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Natural childbirth movement 'denies women choice'

Those who want Caesareans or pain relief are being discouraged from asking for them, say campaigners

By Ian Griggs and Jonathan Owen

Many women in labour feel under pressure to forgo having an epidural, one support group says

Rex

Many women in labour feel under pressure to forgo having an epidural, one support group says

Campaigners will issue a stern warning tomorrow that childbirth has become a political football, with the Government pandering to the natural birth lobby and so denying women the freedom to have elective Caesareans and pain relief.

At a meeting with Kevin Barron MP, chair of the Commons Health Select Committee, the Birth Trauma Association (BTA) and other support groups will call for urgent action to ensure women are given a real choice of treatment. The campaigners accuse the Government of having allowed childbirth to be dominated by policies which suit some groups of women to the detriment of others, and are calling on ministers to create an inclusive maternity policy.

"We have swung from the extreme of over-medicalisation to the opposite of natural childbirth, rather than allowing women to have an informed choice," said Maureen Treadwell, co-founder of the BTA.

The battle lines are being drawn as some people within maternity services attempt to turn back the clock and reduce the number of Caesarean sections, currently a quarter of the 700,000 deliveries each year in the UK.

Louise Silverton, the outgoing general secretary of the Royal College of Midwives (RCM), said last month that the current Caesarean rate of 170,000 deliveries a year was "unacceptably and needlessly high". Only 9 per cent of women had a Caesarean section in the UK 30 years ago and Ms Silverton wants Britain to aim for no more than 15 per cent, in line with World Health Organisation recommendations. She criticised the pattern of women under 40 who are not prepared to deal with the agony of childbirth which, she believes, is driven by celebrity culture.

But campaigners argue that women are being short-changed by the new drive towards "natural" births with no pain relief and are suffering needlessly as a result. They claim that women carrying large babies of more than 4.5kg are not being offered enough choice and that this policy is leading to severe injuries of the colon.

"Childbirth has become a political football where women are often discouraged from having the sort of birth that they want in order to fulfil someone's idea of a 'normal' birth. Women don't want to have to go into childbirth and have to fight for pain relief," said Ms Treadwell. "There is a hidden agenda here, one that will result in women being made to feel failures just for asking for pain relief or other forms of medical intervention."

But RCM general secretary Professor Cathy Warwick said she saw no evidence that women were being pushed into particular choices. "We would certainly support reducing the number of epidurals and we want women to have pain relief based on informed choices," she said. "The final choice should be with the woman. If a woman remains determined, after proper discussion, it is my understanding she would be offered a Caesarean section."

Professor Warwick denied there was an obsession among midwives with "normal" births. "Too much intervention is leading to morbidity in women and babies, but we don't want obsession with normality to lead to women and babies suffering. Just because a baby is big does not automatically mean the mother should have a Caesarean section," she said.

Sheila Kitzinger, the natural-birth campaigner, said women were being duped into medical interventions by marketing. "I think the language of 'choice' derives from marketing, but it has now taken over in childbirth, and women have come to feel they can simply choose the product they prefer," she said. "Women can be vulnerable if it is their first baby, and they can be pushed into feeling that epidurals and Caesarean sections – both heavily marketed – are superior products."

A Department of Health spokesman said, "A doctor has to take responsibility for the clinical risks involved in a Caesarean section so the doctor could refuse, but would not do so without giving the mother a chance to get a second medical opinion."

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Comments

CHOICE OR INTERVENTION
[info]patabast wrote:
Friday, 13 February 2009 at 11:47 am (UTC)
In view of the fact that this is what my normal body physiology dictates, I doubt if I can convince any surgeon to put food in my stomach through surgery unless, I have a jolly good reason why I cannot use my mouth as thoroughfare. Why then do we talk about women capable of having normal birth wanting caesarean section as a choice? There is no comparison between caesarean section and vaginal birth, not to mention the long term consequences which can be severe. I agree with Sheila, women ARE being duped into thinking a major abdominal operation is on par with normal vaginal birth and that its a case of deciding which one would prefer. Please let us get things into prospective. Choice is wanting to get pregnant or not, choice is where to have the baby, choice is what position is found to be most comfortable, choice is how to ease the pain, choice is who to be delivered by and choice is wanting family support. Anything else? Sorrrrrrrry its NOT a choice. Its an INTERVENTION OF A NORMAL PHYSIOLOGICAL PROCESS.
dear midwife: whose interest are you looking out for??
[info]ragingbull101 wrote:
Thursday, 19 February 2009 at 02:04 pm (UTC)
The typical midwife in the UK abhors epidural analgesia, for reasons that are certainly not evidence-based. The RCM accuses mothers of not being prepared to deal with the agony of childbirth!! Can you believe anyone saying such a stupid thing in this day and age?? Who would want to voluntarily undergo the agony of childbirth when measures are available to take away the pain of labor? Only someone who is living in the 10th century will ever voice such a stupid and ridiculous statement. Midwives believe that all women need to needlessly suffer the pain of childbirth, because this is the way it is. Is this evidence-based? No it isn't. The RCM said it loud and clear. It wants fewer mother to have epidurals for pain relief. I suspect the vast majority of these midwives have never had the privilege to soak and marinate themselves in labour pain, because they have never had children!! So basically, they do not know what they are talking about. Plain and simple. Here is an interesting story. A friend of my doctor who works in Hong Kong, said that recently, a western lady who claims to be an expert in natural childbirth and hypnotherapy, who dismisses anything 'unnatural', opted for a medicine to hasten her labour and worse still, she demanded an epidural for pain relief!! Well, I think it is pretty clear what this is all about. Do as I say, not as I do. And to hell with the rest of them.
Midwives are completely right!
[info]ryhmee wrote:
Thursday, 19 February 2009 at 05:33 pm (UTC)
I know the UK, and the US are completely different when it comes to birth and the birthing process. The UK C-Section rates are so much lower than the US, and for good reason. Many women don't need C-Sections until there is medical intervention. Living in the US, 4 of my friends went to the hospital when it was their time, given drugs to speed up a perfectly fine labour, and the drugs worked too well that it dropped the babys heart rate and they had to receive a C-Section. If the US didnt shove medication, and C-Sections down our throat our rates would be so much lower.

Getting back to the article, The RCM NEVER said everyone should have natural, they're trying to get women not into the C-Section routine. A C-Section is NO WHERE NEAR the same as a vaginal birth, its SURGERY that should happen if there is complications. I'm not saying birth everywhere should be natural, women should get an epidural if she wants, but every woman should be excited and ready to embrace birth as a natural miracle. Not treat it like war and want to cut a baby out of herself.
RCM mismanagement and deceit
[info]ragingbull101 wrote:
Friday, 20 February 2009 at 01:38 am (UTC)
It is certainly true that the topic of childbirth has become a political football between the various interest groups. Midwives have always accused doctors of over-medicalising the process of childbirth and to a certain extent, it is true. On the other hand, you can always find instances where midwives have refused to offer analgesia eg epidural analgesia to mothers upon request for rather dubious reasons. The UK's childbirth trust's own survey revealed that 1/3 or mother complained that their request for pain relief had been dismissed by midwives in the UK. So the question is not whether, the guilty party belongs to this camp of that camp. Both sides are guilty. The main point is to get away from this "I am always right and you are always wrong' mentality. If healthcare professions are to give patients a balanced approach to pain relief in childbirth, a sense of balance and proportion must be present. It is common to see midwives [and Lactation people] deride epidural analgesia to every mother writhing in pain and agony. They will commonly mention and exagerrate the risks of paralysis, toxicity, failure of breastfeeding, barrier to mather-baby bonding,etc and more nonsense like that. However, no one ever mentions to the mother that natural childbirth carries significant risks of injuries never mentioned by midwives: eg: anal and fecal incontinence, genital prolapse, urinary incontinence, coccygeal fractures, lower limb nerve palsies, rectovaginal fistulae, sacral dislocation, chronic low back pain, herniated intervertebral discs, etc. Just because it is so-called 'natural', it does not mean that complications are acceptable. I challenge any midwife out there to respond to this.

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