Thursday, January 7, 2010

Why Natural Birth for Normal Women?

It's easy to find information about how modern obstetric practice has failed women. Go to just about any parenting website, and you'll find loads of articles and posts about lack of informed consent, non-evidence-based care, unnecessary intervention, outright lies being told to scare and coerce women into making birth decisions they otherwise would not make. In a less dramatic way, I believe the birth community is also failing women.

While I have always strongly desired a natural, drug-free birth, I used to be an OB believer. When I got pregnant with my first child, I dutifully went to my OB, kept all of my appointments, did everything I was supposed to. I declined induction on my due date, but when 41 weeks came and my OB said I "had" to be induced, I didn't question it. Likewise, I didn't question any of the procedures that were performed in the hospital. It was only after my c-section that I really started to learn about normal childbirth, and it was only as I planned my first VBAC that I realized how much modern obstetrics is designed to keep us in fear and make us feel like WE have failed, when in fact we were never truly given a chance to succeed. I needed an alternative, but instead of finding myself drawn further into the birth community, I've found myself deeply conflicted.

It took me a good deal of time to realize that even though my beliefs about birth were not supported by modern obstetric practice, I wasn't really far enough from the mainstream to be fully embraced by the birth community. I'm not anti-OB, I'm not anti-hospital. I don't think women should have to choose a midwife-attended homebirth to have a good birth- and, perhaps most damningly, I don't think women who choose interventions like inductions or epidurals- or even cesarean sections- have any less right to a fully informed, positive, empowering, birth experience. By and large I think the birth community gives lip service to this issue- "of course you deserve a good birth experience, dear, but how do you ever expect to have one when you make those choices?"

When I was pregnant with my 3rd baby, I went online and asked (basically) this question: "Are we doing women a disservice when we tell them natural birth is impossible to achieve in a hospital?" It seemed to me that the birth community was telling women that they should expect to be treated terribly, they should expect to have their wishes trampled, they will be forced to cede their personal power and consent to any number of invasive and potentially dangerous interventions the minute they walk through the hospital doors. Perhaps my original question was poorly phrased, but I still wonder how that message is supposed to empower women to demand better treatment for themselves. The vast majority of women give birth in the hospital, and when the people who claim they want birth to be better for everyone tell women they are going to fail, well, what kind of message is that?

The responses I got so many years ago ranged from completely dismissive to personally offensive, but they boiled down to: "Natural birth is almost always impossible to achieve in the hospital, and telling women otherwise gives them unrealistic expectations. Women need to prepare for reality." It was defeating. I felt the birth community expected its members to fit a cookie-cutter mold, just like the obstetric community did. My own options were limited to a) the hospital or b) the hospital, and while I knew I hadn't exactly asked for support in achieving another natural birth in a hospital setting (I'd already had one with my 2nd baby), I didn't expect that there would be so little support for the idea that hospital birth doesn't have to be- and should not be- the end of a woman's hope for a natural birth.

A couple years ago I was talking with a friend about our upcoming births. She was heavily leaning toward a repeat c-section, and I was heavily leaning toward a homebirth VBAC, but somehow we managed to talk about our births without judgment or defensiveness- imagine that! I mentioned something about hoping to become a childbirth educator, but not feeling like I'd really be accepted in the birth community. She said that maybe it would be good to have someone like me in the field, and I laughed and said I would call my service "Natural Birth for Normal Women." The idea has festered all these years, and is now the inspiration for my blog. This is my small way of saying it's okay when you don't fit the mold, you still deserve to have your choices respected and your birth celebrated.

And maybe in a few more years I will worry less about whether I'd be accepted, and will pursue childbirth education after all.

(I should probably give my definition of the "birth community" for the purposes of this post. I am primarily talking about anyone who actively promote non-mainstream birthing options. Yes, that includes me. :-) I should also say that while I have always felt somewhat alienated by the birth community, I am blessed to know so many women who believe so strongly in the power of women's bodies. You know who you are- and you never fail to inspire me!)


  1. I completely agree with your friend. Your writings are some of the most logical thought processes I have come across in regards to birth. I had a mindset of "I trust our medical system.". And it's not that I don't now, even after the c-section! But looking back, I was told at 38 weeks by my OB that she thought she needed to induce me because of the size of the baby and if I wanted a chance at all of a vaginal birth I could not go full term. And he was big at 38.5 weeks weighing 8lbs 9oz, 21.5 inches but to too big to birth!). So I entered that labor suite believing in her statistic that no matter what, I still had a 60-70% chance of going to a c-section. After about 12 hours of labor I was at 5cm and 70% effaced and the baby was still at the -2 station. I remember asking her when she said it was time to start thinking about a c/s what the risk was if I just wanted to continue laboring. She told me that she was afraid the baby would get stuck in the birth canal and she would have to break my pelvis or his shoulder to get him out. Well that's a good way to scare me to the OR!!

    All that said, I was raised by a NICU nurse (who has 4 c/s herself) and I still believe in our medical system and definitely plan to return for my next birth. I think what you're doing is not only empowering those of us who are hoping for a successful VBAC, but you also have the potential to educate first time mothers who are just trying to have a safe birth about their true options.

    I vote that you should write a book. :)

  2. I vote that, too!

    As I've said to people as I pursue my VBAC, sometimes I feel like the only choices we get are the extremes. Either we are told that the only way to have the birth we want is to birth at home (and in my state, to do that with a VBAC means doing it unassisted) or we are told we must trust our doctors and go with medicalized birth. There has to be a middle ground that promotes normal birth (which I like as a concept more than "natural birth.") I just met with the holistic birth counsellor at the hospital where I am delivering. She is new and has quite a job ahead of her. But just knowing she is there made me feel a lot better, because she is going to advocate for normal birth within the hospital.