Unpopular opinion: why I don’t think you should be encouraged to have a natural birth.
But I do think you should be made aware of the realities of the system you’re giving birth in…
There’s a really fine balance when it comes to talking to pregnant women about birth - between being honest about what is ahead of you and not scaring the sh*t out of you - and we definitely don’t always get it right. But the important thing is that we keep trying. To speak openly and honestly to women like you so that you are supported to have the best possible experience.
When it comes to giving birth, of course the safety of you and your baby is absolutely paramount. But unfortunately, the reality these days is that little of the intervention that’s offered in hospitals is based on good quality evidence that’s been shown to improve outcomes.
Instead, giving birth within the NHS has taken on a ‘conveyor belt’ approach to care, where interventions are offered routinely to everyone on a ‘just in case’ basis, instead of acknowledging every pregnant woman as an individual with her own unique background and needs. Increasingly this is resulting in women experiencing traumatic births that could have been avoided if policies weren't being prioritised over patient care.
There are lots of issues with this approach to care, but two of the biggest are these:
Nobody seems to be acknowledging that when not needed on medical grounds, many of these interventions can actually end up doing more harm than good and can escalate the likelihood of the need for more significant interventions further down the line. Induction is a prime example of this. When offered because it’s medically necessary, induction of labour can be a lifesaving intervention for mums and babies. However, when induction is offered for other reasons, such as being ‘overdue’ or for a suspected ‘big baby’, there is little to no evidence to suggest that it improves outcomes. And what’s often not communicated to women when they’re offered induction is that it’s not a risk free process, it can be long and painful and sometimes unsuccessful, and it increases your chances of requiring a C-Section, amongst other things.
(If you’re being pushed towards booking an induction and you’d like to know more, In Your Own Time by Dr. Sara Wickham and Why Induction Matters by Rachel Reed are great places to start your own research).
Women are often unaware that all of the things being presented to them are optional. The culture of many hospitals, and the pressures faced by the NHS overall mean that when interventions are being offered to women, it’s not being made clear that they have a choice to accept or decline. It should also be the case that you are given a balanced view of any intervention being offered, meaning that as well as a justification for offering an intervention and the benefits it can bring, you should also be told about any downsides including potential risks you your and your baby, so that you are able to make a fully informed decision on how you wish to proceed. You are fully entitled to decline any offers of care made to you during your pregnancy - from being weighed and giving urine samples at midwife appointments to accepting an offer of an induction or a C-Section. The care you are offered should be on a collaborative basis, with you able to ask questions, be given options and your care providers working with you to find a path of care that works for you and your individual needs.
And then to add to the stress you’re already feeling, along comes the toxic positivity of the ‘natural birth brigade’ to confuse matters even more. Those who only want to tell you that your body is capable of giving birth without intervention or assistance, that if you can stay calm it’s really not that painful, and you have everything you need within you to be able to do this entirely by yourself.
Yes, for the vast majority of women, our bodies are completely capable of bringing our babies into the world without medical intervention. BUT the bit that often gets left out of the conversation is that there’s a whole host of factors that play a part in this, such as being able to create an environment that supports your body’s ability to produce optimal levels of several different birthing hormones which move the process along. And often - particularly if you’re birthing in a hospital - that’s something that is out of your control, especially if you’re unaware of the significance of it.
And the worst part of all this? If you don’t seek out your own information on how birth works, how the process needs to be supported to happen naturally by those around you, you will likely end up experiencing a birth that isn’t what you’d hoped for, and feeling like you’re somehow at fault for it.
Yes birth is a natural process that your body is more than likely capable of without intervention. But for this to be true, the process also needs to be trusted and supported by those around you, providing your care and impacting your immediate environment, not to mention the impact they can have on your confidence and self belief.
So why am I telling you all of this? Not with the intention of causing upset or distress, but to make you aware that this is the reality of the system in which you will be giving birth. Because if you know, and you have hopes for a particular type of birth, you stand a much better chance of achieving it if you’re prepared for the fact you may well have to advocate for yourself in order for your wishes to be acknowledged and supported by your care providers.
All of this is to say that the reason I don’t think you should be blindly encouraged to have a ‘natural’ birth, is because you will be birthing within a system that simply doesn’t support it. Yes, there are many midwives and other individuals within the system that do support natural birth and if you are lucky enough to come across them, they’ll no doubt do their best to support you in this - but ultimately they are bound by the policies and guidelines of the trusts in which they work, so they are limited in being able to offer you this kind of support.
Encouraging women to pursue natural births within this system, with no context or acknowledgement of how complex this can be, is just as bad as ‘offering’ interventions without truly ensuring women know that they have a choice. It all leads to the same outcome… women who feel guilt over something that they are in no way at fault for.
So how can you support yourself for the best birth possible? Educate yourself. Read books that will teach you about the process of birth. Take an antenatal course like hypnobirthing which will teach you about how your body works and all of the ways you can best support yourself through labour and birth. And most importantly? Know that however your birth happens, there is no hierarchy of ‘good’ and ‘bad’ births, nobody is handing out medals at the end for those who did it ‘right’. Guilt should have no place in birth… you created an entire human being and brought them into this world, you should be celebrating yourself for what an incredible achievement this is, regardless of how it happens.
