Friday, October 22, 2010

Should obstetricians be trained in forceps deliveries to avoid Caesarian Sections?

Childbirth has been a feature of this week twice for me. Not personally, obviously, but there are a couple of things I wanted to share with you.

Firstly, I was taken by this report on the BBC today that apparently doctors need more training in forceps deliveries to avoid caesarians. Apparently there's not enough time for training due to the pesky Eurocrats, but it would be so much better if doctors could just yank babies out rather than put the mother through surgery. Frankly, if that was the choice available, I'd prefer taking the pain and the risk of the op rather than giving my baby a very sore head and possibly some injuries to welcome them to the world, but what do I know?

I know that there are times when heavy medical intervention in the childbirth process is necessary and it saves lives. However, I wonder if it wouldn't be better if there were more time given to learning traditional skills, like turning babies manually, or learning newer techniques like optimal foetal positioning. That sort of ante natal preparation, combined with a supportive environment to go through labour in, can avoid complications during birth.

On Monday, the Divine Helen Duffett popped up on Iain Dale's LBC show. Not, this time, representing Liberal Democrat Voice, but to talk of her experience of giving birth to her two youngest children at home. I don't like giving credit to Nadine Dorries, but in the spirit of being fair to everyone that I try to espouse on this blog, I have to say that she talked a lot of sense in encouraging this and saying that women should have the right to choose themselves whether they want a home birth.

There aren't very many men on this planet who can talk comfortably about childbirth, but I have to say Iain did well. I generally define doing well in those circumstances as not asking any really crass questions or pretending that you have a clue what it is like. Having said that, I'd have loved to have seen his face when Helen was describing the purchase of large plastic sheet from B & Q, which she later lent to a friend. A little bit of raised eyebrow did creep into his voice at that point, but he pulled it back.

Anyway, I found another aspect of what Helen was saying very interesting. She talked about how her first baby had had a fairly dramatic entrance into the world because he got stuck. The same situation occurred with her third baby, but the midwife attending to her at home suggested a simple manoeuvre (which probably wasn't that simple to perform in the circumstances, I grant you) which got the little one safely into the world without trauma. Helen pointed out that along with her being able to choose the birth she wanted, she'd also saved the NHS £4000 - an argument she thought would appeal to Mr Dale.

My own experience of giving birth (don't worry, I'm not going to get gory) went through 3 hospital shifts. At the start, I had to hide for an hour and a half from a doctor who was a bit over eager to get things moving. That was not a nice experience. Things improved with a midwife who had the time and knowledge to support me through the hard bits, a female doctor who saw something a little abnormal but didn't panic and a lovely companion who anticipated almost all of my needs and responded immediately to my barked out commands when he didn't.

It's easy for me to see how the actions of the health professionals actually led to me having the intervention free birth I wanted. There were a couple of critical points when they could have made some different choices. That would have led to an avoidable and ultimately unnecessary medicalisation of a process which was proceeding perfectly well on its own. I was very lucky to have that kind of care and I want to see that available to other women.

If we're going to be giving doctors more training in birth, then I think it has to encompass methods which encourage and promote a more natural approach. By all means teach them the skills that they need to use in an emergency to save a mother's or baby's life, but that's by no means the whole story of what they need to know.

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