I had a very stimulating conversation with a patient today that really got me thinking. I've thought about this before, but it was so refreshing to have the discussion with a pregnant woman who is looking forward to a midwifery attended birth. She's in her third trimester and taking childbirth education classes and just completed the section that reviews comfort measures, medications, and epidurals for pain control. She plans a "natural childbirth". I put this in quotes because "natural" means a variety of things to a variety of women.
Natural to me means without medication or an epidural. I could even stretch that to even a labor unhindered by medical interventions such as labor augmentation and artificial rupture of membranes. But typically if I say "natural childbirth" I speak of a pain medication and/or epidural free births.
Natural to others has meant a vaginal birth. The baby comes out of the vagina "the natural way". It totally disregards all the medical interventions involved.
However, going beyond this, natural childbirth to many people in the general public means the woman is either:
- Needlessly suffering
- A hippie
- One of those crunchy nut jobs
- Clearly not of sound mind
- A martyr
I disagree with all of the above, of course, but how often do we hear this? My best friend talks about getting hooked up to an epidural as quickly as possible when she was pregnant; medical assistants in the office joke about wanting an epidural before labor begins; men and women everywhere, it seems, are saying "hook me up!" (whether they are the pregnant one or not).
And not to mention the countless messages women get from media, magazines, books, celebrities, tv shows, and websites that send the message that its impossible to give birth unless numb from the neck down.
What does this do to women's confidence? Not only to the people they love and trust say to them that "you need an epidural to get through it", but the general message anywhere they go supports the notion.
I think this is to the detriment to women's self confidence. Because...guess what....women can and do give birth without medication! It's possible! But when those women are far and few between, and you are getting the message it's impossible, why bother even trying for a natural childbirth when "everyone ends up with an epidural anyhow"?
So, it was a great conversation discussing this with a woman, facing her own birth hoping to go the "natural route". I told her that if I was on call at the time of her labor, I would do everything I could to ensure her natural birth choice. That I would be there as her reminder of her strength. Mind you, I'd do this for any woman....but it feels good to be able to express this in in the context of our conversation.
I could turn this into a dissertation, but one more thought on the subject for now: part of this mindset, in my opinion, is from a belief that the pain experienced in the labor process is abnormal or signifies something bad. I can understand this, as any other time in our lives in which we experience intense pain typically means something has gone awry in our bodies. But the pain experienced in labor is almost always a normal phenomenon and a way of letting us know about the normal progression of the process. If we could embrace that concept, perhaps more people would be open to not medicating it.