Deciding on Childbirth Options: Find Out What Works for You

This is the story of my life: I Don't Fit In. I never have fallen easily into cliques and groups and movements, not when I was a child, and not now as an adult. This is true in almost every aspect of my life that could be categorized and pigeon-holed, childbirth included.

As a newlywed and newly pregnant 19 year old, I was simply clueless. My parents are doctors, and having never had any reason not to trust doctors, I went along with everything I was told. But when my son was born and we struggled to establish breastfeeding, I started to research and eventually began running across the natural childbirth advocacy that so often goes along with breastfeeding advocacy. A whole new world of thought opened up to me, and I began looking for midwives and birth centers. In a pendulum swing, I went from "Whatever the doctor says!" to "I want a homebirth!".

Unfortunately, there are no homebirth midwives in our immediate area, and I was just not ready to go the "freebirth" route, unassisted. I did, however, find a great compromise: a practice of midwives with a freestanding birth center and hospital privileges. But circumstances bumped me out of the birth center and into the hospital, where I delivered my next two children naturally, with the assistance of the midwives.

These experiences have placed me in an awkward position of being a natural/homebirth supporter, never having had such a birth myself. And having found my own inner strength and the ability to stand up for myself and my baby in a medical setting, I am not as terrified of hospital births as some women are. Furthermore, although I did eventually run into some stereotypically horrible obstetricians, I have watched my parents treat their patients with respect and genuine care for decades, so I cannot fall into the mindset that doctors are untrustworthy by their very nature.

I've also begun to understand that pretty much every woman has her baby's best interest at heart when she makes birth choices, and that epidural vs. natural birth, home vs. hospital birth, and similar differences of opinion are not moral issues in and of themselves. We all do the best we can with what we have available to us. For some that will mean living at the Farm and delivering with Ina May Gaskin, and for others that might mean a planned c-section for every birth. For me it meant delivering my babies in a hospital, but with midwives attending, and having refused induction for "post-dates" but also having dragged myself to the hospital for non-stress tests and ultrasounds to ensure that my babies were not actually "over baking" by being overdue.

All of this leads me to believe that what is most important when it comes to childbirth is for each woman to make her own decision, based on information she recieves from a trusted caregiver, and on her own self-education, her own comfort levels, and an assessment of risks and benefits based on her unique situation. For one woman, an unassisted birth at home might be a safe and wonderful option. But another woman, with a different set of circumstances, might find such a plan terrifying and only feel comfortable in a hospital, surrounded by medical professionals. For some women VBAC (vaginal birth after cesarean section) is the healthy and lower-risk option, but for others it may carry a risk that they are not willing to take. Some women weigh normative birth options (epidural, internal fetal monitoring, and the like) and find them too likely to lead to detrimental results. Others may feel safer with all the medical accoutrements monitoring mother and baby and relieving the pain from contractions. Some women may not mind at all the idea of one or two c-sections, while others shy away from the possibility because they're planning a larger family and do not want to risk going under the knife 5 or 6 times. Hospital policy and birth cultures differ from city to city, sometimes drawing women, other times driving them away.

Rather than falling into one group ("Sign me up for the epidural at 7 months!") or another ("Doctors wouldn't know a natural birth if it slapped them in the face") women should ask themselves questions like the following, and determine for themselves which birth options will work for them.

What is my ultimate goal for birth? (One hopes we all answer "A safe and healthy mother and baby")
What would my ideal birth look like?
Is that ideal realistic for me, in my specific situation?
Do I have a support system that will help me accomplish this ideal?
Will my baby's health allow for that "ideal birth"? Or do I need to give up all of some of that for the sake of the baby's safety?
Do I have an concepts of "normal birth" that are biased, or traditional (passed down from mothers, or from society)? Do any of those concepts conflict with known facts?
What role does past experience play in my current childbirth decisions? Am I giving that experience the right weight in the decision-making process, or too much/too little?
Do I trust my caregiver? If not, do I need to find another one? Or be my own caregiver?
What risks, if any, am I willing to take? Do I know the statistics on risk? Do I know what those statistics mean for me as an individual?
What impact, if any, will childbirth decisions now make on my life and my baby's life in the long term?

Ultimately, the decision and it's consequences are yours only. Because of this it is vitally important that you make these decisions as an individual, rather than on group opinion. There is some benefit in having like-minded support, but a group or movement cannot account for 100% of the individual needs of it's members. Choose what works for you.