labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Friday, July 24, 2009

Natural Childbirth

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:

  • Crazy
  • 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.


Stassja said...

I agree that's an unfortunate undertone to all the fear-mongering surrounding childbirth in our society. The disempowerment begins pretty early on, because to me at least, when a woman tells me about how anyone would be crazy to go through that pain, or that I'll be begging for's not just a comment on the discomfort and pain of labor, but a reflection that we are just inherently too weak to go through it without going insane from agony.

And of course this leads right into the years of disempowerment that follows, breastfeeding will be "too painful" and being sleep deprived just the worst kind of misery (and to avoid it one must train their baby to sleep alone immediately, and for long periods, lest they become DEPENDENT on you!) and so on.

I just don't see why we can't encourage new moms/parents. When a woman mentions wanting to avoid pain meds, why do so many play crabs in a bucket and tear her down and tell her she's too weak (often times a total stranger!) and to give up that silliness now! Even if we DID know her and think for whatever reason that she just couldn't "handle" it, why can't we say "That's great hon, you'll do fantastic"?

Is it that hard to be encouraging and positive with anything? Are we (general we) really that insecure in our own choices?

Mrs. Spit said...

I happened to be having a conversation with a woman today about childbirth, and she kept saying that she wasn't a hero, and that she wanted an elective c-section.

Which blew me away. When did it become smart to have major abdominal surgery, so that "things could all be done at once". How does that make sense?

mo*reezy said...

What changed my total perception of it all was reading Spiritual Midwifery and when Ina calls it "pain with a purpose." Also remembering that it will END was helpful too.

man-nurse said...

I always try to tell people how most women can probably give birth without anesthesia/analgesia, and that your mindset has a lot to do with it, but I say it pretty sheepishly because I'm a d00d and so, you know, who the heck am I. And rightly so, I figure. But I've seen it, and I have the impression it's doable. I mean, my wife is not some kind of stoic hero or crazy hippie.

I just posted today my wife's own words about pushing out our eleven pound baby naturally. Your post reminded me that everyone's reaction is that it must have been a terrible coworker's 12yo daughter exclaimed "That's a death sentence!!" I tried to tell her my wife is still alive and okay...but what are you going to do? This girl, like everyone else, is going to continue to learn from her peers, from other women, from her school, and from television that giving birth is the worst thing in the world and should be medicated away.

lostinrain said...

The difference in labor pain vs. other pain that I have experienced (including endometriosis) was fear and suffering. During labor I was never afraid, nor did I suffer. I had pain, sure. But without the other two, it didn't seem like that big of a deal. If only we could eliminate fear and suffering from labor, I think most women would plan on avoiding medication. Of course, the payoff for going unmedicated is the ultimate natural high at the end.

chartreuse said...

What's wrong with using an epidural and making the experience more comfortable for women? Seriously, what is the downside?

There are times when an epidural has clear benefit, say when a woman is at high risk for needing an emergency C-section, if she's hypertensive at the birth, if she's an insulin-dependent diabetic, etc.

Let's remember that historically babies were born much smaller than they are today. A thousand years ago, babies would have been closer to 5 lbs, and a typical 8 lbs baby today would have been incredibly rare. Births are more painful today than they were in times were pain medications were not available.

Real said...

Besides just the pain, I think women/society have a fear of being out of control. I LOVE the video "BirthDay" where a Mexican midwife has her own homebirth. But there's a part in there where she's walking around her kitchen dealing with contractions adn her eyes are kind of rolled back in her head and she is rolling her head from side to side and I think maybe making some kind of noise.

And to me, it looks like a woman dealing beautifully with an intense contraction. But to a lot of other women, they just see that as totally weird and not socially acceptable.

So you just don't have to give up that kind of social/behavioral control if you have an epidural. You can just sit there and talk and laugh. And I think that people perceive that scenario as just being more safe than a woman walking around making strange noises and rolling her head around.

Real said...

The irony of course is that the woman with the epidural only gives the appearance of control. It's the other woman who really IS in control.

Jill said...

Sigh. It's depressing, yes. And even more so because it's so hard to get the word out without sounding like one of those whackadoo hippies yourself. it doesn't help that I look the part most of the time. :/ Sometimes I think people would take me more seriously if I dressed and acted like a 35 year old business professional who slaves away in a cubicle 8 hours a day instead of a 16 year old granola-eating tie-dye wearing Marley fan who sews cloth pads for a living. But, I digress.

And yeah, it's really annoying to hear, "So are you havign a C-section or a natural birth?" Do-wha? How fucked up is it that now NATURAL means NOT THROUGH A HOLE IN YOUR BELLY.

I think it all stems from a common source that intended to be something totally different and wound up being bastardized by our society. It's something I've been meaning to blog on, I've been ratttling it around in my brain the past few days. I think your post has given me the little nudge I needed to get it down!

Heather the Mama Duk said...

People tell me I am so amazing or strong or crazy for having three completely drug-free births (one in a birthing center, two at home). The thing is, I'm not. There's just something so amazing about giving birth without drugs. It's hard to explain and only women who have done, and particularly those who have had drugs in one or more (I had an epidural with #1), really truly understand because our society has forgotten something very important.

We've forgotten that women CAN do this. We think we need drugs because they've been pushed on us for a few decades. The crazy thing is it wasn't all that long ago that all women gave birth drug free (and generally at home). Amazing how a century can change so many things.

I always tell women that they could have a drug-free birth (assuming vaginal and all that... no way would I have a c/s without drugs lol), but they generally don't believe me. They don't think they are that strong. The thing is, they totally are.

Jenn said...

sometimes I wonder if people use the term "natual childbirth" instead of "vaginal childbirth" for births including drugs because they are too ashamed to say vagina.

Yes, agree, the women are raised to believe birth is too painful and only nut jobs don't get drugs.

Sheridan said...

I think that the media and other people do have a huge negative effect on pregnant moms. They tend to feed into the fear many moms have and magnify it.

In reality many moms who educate themselves and prepare for natural birth are able to do beautifully.

I would like to add that with Hypnobabies many moms are able to have natural childbirth without drugs OR pain. Those who do have discomfort are able to manage it well. The intensity of birth is powerful, but meaningful and it can be beautiful instead of scary!

Bethany midwives said...

I have noticed that more and more women are coming to us because they want natural childbirth as well. As I look at my birth log, I notice that more and more women are going's wonderful!

I tell women that labor typically works like they are stepping into a very cold ocean...go slow, your body adjusts so then you can take few more steps in, body adjusts, few more steps in, and so on and so forth. I tell them their pain serves a purpose, not like the pain of a broken leg. I remind them that it will end.

I normally post to you under a different name but have started a practice blog so will use this name from now on :)


Labor Nurse, CNM said...

thanks, everyone, for your comments.

Jenn, I agree that for many "natural" is a more comfortable word than "vagina". That's a shame, really, that many people feel wrong saying a very legitimate word.

Chartruese, I am not saying there is anything wrong with using meds or an epidural to cope with labor...I have a problem with how fear is perpetuated for women and they are grasping at the use of meds/epidurals because they are fearful and have not been able, for whatever reason, to work with their labor. I've met many women where I believe the use of an epidural or meds was very much needed for a positive birth experience.

Mrs. Spit, isn't it something that women turn to major abdominal surgery to avoid the pain of labor? I always find this mind boggling.

Bethany midwives said...

Epidurals can be helpful sometimes. However, it's kind of aggravating that women are led to believe that epidurals are completely safe and benign. There are risks with epidurals just as with any other medical intervention.


Renee said...

Well said!

Danielle said...

Your blog was recommended to me by google reader and I am really enjoying it!

*I HATE when people refer to a natural childbirth when they mean vaginal. Drives. Me. Nuts.

*I had an epidural with my first child (induction, 9 days late, not that it matters) and am pregnant with my second child, due in April. I am one of those that has always looked at the NCB mamas in awe, like, wow, they are SO strong. I didn't even want to try it the first time, really. I did research the effects of the epidural, but just didn't want to feel a thing. This time around, I'm thinking about going the other route. We'll see.

I think one of the reasons that more people don't try for a NCB is that (I believe it was mentioned in this post/comments) they really don't think they'll be able to do it, so why even try? Because if you try and fail, then you have to tell people, I tried, but I just couldn't do it, therefore admitting that indeed, they aren't as strong as someone else who made it through. I hope some of this comment makes sense. :)

Anyway, thank you for your posts! I look forward to reading more.