10 Things You Should Know About Birth

9-months-pregnantI remember being in my ninth month of pregnancy with my firstborn daughter. I thought about the impending birth every day. What would it feel like? How would I react? How long would it take? Would I be strong enough? Strangely, I was curious more than I was afraid.

I ended up having my baby vaginally - with an OB - at a hospital - without drugs. The experience was generally positive, but not outstanding (It wasn't until I delivered baby #2 at a birth center that I realize how much BETTER the birth experience could be).

Here is what I wish someone would have told me about birth when I was a first-time mom-to-be:

1. You don't have to be afraid. Our culture makes birth seem like this terrifying event where something bad is bound to go wrong at any second. Hospital gowns. Beeping red lights. IVs. Medicines. Screaming. That's what we see on TV. But birth doesn't have to be like that.

2. You CAN do this. The truth is that women have been birthing babies from the beginning of time. Your body KNOWS what to do. YOU know what to do. You are strong. You are able.

3. Doctors are not always right and you don't have to listen to them. Do I sound like a rebel or what? I'm actually not. Just ask my husband: I am the girl who *always* follows the rules. Except when it comes to birth. The truth is that all doctors don't always give the best advice - they might say things in soothing, authoritarian tones. They may try to bully you. But don't be bullied. If you want a second opinion, get a second opinion. If you want time to think, ask for it. If you have questions, ask them. If you want to say, "no thank you, I don't want that procedure/process for me or my baby" - DO. And don't feel bad about it.

4. Home birth is not dangerous. The mainstream medical establishment has tricked us all into believing that the best and safest place for a baby to be born is an a hospital, attended by an OB. In fact, that is not entirely true. The American Public Health Association reports that "homebirth is as safe as hospital birth for low-risk women, yet carries a much lower rate of medical interventions, including Cesarean section." If you want to do a home birth, find a midwife and do it. It's a safe, legitimate option for most women.

5. Birth centers are worth looking into. I've written previously about Birth Centers versus Hospitals - and, if you know me "in real life," you know that I am forever singing the praises of our local birth center. And it's not just me either. If you ask my husband about birth, he will automatically talk about how the birth center experience was a thousand times better than the hospital experience. Hands-down. I'm not saying it's the best choice for everyone, but it's certainly an option worth considering.

6. Midwives are highly trained, highly capable caregivers. While I am certainly thankful for modern medical technologies and doctors who have the ability to perform life-saving surgery when necessary, it is important to keep in mind that deliveries by OBs should be the exception not the norm.

Note that "The United States spends more per capita than any other industrialized nation on health care, yet the country ranks only 27th in terms of infant mortality. Much of that expenditure is aimed toward technological advances rather than personalized care during pregnancy and birth. In fact, the majority of countries with the best birth outcomes have midwives as frontline providers of maternity services" (American Journal of Public Health, 2002).

For some women with high-risk pregnancies, a hospital birth with an OB is the best decision. For the majority, however, midwives are likely the better option.

7. Medical inductions are not "normal" - or necessary (in most cases). The following story is far, far too common: a woman goes in for a routine check-up at 37, 38, 39, or 40 weeks. And the doctor says, "let's have this baby today" or "the placenta appears to be declining" or something similar. The mom-to-be is scared and the prospect of not being pregnant anymore sounds enticing so she checks in to the hospital to be induced. From there, a long string of interventions occur (IVs, pitocin, epidurals, uh-oh - c-section).

I'm not saying that inductions are always unwarranted nor am I saying that you made the wrong decision if you chose to be induced at the directive of your doctor. What I AM saying is that it is important to listen to your heart, your body. It is important to ask a lot of questions if induction is suggested. It is okay to say, "no thank you" if you don't want to be induced.

8. Pitocin makes your contractions hurt more (and thus makes getting an epidural more likely). It is well-known among moms and caregivers that pitocin tends to make contractions more intense. It is also important to keep in mind that receiving pitocin will require you to have an IV and be monitored continuously during the administration of the drug.

9. Epidurals are not necessarily safe. Childbirth Connection reports that epidurals:

  • increase the length of the pushing phase of labor
  • increase the likelihood of birth with vacuum extraction or forceps
  • increase the likelihood of maternal fever
  • increase the likelihood of serious tearing of perineal tissue into or through the rectal sphincter
  • can adversely affect newborn behavior compared with unmedicated infants

The data is currently not adequate, but some studies indicate that epidurals may also increase the likelihood of cesarean section and may adversely effect breastfeeding.

I'm not suggesting that getting an epidural is wrong or that you are a bad person if you choose to get one. What I AM saying is that epidurals are not without side effects. It's important for women to understand both the drawbacks and the advantages of receiving one. I like this quote from Childbirth Connection: "Every woman needs to understand these trade-offs and make informed decisions according to her values, preferences, and options."

10. You should listen to your body. If you want to walk, walk. If you want to sing, sing. If you want to squat, squat. If you want to get in the tub, get in the tub. If you want to take all of your clothes off, go for it. Delivering at home, at a birth center, with a midwife, or with a specialist who fully supports natural childbirth will help ensure that you have the best birth experience. IVs, hospital monitors, wires, and constant "dilation checks" WILL impede your ability to relax and to move around.

So listen to your body. Be confident in your ability to give birth. Be excited because your world is about to change forever - in the most wonderful way imaginable.

Motherhood is miraculous and magnificent. You are going to love it.

YOUR TURN: What do YOU wish you would have known about birth when you were pregnant with your first child?

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28 comments on “10 Things You Should Know About Birth”

  1. Love this.
    I myself was a home birth baby so I grew up thinking it was perfectly normal to be born or have babies at home.
    When it came time to have my first baby I immediately went with a midwife but wasn't 100% on having a home birth. I talked it out, explored my options, asked my questions and in the end, we decided on a home birth. I had a perfectly straight forward and relatively "easy" birth.
    My 2nd was also born at home.
    I can't imagine having a baby in a hospital surrounded by foreign things, people and sounds.
    Being in the comfort of my own home was such a beautiful experience, but by no means do I say it is for everyone. It is not. And that is okay.
    It actually really bugs me when people declare one way to be THE way to have babies.
    The only way I know is to educate yourself. Ask those questions. And like you said, doctors don't know everything and they CAN'T tell you or force you to do anything. It's YOUR body and YOUR baby. You take in the facts and make your decision.
    Great post!

  2. I, too, am forever singing the praises of our local birth center! When I think back on my labor I remember being outside on the porch looking at the stars and enjoying the beautiful night. It was a wonderful experience!

    My only regret is in not listening to my body better. When the midwife said I was completely dilated and asked if I wanted to push, I said 'ok' without tuning into my body. I didn't feel the urge to push at that point, and I think that was the mistake. My baby reversed a bit and I was pushing without the benefit of his head on my cervix. That caused my cervix to swell and I went back down to 4 cm! Next time I'll wait for the urge to push that everyone talks about!

  3. Okay....so there really wasn't anything that was of surprise to me since I worked in an OB/Gyn office for 2 and a half years. Anyway, I did want to share with you a birthing plan that I had found out about through a friend of mine from church. It is called Hypnobirthing (http://www.hypnobirthing.com/) I am so glad I did it that way! I had a cousin who had some major issues with an epidural and so I really didn't want an epidural, not to mention I really wanted to be able to walk around after I gave birth. Anyway, I was able to deliver a 9 pound 13 ounce, 23 inch long baby WITHOUT an epidural!!! It was amazing! Thank you for posting this post.... I do know a lot of women don't know what they can do about their own health and the health of their unborn baby! Thanks again!

  4. I love what you have posted here! One of the hardest things about my entire first pregnancy was fighting my doctor against an induction. I did not want to be induced! Of the 18 friends of mine that have been induced, only four have not had to have emergency C-sections. Those are not good numbers in my book. I wanted to have a natural birth if possible and I really had to 'stick to my guns' with my doctor. The DAY AFTER MY DUE DATE they wanted to talk about induction! I said, 'no thank you, I want to wait'. I had to say that for two weeks! My first baby came 13 days past dates and thankfully my labor was completely normal and quite quick. Four and a half hours was all it took for my healthy baby to enter the world...and only at 7lbs 8ozs. Imagine if she came two weeks early??

    My second born was NINE days past due and my labor was only 2.5 hours...hard work, but quick! Thankfully, both were born quickly, with no induction and no meds at all! The doctors tried to push meds on me so much too...even after birth the constant barrage of 'here, take some pain medication..." NO THANK YOU!

    Thanks for posting with such great information!

  5. I had my first child when I was 32, I have known since I was 12 that I wanted a natural drug free birth. I somehow knew a lot of what you talked about here already. Probably not all of it at 12 but learned about it along the road of life. I convinced my very logical husband that drug free, intervention free was the way to go.

    Then my water broke 4 weeks early. I labored for 24 hours on pitocin, it was hell. I got my epidoral and another 20 hours later had a c-section. Not how I planned my birth at all.

  6. I have had six children naturally, one in the hospital birthing room, and five home births(with a midwife). I am so thankful they are all healthy! My husband was a wonderful coach, encouraging me through each birth. The home birth experience was so much more comfortable for me and my family. I agree with Stephanie, listening to your body and knowing that,with the grace of God, you can do this.

  7. Thank you for this post. Since the day I met you at Desert, you have been a source of kindness and positive encouragement and I see that you are now spreading your joy to those all around the world that you touch :).
    My husband and I recently found out that we are pregnant! I am thrilled, but also terrified. I want to deliver completely naturally, but I am worried that something could potentially go wrong and the doctors will push dangerous procedures, convincing me that they are absolutely necessary.
    I have begun watching birthing shows and the way that the women scream and wince in pain and ultimately wind up receiving epidurals makes me think that I too may succumb to this fate. I have fears that I may not be strong enough to do what I need to do when push comes to shove.
    I really appreciate the information that you brought into this post and tie-ins to your own natural chid birthing experiences. It's very refreshing to hear someone speaking from experience rather than touting off something they read in a medical text-book. I am going to be looking into a natural birthing clinic. Could you share some more information about the one you went to and other ones in the Tucson area?
    Thanks again!

  8. I'm so glad to see natural birth spoken about proudly and openly here :)

    Isn't it funny that 'natural birth' is the fad, and medicalized birth the norm? If you haven't seen the new documentaries about birth yet, you have to see them: both Orgasmic Birth and the one by Ricki Lake (the name escapes me.. mama brain!) show the BEAUTIFUL side of birth - joyful, celebratory, painful yes, but amazing :)

    One thing I know for next time: EAT before you go to the hospital ... I didn't really feel like eating, but I regretted it after being pooped after giving birth to my 9'4oz. darling, all naturally - Praise God!
    Oh, and really making your husband a partner in everything - having him at my side, laboring and birthing together was the most amazing experience of my life :)
    Cannot wait to do it all again!

  9. I agree with all but mostly with #10. Listen to your body. Only you know exactly how you feel and what's best for you.

    I made no birth plan. I told my Dr. that what I needed, "please listen and respect what I have to say while I am in labor". I wanted to let things flow and decided to just see how I felt that day and trust my body.

    I'm a nurse also, and got a lot of slack from the nurses there and MD for coming so late, refusing an iv or other tests. But I didn't care I had done my own research and trusted my body. I tell my patients all the time, "you have to be your own advocate, it's your body".

  10. I wish I had known how much we control our labors by how we let ourselves fear or embrace them. I wish I had known that it hurt so much to pee afterwards...no one ever warned me! And I WISH I would have known how much walking, doing pelvic tilts and hip rocks eases the pain of back labor.

  11. Well this isn't really something that I wish I had known, but something that I just realized. With my first child, I 100% wanted to give birth in a hospital with an epidural (I hate pain!) I just recently began researching birth centers (after your posting) and found out that there are ZERO in NE. Bummer!

  12. I wish I had known my Dr. was going to do an episiotomy. He just did it without talking about it or even asking. I had been pushing for almost 20 minutes, he walks into the room, I push one more time, he cuts me, then my baby came out the next push. I did not know how much it would hurt to just walk around after the stitching. Walking from my bedroom to the kitchen just seemed way too far away so I opted to just stay in my bedroom for quite a while.

    With #2 I was induced and had an epidural. I pushed for 2 minutes! 2 contractions and she was all the way out!

  13. I'd say that I wish I had known all of that before having Levi, but I kind of did already. I had heard bits and pieces of it. I knew that a natural, drug-free birth was what I wanted, but I didn't have the confidence to go get it. I thought I had to go to the OB and listen to what she said. I didn't have any real support either. My mom had c-sections and thought they were great. My doctor thought they were great. I was the only one sitting there going, "um, cut me open? are you joking?!!" Levi's entire birth was unnecessarily traumatizing. It ended in an emergency c-section. After seeing me go through all of that my mom is now convinced that natural is infinitely better. So, if there's a next time, I'll have more support, and I'm steering clear of OB's. The thing we so often forget is that they aren't trained for natural. They are trained for emergencies and surgery.

  14. I would definitely reiterate that while it is a good idea to create a birth plan, it also important to keep an open mind and know that sometimes things don't go according to plan. It's also a good idea to at least have a basic understanding of all the options. (Ex: if you never in a million years think you'll have a c-section, its still a good idea to at least GLANCE at those pages in the book instead of skipping). Also, if things don't go according to plan and you don't have your ideal birth experience, don't blame yourself! I was induced at 36 weeks (!) due to IUGR, had an epidural, 20 hours of labor, then emergency c-section b/c the cord was wrapped around his neck twice. Then 10 days in the NICU....not my ideal experience, and I am still trying to take my own advice about not blaming myself 2 years later.

  15. I would add to this for women to strongly consider getting a doula for their birth experience. Most women who hire doulas are seeking a natural, drug-free labor. I was actually induced and knew that I was going to request an epidural at some point in the labor, but having a doula there to help me along the way was one of the very best decisions I have EVER made! There's no way I'd go without a doula the next time I do this!

  16. Thanks for your post! I love how honest you are and so firm with your opinions! Not everyone has the same views...but that is ok! I enjoyed this post!

  17. I wish I had known about birthing centers etc., but even if I had I don't know that it would have been an option 10 years ago when I had my first.

    I actually had a home birth with my first, and sadly, I was one of the rare cases that went totally wrong!!! To make a long story short, I did end up at the hospital after delivery-- I had to have a blood transfusion and surgery. :(

  18. i kept repeating to myself: people have been doing this since time began. people have babies every minute of every day.

    also EAT SOMETHING before you go to the hospital (if you do) its hard to find the energy you need when you haven't eaten in 18 hours!

  19. Oh, and one more thing. Don't expect each birth experience to be the same, even under the same circumstances. I went into my birth experiences with both kids with roughly the same birth plan (I went the hospital route for a variety of reasons & had no complaints except for not being allowed to sleep properly after the fact). They both started with my water breaking before I was having contractions. But my son was a relatively calm and relaxing experience, while my daughter was literally the worst thing I've ever been through (going from 3cm to fully dilated/giving birth in 2 hrs just plain sucks no matter where it happens).

  20. What I'd add is that no matter how much you plan on a feel-good, lovey-dovey, happy-go-lucky birth, it doesn't always go the way you envision. It's kind of like getting married - plan as much as you want ahead of time, but when the time comes, let go and just accept what happens. There is no right or wrong way to give birth and you simply can't fail at it. That baby is going to come out.

  21. I am still terrified of giving birth. Honestly I am so easily swayed and everyone telling me their horror stories, my mother's horror stories...having people EMAIL me horror stories.

    Scarred me for life.

    I gotta figure out how to get over it.

  22. Thanks for number 7. I need the encouragement. I'm 41 weeks today, and my midwife doesn't want me to go past 42 weeks. I'm showing no signs of labor. In fact, if you want to check out my blog post and leave a little encouragement for me, that would be great! :)

  23. After all the pregnancy classes and writing up an elaborate birth plan, I wish someone had told me that things really don't always go according to plan… and that letting go of having to be totally in control at all times is probably a pretty good thing to learn when becoming a mother.

  24. Can I just say "thank you"? I absolutely love your site and only wish I had found it sooner. Seriously, I needed you (and specifically this post) 16 months ago when I gave birth for the first time. I was so timid, so shy, and I naively believed every thing someone with RN or MD after their name said. After 3 long hours of pushing, I finally asked again only louder this time, to not do the hold the legs whyile pushing and then drop them in between contractions manuever. It wasn't until they finally heard me, and this time really heard me, that I got to use the stirrups they way I had requested 2.5 hours before. Not more than 8 minutes later I was holding my beautiful baby and I have never been happier that I stood my ground instead of giving up like they all were suggesting I do. You're absolutely right, women know their bodies and they need to trust their instincts. I don't know if I'm anywhere near brave enough to try a home birth, but I would definitely consider a birthing center for my next. Maybe then I can do things my way... the first time.
    Again, THANK YOU!!
    Rave and Review

  25. I wish I'd known how it would feel AFTER the birth. With both babies I was elated to be holding my child, but got the shakes like crazy. With the first birth I could barely sit, stand, walk, or move for a couple days (but it was a completely different experience with the second). Many people talk about the birth experience, but not so much about afterward. I pictured myself all happy and cute with the baby in my arms, not trying to decide whether it's worth it to get up to pee or to hold it so I don't have to move... That's what I would have liked someone to tell me.

  26. I love this post, Stephanie.
    I wish I would have known that labor was going to be way more intense than I ever imagined and that my confidence going into labor would be met by feelings of unexpected fear as I reached the transition and very long pushing stage.

    I wish I knew how much I was going to rely on my upper body strength. I have always been a runner, and I exercised during my whole pregnancy, but I did not know I would use so much of my upper body to help me push my little bambino into the world. So I would strengthen my upper body more next time.

    And one last thing, I would make sure to have at least three very supportive people with me during the birth. I thought I could do this all my own--I had complete confidence. Having my husband, my midwife, and an amazing nurse all with me the entire time, supporting my every decision, cheering me on, giving me strength when I had none left, is what got me through. I truly don't know if I could have given birth naturally without them, and I am just so grateful they were all there.

    A note to Kim: Thanks for sharing your story. I have two nieces who would not have been born alive if it were not for modern technology and modern medicine. I am so thankful for it when it is necessary. Even though we may want things to go a certain way, the most important thing is that at the end of the birth there is a healthy mom and a healthy baby--or in your case, babies! Congratulations.

  27. I was very lucky to have an amazing doctor and had a very pleasant experience with the delivery.

    Communicating with your doctor/midwife is key. I had concerns about labor and I brought those concerns to my doctor. In discussing my fears (from horror stories from friends) about induction, epidural, forceps, an unnecessary rush in the deliver, c-section, etc we reached an understanding. He took note of all the things I wanted to avoid and none of my fears came to pass. It helped that I used a family practice doctor instead of an ob/gyn. He was the only doctor I saw during my pregnancy and the one to deliver my baby. With ob/gyn in my area, you had to rotate through all the doctors and got whatever doc was on call for delivery. My doctor was the best person for me, but I lucked out by seeing a doctor with a family practice first. Its hard to have a positive experience if you are not on the same page with your doctor/midwife. Find someone with similar views - it will be easier to discuss options before labor & delivery. Bringing things up for the first time while you are in the hospital in labor will not be a positive experience. I had an on-call doctor the first few hours I was in the hospital (long story) and he kept pushing an epidural on me. It was quite annoying repeating that I wanted to try without. When my doctor showed up he didn't bring it up (because we had discussed it weeks before) until I had been in labor for 12 hours with little to show for it (6cm), severe back labor, and extremely exhausted. It made all the difference.

    To sum up: Pick someone with similar views, who you are able to communicate with, and discuss out options weeks before delivery (if possible).

  28. I think this is a great post for the normal, low-risk pregnancies, but everyone's situation is different and what may start as a normal, complication-free pregnancy may not end that way. I agree that a midwife, in a normal, low-risk pregnancy is probably a great option for most families as well, but, don't be closed minded about OB's, because you may have to use one!

    I think the best advice I would give anyone would to look at all the options on the table but know that you may not have the pregnancy and L/D that you have always thought and dreamed of.

    I had twins (spontaneous identical) at 36 weeks (considered full term for twins) and was diagnosed with preeclampsia at 34 weeks and put on hospital bedrest (8 weeks prior to that on home be drest for preterm labor). My husband and I wanted to use a midwife in a hospital prior to knowing we were having twins and once we were surprised of the news at our first appointment we were referred to a perinatologist whom through the process we trusted and loved. I I was induced at 36 weeks due to preeclampsia and the fact that past 36 weeks it was more of a danger to me and our babies to continue on in the pregnancy. Being induced was the best option because otherwise, I may have had to get an emergency c-section. I am extremely thankful for the medical technology that allowed me to have a vaginal, complication free delivery. I often tell people that the labor and delivery was the EASIEST part of the entire pregnancy! No long pushing, no use of forcepts or vacuums or anything. Yes, I did use an epidural with such a high risk delivery, however, that did not inhibit breast feeding (which was successfully accomplished for the first year for both babies). No, my experience was not even close to what I had dreamed of for my first child, but I am sure glad that someone gave me the advice to not expect things to go as I had envisioned. I have no disappointments and no regrets and can only be thankful for such a wise doctor and her team who brought my babies into the world successfully.

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