Imagine if every day that you looked in the newspaper, watched the news or enjoyed a film, driving your car was portrayed as one of the most dangerous things you’d ever do in your life.
Long discussions around the scars you could potentially be left with, the pain you would be in and an insistence that you must listen to all the advice of the experts and attend as many advanced driving courses as possible before getting into a car.
Eventually, as travelling in a car is so dangerous, you might consider taking some precautions to ensure you are as safe as you can possibly be. Perhaps you look into getting one of those bomb disposal suits (like the one worn in The Hurt Locker movie). It makes total sense to ensure you are protecting yourself and your body as much as you can. The only thing is, that with all that padding and protection, you might not be able to react and move as easy as you would without it and it might be difficult for you to look around and be observant with the suit being so restrictive. Not only that, all the experts with their rules and recommendations, the slightly conflicting information you learnt in all the driving courses you took, you now start doubting if you’re even able to drive at all! You have lost all your confidence!
Imagine that – by trying to make it safer you have actually made it more risky and a lot more complicated!
I think this is childbirth in a nutshell! We have all read the headlines, seen the films and heard the stories. The general population believe that giving birth is extremely dangerous and the very best place to be is in a hospital with plenty of doctors and medical expertise around.
However, we know from research that childbirth is overall very safe and it is 99.57 per cent likely that all will be well when you give birth – the very same statistics as to getting into a car, a risk of 1 in 229 which is the same as 0.43 per cent. As both events are relatively safe, there really isn’t any need to take precautions ‘just in case’. Yes, we put a seat-belt on when we go out in the car so having a midwife support you during the birth could be seen as the same kind of sensible measure to take. Adding a doula would further increase your chances of a straight-forward birth.
If you have a healthy pregnancy and your wish is to have a normal birth, i.e. avoid a caesarean, forceps and ventouse, we know from studies that the worst place to be is on an obstetric led unit, often known as the labour ward in a hospital. The Birthplace Study carried out in the UK discovered that only 58 per cent of women with a healthy pregnancy had a normal birth there. Booking a home birth increased that number to 88 per cent. Choosing a stand-alone birthing centre showed 83 per cent of women have a normal birth and a birthing centre alongside the labour ward had a 78 per cent normal birth rate. It is worth noting that there were no significant differences in adverse perinatal outcomes on a midwifery led unit compared with an obstetric unit.
This study suggests that the more experts and machines a healthy pregnant woman has the potential to be exposed to – the less chance of her having a normal birth. The restrictions that are often placed on women on a labour ward, all in the name of minimising risks, often lead to more complications and interventions. Similar to what the bomb disposal suit could potentially do if worn when driving your car.
Obstetric care should be reserved for those women that have more complex needs during their pregnancy and have real health concerns that are best handled by someone with specialist training. Healthy pregnant women are not only very safe in a midwifery led unit but they are also significantly more likely to have a normal birth without medical interventions. In the words of Marsden Wagner: “Having a highly trained obstetrical surgeon attend a normal birth is analogous to having a pediatric surgeon babysit a healthy 2-year-old.”
I totally get it! When you’re pregnant, you want nothing more than a healthy baby and safety is one of the top priorities. What we all have to accept, is that there is nothing in life that is 100 per cent safe. There are tiny risks involved with most things we do, even eating an apple or going for a walk. When you have a straight-forward healthy pregnancy, childbirth is no more risky than going for a ride in a car and statistically, there is no place to give birth that is 100 per cent free of adverse outcomes.
When planning for your baby’s birth, it might be a good idea to look through all the research and recommendations and decide what you personally consider to be safe. You can only do this by getting the research and seeing the actual risks or chances of something happening. When discussing your care, always ask for the actual numbers when someone is using arbitrary statements such as “increased risk” or “double the risk” or “high risk”. You can only make informed choices based on good solid information and this includes real numbers.
Don’t lose sight of the facts by believing the headlines!
Kicki Hansard is a member of Doula UK, however any opinions expressed on this blog are personal views and not necessarily the view of Doula UK.