Why in the World Would Anyone Ever Want a Natural Birth?

Recently I was asked the question, “Why would anyone want a natural, unmedicated birth? What’s the point?” And I have to say, I was caught off guard and couldn’t gather my thoughts quickly enough to give a good reply.

I completely understand the question. I mean if you can bring life into the world in pain and exhaustion OR numb and rested why would anyone choose the pain?

It seems absurd when you put it like that and yet many women are striving for a medication-free delivery. So what’s motivating them? There are lots of great reasons but first, let’s discuss a not-so-good reason for natural birth.

Don’t Do it for the Cookies

Many women who want a natural birth are discouraged by naysayers who tell them there are no special cookies or trophies for women who birth unmedicated. They are told not to try to be a hero and they are reminded that it doesn’t make them a better woman or a better mom.

And they are correct.

Fortunately, most moms who choose to give birth naturally are completely aware that there will not be a special prize waiting for them at the end. They know there’s no badge of courage and that motherhood will still be full of challenges no matter how they give birth.

Trust me, moms who attempt a natural birth are not looking for a reward and they aren’t trying to prove that they are, in any way, better than the mom with the epidural or scheduled cesarean.

So why do they do it??

Natural birthings mama’s do so mainly because they have done their research. They know that one intervention usually leads to another and each intervention carries risk. Not only that, but they know that the body’s natural process of giving birth includes many benefits of its own and they truly want to experience all of it.

Cascade of Interventions

The Cascade of Interventions is a term used to describe the concept that one intervention often leads to another.

For example, what may start out as a simple membrane sweep to induce labor could quickly turn into prelabor rupture of membranes without contractions, which could turn into heading to the hospital for Pitocin, which could turn into fetal distress, which could ultimately turn into a cesarean section, a major abdominal surgery.

Epidurals specifically can be a huge player in the cascade game. Many first time moms are unaware that getting an epidural often means getting a bladder catheter which increases their risk of bladder infection. Secondly, epidurals often weaken contractions and Pitocin is used to strengthen them. Furthermore, due to the fact that epidurals numb the body from the waist down, laboring women are stuck in bed. Because movement is key to progress, labor is usually longer, often the pushing stage is longer, and episiotomy, forceps, and vacuum extraction are more likely to be used.

While of course, none of those things are guaranteed and often interventions work beautifully, natural minded mamas prefer to stay as far away from this cascade as possible. They would rather not introduce anything into the labor process that may overcomplicate things unnecessarily. By letting their body dictate what and when things happen, they are hoping to experience a relatively smooth and straight forward labor.

Risks of Interventions

Beyond the fact that one intervention leads to another, every pregnant woman needs to know that each intervention carries inherent risk with it. For example, narcotics given to decrease pain often lower the baby’s heart rate and he or she is more likely to have low APGAR scores at birth and slowed breathing [source].

Epidurals carry many risks that are often not fully discussed with a laboring woman who is ready for pain relief.

As mentioned before, epidurals may prolong the pushing phase of labor and forceps or vacuum extraction may be necessary. Severe perineal tearing is more likely because of this.

Secondly, epidurals often lower blood pressure which may make the mother lightheaded and lower the baby’s oxygen level. This event may warrant an emergency cesarean.

Next, women with an epidural are likely to develop a fever. Because it’s unclear if the fever is simply a side effect of the epidural or the result of an infection, both mom and baby will usually need antibiotics after delivery.

Additionally, around 1% of women who receive an epidural will endure spinal headaches after delivery. These are often debilitating and may require another procedure to fix. Because the first few weeks postpartum are already full of challenges, spinal headaches can be an unwelcome hindrance.

Furthermore, the mother may become drowsy, experience slowed breathing, become extremely itchy, or have an achy back. She may get an infection at the injection site and need to be treated with antibiotics.

Between 10-12% of laboring women will not receive adequate pain relief from an epidural. Sometimes they only go numb on one side of the body but continue to feel contractions on the other.

Finally, serious complications from an epidural include nerve damage, paralysis and seizures, but these are extremely rare and death by epidural is almost non-existent.

For a full review of the benefits and risks of epidurals click here.

Of course, these risks are low and many women have no issues with epidurals at all, but because there is always a chance, many women choose to opt out of medical pain relief and aim for a natural birth instead.

The Beauty of the Natural

Besides the risk of intervention, natural birth is also full of benefits. Because an unmedicated laboring women can feel everything happening, she is often able to be more in tune with her body. This allows her to instinctively know which position she should move into to help baby descend and continue progressing and she has the mobility to get into any position needed. She is able to push in a variety of different ways including standing, squatting and on all fours. She can feel exactly when and how to push so second stage of labor is often shorter and more effective. She is less likely to tear because she can feel the pressure of her baby moving down allowing for a more gentle descent. Putting all of this together, her recovery is often quicker and she is comfortable walking around independently before a women with an epidural has even gotten the feeling back in her legs.

Because natural birth is an uncomplicated process, labor can happen in an environment that is more conducive to progress. Fear, distraction, and mental stimulation all inhibit the body’s ability to labor effectively. Bright lights, beeping monitors, frequent interruptions and hospital intake questions can all contribute to stalled or slowed labor. On the other hand, the absence of interventions means a woman can labor at home or in a birth center where she is more comfortable, uninterrupted, unhindered, and in greater control of who she has in her space. She is more relaxed and less afraid and her body can labor on. Because of this, the natural birth process often works more smoothly than when interventions are added in without medical necessity.

Though we have made it clear that there is no trophy or special cookies for a natural birthing mama, she may receive a “hormone cocktail” after delivery that leaves her feeling energized and exuberant throughout the beginning of the postpartum period. This is because the body makes Endorphins in response to feeling pain that decrease discomfort and increase positive sensations. When women endure labor unmedicated, they will receive endorphins at full force as well. Cheers to the natural birth high!

Finally, many women find the process of giving birth naturally to be very empowering. Labor is an incredible feat and nearly every woman reaches a point in delivery where she thinks she cannot continue. But when she presses on, she finds out that her body was created to do difficult and powerful things and she discovers new determination and courage that she never knew she had. Women who strive for a natural birth see the beauty in the process and they want to experience it fully.

Keeping it in Perspective

In summary, natural birth is something to plan for because it is less complicated, less risky and it often works beautifully. However, it’s important to keep things in perspective and hold a healthy view of any birth plans a woman may have. Labor is unpredictable and try as we may, there are always factors we simply cannot control. Serious complications do arise and women must be prepared to meet medical intervention with gratitude when it is truly needed. While natural birth might be the goal, healthy birth is the ideal and sometimes medicine is the best way to achieve that.

Related: To the Mama Whose Natural Birth Plan Fell Through

As with any decision, every pregnant woman must do her own research, weigh the pros and cons of each option, assess how much risk she is willing to carry and then decide what is best for her. This looks totally different for different women and that’s completely fine. But I hope this gives you a better understanding of why anyone would willingly want to give birth unmedicated. As always, if you have further questions about this concept, feel free to reach out! I look forward to hearing from you soon.

What Does a Birth Doula Do?

In short, a doula is someone who supports a woman throughout her pregnancy, her entire labor, and the postpartum period. She is not a medical professional but instead she is trained to inform a woman on her choices surrounding birth and helps to turn those preferences into a reality. Typically, when a woman hires a doula, their journey together starts a couple months before the baby’s due date.

Before The Birth
Before the birth, a pregnant woman will meet with her doula a couple times to discuss her birth plan. This may include things like where she chooses to birth, how long she wishes to labor at home, how she plans to manage the pain, as well as her hopes for the immediate postpartum period. A doula does not make decisions for a woman but instead informs her of the risks and benefits of her options and then supports her in whatever she decides. Furthermore, the doula will teach the woman and her birth partner (her husband, boyfriend, mom etc) different techniques that they can use throughout the labor to manage pain and keep progressing. After these meetings, both the mother and the doula should have a pretty good idea of how they plan to manage labor.

During Labor
Usually, the main reason a woman hires a doula is to have a trained professional with her throughout her entire labor. A doula cannot perform cervical checks, take vitals, monitor the baby, or replace the care provider in anyway. She cannot and will not make any medical decisions. However, unlike the care provider who is in and out of the room and may leave when his or her shift is over, the doula is by the mother’s side focusing only on her from the beginning until the end. This consistent presence alone can have a major impact on the labor. A soon-to-be mom may let her doula know that contractions have started and the two can decide together when to notify the care provider. The doula may come to the woman’s home in early labor to help her work through contractions if she wishes. Upon arriving at the birth center/hospital, the doula may take time to set up the room with music, dim lighting, aromatherapy, or whatever the mom chooses. As labor intensifies, the doula will do whatever she needs to do to make the mom more comfortable, including massage, applying heating pads, giving food or water, etc. She will coach the woman through contractions, helping her breathe and find her rhythm. She can suggest different positions to help the baby continue to descend correctly and to encourage dilation. If any unexpected circumstances arise, the doula can inform the woman of her choices and help her ask questions so she can make the best decision for her and her baby. The doula does not speak to the care provider on her client’s behalf but she does encourage her and her partner to speak up for themselves and can remind the mother of her birth plan and preferences to help her achieve her goals. Finally, when it comes time to push, the doula may help coach the mom in bringing her baby into the world.

My doula Jayde helping me through a contraction

It’s important to note that a doula does not replace the mom’s husband, mother or whoever she wishes to have with her. Instead, the doula actually helps loved ones know how to comfort and assist the laboring woman. As a result, loved ones may actually end up feeling more at ease, relaxed, and empowered as a result of having a doula present.

Though a doula can never guarantee better birth outcomes studies have shown that when a doula is present there is a lower rate of interventions, epidurals and c-sections and labor tends to be shorter. A review of these studies can be found in The Doula Book by Marshall Klaus, John Kennel, and Phyllis Klaus. However, a doula is still a valuable asset even if the woman wishes to have a medicated birth or is planning a c-section. In these situations a doula can still help a woman through early labor, she can set up her birthing environment, talk her through pushing, and protect her wishes for the postpartum period discussed in the next section.

Immediately After The Birth
After the baby is born, the doula may remind the mother and the caregiver of any of the mom’s wishes for the postpartum period. This may include things like delayed cord clamping, immediate skin to skin, or weighing and measuring the baby beside mom’s bed. She can help establish breastfeeding and gives the mom plenty of encouragement. The doula may get some food for the new parents and she may help clean up the room. Finally, she may protect the mother’s desire for a quiet, private time with her new little family and will leave shortly after.

A Few Days Later
Within the first week or so of baby’s life the doula will visit the new mother for the last time. This generally takes place in the mother’s home and may last a couple hours. At this meeting, the doula will answer any breastfeeding questions and will encourage the nursing mother. She may do light housework for the mom or she may hold the baby while the mother gets some rest or takes a relaxing bath. To conclude their time together, they will debrief about the birth and the doula will help the mom process her feelings about it. The doula may remind the mom of important events that happened throughout the labor in order to write a positive birth story that the mother can enjoy reflecting on. After this, a birth doula’s job is complete.

Interested in a doula? Check out my website at http://birthway.co

Click the images to read my birth stories.

Blakely’s Birth Story

My birth center bags were packed at 37 weeks pregnant and I was ready to go. Every night I went to bed thinking that I would wake up around 2 am to a contraction but every morning I woke up feeling just fine and no baby in sight. My blood pressure started to slowly rise, my feet were getting more and more swollen, and I was getting very tired but I and my care providers didn’t think it was anything out of the realm of normal. However at my 41 week appointment, things got worse, I was diagnosed with preeclampsia, and sent to the hospital to be induced. I was so shocked because the pregnancy had gone so well and I didn’t expect that I would have to go to the hospital to deliver. I quickly repacked my bags, summoned my husband from work and prepared my mind for a long induction process.

They hooked me up to monitors around 4 pm on Tuesday, May 3rd. To my surprise, I was already having consistent contractions that I couldn’t feel so we skipped cervidil and went straight to pitocin. Contractions were 3-4 minutes apart right away but very mild. I spent the evening trying to distract myself and enjoy the night with my husband. We played cards, watched tv and I eventually got a morphine shot because I knew how important it was to get as much sleep as possible in early labor. Every hour all night long I was woken up for a blood pressure check, had a few contractions, and then fell back to sleep. In the morning, my parents and mother-in-law visited me to wish me well. My sister, who was photographing the birth, and my sister-in-law, who was acting as my doula, joined me. I specifically remember when I sat up for the first time that morning. My contractions immediately kicked it up a notch and around 10 that morning I officially started to progress. I spent the day in different positions on the bed and birthing ball. Because of my blood pressure, I wasn’t allowed to do much standing or moving around which was how I planned to cope with the pain so I had to adapt. With every contraction I had my sister, sister-in-law, and husband helping me relax each muscle, especially in my back, shoulders, and face. My contractions were all in my back so I absolutely loved counter pressure. I brought in a tube sock filled with two tennis balls and had whoever I could find roll it up and down my back and it felt wonderful. I breathed my way through contractions and felt the reward and relief after each one. I was doing it, I was coping, and I was getting closer to meeting my baby.

By late afternoon I had reached five centimeters and baby was in a favorable position for birth so my midwife decided to break my water.

“I would expect that at this point you will start to dilate a centimeter an hour,” she told me.

I looked at the clock thinking just maybe I could have the baby before midnight. At that point, I was also allowed to get into the tub, which was a huge bonus for me because I was initially told that I couldn’t get in due to my blood pressure. I excitedly got in the tub and prepared my mind for what I thought would be a more difficult but noticeably quicker phase of labor.

In the tub, contractions became very painful, all in my back, but because I had to keep my hands and IV out of the water and I was in a circular tub I couldn’t get in a very good position for counter pressure. I started to think I was going to throw up and felt like I couldn’t keep going. I told myself that it was hard because I was progressing and my mind was so hopeful that this meant I had reached transition. If I knew I was in that last stage of dilation, I could accept the difficulty I was experiencing. My midwife must have been thinking along the same lines because she decided to check me to “encourage” me. Unfortunately, the opposite happened. I was still at a 5. I hadn’t made any progress. And I was very discouraged.

I wasn’t ready for an epidural at this point but I was willing to try Stadol, a narcotic that would help me relax and sleep between contractions but wouldn’t be strong enough to keep me sleeping at the peak. I had a feeling it wasn’t the greatest idea but I was ready to give anything a try. So night fell, I got out of the tub and, my support team and I fell asleep.

Some time later (time is difficult to keep track of in labor) I entered into a really loopy state because of the drugs. I felt like I was in three worlds. There was the real world, in which I only knew the very painful peak of contractions and only moaned the word “ow” over and over again. The second world was very similar to the real world except I was asleep, contemplative and dreaming about the third world, where I was in no pain  and running through wild flowers. It was crazy, difficult and hilarious in hind sight. My mom showed up, first in the second world but then I found out she was also there in the real world which was such a relief. She told me I was doing well and was so comforting but my sleeping self started to really envy the carefree me in the third world and I started to consider an epidural. I tried so hard to keep that to myself because I still wanted to avoid it if possible but then a contraction woke me up suddenly and I couldn’t help but to cry out “EPIDURAL.”

I started discussing this option with my mom. She knew I was planning a natural, unmedicated birth and tried to talk me out of it so we called in the midwife to help us decide. She opted to check me and found that after all those hours of difficult labor I still hadn’t progressed at all. I was scared that for some reason my body wouldn’t be able to go any farther and that I would end up with a c-section. Together we decided that an epidural, which would also help lower my blood pressure and allow us to up the pitocin, was the best option at this point. My husband asked me to say the code word we had established to make sure I was serious and then told me he was proud of me for doing what I had to do even though I really didn’t want to. I was disappointed and nervous when the needle went in my back but mainly I was exhausted and fell right to sleep.

Three hours later, at 4 am Thursday morning, I woke up rested and ready to get this thing going. I thought surely after completely relaxing and contracting through the night on a high dose of pitocin that I would be ready to push but my midwife checked me again only to find out that I was still at a 5. No progress. It had been at least 8 hours since I had any dilation. I started asking my nurses about a c-section and prepared my mind for surgery. I thought of my mom, who had the same issue when she birthed me but then went on to have two successful VBACs after that. My labor went nothing like I had imagined, planned and dreamed that it would but in that moment, I accepted that fact and found peace with the situation. I finally remembered the red raspberry leaf tea I had brought and took one huge drink to help strengthen my uterus. I discussed a possible c-section with my husband and  we both got excited to meet our little girl.

At 5 am I called in a nurse to turn up my epidural because I started feeling pressure with each contraction. She was puzzled as to why I was feeling that way and asked if she could check me. To our absolute amazement, I had dilated from a 5 to a 10 in that hour and the baby was starting to descend! I was no longer headed toward a c-section but instead had to gear up to push! My room was suddenly filled with energetic bodies preparing to meet a new baby and my sisters texting the rest of the family to let them know it’s happening.

Around 5:30 am I received some coaching and we got started. It took me a little bit to get the hang of pushing but it was so rewarding to be able to put actual effort in towards meeting my baby. My epidural wore off to the perfect amount so that I could feel exactly when to push. With each contraction she got a little closer until eventually we could see her head. The pressure was great enough that I wanted to push even between contractions but usually refrained to let my body do the work. After every push I took a big drink of tea sweetened with honey to give me energy and reward me for the hard work I was doing. After an hour and eleven minutes her head was finally out. I breathed a sigh of relief and then pushed for her shoulders. She was out. I pushed her out! I couldn’t believe it. She had her eyes wide open and stared hard right at Kevin and I. She had a major cone head and a 5 cm circle engrained on her head but she was beautiful and an expert nurser right away. I felt the most amazing sense of relief when I pushed out the placenta. It was done. I did it. I made it through.

It’s been a little hard for me to tell this story at times just because it’s difficult to accept the way it all happened. I was hoping for a natural birth but had a medical one from start to finish. I’ve struggled to make peace with the fact that I needed an epidural and am haunted by the thoughts of “if only.” “If only I was more relaxed,” “if only I could have been more active,” “if only I remembered to speak my birth affirmations” etc etc. But even though I love natural birth and reading stories about great labors, I have had to learn to see my story as one of victory as well. I received the medical help necessary to save me from the dangers of preeclampsia and Hellp syndrome, I was able to keep laboring physically even though I could no longer handle it mentally, my body did what it needed to do to avoid a c-section even though I thought it was impossible, and I have the most perfect, beautiful girl as a result. As soon as I held her in my arms I knew I would go through it all again to bring her into this world because she truly is the best thing that has ever happened to me. In the end, that’s what labor is all about.

❤️❤️❤️

Click the image to hear what I did in my second pregnancy to try to avoid getting preeclampsia again!

Click the image to read my second birth story!