As plans to cut down on epidurals cause a furore, JENNI MURRAY says… Get real, girls! Pain is part of childbirth
06:52 GMT, 6 September 2012
Let me make one thing clear from the start. I do not approve of the NHS’s plans to persuade women to avoid Caesareans and very strong pain relief during birth in order to save money.
The new guidelines, announced last week, instruct GPs to encourage women to have natural labours with as little medical help as possible.
The reason Caesareans cost the NHS 1,200 a time, while epidurals are around 200. Unsurprisingly, people have expressed outrage, with critics condemning it as barbaric and even a form of legalised torture.
Natural birth: Jenni Murray and youngest son Charlie
They have a point. Why should a condition that affects only women be targeted for cost-cutting No one would dream of asking dentists to stop giving children an injection for a tooth extraction or persuading a surgeon to perform a vasectomy without a local anaesthetic in order to save money
But there is another side to this story, which has been lost in the furore.
Why can many women today not envisage giving birth without drugs or even surgery Have we, with painkillers and surgical techniques, turned a natural function for which the female form is perfectly designed into a terrifying medical procedure Have we sapped the confidence of women to do it their own way and persuaded them, wrongly, that the doctor always knows best
We know Caesarean delivery carries risks and is a seriously invasive and debilitating operation.
There’s been a rise in recent years of women arranging an elective C-section, made fashionable by those criticised for being ‘too posh to push’.
I spoke to one woman who saw it as a way of keeping herself trim for her husband’s future pleasure! But why choose an option that makes the hard work of looking after a new baby even harder unless it’s an emergency
Similarly, the epidural. Why opt for a horrible and potentially dangerous spinal injection only to be deadened from the waist down and miss the sensation of what can be the most significant and pleasurable experience of your life
Pethidine is a marvellous painkiller and reduces anxiety brilliantly. I know — I’ve had it as a pre-med before major surgery and recall being wheeled along a corridor, rabbiting on about how beautiful the ceiling lights were.
On reflection, they were anything but beautiful, so it was clearly a drug-induced experience — not one I would have wanted in the delivery room.
Pethidine can pass to the baby via the placenta, making the baby unresponsive, the mother ‘away with the fairies’ and bonding and breastfeeding difficult.
The natural way: Jenni got fit with yoga before her first birth, which she agreed to have by hospital delivery
When I was getting ready to have my first baby — nearly 30 years ago, but I recall it as if it were yesterday — I made a birth plan. I was determined that giving birth for me should not be like the miserable experience my mother had in 1950.
Hers was the first generation expected to deliver in the maternity hospitals of the new NHS rather than at home. She was given an enema, shaved, strapped down on her back, legs in stirrups and left pretty much alone for 24 hours until I was dragged out by forceps.
She never hesitated in regaling me with the horror story of my arrival and the damage it had done to her physically and emotionally. Unsurprisingly, I am an only child.
When my turn came, I agreed to a hospital delivery as I was, at 33, thought elderly for a first-timer.
I got fit, with yoga every day. I intended to walk around for as long as possible during labour and then deliver in a squatting position — giving gravity a chance, rather than lying on my back and having to push in a direction that makes no sense.
I had an experienced midwife and a sympathetic, young obstetrician — if there was a problem, they knew I’d take whatever modern medicine might offer to help. Labour began at around 6am and we made our way to hospital.
I kept moving throughout and at 4pm went into a quiet, dark delivery room with my midwife and my partner.
At the crest of each contraction, I took a whiff of gas and air, which eases the grasping feeling, but has no toxic impact on mother or baby. /09/05/article-2198918-0ECFBF4F00000578-654_472x309.jpg” width=”472″ height=”309″ alt=”Jenni chose a home delivery for her second birth. She had a bath for half an hour at 9:30pm and gave birth at 10:10pm” class=”blkBorder” />
Home birth: Jenni chose a home delivery for her second birth. She had a bath for half an hour at 9:30pm and gave birth at 10:10pm
Caroline Flint, a former President of the Royal College of Midwifery, pointed out that we are instinctively no different from animals who naturally seek a quiet, dark place to deliver their young, which is why she favoured home over a noisy, brightly lit hospital.
She is right. We are human animals, but in so many ways our instincts have been socialised out of us.
We’ve learned to feel shame about our bodies and about sex — and nothing requires a woman to open up the part of her that is meant to be so private like delivering a baby. We’ve learned to hand responsibility for our health to doctors, rather than trust our instincts.
I don’t believe women who ask for a planned Caesarean or an epidural are wimps. I think they’re afraid.
They have heard horror stories or are worried at being in a big, scary hospital with inadequate midwifery.
Statistics suggest one woman in six is so terrified of giving birth she induces a miscarriage or avoids becoming pregnant: a condition called tokophobia.
So, I have no problems with the principles in the new NHS guidelines, but they should be sold as making birth better for women and babies, not as a means of cutting costs.
We shouldn’t cut back on maternity services; we should invest in the best — whether that is small midwife-led units or home delivery — with fast access to brilliant obstetrics for those few who will need it.
Having a baby is the most important moment in any woman’s history. The arrival of a new person should be safe, calm and full of joy for the mother, father and baby. It’s the foundation of family life.
As for pain — here’s what I held in my head as I prepared for my two big days. The great birth guru, Sheila Kitzinger, wrote that English is poor when it comes to words for pain.
There is damaging, negative pain for which relief is vital, such as with a tooth extraction.
Then there’s the positive pain felt by a marathon runner whose every muscle cries ‘Stop!’ but they go on because the end will be a triumph. Like childbirth.
I have no regrets about embracing the need to work hard for the reward of two splendid sons — the closest to Olympic gold I ever got!