Stop "trying to be good" in your birth choices

February 1 | offbeatbride
Andrea's son, Nico Boon
I thought some of you would super enjoy Andrea's story of her second son's hospital birth. She perfectly expresses the conflicts so many of us experience when making choices about birth:

A few days before I went into labor I had a long talk with a friend who is a doula. Given that I was past my due date and feeling anxious she was wondering if there was some kind of mental block that wasn't allowing my body to relax and go into labor. She asked me a ton of questions about how I wanted the birth to go, what my hopes were, etc. What I appreciated most was that she asked these questions without any agenda.

I had an assumption that doulas and midwives had an agenda about delivering at home, are suspicious of hospitals and generally frown on any sort of pain medication. Turns out I was wrong, and I felt so relieved when it was clear that she really just wanted to know what kind of birth experience I wanted to have. The more I talked with her, the more I realized that not scheduling an induction, not having an epidural, etc. was me trying to be good. Trying to do it right… in the "natural" way that people do it here in Berkeley.

Read Andrea's full birth story, and then come back and let's talk about the machinations we each go through with birth decisions.

Birth is a complex issue, made especially muddy by the swirl of emotions, medical concerns and pressures, cultural trends, and health care issues. That said, I think the goal of any one providing birth support for a friend or client should always be supporting women as they make their own best decisions, and I totally commend Andrea's friend/doula for exemplifying that support.

Obviously, as the daughter of the midwife, I personally support everyone who wants to have an unmedicated and/or at-home birth pursuing that option. I desperately wish that the American health care system was better equipped to allow more women to pursue that vision. I think the world would be a better place if birth was less medicalized.

But, I also support strong women, like Andrea, who know their options and make their own choices. I don't think making a choice based on misplaced guilt or a dutiful sense of what you "should do" is any better than making a choice based on pressure from ill-informed family members or a woefully broken health care system. Ultimately, it's about collecting as much information as possible, and making the best decision for yourself that you can.

  1. "I had an assumption that doulas and midwives had an agenda about delivering at home, are suspicious of hospitals and generally frown on any sort of pain medication."

    Sadly, it seems that some (doulas, midwives, doctors, PEOPLE) have an agenda that they will try to push on others, which can make it harder for people to know what is best for themselves.

    4 agree
    • I wrote a birth story on OBM this past summer about this very issue, as I had planned on going "all natural" and ended up making the decision to have an epidural after 12 hours of unmedicated labor. I was able to later see how having that epidural was actually a huge blessing to me and my family and it truly allowed me to have the birth experience I wanted. I think we beat ourselves up too much over this issue.

      1 agrees
      • I agree. When you get your teeth pulled at the dentist are you going to go for the all natural, paid med free option? Probably not. I'd rather my baby be born in a calm, screaming mama free environment.

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        • While I don't disagree with anyone having the birth they want, including the option for pain meds, I do think that's a bit of a false equivalency, since your teeth were never meant to be pulled, and pulling your teeth is distinctly not a natural process. Plus, I've always felt that statement is derisive toward those of us who do choose to go without the meds, and I really wish we could all just respect each other's choices.

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          • I definitely give props to those who opt for a natural birth. I just wish more people would not be so quick to snub those who choose to take advantage of medical advances we are so lucky to have available to us here in the US.

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      • Yes, we beat ourselves up too much over this issue, and this is only the STARTER issue. Then it becomes breastfeeding, cloth diapering, co-sleeping, making your own baby food, elimination communication, etc. There is one way that is posited as more "natural" and another as more "convenient" and therefore less worthwhile.

        I'm actually a huge advocate of many so-called "attachment parenting" approaches, but I cannot read several of the attachment parenting websites or boards very often because there is such a self-congratulatory tone, and such a party-line, and it seems like some big insider club that one can only enter if one plays by certain rules.

        One reason I love OBM is because it features stories about unmedicated homebirth AND hospital epidurals, and because alongside essays that include the joys of breastfeeding is a wonderful essay from a year or so ago about a woman who could not breastfeed. Etc etc. Lots of balance, no "one way." This is why I check OBM first thing every morning!

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        • heck yeah! i think i'm actually doing a lot of attachment parenting stuff, but i had to stop reading about any of it, too. the fact that we have to write out our guilt and shame for having epidurals, not being able to breastfeed, doing sleep training, using disposable diapers should tell us something.

          we're allowing our culture to make women feel guilty, shamed, silent, and self-loathing, yet again. it used to be The Man putting us in our place, insidiously marketing us into formula-feeding. a good mom used DDT to keep the bugs away and kept a spotless house reeking of bleach. now it's the über-granolas insisting we Must Do Things a Certain Way.

          it's basically a feminist issue. if we can't respect each other's decisions, we're in trouble. healthy debate is probably needed when those choices clearly affect others directly — if you use disposable diapers and wipes for no particular reason, that's a big hit to the environment; vaccination issues directly affect the health of all our children — but most of these things are private. does it hurt the environment a whole lot if you get an epidural? will my grandkids get polio because you sleep-trained? nope!

          1 agrees
  2. I put gobs and gobs of thought into my birth plans, and I was particularly tortured over the epidural issue. Finally, a good friend wrote an email to me quoting back some of my words in an email to her, and she drew attention to how extremely moralistic my language was regarding unmedicated childbirth, and how I sounded like I was headed towards the guillotine when I described the unmedicated birth I was supposed to do, and how I worried I was too "weak" to withstand it, and how I instead feared I would "give in to temptation" and get the epidural. She advised me to do what I wanted.

    A month or so later, my husband and I took a hospital sponsored childbirth class that featured videos of several different birth scenarios, and the professional athlete — no stranger to pain! — who chose to get an epidural and said it helped her relax and stay present for the birth — tipped my decision in favor of the epidural. And it was a wonderful and glorious thing. It was the right decision. And I relaxed so much after making this decision and was able to concentrate on preparing for birth in a much less panicked way. The epidural was wonderful. My son did have some very short-term breathing issues, and I wonder if that was the epidural. However, he was also positioned very weird in me and required a major repositioning, and a lot of doctors might have chosen a c-section. So, perhaps the fact that I was pain free during that extended procedure actually helped it work and helped me avoid a c-section, which also could have brought some breathing issues.

    I, too, though one only had doulas for unmedicated births, and I have since learned otherwise. If I have another child, I am getting a doula next time. And likely an epidural too.

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  3. My mother had me and my twin brothers at home with a midwife. When I became pregnant with my first child I decided to not use medication. My mom and midwife tried to help but it was awful and scary. Second child i walk straight in and said hook me up doctor. I laughed with the doctor, watched movies and pushed a 10 pound baby girl right out. Never felt a thing. I respect each persons decision for a birth plan. I did both and both where healthy.

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  4. I am taking Bradley Classes and preparing for an unmedicated birth, but I still found this story to be empowering and relatable. With all of the differend ideas and beliefs circling around childbirth, it's easy to forget that everyone essentially wants the same thing- a healthy, happy baby. Everyone's idea of the 'perfect' birth experience is different, and I think that is so awesome. For me, how she described her oldest son's birth is how I envision my own baby's birth and I am really looking forward to having that experience (which may sounds totally strange to someone with a different plan in mind). Anyway, this got longer than I intended, I just think all of this stuff is so neat. I loved the story, by the way- especially the part where she was in pain and her son comforted her. Lovely.

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  5. My feeling is that yes, you absolutely CAN do it naturally – but you don't have to. What we're capable of and what birthing path we choose are two different things.

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    • julie, not everyone "CAN do it naturally." that's just the sort of myth that leads people to pass judgement on those who didn't give birth without medical interventions. it's kind of like saying, as my Christian mother does, "Well, your sister decided to choose that lifestyle" when she's talking about my sister being a lesbian.

      My sister didn't choose to fall in love with women instead of men. And I didn't choose to have my baby be two weeks late, almost no fluid left in me (even the doulas and a midwife of my acquaintance, hearing the level/number quoted by my OB/GYN, said "oh my god, that was really low"), and sure as hell didn't choose to be induced and then given Pitocin. but hey, all the hippie stuff like acupuncture and all the nice old wives' tales didn't bring the baby, so what're you gonna do?

      they let me labor without an epidural for 24 hours. then, because of how the baby was reacting, they suggested the epidural might help. so i "chose" it instead of "choosing" to mess up my baby's heartbeat further and have to rush into a C section. after 12 more hours, with almost no dilation and more Pitocin and the baby's heartbeat picking up too fast and the fluids almost gone, we did the C section after all.

      no, i "absolutely CANNOT" do it naturally. and that is totally fine.

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  6. Thank you, thank you for this post. I'm due in two months with my second child and plan to have it at a hospital with an epidural, which is how I had my first child. I would've liked to have tried a home birth, but my hubby is against it, the nearest hospital is 10 miles away and we have pets and a 1 year old at home to think about.

    My first birth went wonderfully, though there are a few tweaks I'd like to make this time (not having to wear the monitors the entire time) that I'll talk to my doctor about. I'd like to try to go longer before getting an epidural, which, for me, is inevitable because I have a very low pain threshold, with or without lamaze skills.

    In the past few years, I haven't read much about women choosing hospital births and choices they could have within that sphere. Most articles and books I've read focus on a natural birth at home or at a birthing center (there are none where I live). I assume the pendulum is swinging the other way after years of only discussing hospital births. It's great to see that this site discusses many options.

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  7. A couple of thoughts about this:
    1. Having an unwanted but planned c-section sent me to the other extreme the second time I gave birth BUT if I had gotten to the hospital in time, I probably would've asked for an epidural.
    2. I'm slowly and reluctantly accepting that fact that the conditions of birthing in our country are nowhere near where they should be, that it will be a long, uphill climb to deinstitutionalize birth, and in the meantime, I should just work with the system the best way I can instead of being angry at it, to get the best outcome I possibly can.

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  8. It's so true — there's so much pressure now to give birth 'naturally', that I even hesitate to tell people I will be having my next child at the hospital with my doctor present (like I did the last one). I feel like I'll be judged for not choosing a midwife and home birth, even though my doctor is specialized in obstetrics and the hospital is perfectly safe. Crazy, huh?

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    • I'm hesitant when people ask about the birth of my baby in March and even more so when they ask about breastfeeding! I try not to directly answer their questions until I know where they stand on the issue so I can carefully construct my response so that I don't get involved in any confrontation. Sad, huh?!

      1 agrees
      • Not sad! I'm due in March, too, and I consider my answers to people carefully because on the one hand I'm tired of hearing the trauma stories from people (women AND men!) who tell me that I can't "do" an unmedicated birth, and on the other hand because I don't want to tempt fate (Hubris and all that!).
        I explain that, if all goes well, I'm planning to give birth in an out-of-hospital birth center, and, if all goes well, I'm not planning on using pain meds. I always end my explanation with a "we'll see!" – it's as much to avoid confrontation as to keep me calm.

  9. I really wanted a natural birth last time I was pregnant. I did the Hypnobabies program which was awesome, but I got sucked into this line of thought where doctors do more to get in the way of a natural birth than they do to help. I was high risk and fully planned on a hospital birth, but this put me in direct conflict with the idea that doctors were going to get in the way of my ideal birth. In the end I came to terms with the fact that my doctors were not evil and in fact I chose them for their willingness to assist me with a natural birth. My baby girl was born totally naturally after only 1 hour in the hospital. I'm so glad I didn't let my fears get in the way of the birth I wanted.

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  10. (This was meant to be a comment to Dinah above but somehow I messed up.) Dinah, I think there is much that is messed up in US childbirth culture, and I realize this a lot more after delivering. So much was done on autopilot, and so much is also decided by L&D nurses, and all those prior conversations with your doctor don't even matter.

    That said, I think we need to remind ourselves of the fact that maternal mortality is still very high in many parts of the world. I support a charity in Ethiopia, the Fistula Foundation (, which helps repair women's birth fistulas; these are almost always women giving birth in very rural areas who needed c-sections and did not get them, and their babies died, and they delivered them several days later once they had lost size, and the whole process tore holes between the bladder and vagina or bowel and vagina, and these women leak feces and urine the rest of their lives while living in huts all alone on the edge of town where their parents bring them food once a day. It's a simple $450 repair.

    My point isn't to push this charity, but just to say that we CAN and SHOULD criticize US birth culture, but that we also must remember that "natural" can result in dead babies and horribly maimed or dead mothers. So, yes, I agree, kind of crazy!

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  11. I planned on having a totally natural birth in a birth center. I got cheers (and jeers, trust me!), and it's what I wanted. But I ended up needing to transfer after dilating 1 cm in 10 hours, and I remember beating myself up on the way to the hospital during my labor, feeling like I failed at giving birth, asking my self why I couldn't "do it", and I wasn't doing the "right" thing…even though I was dying for pain meds by then! I had the most supportive midwife EVER and I still felt like "Maybe she thinks I'm a wimp" or "She probably thinks I never cared about this" (even though that was completely NOT the case)

    In the end, I ended up having a c-section (10lb 22inch long baby…yowza!) but due to some complications with my uterus and bleeding, I ended up having to have a hysterectomy. Even though giving birth in the hospital might of saved my life in the end (or saved me from having a much longer recovery)… sometimes I still feel bad about not being able to do it "right" in my own mind, even though I have a beautiful perfectly healthy son! (And seriously, what happened to me RARELY happens so please mommas-to-be, do not worry about this!)

    I'm still a fan of natural birth, but sometimes it's just not an option…and if you can't handle the pain, it's OK. At least that is what I keep telling myself! It's all about options…and if you feel like your midwife/doctor/doula wouldn't support you if you decide to go one way or the other…there are others who will!

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    • I felt like my first birth was a failure too. 28 hours of back labor and I could not progress past 6cm. I cried as I got the epidural, but 4 hours later I had my little pumpkin. I felt like I failed because things didn't go as I planned, which is just silly because for the most part you are just along for the ride and there isn't much planning you can do. I think relaxing and going with the flow helped me have the natural birth I wanted with my second daughter, but I am happy now that modern medicine was there to help me the first time around.

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  12. I'm an adoptive mama, and so probably have no business commenting about birthing choices. So with that out there, here is my comment! 😛

    As a mother who has not experienced birth I find that when I hear someone really really preaching the wonders of all natural home birth experiences as the only option for a successful birth I feel a bit frustrated. Not because that isn't a wonderful thing, but because I often feel like there is an implication that any child who isn't born "naturally" is to be pitied, or will suffer irreperable harm. There is this implicit assumption of privilege that I hear in the ways that sort of birth experience is often discussed and its benefits generalized- that every woman should be able to afford physically and financially to have that "ideal" birth and receive the education necessary to consider it as an option. I can't accept that it is really SO important, in part because it is so different than the birth experience my child got, and I can't believe that she is irreparably harmed because her first mother didn't have the money, education, and luxury of considering those options. So my reaction is most definitely a product of my own particular mothering experience, and is a reaction more to a lack of awareness/sensitivity on the part of many women who advocate for the all natural option. After all the important thing is that the baby is born, and that the mother is given the maximum amount of real choice in how that birth transpires right?

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    • I often feel like there is an implication that any child who isn't born "naturally" is to be pitied

      Related to this: based on some great feedback we received from a reader, we've shifted the language on Offbeat Mama from "natural childbirth" to "unmedicated childbirth."

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      • that's awesome, Ariel. 🙂

        It's so good to be aware that the word "natural" in association with words like "birth," "family" or "parent" can be loaded for some.

      • I'm so glad you made this switch! Unless you give birth to a robot or a sea monster, I'm pretty sure any birth that produces a human baby is "natural"!

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      • Thank god for that change! I've been getting turned off by my
        Midwife and Bradley teacher's focus on 'normal' and 'natural' birth. So much judgment.

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    • Well, every woman should be able to afford the birth they want. I don't understand why, if it's legal to birth at home or in a birth center with a midwife, Medicaid and/or insurance can tell you no.

      And every woman should be educated as to what their choices are. Many people don't even realize midwives still exist, and many people don't realize that doulas exist, and many people don't even realize they're allowed to disagree with their doctor and the doctor has to respect their boundaries! All of which is an absolute shame.

      • I'm on medicaid – or, really, the little fish is (I'm just the vessel) – and I'm (hopefully) birthing in a birth center unconnected with a hospital and it's covered. Apart from weird looks and a stubborn inability to use my vocabulary, the medicaid folks have been okay.
        Maybe my midwife had to apply to medicaid to be covered?

        • It really depends on the area. I know the birthing center I gave birth to my daughter at in San Diego took MediCal and also TriCare. I'm a milspouse now, but that is the ONLY birthing center in the state of California that has a contract with TriCare–and it's 3 1/2 hours away with no traffic (and since you have to drive through LA, how often is there no traffic?!). I live on base and midwives are not allowed to come on base and attend births. So… my choices are: local hospitals which are not midwife friendly but ARE covered by TriCare, coming up with the $3500 for a midwife out of pocket and renting a hotel room, somehow coming up with $6000 to do a local birthing center, or giving birth at home, unassisted.

          It really sucks that women have to make their choices not only based on what is best for them and their babies, but by what they can afford or their insurance will cover. I have a friend here who had a c-section 11 years ago, followed by a vaginal birth 4 years later. 2 years ago, when she was ready to deliver her 3rd baby, the local hospitals that accepted TriCare did NOT do VBACs, so even though she had already had a successful vaginal birth and it had been 9 years since her c-section, she was basically given no choice but to have another one. If she had had the choice of a birthing center, she quite possibly would have had another successful vaginal birth–which was what she wanted. But in the end, it seems as if it's up to the insurance companies and the hospitals, not the mothers.

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          • I'm not yet a mama, but I am a milspouse and I am somewhat terrified that TriCare will prevent the birth I want in the future. I'm about to move to Washington, which is probably where my potential first child will be born, so I'm hopeful that I'll have some options. It's certainly better than Virginia (where I am now.)

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          • @ Ashley…

            It really depends on what you want and how you plan. I'm pregnant (was still trying to conceive when I posted before) and sort of screwed the pooch on getting my midwife–I paid out for a bunch of dental work and then found out the next day I was pregnant! There went my midwife fund. I have found that there are some midwives on TriCare, though hospital births only at our location. I will get my care through TriCare while saving for a home birth with midwife. If I can't swing it, I'll be going unassisted. Either way, I will get the chance to have the birth I want. I'm stubborn like that. Also, if you don't know about it–if your spouse is deployed when you have your baby, you can contact Operation Special Delivery and possibly get a free doula. If you are in that position, make sure you make use of it!

      • brie, if you were adopting a child you would not be able to go back in time, find the birth mother, and make sure she was given all those options and education. it could be hurtful if you kept hearing about how only unmedicated natural home births are OK. it would imply that your kid was not cool because she got birthed by C section or under an epidural at the hospital… even if you had absolutely nothing to do with it.

  13. I had a lot of guilt initially after "failing" to homebirth my son – we had to transfer to the hospital after 12 hours of labor that just wasn't progressing. I had an epidural and pitocin and all kinds of monitors and machines that went beep around me. Despite my all my fears the hospital staff was caring, the doctor (whom I had never met before) was amazing, and my husband, mom, midwife & doula were all allowed to be there for the whole thing.

    All my prejudices about hospital birthing turned out to be just that – prejudices.

    Other than the fact that I received much-needed care (I bled a LOT) that I couldn't have gotten at home, the hospital might as well have been my living room. Most importantly, I never felt like they took control away from me and my birth team.

    It took me a couple of weeks after the birth to process the experience and to let go of the sense of failure and guilt, and to realize that I had gotten the EXACT birth I needed.

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  14. I had planned to have an unmedicated labor. But, really, this was my first child and I had no idea what to expect and I was single and scared and felt like I had to live up to everyone's expectations. During my pregnancy, my mother (also birth coach, and I use that term in reference to her loosely) told me that I would become hysterical during labor and she would have to slap me. This, of course, made me want to labor without medication just to spite her.

    When I was admitted to the hospital after almost a month of regular braxton-hicks and about 30 hours of labor, I was begging for an epidural. Unfortunately, I still feel pressured to be that superwoman who can labor naturally, I tell people I got the meds because the doctor told me I would need to save my energy for pushing.

    Why do we do this? Why do moms feel like they need to be better than other moms? No woman in labor should ever feel like she's failing. No mom deserves to be guilted into making a choice that's not right for her. How do we fix this? I think it starts on an individual level.

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  15. You know, this whole debate is kind of strange to me. I live an hour from the nearest hospital, which home birth is out. I'm 37 and diabetic, which means that no midwife would really want to deal with m- I need a MD's attention during my pregnancy.

    I plan on pain killers- I've driven 40 minutes passing a kidney stone and am no fan of pain for pain's sake. I'd like to have a vaginal birth, but my child's health comes first. If it appears that she or he is too big, then it's a C-section without a doubt.

    If I were a different, younger healthier person who lived closer to a hospital, I might make different choices. But I'm me- trying to be the best mom to my tadpole I know how to be.

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  16. Bravo! Knowing oneself and one's options are empowerment. As long as we're informed and in touch with ourselves then we can make the "right" choice, as Andrea did. Rock on!

  17. THANK YOU for this post. I feel like I say some variation of this every time a post like this comes up on OBM, but, one of my personal missions as a doula is to encourage women to make informed decisions about what kind of birth they want to have, and to accept that things might not happen the way they want them to — that is, to be open to change.

    The way women judge one another is really unpleasant. The more we can do to encourage each other and support each other's decisions, the better. I love that OBM promotes that mindset.

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  18. I suppose I feel relieved to some extent that any of this pressure was off for me, as a congenital hip defect necessitated a caesarian delivery, something my orthopaedic consultant informed me about a decade before babies were a consideration.

    I have to say, no one's made me feel bad about it when they hear – they do ask me why it was necessary, and I am happy to explain.

    I don't feel any less of a mother for not having been through a natural birth.

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  19. I love this post!!! I am not a mama(yet) but I am a birth doula. I have an awesomely wonderful pregnant friend that I get to be a doula for in March that will be delivering in a hospital here with minimal meds but is still open to an epidural.

    When she first said she was pregnant I had made the comment of her having a free doula if she wanted one. She had said she couldn't but wished she could. ??? I though why can't she? Her husband wouldn't have a problem with it, so why? She then told me she planned on having her baby at the hospital and having pain meds if needed, and doula's don't come to those births! YES WE DO!!!

    A doula's job is to do everything she can to give MOM the birth she dreams of, not to fulfill her own agenda. Sometimes mom's birth dream changes along the way, so the doula adjusts to mom's new dream. 🙂

    If you want a doula have one! If you can't afford one but want one, look for doula's who are trained but not yet certified because they need to have assisted in "x" number of births before they can finish their certification. Most of them will be there for free or at VERY low cost. Either way, interview multiple doula's (or anyone you are needing for birth, MDs, midwives, hospitals) to find a person that you click with. Someone that you trust.

    Everybody likes to go to an ice cream place and fix their own ice cream. I like mint ice cream with chocolate chips, a little hot fudge and whipped cream with 2 cherries on top, but sometimes I like cookie dough ice cream with nothing on it. Sometimes I like to eat it at home, sometimes I go out, sometimes, I like to eat it by myself and sometimes I like to share it with friends. I can switch up how/who/whatever about my ice cream to make it perfect for me. What I think is delicious is NOT always delicious for my husband, who like vanilla bean with tabasco on it. We both like ice cream we just take it different ways.

    Women have the right to feel empowered by their birth choices! They should be able to change their mind and not be criticized for it. Birth is about your experience.

    I wish everyone their dream birth experience, even if it changes.

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  20. In my opinion there is only ONE thing that every woman should do when it comes to childbirth. That is EDUCATE themselves about all the options and paths available. If you educate yourself, it allows you to be in control of the situation (as much as one can be when it comes to child birth). The only time I ever look down on someone for anything, it's if they go into one of the biggest experiences of their lives completely blind. I was fortunate to have the natural birth I wanted – even though, yes, it hurt – I had back labor, I broke my tailbone and I tore.. But I still wouldn't change anything. However, had I not been well prepared for the experience (classes, books, etc) then I don't think I could have done it. It was hardcore – no doubt.

    As long as you are the one making decisions about your body and your child – that's what truly matters to me.

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    • I totally agree with this. I'm not pregnant yet, but I am trying to get pregnant, and I've been educating myself as much as possible.

      I know that when it comes down to it, I won't be able to control things as much as I would like to, but I will feel more at ease if I know that I've gotten all of the information on all of my options. I hope to be able to have a home birth, or at least a birth with as few interventions as possible. However, the most important thing to me is that I end up with a healthy baby at the end of all of this.

      It's up to every woman to decide what she's comfortable with, and I hope that someday we'll get to the place where we as women can all respect one another regardless of our differences.

  21. Love this! My son was born in a hospital with a very no-nonsense OB and a pretty much fabulous epidural. (I could actually still feel some pain from my contractions, but nothing but pressure below my butt.)

    The thing about the epidural that floored me? How fantastic it made me feet feel. Yeah, yeah, contractions whatever — I'd been working on my feet my entire pregnancy, and having them completely numb was amazing.

    That, and having a medicated birth removed a lot of the fear I had about it — I didn't know what to expect, and I tend toward imaging worst case scenarios on crack, so being able to lay back, have the effectiveness of my contractions on the monitor explained to me (and praised; my nurse was great), and marvel in how much my body was able to to without much interference has given me a lot of perspective in how I approach my imaginary next pregnancy. I want to try to take it unmedicated next time, maybe at home if things allow, but I know that either way, my body? Can totally squeeze out a baby.

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  22. What I wish I could do a better job remembering is not only is each mother different, each birth is different. I labored for less than eight hours, from onset of contractions to delivery; others of you labored for hours and hours. It's not just about the mother, and her preparation and plans and pain tolerance, it's also about the delivery itself. One delivery for one mom may be doable and tolerable without medication. The next may not. We need to give ourselves permission to find our way to the best birth possible with the cards we are dealt.

    2 other thoughts — totally agree with the commenter above about education being the key issue. I was educated in advance about a birth with interventions; when my child had late decels and fetal distress, I was comfortable when my husband and I were encouraged to go for a vaccuum birth (especially because the OB specifically stated she wanted to avoid a c-section — it was all good communication).

    Second, I love the language change with unmedicated rather than natural. That phrase makes me set my teeth on edge, as I too did not give birth to a robot.

    1 agrees
  23. Unmedicated birth also involes good luck. You need enough luck to make it an option. I identified with going medicated would reduce my fear. I know I wouldn't have considered going unmedicated when I was younger. I am thinking about reframing the goals of my birth plan more along the lines of healthy baby #1, being present and able to participate in birth. Its a great process women in our culture are going through to learn and have real choices

    4 agree
    • "Unmedicated birth also involes good luck. You need enough luck to make it an option"

      This is exceptionally well said!

      2 agree
  24. This post feels particularly relevant to me since I am 8 weeks from my due date with my first.

    My official stance is that I am hoping for an unmedicated birth, but that I am open to pain meds if I feel that I cant cope.

    But to be honest, I think I will feel like a failure if I "need" an epidural. I have always had a low threshold for pain so this is actually something I have been worrying about since finding out I was pregnant.

    I think, what if I do have an epidural? Will people think less of me? Will people think I took the "easy" way out, that I'm selfish or weak?

    My idea of a perfect birth is pretty much exactly what Andrea described; relatively pain free, able to chat with my husband and midwives and keep calm. But the whole "natural birth" movement has made me associate epidural = bad/lazy, unmedicated = good/strong.

    My wanting a "natural" birth is about me trying to be "good" and do it "right way", not about how I really feel about labour.

    After reading this post and the comments, I am reminded that the "right" way is whatever works for you in that moment provided you have all the information available to you.

    As my cousin says "You don't get a medal for not taking the drugs!"

    2 agree
    • You sound so much like how I was. I felt I "should" go natural, but I knew I would want the epidural. In the end, once I made the decision to get the epidural — about six weeks prior to my due date — I was sooo much more relaxed. It also helped that a nurse showed me statistics at our hospital and 96% of births were medicated (I don't live anywhere near Berkeley). I just finally asked myself, "what do I have to prove?" I have friends — some of whom do live in Berkeley, ha — who have had unmedicated deliveries, and I am very happy for them, but I just had to be honest with myself.

      I think I might have been able to hold out a bit longer than I did, but my baby needed internal fetal monitoring (and he really did), and once I was stuck in bed on my back and not able to move through the contractions, I begged and pleaded for that epidural. I still remember the name of the doctor. When my insurance receipt came a few weeks later, I looked at the bill and thought "I'd have paid that myself." I am just so happy I had the epidural.

      And the thing is, we had early breastfeeding problems that required a lot of persistence and involved a lot of pain. My son took a very long time to sleep through the night, etc. I had plenty of opportunities AFTER the birth to put myself through the wringer!

      Do what you WANT to do, is my advice.

      • Thanks for your comments.

        I'm really lucky that my hospital offers "mobile epidurals" which is a lower dose where you can still walk around, use most of the "natural" labour positions and not as likely to require forceps/vaccuum as regular epi.

        I was pretty anti-epi before, but once I heard this was a possibility, I was like wow why should I have to bear the pain then? I feel like this would be the best of both worlds. But then of course still worrying about the judgment of others…

        • The mobile epidurals sounds nice. Would that work if you had internal fetal monitoring? That's what tripped me up — but my son really needed it!

          In the end, I have to say, I had a very positive birth experience in every way. My husband and I both have very fond memories. There are so many horror stories out there, and I did not have one. I feel very fortunate for that.

          About judgment — one sad thing is that it will never stop. If not the childbirth, it will be something with breastfeeding or diapering or sleeping or potty training or discipline. There's just no escape. Something we do will always allow somebody else to gloat or feel superior.

          One book I read when my son was a few months old was called Momma Zen, and it helped me (theoretically) find more inner calm. I recommend it.

          Good luck to you with your birth!

          • i had as supposedly mobile setup for fetal monitoring, both before and after i got the epidural. some hospitals in my area don't do that, though.

            so i was able to be in various positions and wander to the bathroom (let's hear it for toilet laboring). all the interventions probably did influence my sadly unsuccessful attempts at breastfeeding (for 3 months) but i have no regrets, didn't have much choice in how it went anyway.

            i liked that i felt tough and natural and butch, being in painful Pitocin labor for 24 hours with no epidural… but it was also a little silly, perhaps? i like that i had the experience, just to have the experience, not to be "natural." "natural" tribespeople chew leaves that act as pain medication. even animals eat psychedelic plants. modern humans aren't so evil for using medication.

            PS: i love what someone said about the epidural helping her FEET, above! for me , the best medical intervention was the catheter. oh my god. i was in heaven. after 24 hrs of labor and always having to pee, suddenly i had the epi and the catheter. amazing!

      • Not sure this will get through moderation since it is not in line with the article, but I just wanted to comment that difficulty with breastfeeding can be a side effect of an epidural and that is one reason *some* women choose to avoid them if possible. I'm definitely not criticizing your choice – it sounds like you made the choice that worked for you!

  25. on my mom's side of my family, no woman, going back 3 generations that i know of, has been able to give birth vaginally. or at least vaginally without heavy assistance (think: forceps.) in my maternal lineage, we have a big history of narrow pelvic outlets and failure to progress during childbirth, leading to a lot of c-sections.

    there are several anatomical pelvic variants — and this is no myth, i'm an orthopaedic surgeon — and some of them actually can be problematic in vaginal births, for reasons ranging to inflexibility of the symphysis pubis (the diarthroidal joint between your two pubic bones that relaxes and widens during childbirth) to a narrow pelvic outlet that physically cannot accommodate a baby's head passage.

    as other commenters have noted — educating yourself about your birth options and different scenarios is a good way to help with decisions, or how you feel about your decisions. i cannot emphasize enough to people that not being able to do birthplan X, Y or Z means that they "failed" at childbirth. focus on the beauty of the baby coming out and joining your family with love. 🙂

    3 agree
    • (nicole – i just wanted to say, 3 generations of c sections for my family, too. we don't dilate. that's just how it goes sometimes!)

  26. I love this article!!!!

    I got into a HUGE facebook argument last week when a pregnant cousin of mine got comments ranging from an aunt saying "You're a big girl, you don't need an epidural, I didn't have one." to one of her friends who is currently pregnant insisting that she "Will absolutely not" have na epidural because it shocks the uterus and how she will hypnobirth and smile her way through labour blah blah blah…

    My argument was "Don't listen to ANYONE other than what your own body is telling you" and don't think you are any less if you need an epidural or any other sort of medical "intervention".

    It seems these dayd that everyone thinks their opinions are the best and people assert so much pressure on pregnant women to make "Good" and "right" decisions. The way I see it, as long as the mom and baby come out of the birth experience happy and healthy, who really cares?

    My son is 10 years old now and I had a hospital birth, and he was born using forcepts because he was stuck, not willing to come out when he needed to, and had his umbilical cord wrapped around his neck. The choices I made regarding medication during his birth were my own and I do not regret them or feel the need to justify myself. They were what was right for me at that moment.

    4 agree
  27. I disagree. There isn't anything wrong with "trying to be good". People here are confusing doing the best one can (with the circumstances we have) with peer pressure. Andrea did what she thought was right not what anyone else thought she should do and I think that's great. Home birthing or pain free medication mothers are doing the same any mother here is, the best they believe for themselves and their families. I don't think it's beneficial to paint them out to be the bad guy who makes everyone feel bad about their experiences. There are judgmental people on all sides, we all just have to learn to stand up for ourselves as Andrea did. I support every woman's experience here but I really don't feel the same in return. Personally, I want medication-free birth because I am concerned about the effects not because I am in anyway hardcore or competing against anyone.

  28. The one thing that people say that really bother me as someone who advocates for unmedicated, un-medicalized birth is "You don't get a medal for going without meds." That is as dismissive & divisive as women attacking other women for getting the drugs or saying someone whose baby was born via C-section didn't give birth. In all cases, it's an attempt to invalidate someone else's birth choices. Most women I know who choose to go with unmedicated birth don't do it out of female machoism. They do it because they truly believe it is best for themselves and their babies. I, for the most part, could care less what choice another woman makes, I only hope that they research and educate themselves to find the best options for themselves, their families, and their children, whatever those choices are, rather than simply going by what everyone else says.

    • If I can disagree with you moderately, I find the statement "I only hope that they research and educate themselves to find the best options for themselves, their families, and their children, whatever those choices are, rather than simply going by what everyone else says." just as dismissive and problematic as, "You don't get a medal." Generally when someone says to me, "Well, I hope you did your research," it's from a standpoint of disagreeing with my choice and assuming that I didn't research the benefit/risk appropriately.

      You may, in fact, not mean in that way — but it's how it comes across to me every. single. time. I find it generally appalling how as parents, we tend to assume people doing it different are somehow ignorant or uninformed. How little faith we have in each other as people. (I'll admit that I've done it, and I'm willing to bet at some point most of us have.)

      2 agree
      • What I meant by that is… don't decide you have to go unmedicated because everyone you know says that's the way to go and you think you need to be good, don't decide you have to have a c-section because you are told you should, don't decide to do anything based on "Well, X, Y, or Z said to do THIS"…without doing the research and making sure that it is right for you. I've known people who were making the SAME birth choices I am, but who fully admitted they didn't look into it at all or research anything that could happen. So it's not just something I think about in cases where I disagree with the person. Hell, I've done it too, in my first birth. I listened to things that I could have or should have at least researched. I purposely did NOT research other things that maybe I should have, because I was determined that my birth was going to go my way. My lack of research led me to make a decision I would NOT have made had I actually done reading beforehand. I have supported friends through many different type of birth choices, and I think there are different choices for everyone. The only thing I will constantly and consistently advocate is research and knowledge. It's not an attempt to be dismissive or say that if someone makes a different decision than I do, they're ignorant or uninformed. It's just something I've discovered in talking to people around me–a lot of people don't research and they just take the word of everyone around them. I know I did it. Hence, I don't care if people make the same choices as I do, I just would hope they come from a position of knowledge, not "go with the flow."

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