I will have you know that I googled “doulas near me” and did find that there was one an hour away. This was 2007 and doulas were not quite as known as they are now. I thought to myself, meh… I don’t want to spend the money and that is too far away. So on I went with my pregnancy. Blissfully unaware of what was to come. Without making this entire article about my first birth story we will say that I ended up with what felt like every intervention in the book while still having the baby come through my vagina. After that birth, I vowed to learn everything I could…. And now I have dedicated my life to childbirth! I went on to have 3 natural water births and I serve hundreds of families as a childbirth educator and doula and I have learned a lot in my 12 years in the field. I am here to tell you want REALLY helps when planning a natural birth.
So, what is the point of natural births? First of all, there are no medals in birth and this is not about bragging rights. Every birth is valid and every birthing person is amazing. Natural birth does have some amazing benefits to birthing person and baby and here are a few:
This and choice of provider are the most important decisions that you will make for your birth. Dr Neel Shah, OB/GYN, says that your number 1 predictor of cesarean birth is your place of birth . Do not enter into this decision lightly.
If you are planning a hospital birth, it is important that you research your hospital choice, including their cesarean rate. Here is an analogy: If you are wanting sushi, don’t go to the Italian restaurant. Even if they are nice and want to help you have some sushi, it will not taste the same as sushi from a restaurant that specializes in making it. So too, if you want a natural birth, you want to go somewhere that sees it regularly and knows how to support it well. If the hospital has a 50% cesarean rate and an 85% epidural rate, they do not see normal physiological birth very often. It is true that natural birth can happen anywhere, but you don’t want to have to fight for what you want and you want staff who knows how to support it well. Even well-meaning providers and staff may have a difficult time support normal, physiological birth if they do not see it very often.
Freestanding birth centers are on the rise! While they are not yet in every community, they are a great option for low risk pregnant people. Do not confuse a hospital maternity ward with the words “birth center” in their name with an actual freestanding birth center. Some L&D wards have inaccurately started to market themselves as birth centers due to their growing popularity. While there is nothing wrong with choosing the birth in the hospital, it is very different than birthing in a birth center and should not be marketed as such.
Low Risk Pregnancy
Freestanding birth centers do not offer labor induction or augmentation with pitocin, epidural or other pain medications (though many offer nitrous oxide!), or cesarean sections. They are also not a good choice for someone who is higher risk. The provider (typically a midwife) will monitor the birthing person and the baby similarly to monitoring in the hospital and if needed, will transfer to the hospital in case of needed interventions or distress. If an epidural is desired, transfer will happen for that as well. The statistics show that 84% of those who begin labor in a birth center will birth there and 93% will have a spontaneous vaginal birth, regardless of if they transfer in labor or not. That means, that birth centers have a 6.1% cesarean rate , which is amazing! Freestanding birth centers are a good option for those with a low risk pregnancy who want a natural birth.
Home birth is similar to birth center birth, just in your own home. Despite much misunderstanding among the general public, the same emergency equipment is brought to the birth including anti-hemorrhage medication and oxygen. Home birth providers, typically midwives, are trained to monitor pregnancy and birth well, transfer if the individual risks out during pregnancy or birth, and intervene when needed. Also similar to birth center birth, home birth is a good option for low risk pregnancies.
Also similar to birth center birth, home birth is a good option for low risk pregnancies. Stats show a 5.2% cesarean rate and primary reasons for transfer were non emergent “failure to progress .” When considering home birth, it is important to interview midwives and ask important questions about how they handle different situations and about their training and experience. Home birth midwives are trained and experienced in physiological birth and know how to support it well. If you want sushi, they are the sushi chef!
Birth location is a personal decision. There is not one right way to have a natural birth. Consider where you would be able to let go the easiest. Interview and tour different providers and facilities. And also listen to your intuition.
After considering your birth location, you will want to consider your provider. There are generally three types of providers who attend birth: OBGYNs, Family Practice Doctors, and Midwives. Each tend to approach birth differently and it is important to research the differences. It is important also to consider the providers general policies and beliefs around the birthing process. Ask lots of questions . What is their cesarean rate? Why do they tend to induce (including if they induce at 41 weeks)? What is their episiotomy rate? There are many important questions to ask your provider during interview. I think we sometimes forget that we are in charge and we are the one hiring them, not the other way around. It is also helpful to ask the local birth community, if you have one, which providers tend to be most supportive of natural birth. Doula groups, for example, tend to know which OB/GYNS are natural birth supportive (rather than just paying lip service to it) and which family practice doctors and midwives are especially awesome. Depending on where you live, your options may be more limited. Even if there are not many options, it is still important to ask questions and make your preferences known far ahead of time.
Doulas are statistically proven to decrease cesarean rate, increase satisfaction with the birth experience, and decrease the use of pain medication and labor augmentation medication like pitocin. They offer a continuity of care, physical, emotional, and informational support that is absolutely essential to those planning a natural birth. While not all those who hire a doula will have a natural birth, having one by your side can significantly stack the cards in your favor. Additionally, a doula is an essential part of a medicated and cesarean birth team. They have a special role that is different and complementary to the role of the partner, nurse, and medical provider.
Some childbirth classes are mostly “here is how to be a good patient at our hospital.” These are not the best childbirth classes for those planning a natural birth. The best childbirth classes will cover things such as:
Childbirth education is not just for the pregnant person, it is extremely helpful for the partner as well. This is something that they have maybe never done, or only done a few times, and learning about the process and the choices that can be made is important for the birth partner because during the labor process they will be needed to speak to the staff and help the birthing person consider their options when the birthing person is in “labor land” and not as much in their “thinking brain.” Our favorite birth classes are Hypnobabies and Lamaze based classes.
Pregnancy and birth is a unique and amazing physiological event and preparing well for. It includes specific body preparation to optimize the process. Our prenatal program, One Strong Mama , teaches how to specifically prepare the body for birth through our innovative Body Ready Method. It focuses on exercises that help create mobility and balance of the pelvis, yield of the pelvic floor, support with the core, and more. Preparing the body is an important, yet often overlooked part of preparing for natural birth and we do not recommend the old school recommendation of 100 kegels a day, which can actually create issues.
You would not go into an athletic event thinking “I can’t do this” and during the event you would not think “I can’t, I can’t, I can’t.” This is a recipe for a really difficult experience. High level athletes prepare their brains just as much as their bodies. The same is true for birth. We need to do the work ahead of time to prepare our minds to be able to let go during the strong sensations of birth. There are many ways to do this.
Hypnosis , pregnancy affirmations, and practicing having a calm mind during more challenging yoga poses are all excellent options.
Distressing one’s life also helps prepare the mind to be able to be calm and collected during birth. If milk spills on the floor we can not control that it happened, but we can control our reaction to it. We can choose to freak out or we can choose to sigh and calmly clean it up. Of course there is a range between these two reactions. Choosing our reactions to life’s stress and having tools to be able to de-stress in hugely important before entering the birthing process and also for being a parent! Life skills!!
We cannot control everything about the birthing process. Even among those planning a natural childbirth who do “everything right,” sometimes unanticipated interventions will need to occur. Maybe even a cesarean. Yes, many interventions are used too frequently and that is why it is so important to educate yourself about them, but truly they are not evil and they are very necessary sometimes. The best we can do is prepare well ahead of time, set the stage and have an amazing team during the process of childbirth, and then let go. The only predictable thing about childbirth is that it is unpredictable. However, when you prepare yourself ahead of the time, you stack the cards greatly in your favor for a natural childbirth!
We would be honoured to support you on your marvelous journey.