Something to prove

"We have a secret in our culture, and it's not that birth is painful. It's that women are strong. "
Laura Stavoe Harm

After my hospital birth last Monday, I went downstairs to All Children's to talk to my friend who still works there. While I was sharing a picture of the baby and the details of the birth, a former co-worker questioned why anyone would want an unmedicated birth, "does she have something to prove?" His comments stopped me in my tracks. Was he serious? What does this mom have to prove? What do moms who plan unmedicated birth have to prove? Well, a lot actually. 

When women plan an unmedicated birth they are proving that birth is normal. When you are in labor there is not a DAMN thing wrong with you. Why would you want to use drugs during physiologically normal process? The pain of labor is gradual and rhythmic. Non-augmented labor pain will only take you as far as your body can handle and no further. Your body doesn't know that there is an epidural waiting for you at the hospital. There is an end to every contraction.

Moms who are having unmedicated birth are often surprised at how fast it can go. Once a steady rhythm has been established unmedicated birth is often quicker than those with epidurals. The great thing about unmedicated birth is that you can move. You can walk around, get in the shower or tub, do whatever position your body is telling you to do! This is probably one of the reasons why it can go a lot faster than the births where the mom is strapped to the bed.

There is this great myth that epidurals will save you from the pain of labor and birth. I've been to over 15 births where epidurals have been used and I can tell you first hand that that's not always the case.  Some epidurals leave spots of sensation, you still have pressure and sometimes they don't work at all. However, even if your epidural "doesn't work" that doesn't mean that you're again free to move around the room. In fact, once the epidural is placed you are now tied to the bed, almost literally. IV to saline (often Pitocin as well), blood pressure cuff, fetal monitor, contraction monitor and pulse ox are almost routinely required once you get an epidural. Not to mention the joy of the indwelling catheter to collect your urine now that you can't feel your lower half.

Epidurals are a great resource. I'm not anti-epidural. They can truly help preserve vaginal birth, in some rare cases. However, epidurals are often the first step in a cascade of interventions that lead to an operative deliver, either via cesarean or vacuum/forceps. When women are accepting an epidural are they truly doing so under informed consent? Have they weighted ALL the risk (increased risk of invasive interventions like Pitocin, major abdominal surgery, effects to the baby?) When you have a woman who hasn't eaten deli meat, soft cheese, or had any caffeine for the past 8 months but gladly accepts an OPOID epidural, we have a major dichotomy on our hands which leads me to believe they haven't been properly consented. Why would you subject your body and your baby to the increased risk of complications and additional interventions when there is a better way?

Having a doula at your birth has been shown to reduce the incidence of Pitocin, operative deliveries and the mothers request for pain medication. Epidural anesthesia has become the hospitals version of a doula. It offers pain relief while leaving the mother attached to the monitors, which have become the new labor and deliver nurse.  A doula is your labor partner, your coach, your cheerleader, your tour guide as you navigate something you may not have experienced before. "You can do this, you are doing this," is often all a mom needs to hear as she goes through the most intense time of her life. Why would you not want to be completely present at your birth? This is the most powerful day of your life!

The question shouldn't be what do moms who plan an unmedicated birth have to prove, the question should be what do moms who plan a medicated birth have to fear?