For many women, a positive experience can be hard to come by. Ask around and you will likely discover this for yourself. It is all too easy for a woman’s birth to slip out of her control and into the hands of procedure, routine, the clock, concern for liability, etc. But the key to a positive birth experience is not complicated; it does not require voodoo, chanting, or even homebirth. When it comes to having an empowering birthing experience, it all comes down to something quite simple: making informed choices.
From the moment you get pregnant and throughout the labor & delivery, you will be faced with a plethora of choices and decisions: Will you have a “dating ultrasound” at 7 weeks? Will you drink the glucola drink to test for gestational diabetes? Will you deliver at a hospital, birthing center or at home? Who will you choose to be your clinical care provider— a midwife, an OB, a family doctor? Will you have a doula? What childbirth education will you do? Will you have an epidural? Will you have a hep-lock / IV? Will you consent to an artificial rupture of your membranes and / or Pitocin if labor slows or stalls? Will you do intermittent fetal-monitoring or continuous? Do you want delayed cord clamping? Will you complete all of the standard newborn procedures, including Vitamin K, Erythromycin, and the Heb B vaccine? How do you want to spend the first hour of your baby’s life? What are the risks, benefits, and alternatives to all of these choices? Phew!! Are you overwhelmed yet? And these are just a few of the choices that you will be faced with… welcome to the great responsibility of parenthood!
It can certainly be overwhelming and even confusing at times, and I think because of this many women simply defer to public consensus or their clinical care provider. But, in deferring to anyone but yourself, you run the risk of handing over your autonomy, body, baby, and birth to someone else. When it comes to pregnancy and birth, there are many tests and procedures that are standard care— but with any test and procedure, there are risks and benefits associated with it. Anyone who does their research will quickly discover that there are often expert opinions advocating for opposing positions. As a parent myself, there have been times when I have been brought to tears because of this— I just wanted someone with the facts that could tell me what was truly best for me and my baby; but the more research I did, the more I realized that no such person exists and that the power of decision was in my hands and my hands alone: for only I could truly judge what was best for me and my baby; only I could effectively weigh the risks and benefits.
When I was in labor with my first baby at Hartford Hospital, the choices I made were not fully informed (despite having been very well-prepared for birth with HypnoBirthing® and having done quite a lot of research on the choices available to me). I knew I wanted a natural birth, did not want Pitocin or an epidural, and definitely did not want a C-section. But, with my mother and husband as my support people, we were left unequipped to handle making informed choices during the labor. We were all vulnerable and none of us were experts when it came to birth. When my labor stalled at 7cms and after a few hours of no cervical change, we were left feeling vulnerable and confused. The midwife suggested AROM (artificial rupture of membranes) to help move things forward. Despite this procedure carrying many risks (including increased risk of infection and cord prolapse), I was not told of the risks and was made to believe it was “no big deal”, despite it being a major intervention. My membranes were ruptured but my body did not respond and several hours later, I found myself on Pitocin, for now my labor was really on the clock (risk of infection due to the artificial rupture of membranes) and talk of a possible C-section began. The Pitocin was quite intense and shifted my experience of labor dramatically. After several hours on Pitocin, my baby boy was born and we were all elated, but I did not get the natural birth I wanted and my “choices” were definitely not informed. I was left with regret, wondering what had happened to the birthing experience I sought and wondering how and why I made the choices I did.
Now that I am a doula, I realize how little support I actually had while I was in labor making those choices and I know for certain if a doula had been present, she would have helped me to see that I did not need any intervention, for I was doing well and the baby was doing well and oftentimes labor slows down and rests for a bit. She would have explained the risks of AROM and enlightened me on alternatives to try before going down the road of medical intervention. And, ultimately, she would have empowered me with the information I needed in order to make informed choices…. maybe there would have come a time when AROM or Piton would have been the right choice for me, and she would have helped me recognize that. If my choices were fully informed with the risks, benefits, and alternatives, then I know in my heart I would not have any regret about the way my labor and birth went.
I believe that is true for all women: even if you don’t get the birth of your dreams (and we often don’t), if you know that every decision you make for yourself and your baby is FULLY informed, then it will be impossible to have any regret and to feel nothing but empowerment when you reflect on your birthing.
As a doula, I have seen many mothers be faced with choices they had hoped to avoid, but with information about their choices and fully understanding their options, they all made the right choices for themselves and can now look back on their experience with satisfaction and a sense of empowerment, for they own their choices and experience and they know that they were in control… not their doctor, midwife, nurse, or doula….
So, my advice to every pregnant woman seeking an empowering birthing experience: do your research now, educate yourself on your options, don’t just consent to a test or procedure because it is the standard of care, ask many questions, trust your intuition, and hire a doula (I wish I had!).
Ellie Lindenmayer provides birth doula services to the north shore of Boston, the greater Boston area, and seacoast New Hampshire.
