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Everyone loves a birth story, but there's a certain variety I
keep hearing that makes me kind of cringe. It goes a little something like
this: "So I planned to have a natural birth, and I labored at the hospital
for a while but then when I was seven centimeters dilated the nurse warned me
that the pain was going to be really, really bad. She said, 'I know you want to
have a natural birth and all, but I'm not sure why you want to have a natural birth,' so we talked about it and I
ended up having an epidural. Then my labor stalled a bit and I had some Pitocin
to get it moving. Anyway it all worked out and here's my baby!"
Sound familiar? Look, obviously every birth is a beautiful
thing in a big-picture kind of way, and if a mom wants pain medication, that's totally
her choice. That's a-okay. But doctors and nurses should not be the ones stepping in and scaring women into epidurals—or other
interventions—when those women have explicitly stated that they hope and plan
to avoid them. Especially when those women are in the throes of transition and
need, above all else, a birth team to support and encourage their natural birth
Now, I know many mamas who've had successful natural births
in hospital settings. But many of those women have made those natural births
happen by sticking ardently to their guns in the face of resistance on the part
doctors, nurses or other members of the hospital staff. (And let's face it –
not all laboring moms, especially first-timers, feel empowered to stick to
their guns when what they're really trying to focus on is having a baby.) One
mom I know was pressured by the on-call doctor to have a C-section for no
medical reason except that her birth was "taking too long." (Heard
that one before, right?) The nurse told her on the DL that, in fact, she was
progressing just fine and the doctor simply wanted to get home in time for
dinner. The mom refused the surgery, walked around the room a bit and delivered
a healthy baby the old-fashioned way within an hour.
Other moms I know have had
the c-sections and then wondered later if they really were necessary or not. In fact, too many of these stories end with
the C-section, or the Pitocin or the pain drugs or whatever. And while every
one of these moms was overjoyed to meet her baby, this pushing of interventions
still matters. It matters to them and it matters to us.
It matters because our birthing system is the most expensive
in the world, and the American maternal death rates are twice what they were in
2000. There are
differing opinions as to why American birth outcomes are so dismal, but it's a
fact that interventions beget more interventions and interventions during
labor and delivery increase risk. If a woman has stated that she wants to avoid
interventions, medical teams should do everything within their power to honor
And while every one of these moms was overjoyed to meet her baby, this pushing of interventions still matters. It matters to them and it matters to us.
A birth plan, while not set in stone, matters. Yes, the
maxim "a healthy baby is what counts" is true—and birth plans
sometimes need to be abandoned for that cause—but, generally speaking,
natural births are planned the way they are with the baby's health foremost in a
mama's mind. If interventions are used to save a life or avert an emergency,
that's great; that's what they're for. But their overuse has far-reaching
consequences that affect children and families long after they've been
discharged from the hospital with an ostensibly clean bill of health.
As women research their options and make choices—whether they
want to skip the epidural, whether they prefer not to have their baby bathed once
he or she is born, whether they want to decline the standard antibiotics in the
event of being Group B Strep positive but having had a pretty fast labor—many of these choices are made in the
interests of their babies' health, specifically. Veering from a natural birth plan without
medical necessity can undermine not only a mother's preferences but the purpose
behind those preferences—her baby's health—as well.
After having one unnecessarily high-intervention birth the
first time around, I opted for a natural birth with my second son. I initially
planned to do this in a hospital but it became increasingly obvious that I'd be
working against a lot of push-back so I
switched halfway through my pregnancy to a midwife's care, and had my baby at
home, intervention-free. It was an exhilarating and yet very peaceful
experience, and although my labor was super fast and intense (like, two hours
total) I can say confidently that having a birth team that was as invested in
my commitment to a natural birth as I was made all the difference in my belief
in my own ability to do the thing at all. I
can't really imagine how different the experience would have been had someone
stopped me for a cautionary conversation about pain, and offered potential
alternatives, at seven centimeters dilated.
On the upside, many hospitals are beginning to introduce
midwife teams onto their staffs.
I hope this trend will continue and will mean that moms who make plans for
birthing naturally in hospitals will find themselves fully supported in doing
so when having that support counts the most.
Did a doctor or nurse talk you out of your birth plan?