Doctor in childbirth row

July 13, 2009

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Zoe Danson and Zack

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A MALE doctor has called on pregnant women to experience the full agony of childbirth rather than opting for a pain killing anaesthetic.

Dr Denis Walsh, a professor who specialises in midwifery, has taken Britain's mothers to task for their increasing reliance on an epidural injection to ease labour pains during childbirth.

He said labour pains can help strengthen the bond between mum and baby and act as a 'rite of passage' which prepares a woman for motherhood.

Epidurals are now given to mums in a third of all births - up from just 17 per cent in the late 1980s - and Dr Walsh, who is based at Nottingham University, said many hospitals now offer the anaesthetic on demand.

Yoga

"I am concerned that if we increase epidural rates we do not know the long-term impacts of that", he wrote in a medical journal. He called on the NHS to explore alternative methods of pain relief - such as yoga, hypnosis, massage and birthing pools - rather than relying on epidurals, which are carried out by injecting an anaesthetic into the spine.

Mums in Manchester today hit back at Dr Walsh and said pregnant women should not be denied the choice of any options to deal with their 'most painful experience'.

Mother-of-three Rachel Doran, 41, from Marple, said: "It's a painful experience. I had an epidural with one of my births but I think every person is different. I believe that if you're in agony then some sort of pain relief is good. I don't think something like yoga will work."

Safer

Patricia Hardman, 73, from Worsley, had two children without an epidural. She said: "Anything that makes the birth of a baby safer and easier should be used. I had my babies 50 years ago at home with just gas and air but things have come a long way since then. There's nothing wrong with epidurals if it's safe for the baby."

Zoe Danson, 26, from Whitefield, mother of six-month-old Zack, added: "I wasn't given one but I did ask for one. If I could have, I would have taken one."

But Dr Walsh was backed by Sarah Davies, a senior lecturer in midwifery at the University of Salford with more than 26 years' experience. She said more midwives are needed to comfort mothers-to-be, which could reduce they need for epidurals.

Complex

She said: "It is a complex argument. Some women will need pain relief. We accept that if plans don't go right epidurals maybe needed. But having a high epidural rate does leave a chance of having to use forceps and long term back ache for the mother.

"We have got to look at what are we doing wrong. We need more midwives. If they have midwives who they can trust, they don't feel scared and it takes away the fear and anxiousness. This can help with pain in labour as most of it can come from fear and tension."

Sarah added epidurals should be used 'judiciously' and agreed with Dr Walsh that alternative therapies, such as birthing pool births, can reduce pain without long-term effects.

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shamima rashid (13/07/2009 at 17:01)

I am quite sure if men had to give birth then some form of pain relief would have been used many years ago.Why with the advancement of medical science do male doctors want to prevent women from taking advantage of anything that will help them not only pain relief in childbirth but also menopausal symptoms.

Angie33 , Manchester (13/07/2009 at 17:14)

Ive been at 4 births WITH pain relief.Didnt notice any difference to my own without pain relief,except they took longer.

Ran Droid, Manchester (13/07/2009 at 17:32)

Ah, a professor who specializes in midwifery - in other words *not* an actual medical doctor.

There's a reason midwives are now generally known by 'proper' doctors as 'madwives', and this fool from Nottingham is a prize example. Idiots like him have led to some real tragedies at births, and should be roundly ignored and preferably chased into a more suitable career - snake oil sales perhaps.

Ace , manchester (13/07/2009 at 17:36)

Dr Denis Walsh, associate professor in midwifery at Nottingham University, said pain was a "rite of passage" which often helped regulate childbirth.??

Splurge (13/07/2009 at 17:42)

Here here to that Dr! No pain no gain.....Try man flu on for size if you want to experience real pain. You don't see us running for epidurals do you, no we just get on with it!!

Angie33 , Manchester (13/07/2009 at 17:51)

Ace.It can never regulate childbirth.No one who has not hd a child can describe the pain.There are no words for it,except maybe being ripped apart by dogs.Even then it would be quick.

Andanotherthing, Mcr (13/07/2009 at 17:51)

Mum had six of her seven children at home and only called for attention after wards. That meant getting up and walking to the phone box. I was born in Hospital, where she was induced and then delayed. "Giving birth is not like shelling peas" she would say..." If it were that bad I would have stopped at one."

Jellymay, Cheadle (13/07/2009 at 19:17)

It was male interference which 'medicinalised' childbirth in the first place.

Women should be entitled to any pain relief they may wish for. Unless you have experienced childbirth yourself you are in no position to comment.

The fundamental flaw with child birth in this country is that there isn't a consistent level of care, women are made to deliver in a position which is more suited to conception than birthing, and the facilities available are badly lacking. There is also the issue that babies themselves are, on average, somewhat larger than in previous generations.

As for the bonding issue, why would enduring the agony of having your nether regions ripped apart during delivery somehow contribute to the emotional bond felt for a new born? Common sense (and experience) tells me that the less traumatic the birth, the easier the bonding must be!

bhav k (14/07/2009 at 07:59)

You title should really be "Midwife in Childbirth Row"

Professor Walsh is not a medical doctor. Your article is misleading readers (see comments above) into believing that his views are those of doctors.

LittleMancMinx, Ashton Under Lyne (14/07/2009 at 12:26)

Oh how typical of a man to come out with this, has he experienced child birth I think not. If men where the ones that gave birth the we would be under populated! I am currently expecting and will be getting all the help I can when I go in to Labour, is that going to make me a bad mother and love my child less? I think not!

Jan Elliott (14/07/2009 at 13:57)

Had to laugh at you, Splurge! Very funny.

Personally, as I was a bit of a 'hippie' in those days, and was curious to see if I could endure it, I had my 2 lads with the minimum of 'interference',of which I'm very proud, but had I had the same medication as some do I don't think it would have influenced the outcome in regard to bonding. Each to their own, I say. With hindsight, I don't know if I could have been that brave a third time, even though it sure made for a memorable experience!!

Longshots Wife (14/07/2009 at 14:00)

This man has clearly been at the gas and air! Imagine if he had to squeeze a child out of his kidney nudger? I think not. I had an epidural last year for my birth and it didn't work so I felt it down one side.

Steve (14/07/2009 at 14:59)

Can anyone explain why a man, who, if he lived to be a million, can pass comment on how a woman should give birth and weather or not to take any pain relief during the birth?

I’m at a loss to understand why male medical practitioners, be they doctors or midwives, are involved in delivering babies anyway. They can never truly know how childbirth feels to a woman and they can only guess at the discomfort.
Yet when a woman enters hospital to give birth they remove the last vestiges of dignity from them and treat them like an inconvenience.

Having gone through childbirth four times with my wife I honestly believe that if they could find a way of babies being born with out either parent being there they would.

The whole maternity care situation needs a dam good shake up, it’s a special moment for parents and both the expectant mother and father should be treated with respect and dignity.

Not told to suffer by a person who hasn’t a clue what its like.

Sarah davies (14/07/2009 at 15:29)

Ok, so he may be a man, and he is a midwife with a PhD (not a medical doctor), but what Denis is saying is based on a mass of good research evidence. I am a midwife who has helped many women give birth, with and without epidurals. I gave birth to my own children at home, using a birth pool for pain relief. Let's not forget, women's bodies are designed to give birth. But how does the average UK woman give birth today? Unless she is lucky to be somewhere where there is a small birthing unit, or has chosen a home birth (3% of women) this is the likely scenario. She goes into hospital, as if she were ill, when in fact pregnancy is a healthy, normal state. Nowadays she has a 23% chance of having her labour induced- which causes far more painful contractions than a spontaneous labour. She will travel a long way from home to a large centralised hospital (maybe having been diverted, in labour, from her hospital of choice due to short staffing). She lies down on the bed (although research shows this will make her labour more painful, and about an hour longer than if she were to move around freely). She is not offered the use of a pool or large bath (despite Dept of Health recommendations) to sink into for a feeling of weightlessness and huge relief. She is attended by a midwife she has never met; who is rushing between labouring women, with little time to reassure or tell her how well she is doing, put cooling cloths on her forehead and give her a back or hand massage to relax her and soothe the pain. Then the shift changes, the woman loses the midwife with whom she has managed to form a bond, and there is now another new face, or faces, to adjust to. The unalleviated fear and tension of the whole situation cause the ‘fight or flight’ reaction which makes labour less efficient , far more painful, and increases the chance of fetal distress. The pain becomes unbearable and the woman asks for an epidural, which makes the woman immobile (so it is harder to push the baby out), and increases her chance of having a forceps or suction delivery, and an episiotomy (cut to the vagina).The baby has pain relieving drugs in its system for several days. But it is small price to pay for stopping the physical and mental agony.
If you recognize this scenario, I suggest instead of attacking Dr Walsh, you join the campaign for better maternity care. Believe it or not, it is a well- kept secret that birth, given the right conditions, can be joyful and even ecstatic.

lovinthebanter, Manchester (14/07/2009 at 16:17)

"I’m at a loss to understand why male medical practitioners, be they doctors or midwives, are involved in delivering babies anyway. They can never truly know how childbirth feels to a woman."
Steve ,
14/07/2009 at 14:59

I don't agree with what this man in the article is saying but by this logic any woman who hasn't alreasy had a child also cannot know what childbirth fells like and so there also could not be allowed to be a midwife or doctor at a woman giving child birth.

Also not to mention the outrage if a woman was told she could not have the job because she is a woman likewise a man being told he cannot be a midwife because he is a man is eually as bad, even worse considering the current lack of midwifes and the need for more of them to help regardless of the gender.

Nick Q (14/07/2009 at 17:32)

Who cares? Its women that have to bear the pain etc, So it doesn't affect the ruling race of this world - Us Men. Let's drop this story because its not applicable.

Angie33 , Manchester (14/07/2009 at 18:48)

Sarah Davies.You have described my experience of child birth over 35 yrs ago exactly.So nothings changed then?

Jan Elliott (14/07/2009 at 21:08)

I will assume you are joking Nick Q - or that you practised nicely in crayon before submitting your er, opinion...

LogicalLion (15/07/2009 at 01:24)

It is amusing how it's always a male worker who recommends these things!
An epidural does spoil the joy of giving birth & also adds to complications, there are lots of safe options open to women in the UK that don't spoil the act of giving birth. But it's the mothers place to choose their own birth plan. Midwives just need to be honest about the effect each method might have on mother & baby.

Steve (15/07/2009 at 07:37)

‘what Denis is saying is based on a mass of good research evidence’

There is also a mass of good research evidence that says lying on your back with your legs strapped up it is not a natural position to give birth in.

And an equal amount that says women want a little consideration and privacy whilst giving birth.

And just as much that say they and their husbands would prefer not to have a strange man walking in and out during the birth be he a doctor or not and would prefer a modicum of privacy.

And there’s a growing number of expectant fathers who are being treated badly by maternity staff at hospitals.

Clearly Ms Davies, you are not an avid supporter of the establishment you represent, but you appear like many in the medical profession to pick and choose the information you inform the patient / expectant mother / father of. Or would you be as forthright as you have on here?

lovinthebanter, Manchester (15/07/2009 at 12:32)

It is how it's always a male worker who recommends using these things!

LogicalLion,
15/07/2009 at 01:24

None were complaining when a MAlE came up with the epidural in the first place.

Sarah davies (15/07/2009 at 17:30)

Steve- you are right- privacy, respect and NOT expecting/making a woman lie on a bed are all essential to good labour care. People need to know these things. I ALWAYS try to provide unbiased information to prospective parents. I explain the pros and cons of different pain relief (including the value of water,an amazing method which also shortens labour). I also explain that they can choose a home birth if they wish - many people don't know. The last birth I attended, the woman had an epidural,for medical reasons, and it was a beautiful experience. People are all different.
Ange33,I am sorry your experience was so difficult. Many things have got better over the last 30 years (no more routine shaves and enemas, no routine episiotomy) and I was descibing a traumatic case, but it is a scenario that is still seen too often - as letters to AIMS (the Association for Improvements in Maternity Services) show. A big part of it is due to shortstaffing. The RCM says that 5000 more midwives are needed to ensure that every woman gets the one-to-one support she needs in labour. Every woman should have the choice of water to help her labour (govt policy) but how many rooms have a birth pool? Things are better than they were, but change takes a long time. We need resources too and a realisation that it is hugely important to get maternity care right for both mothers AND fathers.

Donald, manchester (15/07/2009 at 18:52)

This chap is not a medical doctor - he was described on the radio as a male midwife - quite a different kettle of fish psychologically and professionally, methinks.

Sarah davies (16/07/2009 at 05:28)

Yes, the title of this piece is inappropriate. Denis is a caring and well respected male midwife, and he has been widely misquoted in an attempt by the press to whip up a controversy. MAN says women should suffer during birth! Shock horror! In fact, this latest piece has not even been published yet, and in it, I understand, he is pointing out that epidurals should not be considered a replacement for skilled midwifery support for women in labour. He is not the first to point this out either!

claire roberts (16/07/2009 at 19:29)

I am a second year student midwife based a Salford University where Sarah Davies is a lecturer. I find this artical really interesting. Dennis Walsh is highly regarded in the midwifery profession and is not 'A MAN' who doesn't know what he is talking about. This artical has been majorly missinterperated and it is a shame. I find peoples reaction to it very interesting

I feel that Dennis Walsh has made a valid 'evidenced based' point. I have looked after women who have laboured with the aid of an epidural and many have gone to have have other interventions such as instrumental deliveries. Epidurals are medical interventions that should not be dismissed as being simply another form of pain relief. Whilst I agree that there is sometimes a need for epidurals they should not be used as freely as they are. It is more a case of looking at the midwifery support in labour. Midwives are trained and have the necessary skills to help and support women in labour, yet due to the shortage of midwives and the work load they are not always able to provide one to one care and so some women who request epidurals have to endure further interventions may possibly have been spared if they had been able to have one to one care from their midwives.

Childbirth on the whole is a normal physiological process that should be seen as positive experiance. I agree that the pain in labour is not something that should be dismissed. It should and is taken seriously.

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