Natural Childbirth: Not Martyrdom or Heroism

I'm not a martyr. And yes, I am fully aware that a successful natural childbirth does not earn me a medal.

Those of us who promote and practice natural childbirth are often viewed as a strange breed who either love pain, or who want to prove themselves better than other women by "going natural". "Why be a martyr?" and "What are you trying to prove?" are common questions from people who don't understand. Many women who have gone the traditional medical route wrongly assume that in vocalizing my reasoning for natural birth, I am judging them as deficient or bad and they often get angry and defensive.

The truth is, choosing natural birth has nothing to do with some twisted desire to play the martyr, or with a need to somehow be a better woman than others. For most, the choice is made from a desire for a safe birth (physically and/or emotionally), or a personally empowering birth, or an uncomplicated birth, or a quiet, un-rushed birth, or a birth not involving scissors, scalpels, vacuums, stirrups, straps, "Property of" hospital gowns, needles large and small, and a clock quickly ticking away the seconds they are permitted to "try" to labor naturally before the OB jumps in and starts trying to manage nature. For me, considering the risks and benefits of various ways to give birth played a huge part in my decision to refuse all routine interventions and only allow any intervention after serious consideration and with a pressing medical reason. All I have to do if I start to get nervous about my impending delivery is to go over the risk-benefit list.

Elective Cesarean section is the most obvious example of this. Lets not forget that this method of delivery carries with it all the risks of any major surgery, because that's what it is. Even if all goes well, there are many "normal" but seriously unpleasant side effects of this surgery that do not come with natural childbirth. In the case of a healthy mother and baby with a normal pregnancy, C-section might seem like and easy and convenient option, but it carries far more risks than going through a normal, natural labor.

My last pregnancy lasted several days beyond 42 weeks. Why did I go that long, you ask? Because the risk list of induction is far longer and far more frightening to me than the risk of carrying "post dates". The only risks to carrying post-dates are that the "unexplained stillbirth rate" rises very slightly after 42 weeks, and that after 42 weeks the placenta may, occasionally begin to deteriorate (which is why we were happy to check the baby's heart-rate and kick-rate on a frequent basis to make sure this was not happening). On the other hand, induction carries a long list of risks: premature rupture of membranes leading to a prolapsed umbilical cord, induction failure leading to c-section, restriction of movement during labor (also potentially leading to c-section), severely increased labor pains, hypertonic uterus (one that clamps down so hard on the baby it cuts off oxygen), the likelihood of an epidural (which carries its own list of risks), and so on. Now, if I or my baby were in danger and carrying him any longer presented a risk of imminent death, I wouldn't hesitate to be induced. The risk-benefit balance would shift at that point. But while I am healthy, my baby is healthy, and everything is normal, why on earth would I choose that long list of risks just because of a number on a calendar?

The same goes for epidurals and other drugs used in birth. Any drug carries with it side-effects and risks. Anesthesias and analgesics do cross the placental barrier and can appear in concentrated, elevated levels in the baby's bloodstream after birth. Enduring pain has no risk-it's just, well, painful. But there are also many no-risk methods for coping with and relieving birth pain. Like I said before, I'm no martyr. I'm not masochistic. I generally try to avoid pain, and have been known to become hysterical when faced with real injury. However, I avoid birth drugs for several reasons. First, because birthing pain is not like other pain. Generally pain is an indicator that something is wrong. Pain with contractions is normal and not an indicator of something bad going on. Second, because birthing pain isn't purely physical, and can be influenced and affected by a woman's surroundings, her perception of what's going on, her caregivers and supporters, the treatment she receives, and her feelings and emotions. Third, because of the long list of risks and side-effects attached to the drugs, and fourth, because I absolutely would rather try every single natural method of pain relief and if necessary soldier through the pains than allow anyone, even a highly trained individual, to approach my spine with a large needle unnecessarily. If anything, I put up with the "natural" pain because I'm a coward about the effects and risks of the drugs.

Even a seemingly unimportant intervention like episiotomy, I avoid. Being a seamstress, I've got a mental picture of what an episiotomy could do to my nether parts that will stick forever. Whenever I want to rip a piece of fabric quickly and easily, I make a small snip at the starting point first. The scissor-snip opens the way for the fabric to tear with very little effort. Apply that to the perineum stretched and pulled taut by a baby's skull and....ouch! Not a chance! I'd far rather risk a natural tear, even if it is a little more tedious for my caregivers to sew up. I'm not interested in quick and easy-what I want is something that is less likely to tear in the first place (an intact perineum!) and something that will most likely heal quickly (a natural tear has more surface area to heal together) and effectively. And yes, I'm speaking from experience here. A second degree tear is no fun, but I'd rather that than risk what I've heard other women complain about due to their episiotomies.

You would think something as simple as the fetal monitor would be a no-risk procedure. All it does is measure fetal heart-rate and contractions, right? Unfortunately, even fetal monitoring can actually cause complications. It's not been proven to improve birth outcomes, but by replacing the mother as the focus of the caregivers it can have a detrimental effect. And worse, constant electronic monitoring, which requires a mother stay in bed, on her back, and relatively still, can cause a situation where the uterus presses onto the mother's aorta, decreasing her oxygen, and thus decreasing the baby's oxygen and resulting in negative readings on the print out from the monitor. In a case like that, the monitor actually caused the very situation it was supposed to prevent! Internal fetal monitoring also introduces the risk of infection in mother and baby and the potential for damage to the baby's scalp, since it requires a small, sharp screw to be attached to the fetal scalp.

No, I'm not looking for a medal. I don't expect anyone to praise me (except my husband-he's obligated no matter what happens!) for getting through labor with no drugs or interventions. I don't think I'm better than other women. And I don't hate doctors, not even obstetrical specialists.

I just want a safe, low-risk birth and a happy, healthy baby.