Lamaze International, as I’ve mentioned in this post, has (rather arrogantly, IMO) decided to define what “normal birth” is for all us women. Needless to say, most of us mere mortals (98% of American women, according to the survey mentioned in that post and despite the large majority of the women being pleased with their births) don’t measure up.
Now it seems – if the Times can be believed – that the British NHS is taking a leaf from Lamaze’s book, much to some OBs’ (not to mention their clients’!) dismay:
HOSPITALS are under attack from staff and patients for trying to stop large numbers of women from having epidural painkillers during childbirth.
An epidural, an anaesthetic injected into the spine, is seen by many mothers as a welcome and legitimate way of coping with the often extreme pain of childbirth.
However, under targets now being introduced into NHS trusts,epidurals are stigmatised as abnormal. One senior obstetrician condemned the implications of this policy as a “disgrace”.
The controversial restrictions, promoted by the “natural childbirth” lobby, aim drastically to reduce the number of women having epidurals, caesareans or other artificial procedures to 40%.
In some hospitals the proportion of first-time mothers now having epidurals is far higher at 60%.
The targets are contained in a guidance document, Making Normal Birth a Reality, drawn up by the National Childbirth Trust (NCT) with the backing of the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists.
The document argues that mothers and doctors are too ready to resort to medical intervention and that any such procedure brings risks. The guidance was drawn up 15 months ago, and NHS trusts are now striving to follow it – to the dismay of some of their own experts.
Kim Hinshaw, a consultant obstetrician at Sunderland royal hospital, said: “I have major concerns with this. I don’t think we will ever reach a figure of 60% normal delivery using this definition. For example, in Sunderland we have an epidural rate in first labours of 60%.
“This definition implies that if you ask for an epidural for pain relief, but go on and deliver normally after a six-hour labour, your birth was not ‘normal’. That is a disgrace.”
The rationale given is that epidurals have complications (mainly in the sense that they prolong labor and tend to lead to more forceps and vacuum deliveries). Ironically though, only two months ago, the NHS published its take on a recent study which assessed the risk from regional anesthesia procedures (among these also labor analgesia), which stated, “Epidurals ‘safer’ than thought”.
The Times continues:
The authors of Making Normal Birth a Reality argue that better facilities and access to dedicated midwives would make women more confident and less likely to request epidurals. In line with NCT teaching, they say that breathing correctly, assuming the right position and pushing at the right time reduce pain and the need for epidurals.
Breathing? Positioning? Looks like someone at the NCT (National Childbirth Trust) has seriously been drinking of the Lamaze Kool-Aid. And while the idea of better facilities and access to dedicated midwives sounds like a wonderful idea, wouldn’t it be more appropriate to first put those mechanisms in place, and only then discuss the diminishing need for epidurals? Or rather, only then assess the idea that facilities and midwives are an adequate stand-in for pharmacological pain relief to most women?
I hope one of my British readers can clarify this isn’t merely a cynical method of saving money. Because if I were a British pregnant woman, even one planning a “natural” birth, I’d be mightily pissed.