News: Midwives will cease to promote ‘normal’ births

According to a Guardian article, midwives will end their campaign to promote ‘normal births’. I mean, that’s not strictly true, they’re basically just changing the terminology from ‘normal’ to ‘physiological’, but that doesn’t really change what they’re promoting. But the aim is to minimise ‘mothers feeling like failures’ for having a birth that’s anything other than normal. That means a vaginal birth with no epidurals, no inductions, no caesarean, no medical intervention of any kind.

Prof Cathy Warwick, the chief executive of the RCM, denied that the decade-long campaign had compromised the safety of new mothers but admitted it had created the wrong impression. “There was a danger that if you just talk about normal births – and particularly if you call it a campaign – it kind of sounds as if you’re only interested in women who have a vaginal birth without intervention,” she told the Times.
[…]
“What we don’t want to do is in any way contribute to any sense that a woman has failed because she hasn’t had a normal birth. Unfortunately that seems to be how some women feel.”

Our experience, shared with 60% of all births, was very much not ‘normal’; we pretty much hit every medical intervention apart from forceps or caesarean. But while some few midwives in the hospital might have used this now altered terminology, there was certainly no shaming going on, which was a huge relief. It’s a stressful time for mum, physically, mentally and psychologically, and the last things anyone needs is someone endangering her life by shaming her into avoiding the help she may need.

However, I must say that NCT provided antenatal classes were certainly less subtle about their campaign in our experience. The terminology of ‘normal’ vs ‘medical’ births was heavily emphasised, the benefits of one lauded, while the downsides of the other exaggerated. It meant that when events drifted towards the realm of intervention for us, we felt insufficiently prepared for everything going on.

I’m not going say that one way is the right way for giving birth, nobody can say that. It’s entirely up to, primarily, the mum, whilst being as well informed as possible. Maybe changing the terminology to add less pressure, less emotional blackmail will help a little.

A New Arrival – And What I Learnt

Well, a week has passed since the birth of our daughter and it’s gone in the blink of an eye! Sadly, due to a fever, mother and baby were kept in the postnatal ward of the hospital for five days after birth. So between the initial checkups, getting booked in, induction, labour, post-labour recovery and antibiotic treatments for mother and baby, there were nine hospital days in total. Everyone’s home now, and we’re trying to figure out feeding and sleep and life. But before I get on to any of those things, here’s what I learnt from our nine days:

  • Induction: It can take ages, there are several stages/attempt, any of which might or might not work. We went the whole course, ending with the drop feed of syntocinon. That one worked, which is just as well as it’d been three days by that point.
  • Hospital Bag: All of those things were needed. Just don’t expect to get any reading done. Also, definitely bring a pillow, those chairs are uncomfortable to sleep in.
  • TENS machines: They sound great! By the power of electricity, early labour pains will be lessened! It seems their effectiveness is anecdotal at absolute best. We made sure it was properly applied by the midwife, it was a well-recommended brandname product, and it did bugger all.
  • Hypnobirthing: Might have been more successful if started very much earlier. Contractions tend to take you out of your mindfulness.
  • Epidural: As it happened the birthing centre wasn’t an option for us anyway, the induction forestalled that. But as a birth partner let me tell you, the relief you feel when mum’s pain vanishes is beyond palpable. It’s like a tension leaving the room and everyone in it.
  • Hospital Food: Everyone jokes about how gross it is. It’s not a joke, it’s bland, disgusting, barely edible. It’ll do in a pinch if absolutely necessary, but be prepared to buy sandwiches, bring food from home, or order pizza. And yes, postnatal wards especially are generally willing to let you order food in, and it was such a godsend.
  • Wards vs Rooms: If you have a long postnatal stay, try and get a private room. Some hospitals have them on a first come, first served basis, some have private, paid-for options. But it’s going to make quite a difference. You’ll have someone checking in on mum and/or baby roughly every 20 minutes, and they don’t knock. Constant in and out, endless interruptions, no matter what state of undress or distress anyone is in. Now multiply that by four, for a typical post-natal ward, and add in everyone’s guests and partners. Nightmare.
  • Breastfeeding: It’s tough. So much tougher than all the NCT and antenatal classes really tell you. We struggle immensely and even with five days of midwives at our beck and call to help, we’ve still not cracked it.
  • Skin to skin: Forget the apparent benefits. It’s amazing. Why wouldn’t you want to do this all the time?!

There’s so much more, those days went by slowly at the time, but now hindsight has compressed that to a mere blink of an eye. And all the difficulties seem so diminished when I look at my daughter, whimpering in her sleep and making little hoglet sounds.

NCT and Antenatal Clases

We’d heard a lot about antenatal classes run by the National Childbirth Trust; mostly that they were madly useful in terms of providing some information, but essentially they were a way of paying some money to meet local-ish parents with a similar due date. They were described to us as a necessary evil to garner a support network, by getting to know parents in a similar situation as you, and setting up a WhatsApp group for them.

After one session so far, that very much seems to have been a fair description. They’re a little thin on content, and the little exercises and games to teach you things, whilst interesting, are mostly there for the parents to get to know each other and make friends. It’s a bit of a shame that the catchment areas are so large, making future local-area meet-ups inevitably rare, but contacts are contacts. I know parents who’ve made friends for life via the NCT, and it’s really encouraging that there were so many dads present. This has actually been the case for all the classes so far, there’s been a pleasing lack of shirking of responsibility, and plenty of game involvement.

As well as the NCT classes themselves, the local hospital also arranged for a full day antenatal class, provided by an NCT teacher. The emphasis is totally different here, it’s about delivering lots of information and dispelling as many myths as possible in the time available. While friendships may arise, after all the catchment area is much smaller, and even the window of duty dates is narrower, but that’s really not the main focus and up to individual parents. There was a wealth of information here, in some cases shedding new light on things, or suggesting a new avenue for research.

I say ‘a new avenue for research’, because regardless of how authoritative the NCT trainer sounds, they don’t necessarily have any medical training themselves. They are not required to be doctors, midwives or nurses; they do have to go on extensive courses, but don’t think like I did that they are all practising midwives. They tend to deride a birth with any element of intervention as ‘medical’, vs the holy grail of the ‘natural’ birth. Now, in some cases this has provided new food for thought which I’ll cover in a different post, but it can feel a bit heavy-handed. Back in 2013, Kirstie Allsopp made her own complaints about the NCT about this public, to the dismay of some.

Overall, antenatal classes of some kind are useful, and I’d totally recommend them. Build your network of fellow parents and get what information and discussion you can. But, only use it as a base for information, by no means should you let yourself get bullied into a childbirth philosophy that may be at odds to your actual needs.

Skin-To-Skin

When midwives aren’t (rightly) encouraging mum to breastfeed, the other thing they mention a lot is the benefit of skin-to-skin contact after birth, and not just during breastfeeding. It’s not just mums either; while they’ll get a lot of health benefits, as will baby, everyone can benefit from it. Much like MDMA, skin-to-skin contact releases oxytocin, a bonding hormone, which increases the feeling of closeness. Though medical professionals tend to prefer to refer to it as the ‘hugging hormone’ than make any direct comparisons to the effects of ecstasy, for some reason.

Benefits include:

  • Relief of stress, in baby and parent
  • Better temperature regulation in baby
  • Apparently better brain development in baby, possibly due to better heart rate regulation
  • Better sleep for baby, and subsequently the parents, again due to better heart rate regulation
  • Reduces likelihood of post-natal depression.

So, whether mum or dad, whip your shirt off. It’s not like you needed an excuse to cuddle your little one, but now you have one.

Visiting The Health Visitor

I assumed the health visitors came to see you, but it appears the initial meeting is a group session, a death-by-maternity-powerpoint. It was actually of more use than I originally anticipated, I thought I’d be rolling my eyes so hard they’d have rotated all the way to the back of my head. There was plenty of information as to the schedules and expectations and assistance that can be provided in the local area. I’d suggest making an effort to attend for that alone.

Be aware of well-intended codswallop though. It’s well established that breastmilk is healthier than formula for a wide variety of reasons. There’s no need to make up magical GPS boobs that change the chemical make-up of the milk based on physical location.

Stick to the science please, it’s already a sufficiently compelling argument…