The Hospital: C4

Have shouted many things at the first one, but the second one seems to have her head screwed on, there's a huge difference between the two in terms of responsibility

Oh this is making me SOOOO proud to be living in Birmingham. Gah.

I've heard this idea of "wanting a baby to love me" before and it's so sad.

Probably a naive question from a child-free person, but can mums to be insist on caesarians / being conscious or not? I (perhaps stupidly) thought caesarians were only done when absolutely necessary?

How does the needle phobic girl think they are going to give her a general anaesthetic? They don't make you drink it!

I cannot get over this girl's attitude. She doesn't do needles (and reckoned her tongue piercing didn't hurt!), she won't take a tablet and I'm getting the impression she doesn't think labour will hurt! Unbelievable.

You certainly can't insist on a section, but I think that girl's baby was breech, so they often recommend it in those circumstances. I don't know that you usually get much choice over being concious or not, though if you do have a genuine reason not to be, they will consider it. Usually. Maternity services are pretty good at treating women like idiots who don't know their own minds.

Thanks Hazel. I know what you mean about some maternity services - my friend was made to feel like a horrendous failure when she wasn't able to breast feed.

I'm quite mad watching this. I had Pre-E in my pregnancy and a huge fear of needles, I knew a water birth that I wanted was out of the window quite early on - but i did everything the medical people asked of me as this is what was best for me and my child. I looked like a bloomin pin-cushion after pregnancy/labour, due to the amount of needles stuck into me. The girls on here are rather selfish, thinking of themselves and certainly not thinking of their babies "I always get my own way" WTF is that all about. You're gonna be a mother - you better get used to not getting things your way ?. Oh my word - what a shock they have coming to them.

I'm watching on freeview record so a bit behind.

I'm not surprised by the lack of contraception use, I just wonder what we actually do need to do to make people (not just teenagers) understand that if you are not using contraception then you are trying for a baby.

The one who wants a baby to love her, it breaks my heart.

I don't like this talk about money and "10k births". It's a bit Daily Wail.

Completely. I'm a middle class, well educated woman and I dare say my emergency C-section cost a fair packet too ?

It's a shame that they feel the need to throw the tabloid style stuff in there. It was a mostly balanced and thoughtful documentary otherwise. I think it was interesting to see the two "sides" - the one who wanted maximum intervention (GA LSCS) and regretted it, and the one who was absolutely set on avoiding intervention and was downright rude to the midwives who were trying to monitor her ("I told them I wanted to walk around and they're all ignoring me" - like they put her on the CTG just for fun - she had pre-eclampsia FFS....) - I think both were seriously lacking in perspective in very different ways.

It made me so angry that she was insisting on a GA for her c-section. I ended up with an emergency c-section with general anaesthetic and 11 weeks on I still can not get over the guilt / upset of not seeing my baby being born.

Whilst I have every sympathy for you JB I think the moment we lose any element of choice in childbirth and just go with "what medics say goes" then you lose the right for people to make decisions for themselves.

Healthcare is a two way street, and obs especially. For better or worse, you have the right to do what you will with your body. Your LO has no legal rights until it is born. If you agree that women should have the right to try things that may be statistically more risky during pregnancy and labour as long as they are fully informed (e.g. refuse a section) then you have to accept that it works both ways.

Perhaps not the right time to be engaging in this discussion, it must still be very raw for you.

I do worry that it's tough to get a balance between people being counselled on the positive aspects of low intervention births, without causing lots of problems with guilt and sadness in those that don't 'manage' it. Very like BF/FF. It's a real toughie. As ever, the absolute priority is healthy safe baby, healthy safe mum.

I'm not even onna comment for fear of being burned alive by flaming arrows! Those girls are a disgrace is all I'll dare to say.

I had a lot of sympathy for this girl at this stage. IIRC she had researched a birth plan, which contained arguably a lot of what is 'best' practice for mother and baby, ie mimimum intervention, skin-to-skin contact etc. Sadly things didn't turn out as she had hoped (something she possibly hadn't considered) and I just felt very sorry for her as the choices were taken out of her hands. Given that I could understand why she wasn't taking it with good grace, although I don't recall her being rude directly to the midwives? (Which clearly would be out of order) FWIW I also think that the bedside manner of one or two of the health professionals had room for improvement perhaps. She also made a good point in that if she was older, would they have listened to her more? In terms of the documentary itself, I think the editing was pretty leading so am taking it with a pinch of salt. Wish it would explore more with teenagers what the NHS means to them though...teenagers are a pretty soft target and without that it just becomes 'outraged' tv.

I agree it didn't do much exploring. As I commented last week, I wasn't sure whether it was an "outraged" doc about the awful yoof of today, or a documentary about the 'real life' NHS.

WRT to the 'low intervention' girl, I think she said "I hate you all" to the midwives, but I may be mistaken.

I do think her Obs did a very good job of trying to explain the seriousness of the situation without freaking her out. Maybe more time explaining how and why the induction/monitoring were necessary would have helped, but at that stage I think she was so set in what she wanted that it would have been very hard to try and reason with her. That's not to say it's not absolutely worth trying!

Unfortunately this is the danger of birth plans! I totally understand why people want to make them but I've been to so many births where women have changed their minds and/or circumstances have changed significantly so as to render the birth plan fairly academic, that as and when I'm in that situation I plan on just having the vaguest of vague ideas and going with the flow. In my experience, the more detailed your birth plan, the less likely it is to happen like you planned it!

RA, I totally agree that we should have choices - after all I was going to be refusing induction. It made me angry that she didn't have an understanding of missing the birth of her baby, or that she didn't seem to be bothered about not being at the birth of her baby which is how it feels.

Obviously yes, very emotional for me still and probably always will be.

Just re-read my last post and it comes across as very patronising JB, that wasn't how I meant it at all. I'm sorry you had such a traumatic birth experience.

Anyway, I think with all these things, people value different things differently. I don't think it necessarily meant that she didn't care, just that the actual moment of birth maybe wasn't quite as important to her as it maybe is to some other people. I don't think that automatically makes her a bad mum.

RA, I don't think it's about denying choices. I am a huge fan of choices in birth and know from experience how empowering it can be to have the birth you want. But I do not think a hospital should be pandering to the whims of silly little girls to give them c-sections under GA because they're too immature/childish to just face up to the reality of childbirth. That is not a valid choice IMO. Entirely different if someone had medical reasons, physical or psychological (including a genuine phobia of childbirth, rather than the natural anxiety and apprehension that all women probably have), that indicate it was warranted.

I should imagine that the edited part with the full story with the girl actually explaining her fear is on the cutting room floor - I doubt that the hospital would give a GA just for the sake of it.

I do take your point Roobarb, but where do you draw the line between anxiety and phobia? It's a very tough call. I can't see how we could introduce a 'test' for genuine psychological aversion without causing huge uproar about the 'right to choose'. It may not be an approved Hitched choice, but I don't see that you can support right to choose e.g. for non-low-risk home births, but not for a GA LSCS.

At the end of the day, you cannot operate on someone without consent, and she was absolutely refusing to consent to an epidural/spinal. Yes, a GA is higher risk, but it's her risk to take (as with refused inductions, refused sections etc). I was fairly convinced that everyone had a good go at trying to talk to her about the benefits, risks etc. Not sure what the alternative would be tbh.

You see I think they are right to be talking about the costs to the NHS. There have also been similar documentaries over the past few weeks regarding teen binge drinkers who end up in casualty on a friday night because they've had too much too drink, got into fights, car accidents etc etc, and the cost of this to the NHS. It staggers me how blissfully unaware they are at the real life hard cash costs of this.

I do think a lot of people, from all walks of life, take the NHS for granted and whilst I think it would be dreadful to go down the American route in terms of health care provision, I don't think reminding people of the cost is a bad thing. It isn't that I think having paid into it gives anyone more right to anything either, as I am sure I've received more than my fair share over my lifetime having had 2 c-sections myself, but I do fear there is an atttitude of 'entitlement' and 'right' which isn't particularly healthy and not sustainable long term.

Well, you're the medic not me, but I'd have thought for one thing there would be quite a difference in terms of costs/resources for those 2 scenarios, and further I'd have thought an experienced obstetrician could perhaps tell whether someone is just suffering the same fears of childbirth as everyone has, and if seemed more than that, then some sort of psychiatric/psychological examination could weed out phobia versus normal childbirth anxiety? I don't think it is valid for someone, with no reason, to choose an option that costs a huge amount more in resources than the alternative.

Yep, I do see what you mean from a financial POV, but idealogically I don't see the difference.

I try to avoid thinking about money when it comes to making choices about patient care. This may well be a naive way of thinking about things, but I think it's necessary.

Ideally you would see the same healthcare professional throughout your pregnancy, and develop a relationship and rapport with them, and then they may be able to judge to what degree you had a genuine phobia. However, I think that practically and pragmatically if someone has absolutely made up their mind to have X procedure, then whether they are genuinely phobic, or very afraid, or just 'too posh to push' (TFIC) it is incredibly difficult to persuade them otherwise. Particularly then to avoid being slated for being too paternalistic. It's a no-win scenario for the medical staff.

I think all the girls were being supported by the teen mum midwife, who would presumably have taken that role of developing a relationship over time, and yet the GA LSCS girl still wasn't amenable to being persuaded.

What does LSCS stand for ? It's been all over my notes and I can't work it out. I figure the CS is cesarean section but was is the LS for.

Did I hear right that one of the health professionals said to the young father something like "I won't give you the baby to hold in case you drop her" - I found that a rather patronising thing to say.

Lower segment.

I thought she was saying that to the Mum who was coming round from the GA. If it was to the father then it was patronising and blooming rude.

It was directed at the FAaher - The OB Consultant took the baby to go to the Mother.

I didn't watch this, but this has been a fascinating thread.

Jellybaby, I really feel for you, but you know what you did a good job, you delivered your baby and thats all any of us can ask. You should not feel any guilt at all ?

I have experience of childbirth (on the NHS) from two different perspectives, the first time I gave birth I was 17. I was not asked if I had a birth-plan. I was not informed about what might happen in any given circumstance. Nor did I ask. I tried to get over the whole thing as painlessly, and 'silently' as possible - didn't want to make any more of a fuss than I'd already caused. Frankly, when I look back, I'm angry that I couldn't find my voice. I wasn't asked if I minded students being present, if I wanted (or could even facilitate) breast-feeding. I was told what was going to happen, when it was going to happen and what was expected of me. That was 19 years ago.

Second time I gave birth I was 26. I found my voice then. I didn't make a birth-plan, but if I had I would have expected to be accomodated as far as possible. I said when I felt comfortable having students present and when I didn't. I had a voice on a few other things too.

I understand that the NHS is under a lot of pressure, and one of my friends is a midwife and my eyes water at the days she puts in. However, just because I was 17 shouldn't have meant that I was dismissed as some silly girl who had gotten herself into trouble.

You may scoff at these young girls with their voices and maybe the pendulum has swung too far in the opposite direction, but as far as I can see, if they didn't make a fuss then they would be ignored. Birth plans are fine (as far as they go, and I'll bet a lot have to be abandoned), but why shouldn't a young teenage mum be asked what her birth plan is?

Again I haven't seen the programme, but this is my experience.

ETA: the concept of a birth-plan was very much prevalent 19 years ago - in case anyone makes the argument that it was just the way things were 'in those days'! ?

They gave me a book, which told me to make one. But I thought you had to fill in a form or something - a form which no-one gave me and I was too mortified to ask for. (How I ever got pregnant with this mousey attitude I'll never know!) It upsets me (slightly - I'm a bit over it now ?), that after seeing me, the consultant probably had a 20-something married woman in next. A woman with a plan! He probably even asked her if she minded the students being present.