Perhaps less is more even when it comes to childbirth

27 years ago I found out why it would have been a good idea if I had informed myself about pregnancy, childbirth and the maternity services I was expecting to support me for the birth of my first baby. I was informed about lots of other subjects but there seemed to be a fog in my brain about these very important matters. Lots of blind trust and media images seemed to be all I had to draw on when I skipped (literally) into my 39 week antenatal appointment and was told that my baby needed to be evicted without delay because there had been a 10 beat rise in my diastolic blood pressure.

An induction was scheduled immediately - I was bouncing off of the ceiling with excitement to see my baby earlier than expected. Questions I could have asked were:

Does this rise in blood pressure put me or my baby in immediate danger?
Can this rise in blood presssure be treated rather than my labour be induced?
Could this rise be within normal limits for the end of my pregnancy?
What would happen if I was monitored and we waited?
Have you taken any bloods to determine whether induction is absolutely necessary?
What does induction mean?
How will my body respond to induction?
Will my body be ready to complete this process with a baby born healthily at the end?
Will my baby be exposed to any drugs that could cause him harm?
What happens if my body isn't ready to complete the labour process?
If surgery becomes necessary how will that affect me and my baby?

I didn't ask a single question.

So I handed my body and baby over to the obstetrician and attending midwives and the induction failed and my baby was born by ceasarean section and he spent years with respiratory complaints including asthma and irritable bowel syndrome and his immune system showed clear signs of impairment and I have a scar across my abdomen and a perpetual flap of skin over it and my heart was broken and I felt like a big fat guilty failure.

So where is the joy in this?

My son grew strong and learned how to keep himself well despite his shaky beginnings. I fed him from my breast for as long as he wished which I have learned would have made a bad health situation better.

I  went on to join a hive of birthkeepers around the world supporting women and their families to become informed and confident with their birth choices and ability to birth. I became a doula, then a midwife, a KG Hypnobirthing teacher and a Positive Birth Movement Facilitator. This hive around the world is growing and more women and their families are now making INFORMED choices and more babies are having optimal births. It's important. How we are born means everything.

Every day someone will learn that I am a birthkeeper and offer me an abridged birth story. On the odd day a woman will say "I went into labour and I had a baby" - to be expected - women have laboured and birthed for millenia. However 9 times out of 10 it will be one of the following:

"My blood pressure went up so they induced me. The baby went into distress so I needed an emergency c-section"

"My baby was 'late' so they induced me. The baby went into distress so I needed an emergency c-section"

"They think I may have had gestational diabetes. They said I needed to be induced. The baby went into distress so I needed an emergency c-section"

"My baby had a larger than average abdominal circumference. They thought I may suffer a shoulder dystocia so they induced me. I was fully dilated but baby's head was in the "wrong" position. They used forceps, I sustained a 3rd degree tear. No danger of having another baby any time soon.... I can't bear the thought of making or giving birth to another baby....."

"They said my baby was late and that I had to be induced. I 'failed' to progress so I had to have an emergency c-section"

"They monitored me and my baby with the CTG (cardiotocography) and said it would be best to start labour off. I got to 6cms but they said that I was failing to progress and that baby was getting tired so it was best I have an emergency c-section"

"They said at the scan that my baby was big so it was best that I schedule an induction. I failed to progress so I had to have an emergency c-section"

"They said that my waters had broken and that I and my baby will catch an infection unless my labour is induced. I really needed an epidural as the labour was such a struggle. My temperature went up - they said it might have been caused by the epidural as nothing grew in the blood cultures that they took. In the end baby's heartbeat got faster and faster and wouldn't normalise so I needed an emergency c-section"

"I was induced because my baby was late. They said she was back to back so it would be best if I had an epidural. She didn't turn and my cervix had an anterior lip that wouldn't go away and got thicker and thicker so I needed to have a c-section"

'My baby was breech presentation so I had to have a c-section"

"I was exhausted following days of labour following a membrane sweep so I was put in lithotomy position and baby was born by forceps/ventouse extraction. I lost a lot of blood they say. Felt wrecked for weeks..."

"I was assisted by instruments so had to have an episiotomy"

"I had to have a membrane sweep because my baby was late. My waters broke but labour didn't start so I had to be induced/augmented. My baby's head stayed asynclitic so birth was assisted by forceps/ventouse extraction. It was really hard to breastfeed because my bottom was so sore from the episiotomy and stitches"

Are women, babies and pregnancy really that broken? Really? Is it wise to become flippant when recommending intervening in the complex processes of childbirth when we still know comparatively little about all of the nuances of how this dance between mother and baby/babies unfolds? Are we causing unnecessary harm and very occasionally death to hundreds per thousand dyads in order to save less than a handful of babies in that thousand?  Every life is precious but are we marring the long term health of millions for generations to come?

All of the techniques that we are perfecting for 'managing' births that need help are life savers. I believe we are a better world for having them but the overuse of them could well be causing more harm than good.

The World Health Organisation (WHO, Feb 2018) offers this summary of the situation we are facing at the moment when it comes to childbirth

"The growing knowledge on how to initiate, accelerate, terminate, regulate, or monitor the physiological process of labour and childbirth has led to an increasing medicalisation of the process. It is now being understood that this approach may undermine a woman’s own capability in giving birth and could negatively impact her experience of what should normally be a positive, life-changing experience."

I have now created a Facebook group called "Induction of labour" - if you wish to to join it click here and answer just 3 little questions or we won't be able to approve your request. We want to keep the group a safe place to talk. It is a new but thriving group enabling us all to have open discussions on the issue of induction in a closed group environment.

2018 can become the year when together we take responsibility for raising our expectations of childbirth, a process that has happened well for many thousands of years, inform and support each other to that end and confidently create a world where we all are able to sustain better holistic health and joy, long term.

Ultimately I feel Margaret Jowitt, editor of Midwifery Matters speaks my heart when she wrote

“Natural childbirth has evolved to suit the species, and if mankind chooses to ignore her advice and interfere with her workings we must not complain about the consequences; we have only ourselves to blame.”