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Rise of the one and only child

This article, about the difficulty of getting pregnant with a second child, is running on Saturday in the Times Body & Soul section. Some doctors think the problem is increasing. Did you have a problem getting pregnant again or know someone who did?

Couples who have already had a baby are discovering increasingly that they have fertility problems. Lucy McDonald explains why

If your first baby was conceived with no more planning than a romantic dinner à deux, some saucy knickers and a drunken rumple under the bedsheets, it can be perplexing when getting pregnant again proves difficult, if not impossible. After all, your offspring is living testimony to your fertility, so what’s the problem?

Unfortunately, past fertility does not equal future success. Some doctors believe that secondary infertility – the medical term for being unable to conceive when you have given birth before – is increasing and affects as many as one couple in five. An American study last year suggested that it is more common than primary infertility, in part because the age at which women have their second child is rising. Official government statistics for 2006 show that the mean age for mothers having their first child was 27.6 and 30 for the second.

What was your midwife or nurse like?

Yesterday a story ran in the Times about midwives failing women during birth, sometimes disappearing at key moments. To most mums, it's hardly a "stop presses!" moment. Practically every mum I know has at least one horror story about birth.

After my c-section, I needed help getting in and out of bed,  and picking up my daughter from the plastic tub beside the bed. Some midwives were great - including a trainee who popped in several times a day to check on me. But a few were terrible. They gossiped loudly in the middle of the night at the nurse's station right outside the door. When I rang for help becase of stomach pains, the woman who came stood by the curtain and said tersely, "I can't give you any drugs!" as if I'd wandered in off the street with a needle in my arm and a jones for black tar. "I have a lot of other people to look after tonight. You're not the only one," she said, showing just how important I was in your daily to-do list. Only after cajoling did she lower my bed (by foot pedal, which I couldn't reach) so I could get a Bisodol from my overnight bag. I don't even want to think about the state of the loo. I checked myself out early.

This is nothing compared to the stories of friends, who have had post-delivery infections go undiagnosed, had midwives or nurses who made them cry or jeopardised the life of their baby.

The system has slashed budgets, is closing maternity wards and can't find enough midwives to do the job. It's no wonder workers are under pressure and demoralised at their jobs. But to be perfectly frank, when you're giving birth you don't care about those things and shouldn't have to.

In hospital during my pregnancy, I needed medical care. The last thing I wanted or needed was to feel like a name on the list to be ticked off as quickly as possible before someone could go on their fag break.

What was your experience like in hospital?

The NHS needs to stop strategising and get out a mop

The Times News Review section this weekend had a piece about the maternity care on the NHS. There seems to be a lot of head-scratching going on in the NHS on what to do about abysmal maternity care. At the very least the first steps are obvious:

* hire and retain well-trained midwives

* keep the wards clean

The bigger issues of balancing care with surgical intervention will be longer in coming, but the NHS in the short term needs to spend less time developing massive big-picture strategies and start with making the ward a clean, safe place to give birth.

Jenny Colgan: Jordan's great, but she's let us down a bit

I genuinely like and admire Jordan, I think she's great. She does everything her own way and doesn't give a toss what people think - compare her to, for example, the needy car crash that is Jodie Marsh. She's incredibly pretty, ballsy, brainy and a hands-on mum, and it's made her a millionaire a load of times over. Okay, it would have be brilliant if such a role model could have made it to the top with a little bit less masturbatory fluid involved, but on the whole I think Britain should be proud of her. I even think it's a shame we didn't let her go to Eurovision at nine months preggers in that vinyl pink catsuit. After all, it's not like we're ever going to win Eurovision again, so we might as well have shown that we didn't care.

Anyway, she has, though, just let us down a bit. Not in naming her daughter Princess Tiiamii (with the randomly placed accent to make it 'a bit unusual'), which is fab, but in her current interview in 'OK' magazine.

"Are you breastfeeding?' asks the mag.

"No, it's brilliant!" she says, then mentions she's got crates of disposable baby milk bottles, just pops one in and throws the bottles away without having to sterilise. Then follows an extremely large pic of her with aforementioned disposable bottle, label turned towards the lens. "I don't want a baby drinking from me" she adds. "I don't care what people say - you don't have to breastfeed."

Now, I hate prosletyizers of all shapes and sizes, including the hairy- faced breastfeeding fascists who holler "TUMMY TO MUMMY!!!!" at any given opportunity and imply that your child will be an obese asthmatic underachiever if they miss a single drop of the good stuff, regardless of how much blood you may have to shed to achieve it.

Of course bottle-fed children are completely okay. But breast is best. It just is better. And Jordan is such a role model, for so many girls, particularly young girls, in nearly everything she does, that for her to dismiss it with an 'I don't care what people say' (whilst entirely characteristic and in keeping with her take-no-prisoners personality) is nonetheless pretty upsetting. There's no reason people with implants can't feed. There's lots of reasons why people who 'don't want a baby drinking from me' should at least give it a shot.

There is another clue to why Jordan isn't at it though, in a later question:

OK: How have you managed to lose weight so quickly?

JORDAN: I honestly don't know. I blend fruit for breakfast and don't have lunch.

Well, that'll certainly get rid of your milk supply for you.

You think the NHS is bad?

Check out this account of childbirth in Yemen, where the average number of children is 7.9 (bring on the pethidin) and hospitals are beyond basic. Some very interesting pics here showing women giving birth in the full chador

The DIY craze hits C-sections

I'm all for women learning how to replace their own U-bends but performing our own abdominal surgeries? Well, kind of. In Australia one woman opted for an "assisted Caesarean", in which she helped pull her baby out. It's all part of giving women choices at birth. I had a Caesarean and my "choice" was to demand my husband stop moving his head - as it allowed glimpses in the mirrored surface of wall of the operating room of the show going on behind the curtain. I did not want to see what was going on behind the curtain, mainly that a surgeon I'd met minutes before had pulled me open like leather handbag and was wrist deep in my innards. When the anesthetist started to lower the curtain separating me from the carnage, I asked, "What are you doing?", with rising hysteria in my voice. "Don't worry, you won't see any blood," he said, "but you can watch your baby come out". And I did. As I looked down, I saw my daughter emerge from my body in what seemed to me a close approximation of the view of a vaginal birth (pay no attention to the man behind the surgical mask).

I held her against my bare chest right away. But I'm glad that I didn't have to lend a hand in the surgery. My dentist, after all, doesn't ask me to be involved in my root canals.

An Alpha Mummy reader appears in the paper

The "lively" conversation about Caesareans on Alpa Mummy, prompted by Hilly's email and commented on by the always-observant Caitlin (below), have drawn the notice of our brothers and sisters in print. On Saturday, the Body&Soul section of the Times is running an excerpt from Nearly Mummy's post as their Star Letter of the week (and desperate to bestow the customary prize for the best letter - Nearly Mummy, send your email in to body&soul@thetimes.co.uk). A sample:

What utterly eludes me is why a "natural" birth is the only type that many women will even consider. Do they have some sort of awards ceremony afterwards or something? (Read her full post here)

If they do, I think mine got lost in the mail. It's a good idea though - something they could slip into that free pack of nappy coupons and sachets of baby lotion they give you by way of parenting advice at the hospital. The only question is, where would the paparazzi stand?

What is the problem with Caesareans?

What is the problem with Caesareans? Why do some women see them as a personal disaster? "I'd never failed at anything", says Kerry Baggott, until she didn't give birth the way she had planned. (Read Kerry Baggott's piece on her Caesarean in Body & Soul). But whoever said that having a baby was some kind of test to be passed or failed? Of course it's understandable that women should want the process to be as natural as possible. But it should come as no surprise that Mother Nature can be harsh. And childbirth is a biological process that some women are physically more suited to than others. Many of those who aren't used to die. In the last 50 years there has been a decrease of 83 per cent in  maternal mortality rates, and the decrease in deaths of the baby is 78 per cent. 

What worries me is a new breed of mothers who see everything in life as a test of their abilities. There's a type of young professional in their 30s, who got into the best schools, did well in exams, not to mention playing five-a-side and being a prefect. Women's liberation has done them proud: they went to the right universities, got great jobs, promotions. With the material rewards they buy the desirable flat and car, go on holidays to the right places.

Next on the list, girls? Find the right man and give birth the right way - as if another human being is a commodity to be chosen for its desirable attributes; delivering a baby a task for which you get marks out of ten. But there's no application form to fill in for becoming a wife and mother. Finding a man isn't like buying a car. Giving birth isn't like an appraisal with your boss. Feminism has empowered women in so many ways - but how did it reduce them to thinking like this?

Has Kerry thought about how her daughter might feel about Mummy marking her arrival in the world as a failure? She is "pinning all her hopes" on giving birth to her second baby, due soon, naturally. Good luck to her. But what would it be like for little Charlotte to grow up thinking the arrival of her younger sibling, by contrast, was "a success"? Motherhood can be challenging enough without adding fat to the fire of sibling rivalry.

I had two Caesareans, one unplanned and one elective. I won't bore you with the reasons. Why dwell on something that however long and painful is one small step in the exhausting, rewarding, endless learning curve of being a parent? I'm a professional woman who left having children until very late. I'm very grateful that my bright and bouncy children are here at all. Come on Kerry - you've got a gorgeous baby, and there's another on the way. Now get a life.

HILLY JANES, EDITOR, BODY & SOUL

UPDATE: "Thank you for the advice to 'Get a life'": Kelly Baggott replies in the comments.

PREVIOUSLY: Tiffanie Darke on The Natural Conspiracy