Week 34 - Breathe In...Out

I haven’t said a lot about our antenatal classes, largely because there really hasn’t been much to say. We’ve had three so far, and I can’t say that I’ve been terribly impressed.

It’s not that they haven’t been effective in their main objective, to educate the untutored about the complexities of childbirth. I think the problem is that they have been so…I don’t know, perhaps lacking in the vitality and excitement that you associate with having a baby.

The first class covered the normal progression of labour. We talked about the dilation of the cervix, at which point the mother should present herself at the hospital, and the procedure that will be followed up until the successful delivery of the first born (all the parents in our class are first timers like us).

The second explored what happens when birthing goes wrong (sorry for being facetious; I’m still addicted to those wretched ‘When zoo animals turn bad’ or ‘the world’s greatest police chases...5’ type programmes on television), and gave us a lot of, hopefully, useless information about forceps deliver, induced labour and a strange suction arrangement called the Ventose cap (the less said about that, the better)

(Oh, when I say hopefully useless information, I do not mean that the information was useless: I mean that I hope that we won’t have any use for the information.)

After this class, we got to watch an ancient video showing different modes of childbirth. The film started off with a home birth. I watched keenly through my fingers, then made my excuses and left.

(M stayed on a few minutes longer to watch the caesarean section. For some odd reason, they decided to show far more than you would get to see if you were the mother, the birthing partner or indeed anyone other than an obstetrics surgeon. When I stuck my head in the room to check on M, she looked green, and asked to leave immediately. I dread to think what the film about forceps delivery looked like. Sometimes, ignorance is bliss.)

The third class focused on important issues like…parking at the hospital. And the paperwork that will need to be filled out. And registering the baby. And securing a National Health Service number for the baby. And stuff that, I think, had been included in a leaflet we were given during the first class. You can tell that by this point, I was really excited about everything. Gripping stuff. Hanging on to every word.

Again, don’t get me wrong. The information was, on the whole, useful. But aside from the first class, which was led by an enthusiastic and (possibly unconnected fact) newly qualified midwife, the whole process was so dreary. Sort of like ticking a box to confirm that, pursuant to regulation 297 of the Healthcare Reform Act (amendment) 2009, all expectant mothers (and fathers, where they choose to participate in the birthing experience) have had communicated to them all essential features of…you get my point.

There wasn’t much in the classes that felt alive, responsive to the needs of the nervous, apprehensive parents to be. Nothing that one couldn’t learn in a short booklet, that is. It just seemed like a chore. One poor woman started to have kittens in the last class, thinking about tearing and an episiotomy. The midwife was brusquely matter of fact in her response: ‘you’re a first time mother; you’re probably going to tear.’

Factually, she was correct. Also (allegedly) it helps to think about it as you would a cut in a less sensitive part of the body. AND an episiotomy is done under anaesthetic. But I’m sure that the poor woman would have felt a little better if the midwife had been a little more responsive. Never mind…

Dr M, with her sceptical researcher hat on, suggested that the classes seemed to be geared more towards what the hospital would like parents to do to ensure they can get their jobs done efficiently, and with a minimum of inconvenience to themselves. (I paraphrase somewhat.) And for once, I actually agree with her. It was very much a ‘we will do this and this, and you (the mother) will lie back and co-operate with us’ style of didactic tuition.

A part of me sympathises with this. Birthing children is a delicate, sometimes dangerous job. And in order to do it properly, you want to get your prospective patients thinking the same was as you as early as possible.  That way, you avoid tears and recriminations in the labour ward.

(Actually, you will get those anyway, but for different reasons.)

Even so, I think it’s a shame that the process was, on the whole, so mechanical. That said, if I didn’t like it, I could always go private, couldn’t I? Maybe I should stop whinging and instead be grateful for the fact that there was something on offer. Lord knows, there are many parts of the world where they would be grateful for what I have just described so disparagingly.

There was an interesting article in the New Yorker a few weeks back about the evolution of the child-birthing process. In typically circumambulatory way (and yes, I see the irony in this sentence too!), the article http://www.newyorker.com/fact/content/articles/061009fa_fact argues that, as doctors and hospitals have become more proficient in the art of birthing healthy babies, sacrifices have been made in connection with ensuring the optimum experience for the mother. Hospitals are more efficient and effective, but paradoxically have become less capable of responding to the needs of individual mothers. Which is a bit of a shame, I suppose.

Again, I suppose, one could go private if one doesn’t like it. However, I think it is fascinating that the percentage of caesarean sections performed in private hospitals (in London) is significantly higher than in public hospitals. And you pay lots for the privilege, too.

Maybe that is what mothers want.

Last post, I said that I was disappointed that I didn’t get to do breathing exercises at antenatal class. This, you will be pleased to know, has now been rectified.

Dr M has been attending a yoga class for some time. Last week, they had a class for mothers and fathers.

You can imagine the scene. Serene, confident women. Bewildered, somewhat bemused men. Soft lighting. No footwear (thank God, I did remember to pick my socks carefully). Some quiet reflection and meditation before we started (I fell asleep – and I am not poking fun. It was that effective). And then an hour and a half of stretching, massaging and deep breathing.

I quite enjoyed it, actually. It was a rather interesting experience . So I won’t make fun of it.

Incidentally, the midwife at the antenatal class said that they don’t teach birthing exercises any more because there is no demand them. Everyone wants an epidural or medical management of the pain process. I find this just as interesting. Maybe the hospitals do know something that we don’t.

M stops work at the end of next week. The day draws closer…

‘Til next time.

Comments

[M]

I was very pleased to see that for a brief moment I got to be mentioned by my full name- I am honoured. And though I agree with you that we should be thankful for what we get as there are some parts of the world where people don’t get as much- I doubt it that anyone wants to know that much about the hospital (no) parking arrangement or NHS number.

[O]

I was happy to read that you see the sadness in the fact that birth became so medicalized... I must admit I don't believe hospitals are made for child-birthing. As M wrote you mentioned her full name is that allowed?