As a natural birth advocate, I believe that birth is a natural process and that most women have the ability to birth their babies with little intervention if they are properly educated and supported through pregnancy, labor, and birth. Note I said most. I fully understand and acknowledge not ALL women can (I could not in either of my two tries) or choose to give birth with little intervention. But I do believe that the majority of women can. Yet due to the current climate of childbirth (very medically intervention-laden and guilt-heavy), many women believe they cannot (or should not) and so they do not.
If you ask my opinion of birth, I’ll share my belief in the importance of birth education, fetal positioning, birth support as best makes the mother feel safe (that may be partner, doula, midwife, doctor, home, birthing center, or hospital), and certainty in ones own natural ability to birth. Yet, from the perspective of my own birth experiences, I also realize that there are times which natural birth isn’t possible, nor perhaps in some circumstances, even preferable. And when those situations occur, there is good reason for birth interventions, safe access to hospitals for women who choose to or need to birth in a more medically-supported atmosphere, and guilt and anxiety-free support for the choices women make in those situations.
Such is the conundrum of my belief in natural birth, while being a recipient of two c-sections.
On one hand, I fully understand the benefits of natural birth. The sheer naturalness of it. The normalcy of it. The very real and true benefits to mother’s and baby’s health – mentally and physically. I appreciate the very real risks of birth interventions. It is from this understanding that I want to advocate for intervention-free births always, everywhere, for everyone. And yet – on the other hand – I realize that natural isn’t always the best in all cases for all women (though I may want it to be), because all of us women are different: our birth experiences, expectations, desires, wants, and abilities.
So where does that leave me, and perhaps many other women like me?
I came into my first birth experience believing that I would not get an epidural, under any circumstances. This belief kept me from fully researching epidurals before my birth. When I did finally consent to an epidural after many hours of very difficult (read: extremely painful) back labor, not much progress, and no sleep, it was done under what I can only describe as extreme duress. I do not recall being informed of the risks of the epidural in the hospital (I had previously declined the medical pain management class the hospital offered in pregnancy, thinking it wouldn’t apply to me), though I do recall signing something. I do recall wanting the pain to end, yet being terribly conflicted between my intense desire for a natural birth, and my need for decreased pain. Unfortunately, I believe it was my wanting for a “best case” natural birth that kept me from consenting to an epidural earlier in my labor and the anxiety from not knowing what I was getting into, and guilt at not being able to avoid getting into it that kept me from relaxing once I had consented. So, in spite of the epidural, I stayed awake, worried, and panicky about side effects (of which I wasn’t fully informed). I believe most of the potential benefits of an epidural were lost in my remorse at having to have one. Hours after consenting to my first intervention, my birth followed the “cascade of interventions” I’d been warned about, yet was unprepared to avoid, and culminated in a c-section. Now, I do believe my section was warranted. Yet, I also believe that had I been more open to and more aware of all of my options (without all the guilt) BEFORE I was in labor, that my birth MAY possibly have been different. There are far too many factors to know for certain. But how can I deny the possibility that had I not felt such a strong sense of failure from consenting to any kind of intervention, I may have been in a better place to accept an intervention at the right time that could have eased my labor along in just the right way? I can’t.
So, here on the fence I sit: between believing in the benefits of natural birth and conceding the need for interventions. Between my desire for women to choose to believe in their own bodies as well-built birthing machines and my acknowledgement that women need to be able to choose whatever they believe is best for them – which might include interventions, like epidurals.
Few things have the ability to raise hackles, and call out judgment faster than the epidural. Emotions run high on both sides of the epidural issue. Part of the issue is that there are far more than only two sides. There are women who didn’t want an epidural and didn’t get one. Women who didn’t want one, and did get one. Women who did want one, but didn’t get one. Women who did want one, and did get one. You can divide ranks even further: Women who didn’t want one, and did get one – and hated it. Women who didn’t want one, and did get one – and liked it. Women who didn’t want one, did get one – and won’t admit they liked it. Or, those who got one, and regardless of whether they wanted it or not, it didn’t work. And on & on, I’m sure I missed some. The point being, that we all birthing women come from all perspectives on the issue – which makes it such a complicated one on which to “take sides”; yet take sides women do, and the fallout from the mudslinging and judgment on each side can be devastating.
So I’m stepping off the fence a bit to say that I believe we need to stop taking sides over epidurals in birth.
Women need to have fully informed access to guilt-free epidurals in birth. This means information, without glossing over the risks, and without guilt over making the choice to have one (or not to). Informed access means all the information – fully disclosed – of all the very real risks associated with epidurals, well ahead of birth – provided freely by their health care provider, without any glossing over of said risks by said healthcare provider or well-meaning friends (e.g., “Oh you won’t even feel the needle and it will be so worth it” or “It doesn’t really matter if you can’t feel your legs – you won’t be able to feel the pain!”); along with full disclosure of the benefits, without the associated pressure or expectation by said healthcare provider or well-meaning friends (e.g., “Why would you even bother trying to go natural when you can go pain-free?” or “Don’t try to be a hero”), so that each woman can make a real informed choice about whether or not she wants an epidural; without pressure to feel a hero or a failure if one choice is made above the other.
But how can we get to that point when we are still taking sides? When health care providers are glossing over the negatives and natural birth activists are glossing over the positives of interventions like epidurals? Health care providers need to start trusting women enough to give them information and the ability to use that information in the way they choose – whether birthing naturally or not. And women need to start trusting themselves with the very real value of this information given. When you know ALL your options, and when you trust yourself as a birthing woman, you’ll be able to make the best decisions for yourself in birth, without guilt. Without guilt over our own choices, and with understanding of others choices is where we need to be on the very difficult yet amazing journey through birth and into motherhood.
Because all births are amazing. I repeat: All. Births. Are. Amazing. And every woman deserves to feel that amazement and a sense of accomplishment and grace in her birth, regardless of how the birth progresses or culminates.
Birthing From Within: And Extra-Ordinary Guide to Childbirth Preparation by Pam England
(I took a Birthing from Within course with my husband when pregnant with my second child. I highly recommend it!)
The Thinking Woman’s Guide to a Better Birth by Henci Goer
Ina May’s Guide to Childbirth by Ina May Gaskin
Are We Using Our Brains When It Comes To Epidurals - PhDinParenting.com
Why I Won't Leave My Births Up to Chance - TheFeministBreeder.com
I Can't Believe I'm Talking About Epidurals - Strocel.com