The truth about pregnancy.....

Keep getting a bit traumatised about being pregnant and things that could go wrong. Thanks to The Times who published an article in their Body and Soul supplement last week which said:

"In a week of gloom there was one cheerier piece of news: the risk of epidurals, anaesthetic injections into the area around the spine, is lower than that previously stated. In fact, according to research from Bath's Royal United Hospital, it is ten times less. Epidurals are used in surgical procedures but also to kill pain in mothers giving birth, when the risk of permanent harm is less than 1 in 80,000. In the past many mothers may have been put off having this effective form of pain relief because risks have been overstated.

These headlines were particularly welcome because there is practically no other area of health where risk of any sort assumes such significance. Pregnant women are risk magnets, attracting every sort of scare about potential damage to their babies at a time of their lives when they are most fearful, for themselves and for the new life they carry. Not only are food scares (too much liver, too much fish, etc) aimed squarely at mums-to-be, but there are also horror stories about the maternity services. The irony is that the perception of risks may be more harmful than the actual risks.

For example, home birth has regularly been claimed to be too risky, and women who have wanted home births have been generally obstructed, demeaned and made to feel irresponsible by doctors in particular. In reality, for normal pregnancy, home birth appears to be safe, as Charlotte Church demonstrated conclusively this week as she had her second baby at home. And a home environment may even offer a small reduction in risk as far as infection is concerned.

You would think from the headlines that Britain wasn't a very safe place to have a baby. In the past couple of months we have seen stories about negligence payments for maternity claims topping £1 billion and about the chronic shortage of midwives. This in addition to the endless succession of stories on bad births that we are all exposed to - just a couple of weeks ago, for instance, a woman in Edinburgh gave birth in a bathroom by herself.

But the headlines do not reflect reality. Negligence claims, for example, relate to events that occurred a decade ago and involve the few, not the many. Evidence from the confidential inquiry into maternal deaths (and Britain keeps scrupulous records in comparison with some other European countries) make it clear that Britain is one of the safest places to have a baby, with a perinatal mortality rate standing at 7 per 100,000 and falling. Compare that with the US, where the comparable rate is 15 to 20 per 100,000.

And as for the bad-birth stories, let's be honest, the good ones aren't that interesting, are they? The Commission for Healthcare Audit report on maternity services in 2007 recorded that nine out of ten women rated their care in labour and childbirth as good or better. It would be a tragedy if headlines persuaded women otherwise."