What Decisions You Don't Get to Make when Planning a Natural Birth

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Answered by: M. Adele, An Expert in the Pregnancy: Labor and Birth Category
"So you're knocked up," the midwife told me, a congratulatory smile stretching her cheeks. Her easy humor and vibrant energy felt like something I would like during labor and birth. I had a lot of decisions to make, most of which I had never thought about even once.

Over the course of planning a natural birth, I learned so much. Crazy stuff was happening in organs I couldn't have identified a year ago, and the options available to deal with it all were overwhelming. Like many new mothers I was a little obsessive, planning for all possible outcomes and trying to find my sense of control in a new territory riddled with unknowns, misinformation, and some real danger. As expecting mothers, we have a myriad of choices available to us, but I'd like to share with you some of the choices we don't get to make when planning a natural birth.



We get to choose our care-providers; we don't get to choose how they manage the birth. Ultimately, every provider has their own way they like to do things, and when you're strung out on oxytocin and adrenalin, a well-intended suggestion has power to really change your game-plan. If you have strong feelings about pain medication or labor augmentation, it's best to choose your provider with that in mind.

We can choose who comes with us; we can't choose what they do. Many mothers expect their husbands, partners, or other loved ones to support them during the birth, and almost no one plans to give birth completely alone. You may successfully entice/convince/coerce your partner to attend all your birth classes with you, but remember, when the head starts crowning their role is changing as much as yours is. Some dads are amazing in the delivery room and others are squeamish, detached, panicked, or not around at all. Your best bet to prepare is to communicate really clear expectations ahead of time, be as understanding as possible, and bring in a professional doula to fill the gaps and support your whole family.



We can choose what to learn; we can't choose what we remember. You may watch every water birth video on YouTube, and you may read a hundred holistic happy birth stories, and that is all excellent preparation. Just be aware, you will forget that perfect breathing pattern you learned right when you really need it. The horror story your great-aunt told you about umbilical strangulation will definitely drift through your mind during a really rough contraction. By all means, keep encouraging and helpful material in mind, but be forgiving with yourself if that's not all that comes out.

We can choose what we want; we can't choose what we get. Of course, scary complications are unlikely to happen during any particular given birth, and that's what we're betting on when we plan to have a natural birth. However, we don't get to dictate every aspect of our birth, and you may experience the unexpected, ranging from mild but surprising variations, to terrible and frightening complications. Talk ahead of time with your partner, doula, and care provider about what you would prefer in the case of an emergency cesarean section, unexpected birth defects, and the death of the baby. You won't want to make those decisions once you know you need to. More probably, knowing you have a plan for all the outcomes that worry you can give peace of mind while you experience your beautiful, healthy birth.

You have so many choices ahead of you, ranging from mundane to extraordinary. Clear communication with care providers, family members, and labor support professionals can help tremendously with all expected and unexpected events of birth. Make wise choices now, but remember, your own birth story may surprise you!

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