Being Pregnant
Why Aren’t More Women Choosing Natural Childbirth?
I have been encountering this question repeatedly since I started my journey to become a Lamaze teacher, and the more statistics I see, the more the pieces are falling into the puzzle.
It started when I began reading the Official Lamaze Guide preparing for the Lamaze workshop I was going to be taking last July.
Within the first couple pages of the book (page5) I came across some amazing statistics focusing around a survey of real mothers from 2002. The Listening to Mothers Survey.
” In spite of evidence, U.S. maternity care continues to sabotage normal birth rather than support it. In 2002, the Listening to Mothers survey learned that among nearly 1,600 new mothers across the U.S., 44% had labor induced, 71% did not move freely during labor, 93% had electronic fetal monitoring, 86% had intravenous lines, 74% gave birth on their backs, and almost 50% of their babies spent the first hours after birth with hospital staff. Only 1% of the women experienced all six care practices that promote normal birth, and none of these women gave birth in a hospital.”
The six care practices they are speaking of are the base for what Lamaze teaches in childbirth today.
Lots of alarming statistics in there. Of course the survey only included 1,600 women, but it does give us a real look into the way women are giving birth today, despite evidence showing these practices are outdated, unfounded, or harmful rather than helpful.
44% of women had their labor induced!!
That is a huge number for labor induction, especially since labor should only be induced in a medical situation. Letting labor begin on its own is key for a successful natural birth experience for so many women. It is also the way our bodies are meant to work, and the natural stages of pregnancy, and life in general. We need to stop interfering with a natural process with no indication of actually needing to step in. Inductions lead to more epidurals, more cesarean sections, pit to distress, and many more complications including premature babies.
71% of women did not move freely during labor.
Being confined to a bed while laboring is not ideal by any means, not only does it decrease the size of your pelvis, but it also can cause lowered blood pressure, and fetal distress.
93% had electronic fetal monitoring.
Even though numbers of studies have shown no improved outcome to mothers and babies with electronic fetal monitoring. Also, recently there has been a number of controversial articles about fetal monitoring and how providers, or medical professionals are reading the fetal heart tones. Many think that the over analyzable of small decelarations in fetal heart tones is leading to a higher rate of unnecessary cesarean births.
86% had IV Lines.
Meaning, the hospital providers had easier access to give mother things like pitocin with or without her consent. If I had a dime for every woman that told me she was put on pitocin without even being asked, or told it was going to be starting in her IV line, I would be a millionaire! Unfortunately until women start complaining about this practice, it is not going to change.
74% gave birth on their backs.
Which we know is probably the worst position for a woman to give birth in. I recently wrote about this in two posts, Positions You Should Be Giving Birth In Part 1 and Part 2. Decreased pelvis size, blood pressure complications, lack of gravity to help with the birth itself are all huge factors in the lithotomy position.
50% of babies spent the first hours of life with hospital staff!
Horrible! After birth, in those first few hours, it is the most critical time for mother-infant bonding. Between breastfeeding, skin-to-skin contact, and the hormones a mother releases with birth, it is so important for these babies to be with their mothers, not with a stranger.
Only 1% of these women experiences all 6 Lamaze Healthy Birth Practies
Surprising, but not all that surprising to me. Of course they were not in a hospital setting, because if they were in a hospital, they would not have experienced all 6, or even just a few. Hospitals are becoming more and more unfriendly for normal birth practices, as well as less and less Mother & Baby friendly.
So is it really women who are not choosing natural births, or is it the hospitals making it impossible forthose who do wish to have a natural birth experience?
photo: flickr.com/amcdawes
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christine commented on Mar 10 11 at 11:03 amI have a question about all this. How do you object to something in the hospital, if you don’t want it to happen? I know, for sure, that I’m going to want to move around during labor. I already have back issues and know I will need to stretch and not be in the same position. Is it something I put in my birth plan? My doctors are all very reassuring but it seems like the hospital staff, who knows who they will be, will really be in charge.
Danielle625 commented on Mar 10 11 at 11:05 amI would say put it in your birth plan, and let those who are supporting your during your labor (partner, nurses, providers, etc) that this is what YOU want, and what YOU WILL be doing
christine commented on Mar 10 11 at 11:21 amThanks :) It seems daunting, knowing that I won’t probably be at 100% and trying to stay true to myself and what I’d like to happen.
Jacie commented on Mar 10 11 at 11:32 amHire a doula and gain confidence in yourself. You are a consumer, they work for you. Sure some things might be a bit inconvenient for them but you are in charge. Keep in mind BRAND. If they are wanting to do something always ask questions. B what are the benefits? R what are the risks? A what are the alternatives? N what if we do nothing? D decide what is best for you and your baby regardless of what they want to do for the sake of convenience!
Diana commented on Mar 10 11 at 11:47 amI’m under midwife care now and, with 5 weeks left, am already feeling like she’d encourage me to induce if I go much beyond my due date. (This is a completely normal pregnancy and the baby is not in any danger.) I’ve expressed to her that I want a drug free birth and as little intervention as possible. She assures me that she’ll ask me before she does anything but I’m a little wary that the hospital staff will abide.
It’s frustrating to have so few options. I’m jealous of mom friends of mine who live in other states where home births are widely available.
Susan Alexander commented on Mar 10 11 at 9:22 pmI had a hospital birth and I’d say I came darn close to the 6 practices. The only things I allowed – heplock and continuous monitoring (during the pushing phase) were simply because this was my first VBAC. I labored entirely at home and got to the hospital 10 CM.
Next time I plan to decline the heplock and ask for intermittent monitoring (actually I’m going to ask if we can do it via fetoscope!). We’ll see how it goes – I don’t know my new OB or midwife yet and won’t until September after I move. :)
Sarah commented on Mar 10 11 at 10:20 pmI want to encourage women who want to try for a natural birth in a hospital setting – it is possible! I had a natural birth in a hospital, and I didn’t meet the 6 care practices – although that was our goal when we wrote our birth plan. We were successful because my husband and I were well educated and informed about our birth plan – enough so that we could make informed decisions and adapt when the doctor got nervous.
Yes, I had electronic fetal monitoring, yes the doctor got nervous about my daughter’s heartbeat, and yes I delivered on my back. But when I arrived at the hospital, I was free to walk around, get in the shower, sit on my ball, and would have been able to push in any position had circumstances allowed for it. Do I think our doctor was over cautious due to the monitor? Yes. Was I still able to deliver my beautiful baby girl naturally? Yes. Our nurse was awesome, she was the only one on staff who didn’t think I was crazy for going natural. It’s too bad more doctors don’t encourage it, they all seemed to be waiting for me to ask for the drugs!
My hospital was very pro-breastfeeding and definitely respected our wishes in terms of having the baby on my chest right away before any bath/weight/etc.
I had wanted to try a birth center and couldn’t due to insurance … but in hindsight I really enjoyed trashing the hospital bathroom for a few days after and not needing to clean up after myself for a few days!
emily commented on Mar 11 11 at 7:01 am“i really enjoyed trashing the hospital bathroom for a few days after and not needing to clean up after myself for a few days”
sarah,
you sound like an ignorant piece of trash.
That's Mean! commented on Mar 11 11 at 7:40 pmGosh Emily, Calling Sarah an “ignorant piece of trash” is HORRIBLY rude and mean! She was probably trying to be funny I would assume… about not having to clean up after ourselves the same way at home. Why do people get so mean online?
I had all four of my kids at a hospital. No one made me do anything I wasn’t ok with. I don’t see why fetal monitoring is some kind of sin. You know, back in the covered wagon days, before that, all those years… they had babies without these things simply because they didn’t exist. Having your baby at home isn’t natural, its a choice plain and simple. Want to be natural? GO have your baby in a cave or in a field. THAT is natural. I am so sick of people harping on Drs and hospitals. So what if I pushed while on my back> That is what worked for me and that is what I chose to do. So what if 2 of my kids were induced? The pitocin actually made my labor much LESS painful and my contractions more efficient since the first 2 labors were so erratic. That worked for me. Its not the end of the world. Get over the birthing “experience” why do we women make everything about US. Its about the safety of the baby, period.
Dorsha commented on Mar 11 11 at 7:41 pmI went into labor 1 week after my due date. After four hours they gave me pitocin with out asking. I was also told I HAD to have an IV for fluids. Not up to me.
Ellyn commented on Mar 11 11 at 7:53 pmEmily, you sound like a judgemental twit.
Now that the name calling is out of the way and we all can act like adults here, I don’t agree with some of the numbers above, and how it seems like natural birth mommies seem to think there is an evil conspiracy hospitals have and look down on other moms personal decisions.
What are their terms for inducing? My terms are straight up cold jump starting labor. I don’t consider myself induced because I contracted at home for 22 hours before going to the hospital and I did end up getting some pitocin and my water broke to make sure my labor wouldn’t stall. My body was doing wonderfully, and for the most part I was free to walk around, curl up during contractions, do what I felt would help. Some women think for some reason this means I was induced and I don’t agree with that.
Also the on your back percentage.
Did they also count the women who opted for an epidural? They shouldn’t be counted if so. Id like to see what position you can get into when your legs are deadened. I don’t really think its realistic to include that number of women into the equation since its not exactly going to work trying to get into other positions.
that’s just some of the thoughts I have.
I also think it should be mandatory for OBs to sit and talk about what options are available for the mom, and the us needs to make a bill of rights for laboring women. The hospitals where I live have great “pro choice” standards, explaining all options thoroughly and side effects and procedures that may need to happen before the need arises so the mother is informed. I know all hospitals aren’t like that, which saddens me.
Randi commented on Mar 11 11 at 8:03 pmI have had 2 labors induced and have had two healthy vaginal deliveries. The second was “simpler” than the first, but both went pretty well. While I completely understand that there is a large group of women out there who think that fetal monitoring, IVs, and pitocin are horrible, I think there is also a very large group of woman who do not. My labor was induced because my husband was about to deploy for 6 months. I didn’t want him to miss the birth of our son because he missed it by a handful of days. To me, it was worth using pitocin and an IV line to help get things moving so we could experience a handful of days together with our newborn before he left the country. I realize that all women are different and that we all have different expectations and desires. I hope that birth can go exactly as each woman would have wanted it to. But, I will say as a woman who is perfectly fine with an IV line, blood pressure cuff, and an epidural, please don’t make it sound like my labor and delivery was horrible and unnatural just because you (general you) think women should deliver in some other way. I don’t judge home birthing women for their med-free deliveries, please don’t judge me for my hospital delivery either. It was still a wonderful experience that I will never ever forget.
Danielle625 commented on Mar 11 11 at 8:11 pmEllyn – I am the author of the above, and I am having a c-section with this child, so I am by no means one of those women you are talking about, this following two previous c-section deliveries also.
When it comes to “inducing” that means starting labor, when a woman is in labor already, and pitocin is used it is considered “augmenting” labor or helping it along.
As for the numbers above, it is not a study, it is a survey. You can find more information about the Listening to Mothers survey : http://www.childbirthconnection.org/article.asp?ClickedLink=205&ck=10068&area=2
Melissa commented on Mar 11 11 at 8:12 pmIt is very difficult to have a natural childbirth in the hospital. My goal was have a natural childbirth. I took the Bradley classes and wrote my birth plan out of what I had wanted. I did all the research and ate a healthy diet. But as a result of developing high blood pressure and preeclampsia I was induced. I had to fight to be able to get to 38 weeks. I took almost every natural remedy I could and thankfully mad it to 38 weeks. Once I was at the hospital they hooked me up to all the monitors, IV and everything even though it was in my plan that I did not want them. I was told I could deny it but it was going against medical advice and then my insurance would not cover it. I was able to move around as much as I wanted but was difficult due to the monitors and I was able to use the tub. But they really push the drugs on you. It is very difficult to get away from it. I really wished I could have had a natural birth.
Shelly commented on Mar 11 11 at 8:37 pmI am one of the “medical cases” you mention in your post…if it were not for intervention my sweet blessings would not be here. My doctor and nurses were wonderful and allowed my husband and I to make our own choices. I don’t know if it is the same at all hospitals but ours has a “Patient Bill of Rights” stating that in a nutshell they cannot MAKE me do anything ie.if I am uncomfortable with a on call nurse I can request a new one, which by the way I have done.
In my circle of friends and family the natural way is almost looked at as the “holy” way to have children, (if it were so mine would not be here) I am VERY glad for the women who have wonderful births at home, at a hospital, “natural” or not as long as momma and baby are healthy and the parents are making a decision they feel is best, why get so worked up about it?? Love your neighbors, no matter how they give birth.
Tina commented on Mar 11 11 at 10:08 pmI have had two natural births in two different hopsitals and would say that going in with a birth plan and being informed about birthing procedures is the best policy. With my first my husband was there and we didn’t go to the hospital until I was 6-7 cm dilated. Of course the nurse looked at me like I was crazy when I said not drugs but when she saw that I could handle and manage the pain (mind you I was on my back when i arrived and gave birth that way, so not the easiest way) she stood behind my decision and literally cheered me on until my first son was born. When I went into labor with my second son my husband was deployed and we were lucky enough to be able to get him on video teleconference during the labor and delivery. I had a doula this time around for my birth coach. My nurse actually thanked me after my second son was born. I was a bit puzzled and she said it is very rare that she actually gets to use all her training. So there are nurses out there who will support you and can help you acheive your goals. I am due with our third in 10 weeks and yes will be delivery at a different hopsital and plan to walk in with my birth plan and my mind strong. As far as natural moms judging others, I think its important to understand that it is very impowering when you conquer birth without pain relief and interventions. But as many have said birth experience is very important and if a mom is unable to manage her pain for what every reasons she shouldn’t be judged. My hope is that more midwives will be brought into OB practices so that women have all options available to them!
Kelly commented on Mar 11 11 at 11:17 pmI believe that the reason a natural birth is not encouraged at a hospital is because it is easier for your nurses and OB’s to hook you up to machinery and forget about you. It takes time for a woman in natural labor to deliver. If you are on Pictocin you can be scheduled to when it is convenient for your doctor and they can hold you off to meet their schedule. I feel that natural labor requires a support system and strong will. If it were not for the coaching of the nursing staff and my mid-wife I do not believe that I would have had the natural delivery that I wanted. My former OB plainly said he would not be there for labor support so if I needed encouraging I should bring someone along qualified to coach. That is the reason I switched to a mid-wife. We each make decisions everyday about what we think is best for our child and that starts in the delivery room. I just wish people took more time to educate themselves about birthing options instead of trusting that the OB is doing what is best for you. They are doing what is fastest for them because that is how money is made. Interventions and labor augmentation were developed to make safer deliveries, but I feel that they are over-used in America for convenience.
jaimie commented on Mar 11 11 at 11:27 pmEllyn said,” Id like to see what position you can get into when your legs are deadened. I don’t really think its realistic to include that number of women into the equation since its not exactly going to work trying to get into other positions.”
i’ve got four kids. i delivered on my side with my #3 and #4 and i had an epidural with all of them. i could’ve delivered on my side with #2 if i had wanted to. when i asked my doc “should i roll onto my back?” i hadn’t considered there were other positions and my doc said “whatever makes you more comfy”. she wouldn’e delivered me on my side if i’d considered it. i did deliver her on my back but if i’d known better i woulda’ just stayed on my side. when i had #3, i was there laboring on my side again and i was ready to push so the doc just left me on my side and said to my hubby “hold her leg up” so i could just get straight to it. sometimes i think its the docs and nurses that are uncomfortable with it. one of my nurses even said during #4, “shouldn’t she get on her back?” and my doc said “no its fine, just hold her leg up in position and scoot her down a bit.” it was much easier delivering on my side…much more comfortable for me. it was nice not to have to change positions just to push because i was so uncomfortable and still in pain even with the epidurals. i am grateful my doctor supported me even with others there questioning it.
Sera commented on Mar 12 11 at 12:00 amWhy is it that whenever natural birth is mentioned, women who prefer induction/augmented/epidural birth feel the need to chime in and justify their birth experience?? THIS IS NOT ABOUT YOU!!
This is about women who WANT a natural birth! Please stop trying to denigrate the desire to labor and birth intervention-free. YOU are a part of the problem the author did not address.
Randi commented on Mar 12 11 at 7:02 amSera, The name of the article is “Why aren’t more women choosing natural childbirth?” I read it and didn’t judge the author for writing it and didn’t judge any of the ladies who responded about their birth experience. I simply added my 2 cents. Short and simple…not all women WANT a “natural childbirth” for a whole variety of reasons. If you want a natural birth, go a head and have one, but if I don’t, please don’t just disregard my opinion because you don’t agree with it. If me reading and responding to the article irritated you, just skip my comment! :-)
Stephanie commented on Mar 12 11 at 5:49 pmI got REALLY lucky that I found an OBGYN who supported my decision to go “natural” and she happened to practice at one of the best hospitals in Indiana. I typed up my birth plan and the nurses were all very excited and supportive about my decision to try to go pain-med free. I had a tub that I labored in for hours in my room, and I LOVED it! My husband and I did our research and took childbirth classes before the due date. Everyone should read “Your Best Birth”. It was so EMPOWERING!
My water broke at 41 weeks, but my contractions never started. I was so stubborn about having a natural birth that I waited 3 days before I called the doctor and went in. They put me on Pitocin, which scared me to death because I worried so much about one intervention leading to another, or that I wouldn’t be able to handle the more intense contractions. BUT I got through it! I wanted a natural childbirth, and without the support of my husband/coach, the nurses, and my doctor – I might not have.
Melissa commented on Mar 12 11 at 9:49 pmEllyn – I had an epidural and ended up pushing on my side, on all fours, and squatting. My epidural was low and wearing off by then, which helped.
Sera – I wanted a natural birth but it didn’t happen for me. I have no qualms about the birth experience I did have — the hospital staff let me take the lead on things and never pushed me into anything — but I do wish I’d been in a situation where a natural and intervention-free birth was more possible. Natural childbirth kicks ass.
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