Has anyone considered the following aspects which may have an impact on
the cs debate?:

1. Most women when asked antentatally would prefer a normal birth, even
in countries such as Brazil where the cs rates are very high

2,. Most births we record as 'normal' are not - they may be a
spontaneous vaginal delivery, but they are preceded by interventions
such as induction, augmentation, epidurals, fetal blood sampling, ARM,
episiotomy &etc.

3. It may not be suprising then that women hear stories of terrible
'normal' births from their friends (or they that experience this
themselves) and they are made afraid, and therefore request cs as a way
out of this (aberration of) 'normality'.

4. this situation arises because many midwives are afraid of birth, and
cannot support women for their wished for physiological birth.

5. while negative birth stories are very powerful, so are positive
birth stories.

The concusion than is that many women may not be afraid of childbirth
per se, but of the kind of technological birth we are offering them at
present. I also conclude that, though work such as that you are doing
Else is vital, we cannot ultimately solve the cs problem by looking at
cs and womens views of it. In the end, we can only really reduce cs and
other interventions by maximizing physiological birth and our midwifery
skills, beliefs, trust and respect of it. Each positive birth we
facilitate generates stories in the community that infect women
positively and, maybe, that reduce fear proportionately. This has an
exponential effect if the women who hear the positive stories also have
positive births.

A propos of this, at a recent normal birth conference in New Zealand,
Karen Guilliand presented the following quote which I think provides
significant food for thought in this area:

There are only two feelings: Love and fear. There are only two
languages: Love and fear. There are only two activities: Love and fear.
There are only two motives, two procedures, two frameworks, two results.
Love and fear.

Michael Leunig's prayers from A Common Prayer


Maybe if midwives can move from fear towards love we may change the
situation from the bottom up? These are the areas I am planning and
undertaking research in. They may provide additional possibilities for
insights into your findings Else, which I am sure will be fascinating

Id be interested in everyones views on this!

all the best

Soo

Professor Soo Downe
Director
Midwifery Studies Research Unit
University of Central Lancashire
Preston  PR1  2HE
Lancashire
England

+44 (0) 1772 893815


tel: 01772  893815

>>> [log in to unmask] 11/09/04 03:29pm >>>
Thanks to all for your reflections and suggestions.
I thought of another issue: the fact that some pregnant women
-even those who want to make use of the choise for a c-section,
inquired, don t like having the choise at all. Because, as someone
tells me:
"It complicates everything, I would rather have been without that
speculation"
Such opinions don t prove anything, of course, but they might be
interesting for
further research.

Else


----- Original Message -----
From: "Patricia Burkhardt" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, November 09, 2004 3:49 PM
Subject: Re: c?Section and social pathology


> I just sent a reference from Maternity Center Association re the
issue of c-sections and what women need to know.    Pat
>
>
> Patricia Burkhardt, CNM, DrPH
> NYU Midwifery Program Coordinator
> Tel: 212 998-5895
> Fax: 212 995-4679
>
> ----- Original Message -----
> From: "Janet Brooks CNM, MPH" <[log in to unmask]>
> Date: Tuesday, November 9, 2004 7:39 am
> Subject: c?Section and social pathology
>
> > Else,
> > I think this is a wonderful topic to research.  Here in the USA I
> > see so many
> > women who are convinced that C/section is the safest way to have a
> > baby.Even when counseled about ??risks and ??benefits they still
> > say they have a
> > choice and that this is their choice. i do not know any papers on
> > this topic, but
> > you could research ACOG website  (American College of OB/GYN) and
> > see their
> > position papers on elective C/section.   Also the ICAN webite---
> > www.ican.org .
> >
> > Best of luck, I would love to hear updates on your work,
> > Janet Brooks, CNM, MPH
> >
>