23 Weeks: Pregnant In America


Matt and I were flipping through Netflix on Saturday night and I found this saved in my queue.

We watched The Business of Being Born back at 11 weeks, and then this one, and we feel that both of them are majorly biased and overdramatized. The couple in this film spoke of OBs and hospitals as though they were against womankind. They chose the worst clips to share, and I felt this was a perfect example of biased media.

While I think it’s important to learn as much as one can about natural birth to understand the process (even if you’re planning an epidural), both of the films portray hospitals and doctors as pure evil. While I DO believe there are OBs and hospitals out there that might act more in an assembly line fashion, my gut says that most don’t have bad intentions. There is definitely a statistical trend toward c-sections and interventions in this country, and I do think that convenience often overpowers nature in many aspects of birth.

But what if you are in the small percentage that actually DOES need a c-section? Or your baby does end up needing emergency medical care? Are hospitals still evil then? I’d be pretty thankful for doctors. I’d like to see Ina May Gaskin make a documentary. I bet hers would be inspiring without being so critical.

I’ve read/listened to so many birth stories, and no matter how anti-hospital you are, doctors do save lives. And because of that, I wish these documentaries would portray them a little differently. One woman on Pregtastic had a baby in a birth center, but her baby had a collapsed lung. Thank goodness for hospitals. This story about a crunchy mom was determined to have a natural home birth was incredibly eye opening to me.

I think it’s important to be informed and flexible. Do your research on all options, interventions and natural birth alike. I would never want to have a hospital birth without an experienced doula at my side throughout the whole labor. Nor would I want to have a homebirth without being less than 5 minutes from a hospital. For me, the best plan is to bridge the two. I feel that bringing the natural into the hospital is easier than driving yourself and possibly a traumatized baby TO the hospital in an emergency. When the couple in the film had to do this, it made me wish they had just been there all along.

Luckily, it seems that our hospital and my group of doctors are not part of the “evil side” of medicine. My friends who birthed at Martha Jefferson had nothing but good things to say. And most of them did it naturally. I think I have heard an equal number of birth stories split between “My birth was awesome!” and “This and that went wrong and I went into a downward spiral.”

Matt says if he has learned anything from the two films it’s to be aware of the domino effect that induction –> pitocin –> epidurals –> c-section can bring. And the important role of oxytocin. But he is still glad we chose a hospital. For me, I’ve learned the importance of movement during labor. I want to be in all kinds of different positions. In the tub, walking, on a ball, on a birthing stool. We’ll see how it goes…

I am not anti-epidural. But I hope to labor without one. My tentative birth plan is to go natural unless my birth is extremely long OR I have something abnormal going on.

What is most important to me is to experience labor. I’ve been curious my entire life what it’s really like to have a contraction. How it feels to push a baby out. I admit I’ll be disappointed if I don’t get to experience either of those things. (A scheduled c-section would be my worst case scenario as far as birthing goes.) If I get a few hours into labor and decide I’ve experienced enough contractions to know what labor is like, I’ll consider an epidural, but my hope is still to be strong, focused and as athletic and mobile as possible.



Pumping (And I Don’t Mean My Breasts)

Baby You’re A Firework


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163 thoughts on “23 Weeks: Pregnant In America”

  1. I love your Berf website. I always read it, but never really comment. I had to comment today. I am the proud mother of 4 wonderful children. I was convinced I would have an all natural birthing experience. I stayed healthy and worked out during my pregnancy. I ended up needing to be induced with my first child because I was at 41 weeks and a stress test showed that the baby was not active enough. Needless to say, I was freaked out! I had to have pitocin and I ending up getting an epidural because the contractions were painful. When our baby boy was born the cord was wrapped around his neck two times and tightly wrapped around his body. He did not cry for 2 hours after being born and I was not able to hold him for quite a while. Most likely my induction saved his life. Had I waited for him to come naturally, I’m not sure what the outcome would have been. Sorry about the long winded response, I just wanted to say that people don’t always choose induction out of convenience.

    1. Note, the midwife in that book was a lay-midwife, meaning no formal or medical training. Many midwives are Certified Nurse Midwives with years of medical experience…Although, it was a a great book

  2. So glad for this post. Semi-crunchy mama here who got pregnant at 40 on the first try, no problem, thought I had it all figured out (after all, “they” told me I would have so much trouble getting pregnant). My nice OB let me go 2 weeks past due date because I was in great health throughout the pregnancy (health was fantastic), because I really wanted my water to break naturally (I was stubborn about this). After my water broke at home & then 18 hours of labor (wasn’t planning to deliver at home, just expected to have a natural delivery at the hospital with a very detailed birth plan a la Bradley Method classes), my baby simply would not descend and I was not dilating the least bit, so I had to have an emergency C-section (my blood pressure was dangerously low & the baby’s heart rate was dropping fast). The doctor opened me up and exclaimed, “Holy cow! No wonder!” whereupon she proceeded to explain there was a fibroid (that had been missed in all 3 of my ultrasounds) the size of the baby’s head! It would’ve been like trying to deliver twins at the same time. Not saying all C-sections are justified, but sometimes it can result in a life-saving delivery. I’m so grateful for that C-section.

    (Oh, and I did get to experience lots of contractions — like very painful cramps — and when they put the pitocin drip in, I nearly passed out from the intensity of the contractions but by then I was beyond worried. And got the epidural (obviously) and it was fine. No headache, no nausea.)

    1. Oh my gosh, can’t believe they missed it! But lucky everything turned out ok – esp with a healthy baby!

      1. I got so worked up writing about my experience that I forgot to mention that, yes, my baby was very healthy and is now 9 years old! It makes me shudder to think what could’ve happened had I insisted on a home delivery, which I was set on until for some reason (maybe my intuition?) around the 4th month I decided to deliver at the hospital. I know it’s just something I have to get over, but I do feel that stigma when people learn I had a C-section — as if they’re wondering if it was really necessary. I get defensive about it sometimes. I even had a good friend’s husband say when she delivered naturally that he was so proud that she was tough enough to do it. Sometimes that stings. I think in the end, we just need to respect each other’s choices.

  3. I couldn’t agree more. I honestly get really tired of hearing some women go on and on about how a natural birth is the only way to go, doctors and hospitals are evil etc. I have an open mind because you never know what could happen in labour! I am so happy and comfortable with the decision to give birth in a hospital, with an epidural and baby delivered by my OB (who is awesome!). I think your approach is great and I also can’t see any reason why you can’t have a doula and mix natural and hospital birth. Everyone acts like dr’s are out to get them and I just don’t think it’s true. I will feel so much more comfortable and relaxed in a hospital because they make me feel safe! If anything goes wrong they will all know what to do. I think women who build it up in their mind that a natural, at-home birth is the only way to go and then they end up in the hospital for whatever reason, are the women who are majorly disappointed for months/years about their birth not going the way they wanted it to. This is another reason I just kinda want to go with the flow but also be educated about the different things that could happen.
    Even though I DO want an epidural I would also like to feel contractions and see what it’s like, I’m so curious as well!
    Love your outlook on the whole thing 🙂 I think happy, healthy baby and mama should be the main goal.

  4. I was really upset to learn there was a “business” side of birthing but its also upsetting to hear the answer is anti hospital .I had a hospital birth and it was a great experience. more important than where do you have you baby is that you know your options and get the support you need on your own.

  5. As someone who had induction –> pitocin –> epidural –> totally normal vaginal birth, I had a completely stress free hospital stay. I’ve always thought part of the birth experience depends on the personality of the mom. I’m pretty laid back and level headed, but the ladies that I know that are high-strung have had more difficult births (obviously this doesn’t apply to everyone).

  6. I’m with the natural camp. While I am not pregnant I intend to deliver at home and with no intervention. That stated, I am not crazy — there IS a time and place for medical intervention: emergencies!

    The United States has the highest infant mortality rate of developed countries and I believe medicine to be a huge factor in that statistic. By walking in to a hospital I am more likely to go with their ideas and influence.

    I don’t believe these documentaries were made just to be against the norm or to scare people — I believe they were made to inform people of the alternatives out there as well as the risks associated with hospitals. The more information, the better informed choices.

  7. I’m so glad you’re researching every side of things. I think that is SO important because as they say, education is the best tool against fear and fear is the enemy of peace.

    I had an amazing all natural, med free birth in a hospital that I will cherish. I understand that hospitals are there for the ‘just in case’ and in my case my house is not properly equipped for a home birth and we’re 30min from the nearest hospital so we chose hospital. I will say, do not under estimate hospital ‘procedure’. They will probably push you to do something you don’t want to. Even though I had the pretty much ideal labor and delivery I was still pressured quite a bit and was SO grateful my husband and I were on the same page so he could be there for me to make sure nothing happened that we hadn’t wanted.

    Though I agree that these documentaries are biased and I DEFINITELY didn’t like the dude from Pregnant in America because he was so confrontational and overly pushy, I do love the message that women are strong enough and powerful enough to do birth on their own without intervention except in the emergency cases.

    I’m a part of the series that Ash is doing over at neverhomemaker on med free hospital births coming out soon so hopefully reading those stories can help you learn ways to make sure your birth is a peaceful one without attempted interventions.

  8. I’m really glad you posted this. I’ve been reading a lot of pregnant blogger’s blogs and I’ve been surprised about the medical field hate. I’m fully supportive of natural births because they’re amazing and touching for the parents and child. That said, I think I see the other side of the story from the doctor’s perspective. My sister is a pediatrician who works with very small babies frequently, and I’ve never seen someone more caring or loving towards babies. It just makes me sad that people frame her as a cold, heartless, money-grubbing doctor who’s only out there to pump drugs. As a doctor, her interest is the patient’s health above all. I just hope this posts brings some more perspective to those who have already made their mind up about doctors.

  9. I’m a first time mom, too. I have a pretty relaxed birth plan, if you could even call it that.
    One of my biggest fears is to have a scheduled C-section. I really want to experience labor as well. But keep in mind a scheduled c-section is probably better than an emergency one!

    I read an article a few weeks ago that said pitocin AFTER 40 weeks does not lead to nearly as many c-sections as it does when you are induced before 40 weeks.
    I will have to try and find the article again.

    1. Oh, and I believe that most hospitals will disclose what their c-section rate is. I know this information was available on my hospital’s website.

  10. I know a lot of woman have horror stories about c-sections, but my baby was breech from 29 weeks and I had a scheduled c-section, but ended up going into labor 5 days before the scheduled date. My OB and her team rocked, I had an excellent surgery and my husband got to bond with the baby while I was in recovery. It was really not that bad and i recovered from my c-section so quickly that after 2 weeks i was cleared for light exercise. I know a scheduled c sections sounds like the worst thing ever right now, but nothing is as bad as it seems once your little boy arrives. Your whole focus will change and you will look back at some of things that you thought while pregnant and just laugh…

  11. My uncle, who is a world re-knowned neonatal surgeon recently told me, when discussing the trend of natural births and negative opinions of C-sections, that the fact is, nature never intended for everyone to survive. If you look at history and the animal world as well, you see that mothers and babies die all the time. So when he hears and sees women (including his daughter in law who pushed for 5.5 hrs despite all her doctors recommending a c-section- and her baby came out with an apgar score of 1), he said he gets frustrated that women insist on resisting medical interventions that are designed to fight nature, which really doesn’t intend for everyone to survive. Now as far as drugs go, he’s strongly opposed to pain killers and epidurals! Says they fight the bodies natural instincts.

  12. I actually found Ina May’s book rather negative as well. I’ve had 2 natural (hospital) births so far and am glad i avoided the epidural simply because it seems to take women longer to recover from one-learned from my circle of mom friends. I don’t believe experiencing the pain makes me a better or stronger person-just a lucky one who didn’t have to have a needle put in my spine *shudders at the thought*. My third i’m prepping to have at home, but my midwife and i won’t make the final decision until i’m in labor-if everything seems to be going smoothly-great. However, if anything seems or feels off-to the hospital we go! During childbirth–flexibility is important.

  13. You’ve echoed my sentiments about childbirth exactly! Here in Asheville people immediately ask me “who my midwife is” and when I tell them I have a regular OB/GYN you’d think I was drinking out of a styrofoam cup while shopping at Wal-Mart with a gazillion plastic bags. I’m not anti-midwife by any means, I’m also just not anti-doctor either. My doctor is great (so far) and we’re on the same page in terms of the whole birth experience…which, like you, I simply want to experience in as present and comfortable a way possible.

    As a side note, I haven’t read Bringing up Bebe, but someone was telling me about how in the book, it talks about how the French generally take a relaxed view of childbirth… like, why be miserable and in pain when you can, well, not? I find this contrast with our view of childbirth in the U.S. quite interesting.

    1. As someone with a hubby in the medical industry I also feel the same way. Why be miserable and in pain when medical advances have made it possible not too. By the way I am Australian (although I did spend 8 years living in the USA).

  14. With my first two babies, I had to be induced and chose to get epidurals. With my third, I also had to be induced but because I progressed so quickly, an epidural was not an option. I am so thankful that I got to experience labor without any sort of pain medication. Of course, at the time I felt a little differently but if I had to go through it again, I would choose to be pain med free. It was not nearly as bad as I had imagined. Mentally, I attacked it the same way that I go at a long distance run. Take it 10 minutes at a time.

  15. As someone planning to follow the “crunchy path” I’m currently planning for a homebirth. It is obvious that this will be my ideal plan and I do understand that there are things that may come up to alter this plan whether during pregnancy or delivery. While I do agree that these documentaries are biased we also have to recognize that the vast majority of information that is passed around regarding birth is biased to say how dangerous and risky the birth process is. Having been around many (animal) births (I was raised on a farm) I have to say there are very few births in my experience that actually present themselves as dangerous. We’ve helped cows deliver difficult calves but the majority of the time they can handle this stuff well on their own with very little intervention. My experience has convinced me that birth is a natural process, not something to fear and my midwife is there to watch for signs that something is outside of the “normal” range at which point I am fully thankful we have doctors and hospitals in this country. They’re not evil but for the vast majority they are not necessarily a needed.

    1. My homebirth with my third son was the most amazing experience of my life! My other two natural births were also wonderful in different ways (hospital with an OB with my first that taught me how to be a powerful, birthing mama demanding good care and my birth center birth with my second that taught me what it feels like to be truly supported during birth!) but neither could hold a candle to my homebirth experience. Totally life-changing 🙂

  16. I loved the business of being born but I found pregnant in America beyond one sided. I actually couldn’t finish watching it. When I get ready to have a baby I plan on being fully informed which is why I’m doing my research now. Lucky I live less than ten minutes away from the hospital and I’ve met with a doula that seems wicked nice and has taken the time to talk to me about options rather than just preach to me about how it should be. Also as someone not being front he area it was important to me to find someone I could trust to tell me what the hospitals are really like I the area for birth. Since I didn’t like the general concensis I decided that when it’s time for a baby I will be birthing at home as long as the baby and I can handle it. Mind you it was through weighing all the options as well as being well informed before I made my choice and I never thought it would be a ho
    E birth either. I just feel that people need to be informed fully from. Oth aides before they make their decisions. It’s not a one size fits all answer that’s for sure.

  17. I agree women are so against OBs now for some reason. I, for one, was all for birthing in a hopsital where if something went wrong, I had medical staff all around me to help. I had pitocin, but no pain meds since i know it ups your chance for a c section. Mind over matter! Birthing is the most personal experience and no two can compare. Whats good for one, may not work for another.

  18. I think you have the perfect outlook on things.

    My baby was was face up and not quite in the proper birth position (she trying to come out at an angle). I got to 10 cm then spent 4 hours regressing to 8 cm. And they say you can never go backwards. I ended up with a C section and it turns out she had the cord wrapped around her neck so tightly that she couldn’t come any further. It’s very possible she would have died or suffered lack of oxygen and brain damage had she been born vaginally. Her heart rate was also dropping with contractions so my doctor was worried she had the cord around her neck through labor. How amazing that we have such great doctor and technology to know these things now.

    I’m so happy that she’s healthy and thankful for the C section (she’s 1 now!) But I’m also sad that I’ll likely never experience a vaginal birth. I, too, wish that would have been the path for me. Everyone says “just be happy you have a healthy baby!” and truly, I am. But I think it’s also ok to mourn the loss of the birth experience you’ll never have.

    Again – good job being informed, but all flexible. That’s the best attitude.

  19. Hi Kath. I always tell my pregnant friends to have a birth idea, not a birth plan, and to be willing to be flexible. In the end, how your baby comes isn’t nearly as important as delivering a healthy baby. Nearly all of my friends who were induced ended up with C-sections, but there’s also risk in delivering naturally but late because a woman doesn’t want to be induced. It’s like women are screwed no matter what! 😉

    You said “A scheduled c-section would be my worst case scenario as far as birthing goes” and you’re totally entitled to your opinion … but as you alluded to yourself, not all C-sections are done for convenience sake and it doesn’t make one less of a mother if that’s how she delivers. I had a very complicated pregnancy and knew as of 34 weeks I’d be having a C-section. The cord was wrapped around her neck, she was measuring gestationally too small, and there had been complications early on that made my perinatologist and OB recommend a C-section.

    Instead of wallowing in it, I used it to my advantage. We watched a C-section video, read up on the procedure and post-partum care, and mentally prepared myself as best I could for my first ever surgery. My mom was able to be here. And I picked the last possible day in my pregnancy (39 weeks, 6 days) — December 18, 2010. In my religion, 18 is a lucky number. So there was some beauty in having a say in her birth day. It wasn’t some rushed emergency C with no prep. I knew what to expect, I nursed right away in recovery, she never left my side, and she was in my arms (held over me by my DH) the whole time I was sewed up.

    No, I didn’t have contractions, didn’t experience labor … but I don’t think that makes a woman a mother. It was the only way to ensure the safe and healthy delivery of my daughter. The other option was risking a stillbirth. Um … no thank you. She was 6 lbs 4 oz of deliciousness and it didn’t matter how she arrived.

    And I guess one thing to add — no one has a tattoo on their forehead saying “I had a C-section” or “I went drug-free” … it’s the least important thing, you’ll see, once you’re a mom (the “how” — it’s just a conversation piece). That said, for some women the “how” IS important and they feel robbed when things don’t go as planned — and I respect you for having an idea of what you want (that is important!) but I just wish there wasn’t so much animosity in the blogosphere and world in general towards C-sections as the devil. I will do it that way next time … it was a good experience and the bottom line — Maya was delivered healthy and safe. Ultimately, that’s all that matters.

    1. If my doctor said a scheduled c section was necessary for the health of my baby, I would never fight it. But I can’t help but admit id be disappointed. You had a great attitude to research and accept it, and I hope I would do the same.

      1. That’s the spirit! And even if you had to have one for some reason, you could always go for a VBAC next time. Hopefully it won’t even be an issue, though.

      2. I have to ask: Why would you be disappointed?

        I went into the birthing process with a very open mind and NO plan. I had hopes – a drug-free birth – but no expectation that it would go my way. I ended up being sent for induction at 39 weeks 2 days because they were worried my son was not growing properly. The induction caused his heart rate to drop and I had a C-section. By that time, I didn’t care – I wanted a healthy baby in whatever way it had to happen.

        I feel like comments like these, and those on other HLBs, make me feel like I should be disappointed that I had to have a C-section when, in fact, I’m not. I had an amazing recovery – was walking for exercise within 2 weeks and running at 6 weeks post-partum – and had no complications. I have the most amazing, spirited 10 month old who definitely knew how to make an entrance.

        I understand that talking about the birthing process is a touchy area for everyone – not just me, but you – but I would urge you to approach the topic with sensitivity.

        1. I never said anything anti c-section. In fact this whole post is about how women should be more supportive or all kinds of labor. I shared what was important to me – which is experiencing birth. I don’t think there’s anything wrong with sharing emotions. It would be like graduating from high school and not getting to walk across the stage in a cap and gown. Does that mean you didn’t graduate with an awesome degree, no, but if it’s something you looked forward to since kindergarten, then it might create some disappointment.

        2. There is a VAST difference between a scheduled c-section and an emergency one. I had a scheduled breech c/s w/ my first child and was v disappointed about the whole thing, even though the c/s went perfectly. I had wanted a natural birth at our local birth center & instead didn’t even get to feel a single contraction. I did all of the work of carrying the baby & none of the satisfying work of birthing it. You may have ended up w/ a c/s, but you have the fundamental connection w/ other mothers the world over of laboring. I did not have that. Had she been my only child, who knows how long that would have saddened me. My recovery was easy & I always say my c/s was easy, not all c-sections are bad.

          Thankfully, my second child was a drug-free hospital birth & went great. That birth was incredibly healing for me. At the same time, b/c of having a c/s, my future fertility was affected. For instance, I’m no longer legally allowed to birth at our birth center. My choices are hospital or at home w/ a lay midwife. Currently facing this choice w/ baby number three. Well, my mind is made up, it’s my husband who is not quite there yet. I want the full arch, from totally medicated to totally not.

          This isn’t the Pain Olympics, all of our stories are different, but to imply that the way the baby is born is not important to the soul of the mother is to partially discredit the role of the mother.

          1. Actually, I was never in labor. Never dilated. Never had a contraction. So there you go. My issue, and maybe it’s not with this post, is that the birth process has become more about the mother and less about the baby. I think some people – maybe not you, maybe not Kath – feel selfishly entitled to this existential experience and think it makes them more of a mother because of that. I feel like when people act like that, it discredits my experience, relationship and bond with my child.

  20. I had c-sections with both of mine, and no intention of it with the first. But both of my girls were almost 10 pounds, and there was no sign of them coming by 40 weeks. Doctors and nurses were awesome, and from other experiences have been. Research and the right mindset help!

  21. My mom is a L&D nurse in your area so I’ve grown up hearing the ins-and-outs of child birth (but have not experienced it myself). I think you are educated on the subject but it is important to keep one thing in mind: you want a healthy baby. Period. Wax poetic all you want about a homebirth, but please remember there is a reason it is technically illegal in Virginia to have a homebirth with a certified midwife (or any legal medical personnel) present because most medical practitioners don’t condone the dangers. Maternal/infant mortality rates have dropped significantly since the days of homebirth. I understand you want to go natural, which is absolutely fine and your choice, but I think you may be giving off the impression that friends have told you you’ll be stuck with a needle and injected with mystery medicine the minute you walk into a hospital. No doctor or nurse can medicate you without your consent (unless you are unconscious or in a true emergency situation) and you can have a natural birth at any hospital. People who have bad birth experiences tend to go into it with super high expectations and as soon as something changes they believe everything is shot to hell. Have an open mind and know that people like my mom are there to help you, not harm you, and have been doing this a long, long time. In some cases it may be “assembly line” like you say, but no one is going to force you to do things that are not medically necessary. At the end your goal should be to have a healthy baby, no matter how it comes into this world.

    1. For the record, it is perfectly legal to have a home birth assisted by a licensed MD, a licensed CNM (RN) or a licensed CPM (lay, since 2005) in the state of Virginia.

      What gets lost in this whole OB/”medicated” vs. Midwife/”natural” debate is that both professions exist for a reason, and for unique purposes. A midwife is trained to assist in normal labor situations, as an aid to the a woman going through a very normal and non-emergent process. An OB is trained to step in and take care of emergent conditions should they arise, which is most cases is rare.

      It is sad to me that every hospital does not offer a woman a team of midwives to assist in normal labor and delivery, without unnecessary medical intervention. Then, if and when an emergency should arise, and OB would be available to step in and do what they are trained to do. Unfortunately, few hospitals in this country offer a cooperative midwife practice, and it is even more rare for a hospital to allow an unaffiliated midwife practice privileges. This is why, unfortunately, many women resort to an all or nothing approach: home birth (perfectly safe, with a healthy pregnancy, unless the rare case of something going majorly wrong) or hospital (also perfectly safe, but running the risk of being pressured into unwanted or unnecessary intervention).

    2. Depends on your situation. As a person who has had a prior c-section, the hospital I go to, which does have an awesome team of midwives, still has its own rules that I must follow if I want to birth there. This includes monitoring and a hep-loc *even if I don’t want them*. If I do not consent to them, the hospital does not have to consent to assisting me give birth.

      The underlying problem with hospital midwives (CNMs), who are often wonderful, is they still have to adhere to medical rules no matter who objects. Mama-to-be objects, they recommend another hospital 🙂

  22. I just listened to those birth stories on Pregtastic last week. ugh. I can only hope and pray that things go well for me and baby. I will continue to try to be informed but not get carried away with biased points of view one way or the other. Great post— you just put into words what I have been feeling.

  23. I think you are in a fantastic frame of mind for giving birth. I got so stressed about how the hospital would handle things (they did not allow doulas) when I wanted to have a natural birth that I even cried before going to the hospital because I wanted to labor as long as possible at home for a better chance at a natural birth. In the end, I spent the most time with the nurses at the hospital who were FANTASTIC and very supportive of the type of birth I was hoping to have. Things went smoothly and worked out in the end. However, the doctor on call (not my doctor) was not as supportive. Even when I was 9 cm, she said it was going to take 3 more hours before I would give birth (they broke my water at 9cm) and it was 45 mins. The nurse had suggested that it wouldn’t be long and she was right. And, I ignored her completely, but the Dr also told me “it’s not too late” to get an epidural before I started pushing. Why in the world would I get one so far into the process?

    In the end, I was still very thankful to have given birth in the hospital. I was very concerned with how I wanted to give birth and what would happen to ME, but my daughter needed the help of the hospital after being born as she wasn’t breathing well. I can’t imagine not having the help of the doctors immediately to take care of her.

  24. I have to speak up for my scheduled c-section. My baby was transverse and wedged in there pretty good…the doctor said an ecv wouldn’t have moved him. Planned c-sections are not that bad…the mood in the OR is easygoing and friendly rather than rushed and businesslike. I do wish I knew what contractions felt like out of curiosity, but a healthy baby trumps everything. I would much rather have a planned c-section than go through hours of labor and end up having one.

  25. I love what you had to say about these videos. I agree with you that doctors and hospitals have been made out to be evil and I don’t think that is always true. My husband and I are a lot like Matt in the fact that we had no idea that induction, epidurals and c-sections sort of went hand in hand in the fact that one intervention sometimes causes a domino effect. So I think education on the mothers part goes a long way.
    I also agree with you that if you want to try for a natural birth one of the best things you can do is hire a doula. I was SOOOO thankful to have her there during the birth of my daughter. It is so nice to have someone there that has been doing this for a long time, there were so many times during labor that the nurses would leave the room and it was just sort of scary and we weren’t sure what to expect, so it was so nice to have her there talking us through everything and giving my husband a break while I was in the really really intense part of labor.
    Hoping that you get the birthing experience you want! As my bradley teacher always said “The goal of the day is healthy momma and healthy baby!”

  26. Good for you for researching and being informed and flexible about all options. I had my baby girl 7 days ago and I was induced and had an epidural. I will say that even with the epidural I was able to feel ample pressure, enough to tell the Dr when I needed to PUSH. I was thankful that while I had some pain relief, I was also able to feel enough to be involved in the process.

    1. “I was also able to feel enough to be involved in the process.”

      I like this comment because I am being very open minded about my birth (I am almost 30 weeks) and while i am not against an epidural, I don’t want one so strong that it completely numbs my lower body and makes me into a zombie. I still want to be present and involved. Thanks for posting your story.

  27. From the start my plan was to get an epidural no matter what. In my words, “I’m not trying to be a hero” 🙂

    However, one of the things that surprised me the most about labor was how much you still feel even w/an epidural. I was under the impression that I wouldn’t feel ANYTHING and that was certainly not the case for me! When I was pushing, while I didn’t feel any pain, necessarily, I did feel a LOT of pressure. Hard to explain but no one really ever talks about that. I was in active labor for close to 18 hours and things started to get a bit hairy for me towards the end (chance of infection, elevated heart rate) and I came very close to a csection but was able to deliver vaginally. At that point, all you really want is a healthy baby OUT by any means necessary.

  28. I suppose I have a bit of a different perspective. After working at a small maternity ward, then one of the largest Labor and Delivery hospitals in the country, I can attest to a lot of what may appear “sensationalized”. Oh yes, there are women that need a c-section, and hospitals can be great things, but a lot of docs out there will induce you or give you a c-section because they want to be home for dinner or want their weekend off without being called in. It was so common, we knew that Tuesdays were the busiest days BY FAR. Because then they had until Friday to discharge their patients. And while I agree “Business of Being Born” is a bit overly dramatic, there is more truth to it than I’d care to admit. Now I live far, far away from all that crap.

      1. I would totally second that. Having both dated and OB and also having work in medical education for a long time. It’s also important to note that other countries do train their medical students to deal with complicated deliveries without automatically resorting to a C-section. Litigation is a huge issue in North America, and in my opinion totally absurd, and that is why a lot of specialists do jump to a c-section, but not all.

        And yes, to get home and see their family. I know it’s their job and what they signed up for, but it does get tiring for family and spouses – no excuse, I know. But it’s very very hard on relationships – especially if they are traditionally dedicated.

        1. Oh yes, the fear of litigation. Such a huge factor in every medical decision. Oh, and insurance companies. The roll they play is insane. You get discharged 48 hours after vaginal delivery, 72 after c-section. Wham, bam thank you ma’am.

          I just think that if the US has the highest rate of c-sections, induced deliveries, and infant/maternal mortailty in the western hemisphere, something is terribly, terribly wrong. We’ve become way too over medicated and afraid of natural processes. Let’s start there. I know for both places I worked at, after 7 or 8 cm, off the ball/out of the tub/etc and into bed you went! But who cares if you were progressing just fine and were comfortable and everything was going great. God forbid the Doc have to do his job anywhere but on that stool. And if you wanted a midwife or doula? That was a whole other hassle.

          Anyway, I could clearly rant about the healthcare system all day, but Kath, just continue doing your research and don’t forget to tour the place you are delivering! A lot of women forget that. Know what their protocal is before hand, so like other women have said, you don’t get disappointed when things don’t go according to plan.

  29. I was completely set to have a natural birth with my firstborn. But because he was “sunny side up” the contractions were horrendous and I was only 2 centimeters dilated. By 3 centimeters the pain was so bad my eyes were rolling into the back of my head and I was begging for an epidural. They would not give me one until 5 centimeters. Once they gave it to me I felt so relieved and happy. Like I could finally focus on childbirth and welcoming my baby into the world. So I did get to feel the contractions prior to the epidural and I want to mention that even with the epidural, Kath, you can still “feel” yourself pushing the baby out into the world. Of course not the same as someone without an epidural, but the sensations are still present. Anyways, after 3 hours of pushing, and 12 hour total labor, my son was born. I was just so grateful for that epidural! I am happy you have an open mind when it comes to your options. You just never know until you are in the situation.

    1. I’ve heard a lot of women say that the epidural helped them relax and enjoy the birth. I’m really not opposed to them, but I also am scared of the needle and would ultimately rather do it without. I’ll just have to see how it goes!

      1. I haven’t had time to post a comment until now, so I hope you see this. SOMETIMES EPIDURALS DO NOT WORK. Mine did manage to numb my left side, and my cervix and vagina when the time came to push, but my entire right side, I felt it all. My anethesiologist and my ob/gyn and all the nurses said this happens (they are called hot spots) and offered me other forms of pain relief. I chose not to use them, and was fine, but epidurals are not the be all end all.

        Also: I had a hospital birth and used Hypnobabies. My back labor (which Hypnobabies acknowledges is different than regular labor, and thus might not work) meant that after 12 hours, I did ask for an epidural. As noted, NOPE. 12 hours later, I delivered my baby vaginally with the help of forceps. My doctor is the doctor that trains that hospital’s residents in the use of forceps, and we were totally comfortable with her suggestion (yes, suggestion. My labor was my labor). I was only checked for dilation 3 times in 24 hours (once at my request, and once to verify a full 10 cm with no lip), and was enouraged to forgo use of the IV until I could no longer walk around to encourage more dilation and progession. Good hospitals and good doctors are out there!

        1. I read every comment 🙂

          And that’s why it’s important for everyone to be prepared for a drug free birth!

  30. My husband and I also watched the Business of Being Born when I was pregnant and were concerned about the likelihood of an unnecessary C-section. After speaking with my doctors, we were comforted to know that they were on the same page as us–they would only perform a c-section if medically necessary. My daughter was overdue so we did schedule an induction, despite the fact that I had hoped to go into labor naturally and labor at home for as long as possible before going to the hospital. I felt very lucky because I was only partially induced, my body took over and my water broke on it’s own. I did not need pitocin, but I did get an epidural to help with the pain of contractions. After 4 hours of pushing, I gave birth to my daughter. Even though I was induced, I did not end up with a c-section. I’m pretty convinced that if I had tried to push my daughter for 4 hours without an epidural, I would have ended up with a c-section because I would have been too tired to keep going. Or maybe I wouldn’t have, I really don’t know. For me, the induction and epidural resulted in a wonderful experience with the best possible outcome–my healthy baby girl. Nothing else mattered.

  31. The hospital I gave birth at won’t let you get out of bed once your water has broken. Lawsuits make them have all kinds of rules! I’d check with your hospital to see their policy if you haven’t already.

    I loved my doctor. She said that her job was to show up and help deliver the baby. It was my choice on how I wanted to do that. She didn’t care if I chose an epidural, chose induction, etc. She made it clear that it was my choice (as long as the baby was doing well) and I loved her for that.

    1. I’d be all over that bed, squatting, hanging off it, upsidedown. Crazy rule, but I can see why they are scared of lawsuits

  32. Yes, totally agree with it all. I haven’t seen this documentary but The Biz of Being Born felt propaganda-ish to us too. (Ironically, the OB who will back up our midwives is the dude in the movie who delivers the filmmaker’s son when things go wrong with the home birth at the end!)

  33. That is a great mind-set to have. I originally wanted a home birth. We then decided to go to the hospital just in case something were to happen. Well something happened and my son or I would not be here today if we weren’t in a hospital. I think there are some doctors out there that are c-section happy but I also think if you do your research and be your own advocate to what you want you can find a doctor willing to be there for you. The doctor we choose was 100% on board with our birth plan (no induction, no drugs, mobile labor, skin to skin, etc.) but in the end we needed an emergency c-section and it was unavoidable. While I am thankful and greatful for the doctors that preformed our c-section I had a hard time getting over the fact that I didn’t get to “birth” our son – I wanted to feel everything and instead I was knocked out and he was just taken out of me. I didn’t prepare myself for the alternative – I assumed it wouldn’t happen to me and that was my own fault. As long as you are open to either and know that either way can be a possiblity I think you will have an amazing experience. And yes – those documentaries only show what they want to show. You can find a pro c-section documentary that talks about how bad midwives are just as well. Again I will say – you have to be your own advocate with what you want and be sure to communicate that with your doctor and the staff.

  34. My birth experience was probably what you personally wouldn’t want, but it was perfect for us. I had a scheduled induction at 39 weeks, 4 days because I was ready to get the ball rolling. I had Pitocin, epidural, pushing and got him out within 45 minutes. I feel that I experienced all I needed too–the long labor, the worst pain of my life after my water broke, the relief of epidural, and the pushing and the feeling of birth. I also didn’t know going in that we would have a nurse in our hospital room the whole time I labored. No doula necessary for us, she was our personal nurse stationed with us for her whole shift. Just remember that the epidural can help you relax and take away a lot of the pain to leave you strength for pushing. I also felt more with the epidural than I expected in a good way.

  35. Interesting post and I think that’s a great mindset! I read the story on the ‘crunchy’ mama that transferred and would call that the extreme of one end and also representative of a VERY small minority of birthing women. I think it’s important to recognize why Business of Being Born (haven’t see the other one you mentioned b.c everyone who has has said similar things as you–too biased) may see biased or even angry. The reality is that things change depending on where you are in the country, so the state of birthing will change then too, but in some of the largest hospitals all across the nations there are doctors filling the halls that have never seen a natural birth, doctors that say ‘you need to have a c-section for your baby’s sake’ because they’ve never seen a woman in labor very long OR because of insurance purposes…this is not ‘painting them as evil’ but rightly recognizing what you need to be aware of. When I learned about birth in our repro course (i’m entering 3rd yr med school now) there is absolutely no talk of a natural birth or the affects of the meds on a woman–that’s not our concern when we view birth as a medical problem. Of course this is not ‘evil’ or ‘mean spirited’ on the physicians part, but there is a lack of education that really needs to be addressed. What’s important is that you’re able to talk to your doctor about this and feel supported. Many women walk into a hospital after starting labor and slow down in labor b.c as mammals that’s the natural thing to do when we walk into an environment that is so counter the one we’re meant to birth in…this can easily be mistaken by OBGYNS and nurses alike as stage 1 arrest and pitocin may be pushed…this is just an example of something you have to be mentally prepared and emotionally prepared to work for your vision of a birth.

    Either way, you’re definitely not shying away from reading as much as you can about what you expect…I think the best advice I’ve ever heard is that if a woman thinks she can do it, she will. We’re pretty powerful beings!

    1. It’s interesting to read the perspective of someone in med school now, and what you’re saying seems true to me based on what I’ve seen and what friends have experienced in our incredibly huge Los Angeles area hospitals – the doctors and nurses do not have much (if any) experience with natural birth, and do not know how to help a woman cope with that kind of pain beyond offering medication. That’s not a bad thing necessarily, but if you’re trying to give birth without medication in a hospital I can see how it can feel like an unaccommodating environment.

    2. I agree with you 100%. Most people don’t know that most OBs leave med school without ever witnessing a natural birth. So is it any wonder that they have no clue how to work with naturally laboring moms? They do what they’ve been taught to do–intervene to speed things up. Are they bad people? Nope–they’re just doing what they’ve been trained to do.

      Match low-risk women with low-risk care providers who see birth as a natural normal event in a woman’s life and match high risk women with competent surgeons (OBs) who view birth as a medical event and everything evens out! Mix the two up and you get what we have in the USA–an almost 40% c-section rate that is totally unacceptable!

      1. Kathleen, I’m actually in SoCal so it’s no wonder we’ve had similar impressions–definitely at the county hospitals here in particular this is an issue.

        Nicole, well said! I agree completely and think you’ve got it right when you say matching the right candidate with the right provider is key.

  36. I had SO many people tell me, “Oh, you want to give birth naturally? There’s no way you can do that in a hospital!!” Well, Alabama doesn’t have birthing centers, and to be honest, I think I still would have gone the hospital route even if a birthing center was an option. I was nervous that those people were right– that I’d be pushed into unnecessary meds or procedures…but nothing was further from the truth. Once the nurses saw that I wanted to give birth without meds, they were never mentioned, and all of the nurses (and my doctor) were SO encouraging during the whole labor process– they were like cheerleaders! I never had any regrets about going the hospital route.

    Funny story– we watched The Business of Being Born and had ordered a pizza for dinner, and the pizza delivery guy came RIGHT as Ricky Lake’s water birth was coming on, front and center on the big tv mounted on our living room wall. Ugh– awkward!!

  37. I have three children and I am a pretty granola type of mom, but all three of my pregnancies were induced. I went to 42+ weeks with all of them, and even walked around for a couple weeks slooooowly dilating to a mx 3-4cm. I had every intention of a natural birth, but each time my body never went into labor by itself. I tried to hold out as long as possible, but eventually it became a hazard to myself (high blood pressure), as well as the baby.
    I don’t have anything to compare it to, but labor after induction is pretty much hell. There is no gradation to the contractions-they come on so strong and powerful. I really tried to hold off on the epidural, but after X amount of hours in labor, there’s only so much a person can take. My second baby was sunny-side up and his cord was wrapped around his neck four times!!
    I’m not trying to scare you, but reinforce your decision to have a “let’s meet in the middle” type of birth plan. Sometimes, even with the best intentions and actions, things don’t always go as planned. A healthy mother and baby should be the primary concern, and if modern medicine has to get involved to make that happen, then so be it.
    Good luck! you will be a fabulous mama!

      1. I wish more women would talk about this– epi and induction. I was naive to the difference in contractions during my induction and wanted so badly to continue naturally— obviously the outcome of a healthy baby is number one but I was totally unaware that induced labor is completely different than natural labor. I would have got that epi the MOMENT I was able to, not hold off for 6 hours thinking I could do it!

        1. I had an induction and still didn’t get pain meds. I’d never known any other kind of contraction and was able to handle them. It’s more than possible! I’m very glad that I didn’t because I think my mobility during the pushing stage enabled me to have a vaginal delivery that I otherwise wouldn’t have had.

        2. Yes, most inductions lead to what us birth workers call “the cascade of interventions” which makes it very hard to have a natural birth. Induction leads to having to be monitored the entire labor, which leads to being stuck in bed, which leads to more painful contractions (both because of the actual pitocin and also because of not being able to be upright and moving), which leads to an epidural, which leads to a higher c-section rate (both due to common fetal distress and also not being able to push effectively or use gravity to aid pushing). There’s a lot of other things in between all these things I listed but that’s the gist of the cascade and it happens VERY often! Which is why I urge moms to avoid an induction unless it’s truly necessary. ACOG actually states that moms should not be induced unless the life of the mother or baby is greatly at risk. Inducing for a “big baby” or just being 41 weeks does not qualify as a life-saving induction.

  38. Thank you for the thoughtful post! I veer more toward the natural side but I also believe that doctors are good well intentioned people whose ultimate aim is the same as yours. Some hospitals (I’m not in the US) are potentially too busy (I know someone who labored for 8 hours in a corridor) and so I think it comes down to finding the right people and place for you. I don’t think anything is the wrong decision if it’s the best decision for the individual situation.

  39. I hate that they used the word miscarriage in the subtitle. That just shows their negative attitude and really offends me since I had an actual miscarriage. I will not be watching that documentary.

  40. Your “birth plan” sounds much like mine was. Hopefully your hospital has wireless monitors if you have to go that route. I had to be induced and they required monitors the whole time so I was stuck laboring in the bed. They wouldn’t let me get up and move around and it was not fun. Who knows if it would have made a difference but I was very set on getting up and trying different positions and didn’t get to do that. I will say that I got the epidural when I was about 8 cm and I still felt a lot but it made things much more manageable. No problem with feeling when to push, maybe because it ran out by the time I was ready to push.

  41. I didn’t get to experience real labor or pushing and I’m okay with it. I feel thankful and lucky that I was at a hospital that had experience and worked fast! My entire labor was spent worrying about full placenta previa. At my 36 week ultrasound I was given the clear to go whenever I wanted to. My water broke naturally at home but I had 0 contractions. I did end up needed to be started because they were worried about infection. I had barely got started and ended up with severe bleeding that resulting in a very fast emergency c-section. I couldn’t imagine being at home and having that happen. We were very scared and the medical staff worked fast all while trying to reassure me everything would be fine and it was! I have a beautiful 6 month baby girl who is perfect. Scary things do happen and I believe the importance of a fully capable medical staff to assist you. Good for you to be real about the risks. I’m a pro-hospital fan 🙂

  42. There are extreme stories everywhere, on both sides (that C-section story you linked to is a fine example). I’m having my baby at a birth center with a midwife, though my initial plan was to go to a hospital just because it would be easier with my insurance. I toured the hospital at 17 weeks and felt good about it, and I loved the nurse practitioner who was handling my prenatal care. My turning point came when I met my doctor. I told him that I wanted to try for an unmedicated birth, and he laughed. He said that, if he had to guess, around 5% of first time moms who came to him went without an epidural. I asked him if he would be willing to look at my birth plan with me, and he said he would, but then said it was a “running joke” around the hospital that the longer a birth plan a lady had, the more likely it is that she would have a c-section. He flat out told me that if I wanted an unmedicated birth, I should go elsewhere. Though I appreciate him telling it to me straight, I was so disappointed when I left his office.

    After interviewing lots of my friends about their birth experiences, I found a trend – that its absolutely possible for you to have birth without medication in a hospital setting, but you always have to fight for it. You have to make sure your birth plan is read. You have to argue with doctors and nurses between contractions. You must have an awesome support team there who can fight for you. And though a lot of my friends did just that and had a wonderful experience, that’s not what I wanted. It’s a very personal, personality thing, but honestly, I can’t imagine giving birth in that sort of confrontational environment. That’s why I switched to a midwife. And no, I do not agree with her on everything, and yes, I am mentally prepared and have discussed with her the logistics of transferring to a nearby hospital if I need to (or even just WANT to, once things get intense).

    Maybe its because I’m located right near Los Angeles and our hospitals have a different perspective on birth, because I read lots of stories and have heard firsthand experiences from people in other parts of the country who have had wonderful unmedicated births in hospitals. I just didn’t feel that was going to be the case for me, so I’m going where I’m most comfortable. I have the greatest respect for doctors and medical professionals, and don’t believe I am DISrespecting them in any way by wanting to have my baby without a physician’s care. I simply don’t feel that birth is a medical issue, so why involve medical personnel? If something does go wrong, or doesn’t feel right to me, I am incredibly grateful to know that I have access to doctors and hospitals.

    Sorry for the long-winded response – this is something I feel pretty passionate about 😉

    1. Exactly! I am actually glad to hear your OB told you to go somewhere else! What usually happens is they lead a mom to believe she can get what she wants (if it’s a natural birth) only to pull the bait and switch on her IN labor (happened to me with my first with OBs who acted supportive but were not). And yes, I had a natural birth and YES, I had to fight for it every step of the way. I always tell my childbirth students that NO woman should have to fight in labor–it causes her body to release cortisol and other stress hormones that will stall or stop labor in it’s tracks!
      My other two births were with midwives–one in a free-standing birth center and one at home–and my experiences were like night and day as compared to my natural hospital birth!

      Again, it’s not that OBs are bad or mean people–it’s just that they’re trained to handle birth in a way that usually does not support the woman and her choices. Most OBs graduate from medical school having never witnessed a true natural birth….so what makes us think they would know how to attend one appropriately????

  43. I totally agree with you – after watching both documentaries and listening to KC’s birth story on pregtastic, I think you have the healthiest outlook.

    Also, what is the link to that sweet animation that shows how your baby and uterus grows with you through pregnancy? A poster on a wayyyy earlier post mentioned it and I lost the link. Its through University of Maryland or something?

  44. I think it’s all about attitude. 2 couples can have the same birth scenario and one will say, “it went great!” but the other one might say, “it was terrible”. It’s all about your personal outlook on life. Is the glass 1/2 full or 1/2 empty?

  45. I think you have a great birth plan layed out. Somethings are beyond your control. I try and tell people to tell you doctors what you would like to happen and then go with the flow after that, because your baby is heading up the show. I was in labor for a long time and held off for the epi has long as I could. I ended up getting it and was so happy that I did. I was still able to push my son out and still experience all the joys of having a baby. I wouldn’t change anything about my labor. Just make choices that are best for you and the baby, in the end that is all that matters. Love reading both of your blogs.

  46. Well-written post, Kath. I wanted to experience natural birth, drug and intervention-free like you do, and for me, it was a reality and it happened. Had things not gone down that path and a different course of action would have been needed, I was open to weighing my options when and if it was time to cross that bridge.

    I am a huge believer in eastern medicine, in all things natural and holistic, but I am also a believer in western medicine and hospitals and modern technology. Both have their time and place.

  47. I did have an epidural with my son and had to be induced. I also tested positive for group B strep and so have an IV of penicillin going into my arm. All that on top of being RH negative definitely made the hospital the right environment for me to have my baby. I would be interested in trying the more natural route if possible next time. We are currently trying to conceive #2 but I wouldn’t turn down another epidural if I really feel like I needed it. I did not need a C-section though…

    1. Being RH negative really should not have any effect on where you birth since the rhogam shot is given during pregnancy. I am also group B strep + and still had a birth center birth and a homebirth (they can still give you antibiotics in both settings just like in the hospital). I’m not telling you this to be a know-it-all…rather so you can see that you still have options even with those things 🙂

  48. I agree that Being Pregnant in America was pretty biased. However, how did Business of Being Born say that hospitals were evil? They presented less popular facts and statistics related to birth that can shed hospitals in a negative life (and I think it is crucial to be educated in all aspects of birth). Moreover, the Cesarean of the filmmaker who had a breech baby emphasized that there’s is a very real need for hospitals and OB/GYNs as well.

  49. At the time of her birth my baby was in a transverse lie and the staff at the hospital tried everything to get her to turn head down. No luck and before the baby could go into distress I was taken in for a c-section. I’m so glad I was in the hospital at the time. I got a beautiful baby out of the process and mom and baby did just fine.

  50. I am with you – it’s all about options and knowing what they are in order to make a decision. I was actually one of those people that said that I wanted nothing but a scheduled C section years before I got pregnant. When I got pregnant I started doing research, watching movies you listed above, and joined a couple of classes. Halfway through pregnancy I was on the “natural labor” bandwagon. By the end of my pregnancy I was on the “let’s be flexible but have a goal in mind” bandwagon. I’m glad that things went as they did and I got as close to natural birth as I could (I ended up getting an epidural MINUTES before I started pushing – long story….it is posted though) and we’re all pretty sure that they didn’t actually give me any drug aside from the initial small push because I was able to stand up during and after labor. It was painful, but I’m glad I had the experience.

  51. I have always been a fan of KERF, and always hoped that you would have kids so that you could have equally healthy and fun blogs about food, kids and health!! Congrats to you and Matt!
    I agree with your post. I seriously considered a home birth, but wanted an ER next door down, just in case, so we choose a hospital with my Dr. (OB) no midwife (just a great hubby, like you). I had an epidural for the first and went naturally with second and third. I didnt like the feeling of not being able to feel!! Either way, all births were incerdible – by far the best moments of my life! I also read Ina May’s book and it so inspired me to try natural and luckily I had no complications and short labors, so I lucked out. You will do great!! Just wanted to share that I am a fan and so happy baby KERF is on the way for you (and me!) Looking forward to your adventures!

  52. I’m due in December and my “birth plan” is to go into the hospital and come home with a baby. That’s it. My “worst case scenario” would be for that not to happen. Everything else is details to me, honestly. Would I like a natural birth with no intervention? Sure. Am I pinning my hopes and ideas of what a “successful” birth is on details like that? Absolutely not. There is enough emotion surrounding childbirth and post-partum that I don’t want to set myself up to be disappointed when I will (hopefully!) have a beautiful baby to enjoy.

  53. I haven’t seen this documentary, but I did watch the Business of Being Born and felt the same way. Sure, there were some good points in there, but so much of it was just scare tactics that I didn’t like it much.
    I think it’s dangerous that people are starting to turn OBs into villains. When I miscarried my first pregnancy, I was treated like dirt by my supposedly holistic, crunchy midwives. And at the hospital, scared and needing surgery, I met my OB, and he was wonderful, and talked with us, and I stayed with that practice through this pregnancy and they’ve been nothing but responsive and wonderful. I just think the “midwives good, OBs bad” dichotomy is so dangerous. There are good and bad healthcare providers, period, regardless of title.

  54. Fairly long-time lurker, first-time poster. The Business of Being Born just pissed me off. I realize that I am one of the 2% who truly needed a c-section (frank breech, retinal neovascularization), but that movie still made me feel like less than a “real woman”. I had a high-risk (type 1 diabetes) pregnancy, so I got really used to being told what to do and when to do it. And I had a perfect, healthy 6lb 9oz baby at the end. A scheduled c-section is a little weird – you walk in, no contractions, have a baby ~2 hours later. I kinda wish I’d experienced some of a natural birth, but at the end, I got my healthy little guy. Good luck to you and keep an open mind!

  55. I think it is important to know WHY things have changed so much over the time, that women were forced to give birth while laying on their backs just for the convenience of the doctor for example.
    Of course we are lucky to have such great medial help, but we should see it as it is- a help when it is necessary and only then.
    Not all doctors are evil, but the majority do things for money/hospital statistic/convenience. I am glad to hear that you have found a normal hospital though.
    Overall, I believe women should be empowered. Being able to get pregnant and give birth is a sign of such strength and everyone, from a midwife over a doula to a doctor should help women feel strong and have the best birth experience possible.
    Also what bothers me is how some people talk about c-sections. While it sometimes is unavoidable, it is a big surgery and causes trauma, and it is not something that one should chose if things are ok.

  56. I’ve had 3 scheduled c-sections. Although not ideal, there are medical reasons some people need them. You can make a c-section special if that’s what ends up happening. My doctor is very caring and really made the experience special for us. I don’t wish it upon anyone and yes, I do wonder what giving birth feels like but my kids are my trophy not my birth story!

    1. I do see the plus now to a scheduled one – since there’s no rush you can make it more special and ensure you get to see the baby right away and things

  57. The reason there is an increase in doctors performing c-sections in the US is due to the fear they will be sued for malpractice should anthing go wrong during the birth. I had my twins here in new zealand where individuals cannot sue doctors. I had a very complicated birth but my OB was comfortable (and promoted) having a vaginal birth as she was not motivated by the fear of being sued but rather what would be the best option for optimal outcomes. We need to realize the litigious nature of America has changed the way our health professionals make decisions.

  58. Good for you for wanting to go natural for as long as possible…to each his own! I was adamant about having a natural birth but was also worried that when the time came I wouldn’t be able to handle it. Needless to say, I did (it was not easy!) but I’m happy I got to “experience” the labour and birth (some women may think I’m crazy for saying that,lol!) The one thing my doula said before i went into labour that really resonated with me was that most women “give up” once they get to 5-6cm, and she told me that if you get that far, you can make it the rest of the way…it was true (for me at least!) Also, my llifesaver were those little black combs which I held in each hand and squeezed with every contraction…they put the focus elsewhere. Sounds crazy, but it worked-the nurses had to pry them out of my hands when it came time to push!! Lol!

    1. I second the 5-6 cm thing! With my first in the hospital, I hit 5 cm and my OB came in and told me she thought I should get an epidural (I didn’t want one and also had a doula with me along with a supportive husband). This was my least favorite OB out of the 4 in the practice. Because my doula and hubby knew how much I wanted a natural birth, they were able to stall for a bit to get me “over the hump” (guess my doula also knew about the 5-6 cm thing!). When the new OB came on and checked me and found me to be 7cm, she said to me “I really think you can do this without an epidural” and that was ALL I needed to hear. I went on to have a natural birth with my first who was also 9lbs 4 oz! Sometimes all it takes is true support from those around you instead of doubt that you can do it–makes all the difference in the world!

      1. Wow, I don’t know if I could have done it with a 9-pounder…my son was only 6 pounds! lol! I think our doulas know what they’re doing!! 😉 Didn’t it almost seem like once you got past 7cm, going from 7-10cm was “easier?!” (if that makes any sense!)

        1. Sure you could have! I am a firm believer that it’s not the baby’s weight that determines the ease of labor and birth but rather the mom’s positioning and movement during labor. My biggest baby (10lbs 4 oz!) was by far my easiest and least painful labor (it was also at home). If a baby is in a good position and mom is able to move and stay active throughout the entire first stage of labor, the birth usually goes well.

          All these diagnoses of “failure to progress” that cause most moms a c-section, are usually moms that were stuck in bed and not able to move (usually due to an epidural or constant fetal monitoring due to being on pitocin) and the baby can’t get in a good position for birth. Also being upright and moving can open the pelvis by up to 30% more than when a mom is in bed. 1-2 lbs of baby fat surely isn’t going to be the major determination of whether or not a baby can “fit” but more likely that it’s the mom’s positions that matter most. After all, fat is squishable–we’re not talking about 2-3lbs of extra bone 😉

  59. I wish I had gone longer without an epidural. The epidural did not work for me, but despite the fact that I could feel every pain, I wasn’t allowed out of bed because I had had an epidural.

    I was on Pitocin because the baby’s heart rate was dropping so they were trying to speed things along. Pitocin + back labor + non-working epidural + not being allowed to move around much = basically awful. 🙁

    So if you can handle the pain without drugs, handle it for as long as you can.

    1. That’s interesting that they gave you pitocin when you’re baby’s heart rate was dropping because pitocin often leads to fetal distress–thus the higher c-section rates for moms who have pitocin. I also had back labor with my first and it is excruciating! Glad it all worked out for you in the end!

  60. I think it’s funny to hear so much anti-OB stuff these days, because I remember my mom, aunts, and grandma being anti-midwife when I was young. Maybe it’s a generational thing?

  61. I read quite a few bloggers birth plans before I gave birth myself and I have to say you seem to be the most practical about it. You just don’t know how things are going to play out! I gave birth in a specific hospital solely because I love my OBGYN and that’s where she delivers, Their rate of epidurals was over 90% (it was never “pushed” on me fortunately) and that did concern me, but the fact that this hospital is very mom and baby friendly more than made up for it. They believe in not separating mom’s from their babies and allowed us to stay as a “guest” after I was discharged but my baby was kept an extra two days for jaundice. I cannot imagine if I had been forced to go home and leave him there!!! With all that being said, I did not care for the poking and prodding you get at the hospital after the birth. There wasn’t a half hour of peace EVER. I believe in making the epidural decision in the moment based on your needs then, and that there is no shame in getting one if you choose to. For me it was completely based on how long my labor was (long) and how high they had the pitocin cranked up (all the way), causing labor to be more painful. I tried but after almost 24 hours and no end in sight just couldn’t take it anymore. As Matt questioned, in my case pitocin absolutely led to an epidural. I am so glad to read that while you know your preferences, you are also very open minded! That is going to help you tremendously when you finally get to that point. Good luck, you’ll do great however it unfolds.

  62. Sometimes pitocin + epidural = a calm stress free vaginal birth. At least, both of mine were (8lb 6 oz, and 9lb 12oz). No tearing, no stitches. Easy peasy. My hubby and I had some of our most cherished heart felt talks during the hours of waiting for our boys to come while I was laid up (and happy) with my epidural. However it happens, let it be joyous.

  63. Kath, great post today on balance of hospital care! My friend had a baby in December and hoped to experience child birth naturally. She was at I think about 35 wks and her baby was breech. She had an appt. with her doctor to try to flip him but in the meantime, her water broke. At this point, her doctor said she had to do a C-section. My friend asked if there was ANY way she could deliver naturally and the cons outweighed the pros, so she had one. I know she wouldn’t have chose it but it was the best for the health of the baby in the long run. It is so good to have in mind as many scenarios and how you would want your doctor to react to them so you feel on the same page. My friend was very thankful this doctor was frank with her and her baby was born (albeit c-section, boo for her) healthy!

  64. You might be interested in watching “No Woman, No Cry” – Christy Turlington’s documentary on maternal health in developing countries. It was truly fascinating – I think the documentary follows a pregnant woman in Tanzania and Bangladesh, and also looks at a post-abortion care clinic in Guatemala (where many women attempt an at-home abortion b/c it’s illegal) and a free prenatal clinic in a low-income part of Miami – I think this last part was to show how a low-income, uninsured pregnant American woman differs very little from a pregnant woman in a 3rd world country. Where in the US, you hear about many women trying to have home births and as little intervention as possible, in developing countries they are actually trying to encourage more women to seek medical intervention! There are so many barriers to access for these women – money, distance, cultural values, distrust of medical personnel, lack of education about their bodies and pregnancy, and all this leads to more maternal and infant deaths. It made me incredibly grateful for the opportunities I am afforded by living in the US, living near hospitals, having health insurance, being educated, being a member of the cultural majority, etc. Check it out! 🙂

  65. Like many women, I wanted my birth to be as natural as possible and I wasn’t comfortable with being far from a hospital setting. I was so lucky to be able to deliver in a birth center that is part of a hospital. The midwives in the birth center and the OBs in Labor and Delivery work together and the respect for all birthing scenarios was evident. It was comforting to me to know that I could labor as long as possible in a birth center with balls, stools, tubs, etc but that if there was an emergency or I wanted an epidural, I could be transferred two floors down to L&D with no problem. I wish every women had the option of this type of scenario. I feel like it took a lot of stress off of me as a first-timer who really wanted an unmedicated birth.
    The funny thing is that my birth- as most women will tell you- was nothing like I imagined. Ironically, my labor was so fast that by the time I got to the hospital, it was time to push. I didn’t end up using all the tools that the birth center had available, and even if I wanted an epidural, there was no time. Haha.

  66. hey x just seen your blog…i am also 23 weeks preggers…my first baby and i am loving being pregnant!! Especially now that I am feeling the kicks a whole lot more! My husband also felt the first kick last tuesday…amazing. When are you due……I am due sept 4th…feels like ages but sure it will fly by!!xx

  67. here’s a happy induction story for you: i was induced about two weeks early because my blood pressure was higher than my ob/gyn was comfortable with. i was very worried about the same ‘induction-pitocin-c-section’ scenario. i got a dose of cervadil at 1pm and again at midnight, and at 7am i was started on pitocin. by about noon i was still not dialated past a 1 or 2 and was getting uncomfortable. i chose to get an epidural (it was fantastic and not at all scary-i had been more worried about that than any other aspect of birth my whole life!!) but was very worried about not progressing since i got an epidural before i was even 3 cm dialated. but by 5:30 i was a 10…pushed for an hour (laughing…telling jokes…it was great) and our daughter was born at 630pm. so. induction isn’t always bad, and pitocin doesn’t always lead to c-sections. in my experience, anyway!

  68. Hi Kath!
    I very rarely comment (I think I did to congratulate you on your announcement post) but I’m a pediatrician and i have to applaud you on your attitude to this whole birth thing! I have to be present at many vaginal deliveries in the hospital if there’s any complications (like meconium) and ALL c-sections. And really, NOTHING else matters at that point when the baby comes out (to me OR the family) except for making sure the baby is healthy, regardless of the manner in which he/she was born!!! I have also seen worst case scenarios that came to our NICU after being born at home and having things go wrong….not good. Hope everything goes as you would like it to, but glad you are going to be within helps reach, just in case:) Excited for you!!

  69. Just another perspective:

    I gave birth to my beautiful son in February at the age of 41. I had no trouble getting pregnant – in fact his conception was a big surprise. Other than a bout of sciatica in the third trimester I had a very easy pregnancy. As a technical ‘high risk’ patient due to my age using a midwife alone wasn’t an option for me.

    At 40 1/2 weeks my doctor suggested induction as my blood pressure was slightly elevated. I never had much of a birth plan – I basically wanted to be sure my baby arrived healthy and that I was in the least amount of pain possible.

    I went in on a Monday night and had Cytotec. I was woken up a few times to check vitals but had a pretty good night’s sleep. They started Pitocin early the next morning. After 2.5 hours of painful contractions I opted for an epidural. I got incredibly itchy as a result and got some IV Benedryl. I went from 1.5 cm the day before to 6 by 10 am. Because of the Benedryl I slept most of the afternoon. I was 10 cm by 3:30 pm.

    I pushed for 40 minutes and Ryan was born.

    I understand people have reservations about interventions and concerns over epidurals but I have to say – I was incredibly relaxed throughout the whole process and Ryan’s birth was as trauma free as I can possibly imagine. When in the final stages of labor I felt plenty of pressure and knew exactly when I needed to push so I don’t think I missed out on a thing.

    I fully believe everyone is entitled to make their own choices when it comes to their labor and delivery plans. I for one never had any intention of not going to the hospital or experiencing natural childbirth and I would not have had it any other way.

  70. I’ve been reading Baby Kerf for a while (I’m only 14weeks myself) and I have to say that this is my favourite post on this blog so far

  71. Thank you Kath for this post! Well I’m going to express a view I fear will be unpopular. It’s a perspective that I think is a little taboo in these types of discussions. I’m going to go a step beyond most commentors who say that interventions like c-section are fine when necessary. I’d go so far as to ask what’s the matter with opting for them for convenience? I’m not ignorant to the issues – I’ve read my Robbie Davis Floyd and all about the natural birth movement. I get it. I understand why some woman want to go that route. It is a wonderful choice. But plenty of women (myself included) know the ‘medicalized birth’ critique and would still choose it over natural birth. Because, I personally don’t care all that much about the experience of birth. I gotta be honest and say I’m not looking for a transformative experience. And I don’t feel guilty about that – I don’t feel wrong for being indifferent about that. Whatever puts the baby in my arms the fastest and with the least inconvenience to me is what I want. Maybe that’s elected c-section, who knows? Sometimes I get the feeling that many plugged into these debates want to write this view off as ignorance and as simply not understanding the ‘real’ patriarchal issues at play but it couldn’t be further from the truth. In fact I am proud feminist who is very much up on these issues, but who is also highly suspicious of the contemporary equation of inconvenience/suffering with ‘good’ motherhood. I’ve seen the insistence on doing all things ‘naturally’ contribute to this dogma. ‘Natural’ can be as oppressive a force as it is an liberative one, in my opinion, depending on how it is wielded. We don’t stigmatize and attach moral significance to ‘convenience’ around other forms of medical care but we do it around women and childbirth choices. Why??? That concerns me.

    1. Interesting viewpoint!

      I think the main drawback might be cost of healthcare since a C/S is certainly more expensive than a natural birth. I’m not sure what the implications are for both your insurance or the trickle effect if everyone woman just elected to have a C/S. If all births were the same price, you bring up a great point – freedom to choose.

    2. Laboring physically prepares the child for entrance to the world. (This is one thing I think the Business of Being Born actually did well. It’s a complex dance we don’t understand fully) In general, babies come when they’re ready to be in the outside world, so electing baby’s birth date isn’t best for it. Labor also prepares the mother emotionally.
      If I had to choose between a very difficult birth and a c-section I’d still choose the former. As a mother, it helped me make the transition from pregnant person to mother. And a vaginal birth is much MUCH easier to recover from than a c-section.
      And I would not describe birth as suffering. There’s a difference between pain and suffering, and that’s incredibly important.

      1. I wouldn’t make generalizations like “a vaginal birth is much MUCH easier to recover from than a c-section.” There are way too many factors at play. I had a very difficult vaginal birth – pushed for three hours before my son was finally removed by forceps. Almost 2 years later and I am STILL dealing with issues stemming from delivery. I wish now that my doctor had called it earlier.

        1. I think the recovery time has a lot to do with the individual rather than the method of birth, but a c-section is major surgery that has serious side effects. I don’t mean to minimize your experience.

          1. My experience has been that the c-section was WAY easier to recover from. Ive still got issues from my vaginal birth which, I think, will never go away. And it’s been 3 years. Of course it’s an individual experience. But that’s exactly why you can’t say it’s always easier to recover from a vaginal birth as opposed to a section. The side affects from my first delivery are still with me, not quite 11 months later all I’m left with from my section? A scar and some itching every once in awhile.

  72. Have you read Ina May’s book called Birth Matters? That seems to be the closest she’ll get to actually making her own documentary about birth. (Or maybe it’s not – we can always hold out hope ;)) She talks a lot about working to make hospitals safer for mothers and babies during labor and birth and what sort of options qualify a hospital to be labelled mother-friendly or baby-friendly. Very interesting read, although if you haven’t yet read her guides to childbirth and breastfeeding, read those first. (I know they’re on your list.)

  73. This is by far my favorite Baby KERF post. Thank you so much for being open minded and informative.

  74. Hi, Kath!!
    I am a long-time reader, but I have never actually commented. I am 14 weeks along with my second pregnancy, so I love reading this blog!

    With my first daughter, who is now four, I was determined that I would have a natural birth. Maybe even some sort of water birth, because I truly feel that a woman’s body is designed for natural childbirth.

    Well, I was 41 weeks, not dilating at all, and ultrasounds estimated she was close to 10 pounds. My Doctor (who actually delivered me) laid out the options. I could be induced (which was scary to me) and try laboring on my own but he guessed I would end up in labor for quite a long time, and end up needing a c-section anyway. Or, I could just come in the next day and have a c-section.

    My husband and I discussed it, and chose the c-section. This was a really hard decision for me because I had heard so many terrible stories about epidurals gone wrong, but everything worked out perfectly!! Getting the epidural was the worst part. I had a smooth recovery, my daughter latched on right away, and my scar is itty bitty.

    I just wanted to give you my perspective on the whole thing. This time around I think we are going to schedule a c-section again. This is my last pregnancy, and I’m not willing to risk taking a chance at natural birth and having my scar/uterus split open.

    Good luck!! Whatever happens, you will be amazing. 🙂

  75. I was induced at 40 weeks after my water bag started leaking and my labor hadn’t really started by 24 hours. I was fully ruptured at 24 hours and the pit was started. After 2 hours of the most excruciating pain I could imagine (full-dose pitocin is evil) I was getting really tense with each contraction – despite my wonderful doula-like husband and nurse supporting, holding and breathing with me.

    I asked for and got my epidural at 3 cm. It was the best decision I ever made. All I felt was a little pinch and burn from the local anesthesia on the back (which was nothing compared to my contractions). I was finally able to relax, rest, nap a little, and actually enjoy and BE PRESENT for the rest of the process. Whether it was from the pit, the relaxation, or both, I dilated from 3 to 10 in 3.5 hours. I felt plenty of pressure despite the epidural, and was able to control my pushing AND let my providers know when I thought things were progressing.

    Oh, and I also got a “half-epidural” – it didn’t get to the right side if I was on my left side; luckily I was covered when on my back.

    One tip for pushing – mine became much more effective when I took advantage for my yoga practice (and the nurse’s suggestion) and started to incorporate pelvic tilts into each push – tipping the front of the pelvis toward my chin, flattening/curving the low back. I pushed for 45 minutes.

    I had wanted a natural “homebirth in the hospital” but it just didn’t work out that way. But I felt empowered throughout because I trusted my family doctor (not OB or midwife…) and just concentrated on the moment at hand and the end goal – my healthy little girl.

    Good luck! Enjoy your last months of being a 2-person family 🙂

  76. I watched both of those films while pregnant, and I agree that they are very biased, and probably end up scaring some women! I went into my birth wanting to labor as long as possible at home, and have a natural, drug free birth at the hospital. I ended up being induced. I had heard horror stories about induction, but I feel like I actually had an INCREDIBLE birthing experience! Sure it wasn’t my first choice, and I couldn’t move around quite like I wanted, but my hospital did let me bounce on a ball and move a bit. I just wanted to share because I know it is one scenario that people normally describe as absolutely awful, but for me, it wasn’t bad! I think you are smart to research everything. The best piece of advice I received was not to go into it with your plan too set in stone. Know your stuff and be flexible, going with the flow will allow you to have an amazing experience, regardless of the circumstances!

  77. I am just going to jump on the bandwagon and chime in as well. From my own experience, I had planned for a natural birth, no epidural, but in the hospital (my BFF is an OB and she did a good job of educating me, fairly, about the benefits of hospital births). But after two episodes of syncope (that would be passing out cold, for no known reason in my case) during my pregnancy I was placed on house arrest, no driving, no going out alone, and induced at 37 weeks. I had back labor and chose to have an epidural because I really, really didn’t want to be overwhelmingly exhausted, drained by the pain and pissed off when I met my son. The right choice for me.

    As for home births, I know many folks feel like they would have time to get to hospital if anything were to go wrong with a home birth, but unfortunately it just isn’t the case…and why take the risk. One of my dearest friends had a very normal pregnancy but when she delivered she immediately began hemorraging. Immediately. She was rushed into surgery where she remained for 4 hours. She lost a ton of blood, she lost her uterus. But she survived as did her baby. Had she had the baby at home there wouldn’t have been time. I really, really don’t tell this story to be sensationalistic, I tell it because I don’t want mothers and babies in our first world country to die for silly reasons. As long as you are a strong advocate for the birth experience you want to have but are open to weighing your desires with the safety of the baby and yourself you can have a good, natural childbirth in the hospital. But ultimately is the goal to have a natural experience or a healthy baby and mom???

  78. Great post! Just wanted to share… I have the essentially exact same “plan” as you for the birth of my first and he ended up being breech and we had a planned c-section. It was beautiful, he was beautiful and I recovered like it was nothing. An absolutely, amazing experience and although I felt a bit of disapointment when I found out I was going to have a c-section, I would not change that experience for the world! For my second, I was determined to have a v-bac and was trying for no drugs. However after 24 hours of labour (which for the intense part… esentially once I got to the hospital after about 8 hours of labouring at home…. although I had lots of plans of different positions, the ONLY position I could hold without the pain overcoming me was to stand and sway!) I had what they call a “walking epidural”. It was essentially just enough for me to rest and for my body to relax and let it to it’s thing. For me, this was awesome… I was still able to stand, walk (for short distances) and go to the washroom. They also let it wear off as the baby got closer and closer to coming out, as per my request. Once I was ready to push, the edipural was completely gone and I was able to have FULL control over pushing. The pain was essentially exruciating (sorry!), but it was so purposeful!!! Once again, beautiful experience, beautiful baby! If I had not had that epidural, I am sure I would have been in for another c-section, as I would have been much too exhausted to push.
    Good luck!

  79. Kath, you are very smart to educate yourself on all the birth options/possible outcomes. With my first son I labored and pushed but he was not moving down so we ended up with a c-section on my doctor’s advice. I was totally unprepared for it and had a hard time afterwards dealing with the physical and emotional aspects. If I had read up more on the possibility I believe I would have had an easier recovery. I ended up with two scheduled c-sections for my other sons b/c the issues were the same and I had a much better recovery. so, I just wanted to add that if you go in hoping everything will go to plan, but prepared to veer from the plan if necessary, emotionally/physically you will be in a better place.
    Good luck to you!!!

  80. OBs and hospitals are certainly NOT evil…but what it does come down to is how they are trained to interact with laboring women. Everyone must understand that OBs are trained surgical specialist…they are surgeons…and they like to do surgery (which is a good thing when you really need a c-section!) The problem becomes when a low-risk woman goes to a higher-risk care provider for her care. You cannot expect a care provider to change how they always practice for YOU. I tell my students it’s like going to McDonalds and asking for pizza. If your birth plans is a bunch of “I don’t want ____, I don’t want _____, We’d prefer not to have _____” then you probably are not with a provider who’s a good match for you. A truly good match doesn’t need a birth plan!

    So instead of going to an OB when you desire a low-intervention birth, choose a care provider who wasn’t trained using surgery as a major option and one who doesn’t routinely do the things you know you don’t want.

    Lots of other countries have already figured out the balance of low risk women going to low risk care providers (midwives) and high risk women going to high risk care providers (OBs or perinatologists). The countries that have this balance are also the ones whose c-section and intervention rates are right on par with what the World Health Organization states should be the maximum % of c-sections–no more than 15%! Anything over that has NOT been proven to improve outcomes for mom or baby and in actuality, causes more problems since a c-section is a major surgery.

    The other aspect here (and to address what you said Kath about those women who NEED a c-section) is trust. When you choose a care provider who respects you, your questions and your needs (emotional as well as physical), then you have trust with that person and when an intervention becomes necessary, you know in your heart that it is truly necessary. With my first OB, I asked her what their episiotomy rate was and she replied “We only do them when necessary.” She would NOT give me a %. This was right after she “kindly” reminded me that she was the one with the degree in medicine. My point is that had I had an episiotomy, I likely would have felt negative about it and like it may not have been necessary. Fast forward to my midwives with my second and third births. They were very open about what their episiotomy rates were (1-3%) and they treated me and my concerns and questions with respect. So had I ended up with one at one of those two births, I likely would have felt ok with it because I TRUSTED them.

    While I strongly favor midwives for most women for many, many reasons, I do not have anything against OBs–what I do have a problem with is their use of lots of interventions that have not been found by science to be helpful to large majority of moms and babies. I strongly recommend Henci Goer’s book “The Thinking Woman’s Guide to a Better Birth” to better understand all the of the most commonly used interventions and what the studies have really shown when it comes to their effectiveness for labor and birth–not to simple speed up the process for care providers who don’t want to be patient with the laboring mom (and yes, this includes midwives).

    1. I think the problem is the choices are limited. I would have loved to go to a midwife who worked in a hospital where emergencies could be handled, but the one we have here was already booked solid. I would also love a birthing center connected to a hospital, but we don’t have one. And obviously moving is unrealistic 🙂 And insurance also sometimes really limits this. But I think like the food industry, as more and more women are requesting, seeking out and supporting the use of midwives, the more they will become mainstream options.

      1. I agree Kath and things are definitely starting to change within the birth community! For a long time, midwives were held back by ACOG (American College of Obstetrics and Gynecology)…and there is still a HUGE power struggle that goes on between OBs and midwives–which really ends up hurting birthing women. There is no reason they can’t work together–god knows there’s enough pregnant women to go around 🙂

        And yes, there’s a reason the midwife in your area fills quickly–women are now demanding the kind of personalized, supportive care that most midwives give. I know you think those movies you watch are sensationalized but as someone who has worked in the birth field for the past 10 years, I can tell you that there really are BIG problems with it. When one out of every 2-3 women who walk into a hospital end up with surgery for delivery, that’s a sign that something is VERY wrong! If all our c-sections were truly saving more moms and babies, we wouldn’t be rated so low on the infant and maternal mortality charts.

        I think us “birth workers” get so frustrated because most OBs (and some midwives) are not practicing evidenced-based care. They are continuing to do things that have been proven beyond a shadow of a doubt to do more harm than good in labor and birth. And that’s why you’re seeing this back-lash in these films and in books like Henci Goer’s or Ina May’s. BIG change needs to happen–and fast– and it’s not going to happen by tiptoeing around the issues.

        As I said in my previous post, finding a good balance isn’t hard and it many other countries have figured this out. But in our country, birth (and especially high-intervention birth) is a HUGE money maker and it’s going to take major change to shift the focus from $$ to laboring moms and their birthing experience!

  81. There is a wonderful CNM in my area and as I’ve talked with my Dr about getting pregnant, she STRONGLY recommends that I go to an OB/GYN due to my normally high blood pressure. I was disappointed at first but realized that the point of getting pregant is to have a healthy baby (and retain my health as well), so if that means an OB/GYN instead of a CNM, so be it!

  82. When I was pregnant with my first (who turns one tomorrow- 🙁 where, oh where did time go?) my worst “nightmare” was having to end up having a c-section. I had met my due date and still no baby so my Dr. said we’d go ahed and induce the next day because she said there is no reason that the baby needs to stay in there anymore. I felt the same way and I wanted her out! I was beyond uncomfortable and my ankles and feet were so swollen, I had terrible hip pain and wasn’t sleeping a wink. So we went in and I got hooked up to the pitocin. They tell you it works fast and it really does and it IS painful. I wouldn’t say that I have a low threashold for pain, but it was an agonizing pain. In less than 4 hours I was feeling pretty strong contractions and was 4 centimeters dialated. Now when you’re on pitocin, you are also hooked up to fluids so you have to get up to pee a lot. I think I was up at least every 30 minutes because the urge to pee is so strong and you really do have to pee. After the last time I got up to pee I was hooked back up to the monitor and by daugther’s heart rate dropped so the nurse came in. She tried checking me and “couldn’t find my cervix (seriously?!) so she called in the doctor. Dr. checked me said I was 4 cm and then she said “oh wait, that’s not a head, that’s a butt.” I immediately broke down in tears because I knew what that meant. They tried telling me that she must have just flipped when I had gotten up to pee but I know that wasn’t the case because I would have felt it. I was pretty sure she had been in the breach position for a while. Long story short, I ended up having a c-section and looking back it wasn’t really all that bad. I know it’s major surgery, but I recovered pretty well so I wouldn’t say that it was that bad of an experience. I do sometimes feel as though I was “cheated” out of experiencing childbirth, but yet I don’t know that I want to try a VBAC (which my dr. said was possible) when we have another child. My friend, whose son was born three days after my daughter, torn so bad that she was in pain for weeks and all they told her to take was Tylenol. They didn’t even send her home with 800mg Motrin…at least I got pain meds and was feeling really great in about a week. Bottom line, have your birth plan in place, but be open to anything an everything, because in the end it’s all about getting your baby out in the best way possible for your situation. 🙂

  83. Great post, Kath!

    I believe that I am more knowledgeable going into childbirth for the second time. I want to experience what it is like to have natural birth without an epidural. However, depending on the circumstances, I may consider an epidural. But as for now, I am aiming for natural childbirth.

    I am hoping that I do not have to have a C-section, though, so I can experience the real deal.


  84. I wanted a natural birth my first time. I wasn’t anti- epidural (i figured, I take Tylenol when I’ve got a bad headache) but wanted to see if I could do it. I’m not a huge fan of hospitals and, quite honestly, didn’t know I was having a baby when it happened. So, when I didn’t feel good, I figured it would pass…after 2 hours I woke up my husband to ask what he thought – that we should go to the hospital – so I consented. On the 20 minute drive, suddenly, yep, those were contractions…and, yes, 2 minutes apart. We FINALLY got there, got checked into my room and was asked if I wanted an epidural. I’m not ashamed to say, I fairly shouted YES! at the nurse but I was too far along. I pushed for 1 hour and 45 minutes (pretty much as soon as we got to the hospital) and finally, with the help of an episiotomy, major rippage, and the vacuum, delivered a baby girl. I’ve heard of others who’ve had some issues with delivering their babies but never talked to another person who took as long as I did to heal with a ‘natural birth’. With my second baby, I was terrified to make a decision about the birth. I didn’t want to do something that could harm him in any way, nor did I know how I could take care of a toddler and a newborn if I could barely move (as per my first birthing experience) for 3 months. I finally ended up deciding on a c-section and it’s the best decision I could have made. The recovery was less than 6 weeks, I felt a MILLION times better than after the birth of my first. If I have any other kids, I’ll be choosing to do it that way, too. I’m kind of sad to know that I’ll never do it naturally, but being a good mom, for me, trumps trying to steer clear of medicine and medical interventions. Thank God for hospitals and doctors!
    I think, in the end, it’s not one way or bust…different people and experiences merit different choices. I’ve heard a billion horror stories about doctors and hospitals, and quite a few about the awfulness of midwives too. I’ve also heard good things about both. Every thing has a season, a time. And nothing is ever completely black or white.

  85. I’m a new fan of your blogs and I like your perspective on food and now on pregnancy/childbirth. I had positive births for both of my kids, one with and epidural and one without only because it all happened too fast.

    After reading some of your posts on katheats I went to order Intuitive Eating and saw that there is a new edition coming out in August that has a new section about raising intuitive eaters. I thought you might be interested in knowing that with the baby on the way.

  86. Thank you. Thank you for saying that about TBOBB because I 100% agree with you (as does my husband) but have met very few women who shared my opinion that it was majorly biased and overdramatized.

    Btw, if it weren’t for modern medicine, I might have bled to death when I had my son last year. Everything was completely normal and there were zero complications before and during labor. However, my body simply just did not quell the bleeding itself after my son came out so my midwife had to swiftly intervene with a couple of medications (Pitocin and Cytotec…I was vehemently opposed to Cytotec, yet my hippie-esque midwife said she had had very good experience with it post-labor and, indeed, it worked very well for me in that context.). As someone who wanted as little intervention as possible and labored freely with almost none, I am thankful she was there and that I was in a hospital. 🙂

  87. My best friend did a natural home birth because she didn’t have health insurance, and she was initially terrified. She had always had a low pain threshold, and her dad is a doctor, so she had wanted a hospital birth and an epidural. Unfortunately, without insurance, she didn’t have much of a choice. She had a fantastic midwife, did all the research, and the birth went smoothly. In the end, she loved her birth experience. Now she’s a big proponent of natural birth. A few months ago, she was talking about homebirth and all that, and paused to say that she knows that some people HAVE to have C-sections. That was when I told her that I was born in a C-section. I was 2 weeks late, almost 10 pounds, and showing no signs of coming out any time soon. According to the doctors (granted, this was the 80s, before natural birth was all the rage), neither Mom nor I would have survived if it hadn’t been for the C-section.

    That’s a really long way of saying you’re spot-on. Every mother is different. Every birth is different. We need options and a chance to make informed choices.

  88. I was induced 3 days after my due date when testing confirmed that I had cholestasis (which is very rare and you probably won’t need to worry about) and subsequently my daughter was at an increased risk for stillbirth–not to mention that I was unbearably sick and itchy from it! I am so grateful that I live in a time and place where induction is possible. I can’t even bear to think about what could have happened if I hadn’t had such access! And for the record, I had a ton of Pitocin and an epidural and no c-section–it is possible!

  89. I think a lot of it comes down to awareness and patient advocacy. This isn’t limited to birth. Most of my relatives on my maternal side work or have worked in medicine, and when my mom was diagnosed with breast cancer, she had to fight tooth and nail as her own advocate, because nobody was going to do it for her. She demanded options, which everyone in my family has learned that most medical providers do not sufficiently discuss. This also isn’t necessarily anyone’s fault. It’s just circumstance. A doctor is limited by his education and experience (and insurance regulations. Big one, but that’s a whole other argument!). You can’t really force him to do (or know) something for which he has no experience or education. If you feel he cannot or will not offer the care you feel you need, by all means search around. Doctors are not infallible, and neither are midwives. Show respect, but don’t treat one care provider’s word as gold.

    My mom was induced when she had me and both my sisters. She even admitted that if her doctor hadn’t been fully aware of her family’s medical background and been confident she wouldn’t sue for malpractice, he would not have let her “get away with” as much as she did (moving around, not rushing too much, not having a section, etc.). She’s one of the very rare people I have met who induced and did not C-section.

    I personally am going to be in a very unique position. I have uterine didelphys (double uterus+cervix), which puts me at a far greater risk of breech and preterm birth. Most care providers have little experience with my condition and are likely to push as many interventions as possible (because that’s what they know, and there are very few conclusive studies done on this specific condition), and most women I’ve met with this condition are so scared of their bodies that they’ll do whatever one medical professional tells them. I’m not saying that I plan to discount anything a high risk OB tells me. But I’ll also take all opinions with a reasonable amount of study, thought, faith, skepticism, and lots and lots of prayer. Do I want a natural birth? Yes. Am I willing to seek out the wisdom of experienced OBs and midwives who are not rattled by my condition, even when that will take me 400 miles away? Absolutely (disclosure: my family lives there and have been expecting a situation like this since I was diagnosed at age 12), Am I also willing to let go of my ideals in the event a real problem arises? In a heartbeat. I also have to learn that the decision to submit to a cesarean does not mean you have failed or lost all control. Even during surgery, you have rights as a patient, and a choice in how you, your family, and your child are treated every step of the way. Own it. 🙂

  90. You’ve obviously had LOTS of feedback and stories on this topic, so I’ll spare you the details of my experience… except to say we LOVED our hospital, did need medical help throughout and after L&D, and we all went home healthy and happy. Can’t wait to have #2 at the same hospital this September (I’m just a couple of weeks behind you, I think). 🙂 It’s so interesting to read everyone’s experiences and thoughts. Thanks for opening this discussion up!

  91. I’m not going to go into my opinions on birth and birthing here because I feel like that’s a little too intense for a comment field =) But I did want to say that I tend to side with the natural side. I did not like Pregnant in America, but I did think that The Business of Being Born was pretty accurate – it certainly reflected my personal experience with a hospital. My first pregnancy with my daughter was high-risk and my husband and I were not given a choice in our care; we had to find a specialist who dealt with the problem that we encountered and that was that. But this pregnancy is not high risk at all, so I’m going with a birth center. My home is not particularly conducive to home birth because it isn’t emergency accessible if something happened, and the midwifery center allows us to work in conjunction with my high-risk OB from my first pregnancy as well as with the midwife. I can request emergency transport at any time, I’ll be very near a hospital with a NICU, etc. And I’m really looking forward to it. If something happens, then obviously my plans change and they can slice me open without anesthesia for all I care. But I’m happy to know that the illegal things incompetent doctors did to me in the hospital last time are less likely to happen this time around.

    The truth is that I really wish there were better options. I shouldn’t have to choose between birthing somewhere that is arguably safer because of all the emergency options available – but where women’s health is often manipulated for the sake of business and expediency – and somewhere where I’m more comfortable and where the care is more woman-centered – but where emergency care is more difficult to come by if something takes a turn for the worse. I wish there were better choices available to women in America, but there aren’t. Before I was ever pregnant, I was with you on this, that hospitals were the way to go. But if you’ve had a horrible hospital experience it’s no less traumatizing than a horrible homebirth experience, and you’re just likely to swing the opposite direction, so now I believe birth centers and home birth are the way to go. I wish there were a middle place.

    1. I should say that I also really strongly believe that alot of how your experience goes comes down to knowledge and advocacy. If you know what you want, know what your rights are, know enough to ask for multiple opinions, and consider alternatives – you’ll be fine. I don’t believe it’s ever a good idea to blindly trust one caretaker – whether OB or midwife or nurse or all of the above, they’re all just human – and I think it’s a very good idea to trust your instinct and your body. If you think something’s wrong, don’t listen to other people, look for answers. And if you like the way your care is going, then stick with it. The first time around, I didn’t know enough to advocate for myself when doctors illegally administered drugs against my express wishes. I didn’t know that if I said “NO” then they weren’t allowed to give me morphine “to slow me down because a bed isn’t ready yet” for example, and I had a very negative reaction to the morphine so my labor then spiraled out of control at 10cm dilation – and the problems related to that persisted for months postpartum. Had I known better, I would have done better.

      Hospital or not, it sounds like the fact that you’re educating yourself on your choices and rights is evidence enough that you’ll be okay whatever your choice.

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