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Posts Tagged ‘childbirth’

Epidurals prevent bonding according to male midwife

Posted by hannahflynn on July 14, 2009

The Associate Professor in Midwifery at Nottingham University has caused a furore over the last few days by suggesting pain during childbirth is a rite of passage, helps strengthen the bond between mother and child and that women should forgoe epidurals as they increase the risk of intervention.

The Daily Mail quoted him saying, “A large number of women want to avoid pain, but more should be prepared to withstand it. Pain in labour is a purposeful, useful thing which has a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby.” He also said, “emerging evidence shows that normal labour and birth prime the bonding areas of the mother’s brain more than Caesarean or pain-free birth.”

Much of the focus has been on the Associate Professor’s sex – Dr Denis Walsh is a midwife and a man – rather than the evidence behind his research. Published in Evidence Based Midwifery Dr Denis Walsh has claimed epidural rates are already too high and are rising.

His terminology has rightly been called into question by Maureen Freeley in Comment is Free in The Guardian. She has asked “Even if this man had a degree in anthropology, I’d want to question his terms. And what the hell does he know about Bonding with Baby?” She goes on to argue this most recent commentary on childbirth is typical, “As is so often the case in discussions about motherhood, it is laden with moral assumptions.”

The Times’ Alpha Mummy blog points out “his attitude that pain prepares women for motherhood sounds a bit old Testament to me.” The Alpha Mummy team go on to argue that yes, childbirth is a natural process, but so is infant mortality. They also make the interesting point the tables appear to have turned on the assumption The Man was trying to push interventionist approaches to childbirth on women, but now things are going in a different direction.

In the good old-fashioned name of balance the papers have been providing other expert opinions on the matter, many of which are surprisingly blunt in suggesting Dr Walsh’s analysis is lacking.”He’s exaggerating the risks of epidurals. They aren’t overused. In the main they’re a good thing and almost always necessary.” says Dr Justin Clark, an ObGyn based at Birmingham Women’s Hospital in The Telegraph.

Our very own Dr Maggie Blott, mother and head of the Royal College of Obstetricians warned the BBC, “Do not under-estimate the pain of having a baby – it is a very, very intense and painful experience. If it is happening hour after hour in a very prolonged labour it is very tiring and wears people down and I think epidurals are very useful in that situation.” She was backed up in her comments by Cathy Warwick, general secretary of the Royal College of Midwives who said, “At the moment it is very easy for most women to ask for an epidural, and if they want one they definitely should get one.”

For a more irreverent look at the realities of obtaining an epidural on the NHS, have a look at Zoe William’s brilliant Anti-Natal column in the Guardian here.

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Trauma during birth results in lower desire

Posted by hannahflynn on May 28, 2009

There is little significant difference in the sexual activity of women after birth who have experienced major trauma during labour compared with women who have experienced minor trauma.

Researchers asked women to complete a twelve point questionnaire know as the Intimate Relationship Scale in the study reported in this month’s Journal of Midwifery and Women’s Health.

The study found 85 percent of women had resumed sexual relations three months after birth and total IRS scores did not differ between trauma groups nor did complaints of pain on intercourse.

However, women who had required perineal suturing had lower IRS scores, and women who had experienced major trauma during birth had less desire to be touched and held by their partners.

The study excluded women who had experienced episiotomy.

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Interview with Dr Maggie Blott, vice president of Royal College of Obstetricians and Gynaecologists

Posted by hannahflynn on April 26, 2009

Dr Maggie Blott is the vice president of the Royal College of Obstetricians and Gynaecologists, she spoke to me recently about the truth behind the headlines on a recent Cochrane review, which found women who remain upright during the first stage of labour have shorter and less painful deliveries.

So, does walking around during labour make it any shorter and less painful?

“[These headlines are] because of a Cochrane review which found women who were upright during the early stages of labour, whether that was standing, walking, kneeling or squatting had a shorter first stage of labour and were less likely to ask for pain relief, well … big pain relief anyway, like epidurals.”

How does this affect current recommendations?

Low risk women without any complications should keep upright and mobile as much as possible and get up and move around; use a ball or change positions. For high risk women who need to be monitored frequently throughout, we recommend that [any monitoring] doesn’t stop them being mobile.

What is the mechanism behind this?

That’s a good question! We are not sure what the exact mechanism is but I think it is probably simply gravity and the pressure of the baby’s head on the cervix, which leads to more effective contractions. And it aids the rotation of the baby’s head into the right position, which is more favourable for a normal delivery.

Lawrence A, et al. Maternal positions and mobility during first stage of labor. Cochrane Database of Systematic Reviews. Issue 2, 2009.

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