So You Want a Natural Birth, Part 1

I can’t tell you how many first time moms I’ve heard say they want a natural birth.

“Great!” I say, “How are you preparing? What’s your plan?”

And you know what the most common response is?

A shrug. A confused look and, “I don’t know. I’m just going to wait and see how it goes when the time comes, you know?”

Every time I hear this my heart breaks a little. Maybe you will get the birth you want, but chances are you won’t. About 25% of women giving birth say that they want a natural birth. Less than 2% actually get them.

So if you are serious about having a natural birth, here are a few things to carefully consider.

The first, and perhaps most important, is preparation. This can take on many forms: childbirth education classes, discussing birth with your care provider, watching birth videos, reading, researching - anything that gives you knowledge of birth. Before I proceed, however, allow me to acknowledge (and refute) some common arguments against thoroughly educating yourself.

Objection #1: “It’s just birth. I can learn what I need while I’m in labor. I’ll just...see how it goes.”

Know what? You’re absolutely right. While a highly intricate process, it is “just” birth. Women and babies do have the instinctual knowledge necessary. Here’s the kicker - for the past few hundred years our culture has been progressively moving away from trusting a woman’s body and placing its faith in medical technology instead. In ages gone past, a woman’s friends and family came to help her labor. This meant that women saw births. They got to see what worked and what didn’t. Just as importantly, the process was normalized in their minds.

In today’s society, most women haven’t seen a birth before their own, much less a natural birth. The normal sights and sounds of an unmedicated woman giving birth aren’t accepted or acknowledged as normal, good and necessary. So no, it’s not a good idea to just “wing” it. Not today. Not in our society. Not if you want a particular type of birth.

Labor takes preparation. Labor takes practice.

Objection #2: “I don’t have time to spend studying about all this!”

Would you go into an important interview without first preparing? A first date? Your wedding? A marathon?

Your baby’s birthday is one of the most important of your life. You will remember that day forever. Don’t you think that’s worth spending a little time to prepare, even if it means missing a few episodes of your favorite show or spending a little less time facebooking?

Objection #3: “All that breathing and relaxing stuff is just a bunch of crazy, natural birth mumbo jumbo. It doesn’t actually work.”

You have a point. The whole “relax and breathe...put yourself in a happy place” thing is pretty cliche in the birth world, and I totally understand healthy skepticism. If you are skeptical about the benefits of breathing techniques, visualization, vocalization, relaxation or massage, look into the science behind them to understand why  they work. Not only is the science behind it absolutely fascinating, but once you understand why certain comfort measures can be helpful, you are more likely to remember and use them when the time comes. And yes, there is science behind many comfort measures! Browse these articles to get started! Waking the Neighbors: Screaming Versus Moaning and Indecent Noise: Embrace Your Primal Power.

Objection #4: “My doctor will tell me what to do. I’m not a medical professional - why should I think I know better than one?”

Again, you’re right - you aren’t a medical professional. But you are a unique person with your own beliefs, desires, goals and needs. No two people think exactly alike on a subject, and your doctor may have different preferences than you do. You want a natural birth, but maybe your doctor doesn’t mind so much how your baby comes, as long as it’s healthy. Maybe he/she will recommend things that may make natural birth harder, such as induction, not taking into consideration that you will probably end up needing an epidural.

Sadly, many doctors and hospitals do not practice evidence based medicine. As an article on Evidence Based Maternity Care: What is Evidence Based Maternity Care & What everyone ought to know says, “A team of national experts at The Journal of Perinatal Education, spent 2 years reviewing 15 1/2 years worth of medical evidence, studies & literature (in the U.S.). They concluded many routine medical interventions used during birth do not improve birth outcomes for mothers and babies. Some can cause harm.” 

I won’t get into why this is the case. That’s a topic for a whole other article, but the important thing here is to know that you need to collaborate with your provider. You need to know what you want and under what circumstances you can safely achieve those goals. If you want more information on doctors and evidence based birthing practices, try these pages: Improving Birth , Maternity Care, What is Evidence Based Maternity Care and the State of Maternity Care in the US.

Going back to induction, many doctors get nervous when a woman goes past 41 weeks and begin to suggest induction. If you knew that ACOG defines a full and late term pregnancy at 39-42 weeks, however, you would know that it is normally safe (with proper monitoring) to let your body naturally go into labor.

Another example: traditionally, many doctors and hospitals have restrictive policies on “how long” to “let” a woman labor before diagnosing her with failure to progress and recommending a c-section. However, as ACOG says in their paper entitled “Safe Prevention of the Primary Cesarean Delivery”, “it may be necessary to revisit the definition of labor dystocia because recent data show that contemporary labor progresses at a rate substantially slower than what was historically taught.”

Basically, a doctor in the 1960's came up a timeline for labor known as Friedman's curve. According to his study, a first time mother was supposed to dilate at 1.2cm an  hour. A woman who'd already borne a child was expected to dilate at 1.5cm an hour. Now, we know that dilation varies from 0.5-0.7cm an hour for first timers and 0.5-1.3cm an hour for mothers of one or more.

Why do I bring this up? Because the leading reason for first time c-sections is failure to progress, and many doctors today follow Friedman's outdated curve as criteria for diagnosing labor dystocia. Know your facts. 

I’m not saying that doctors are bad, but they can be just as human and flawed as you are in their decision-making and may hurt your personal desires for your birth as a result. All you have to do to prevent this from happening is to know your facts and stand up for yourself to achieve a satisfying relationship with your doctor.

End Story?

You want a natural birth. Maybe you’re a first time mom, tentatively facing the new world of birth that’s suddenly opened up before you. Maybe you’ve already had one or two with an epidural and you want to try another option. Unmedicated birth can be intensely empowering and fulfilling. However, it is also very difficult, which is part of why it is so rewarding when achieved. Through careful preparation, you will put yourself on the road to a wonderful birth experience.

What questions do you have about birth education and what you need to know about birth? Shoot me an email at birthbeyondbias@gmail.com, comment below or use the submissions page!

Special thanks to Welcome Back Photography for contributing the picture! Check put their Facebook page and give them a like!