I was having to make decisions on my labour without any in depth information whilst in a delirious sleep-exempt state.

The casual attitude to pregnancy and how it's just supposed to go swimmingly leaves me cross for all the above reasons. But it also leaves me cross because I truly believe there are women out there who are beating themselves up because their labour and birth WASN'T like they were told it would be, and in their minds it is their own fault - they feel they did something "wrong"

shagmundfreud Wed 18-Jan-12 16:07:34

"Do you want names? Addresses? Phone numbers?

It's a general attitude I've noticed in my 31 years on the planet."

I assumed you were talking about general social trends, rather than the particular attitudes of your friends and family.

shagmundfreud Wed 18-Jan-12 16:14:40

"because their labour and birth WASN'T like they were told it would be"

Don't most women know that over one in four births is by c-section in the UK, and that the majority of these are emergency c/s?

Who is telling women that their births WILL be straightforward?

thebody Wed 18-Jan-12 16:19:32

very interesting post and agree with Cailindala.

I once heard a male consultant on tv saying that the journey to 10cm is the most dangerous journey for mum and baby and thats right.

I nearly lost my first ds, in a hi tech hospital, hes fine now thank god and I had a good friend who lost her child in a home birth so pregnancy IS riskyand yes I get sick of the attitude of some that 'chinese women give birth in a field and then carry on' yes and lots die.

I have another friend who has a permanent illeostomy as she was cut during birth and the midwife caused her parmanent damage.

after 4 dcs I take for granted the bladder weakness, droopy tits, stretch marks and loose pelvic floor, feel got off quite free tbh

mummy magazines are ridiculous in the headlines, 'get the birth you want'. thats crap, you get the birth you get and theres very little you can do to alter this.

I hate the attitude of the types who say all births can be vaginal if you stay calm or go to the right classes, crap crap crap.

however I tend to think that its women doing this to women most of all.

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