Actually, it does matterhow you give birth

Actually, It DOES Matter How You Give Birth

Whenever people discuss c-sections and natural childbirth, one well-meaning sentiment always rises from the fray:

It doesn’t matter how you give birth, as long as baby comes out healthy.

I appreciate people wanting to remove the judgment that often surrounds women’s choices and experiences. However, it’s disingenuous to say that how a woman gives birth doesn’t matter. I don’t want anyone dismissing my birth experiences as “not mattering,” simply because I got three healthy babies in the end. As one of the most significant events in a woman’s life, childbirth matters a lot.

Granted, taken alone and out of context, the means by which a woman gives birth doesn’t matter much in the big scheme of things. Having a c-section, an epidural, an unmedicated birth, or a forest birth in a pool of unicorn tears doesn’t define who you are as a mother.

But how you give birth does matter. More specifically, how you experience giving birth matters.

It matters how your doctor, midwife, or other caregiver treats you before, during, and after your birth.

It matters how much you educate yourself about the birth process and how knowledgeable you are about what’s happening with your body.

It matters how much you understand about your choices, how much support you have for those choices, and how empowered you feel to make those choices.

It matters how you feel about your childbirth experience throughout.

A birthing woman should, first and foremost, feel empowered. Yes, even if everything goes wrong and circumstances beyond her control result in the exact opposite birth than she hoped for. Even then, a woman should feel empowered by her caregivers. She should feel listened to. She should be given as much choice as possible—and her choices should be respected even if it turns out that they won’t work for whatever reason.

If you grow a baby in your body for nine months, you should be in the driver’s seat when it’s time for that baby to come out. Yes, sometimes the conditions get hairy. Sometimes obstacles spring up unexpectedly. Sometimes your vehicle breaks down completely. But you’re still the driver. At no point should you feel like someone has forcibly taken the wheel and kicked you out of the car, unless the car is on fire and that’s the only way to save you.

My first two birth experiences were incredible. The first was at a birth center with a midwife, and the second was a home birth with a male MD. Both of those providers made it clear that I was in the driver’s seat. They trusted me and my body and helped me do the same. They were prepared in case of emergency, of course, but they let me labor and birth the way I wanted. I came out of those births feeling like a superhero.

My third baby was born in a hospital with a female OB—a choice we made for insurance reasons (and because the doc who delivered my second had retired). That birth experience wasn’t bad, but it was distinctly different than the first two.

In the hospital, I felt limited in ways that people might not even think of if they hadn’t experienced anything different. I couldn’t leave the maternity ward and was only able to walk up and down one hallway. (Staying active in various ways during my first two labors helped immensely.) Whenever I was in bed, they had me strapped to the continuous monitor machine parked beside my bed. (I had intermittent monitoring with my first two births, which has been proven to be just as effective.) I was only allowed to eat popsicles and jell-o for 14 hours. (No food restrictions with my first two labors.) There was a lot more poking and prodding and checking and monitoring in the hospital, which all felt extraneous and rather invasive.

This was all at a renowned hospital in the Chicago suburbs. It had lovely, rooming-in birthing suites, baby-friendly practices, a great reputation, etc. The OB group was recommended by my home birthing doctor. So it’s not like it was a bad hospital with backwards providers. For a hospital birth, it was good.

But that’s kind of like saying Olive Garden has good pasta. Compared to some fast food place, sure, it’s good. But if you’ve had real, home-cooked pasta made by a genuine Italian grandmother, Olive Garden is going to seem sub-par. It’s not that the hospital experience was horrible. It just didn’t compare to my midwife birth center birth or my home birth. And in the end, it came down to empowerment.

Here’s one illustrative example: After I delivered the placenta during my third birth, the doctor announced, “Okay, we’re going to give you a shot of Pitocin now to help contract your uterus.”

Now, that might not seem like a big deal, but I was taken aback. I don’t like putting medications into my body unless necessary. If this had been my first baby, or if I didn’t understand how breastfeeding helps contract the uterus, I probably wouldn’t have thought anything of it. But I had delivered two children previously and contracted my uterus successfully by breastfeeding. I wasn’t bleeding heavily or anything. There was no medical need for Pitocin.

But the thing that bothered me most is that she didn’t ask me if I wanted it—she told me it was going to be done.

“Is that really necessary?” I asked. “With my other two I just breastfed and that seemed to work well.” She seemed slightly annoyed, but said, “Oh. Sure. If that’s the way you want to go.”

I haven’t always been someone who would question a highly qualified doctor. This woman happened to be the one doctor in my OB group that I hadn’t met before the birth, so it’s not like we discussed any of this beforehand. In the large scheme of things, what she did wasn’t a big deal—except when you add up all of those little choices being taken away, it does become a big deal. It was only because I knew first hand what a truly empowering birth experience looks like that I even recognized how disempowering those little things can be.

This is my body, my baby, and my birth. There should be nothing unnecessary done with any of those things for anyone else’s profit or convenience. And there certainly shouldn’t be anything forced, either through assumed acquiescence or outright coercion. There’s a big difference between suggesting an alternate route and reaching over and taking the steering wheel. Barring true emergencies, birth belongs to the birthing woman.

Generally speaking, midwives have a leg up in this area. Midwives are trained to help a woman harness her body’s own power, physically and mentally, and they encourage ownership of the birth process. There are some amazing OBs who operate the same way, but you do have to vet them out. There are also some control-freak midwives, I’m sure, so it’s not an across-the-board guarantee. But whom you choose as a provider makes a big difference.

The problem with saying “It doesn’t matter how you give birth” is that if women take that to heart, they may not take the time to educate themselves on their choices or vet potential providers to find the right fit since the birth process doesn’t really matter anyway. Empowerment starts with women educating themselves on the childbirth process and understanding that they are the drivers of that process. Birth attendants are primarily experienced navigators who know what to do if inclement weather hits or if the car breaks down. They should not take the wheel unless there is truly no other choice.

Childbirth is the likely the hardest, most overwhelming thing a woman will ever do, so of course those experiences matter. If you walk away from your birth feeling powerless, that’s important. No matter how your baby ultimately enters the world, how you experience birth and how empowered you feel throughout the process does matter. Let’s stop telling women that it doesn’t.

(Note: I’m aware that empowerment doesn’t always look like what I wanted in my birth experiences. If a woman wants to hand over the wheel and let her provider drive her whole birth, more power to her. I may not understand that choice, but I respect her right to make it. If that’s what empowerment means to her, I’m glad she has that option. Truly.)

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Annie writes about motherhood and other hilariously beautiful things. On good days, she enjoys juggling life with her husband and three children. On bad days, she binges on chocolate chips and dreams of traveling the world alone.

Comments 25

  1. Lynn Flewelling

    This article raises a lot of reactions and emotions. After 24 hours of labor, I had to have an emergency C section with my first son 31 years ago. It was during that birth that it was discovered that my pelvic opening is narrow and I couldn’t birth the hefty babes I had. Without medical intervention and being in the hospital where it was available quickly, neither my son or me would be here. I loved my OB. He 100% supported my desire for a natural birth. But I remember with gratitude him squeezing my shoulder and saying kindly, “You have done all you can do.” My second son was a scheduled C section. I regret that I didn’t stand firm and wait until my water broke to go to the hospital. It was scheduled supposedly for “safety reasons” given my first birth and the fact that my second son was huge! But I’ve always wished I had insisted that we had to wait until my waters broke, so that I would know the day my son was supposed to be born. The first birth was a grueling process that ended in me cuddling my child. After the second I cried for an hour and my postpartum depression was worse.

    However, these are First World problems. I can’t speak for others here, but I know that I benefit from considerable privilege. I am white, middle class, had health insurance and a supportive husband, and access to good care. Saying that all women should educate themselves to have the best, most empowered birth possible places a judgement on women who don’t have the access and advantages I had. And saying “For a hospital birth, it was good. But that’s kind of like saying Olive Garden has good pasta” borders on shaming and discounts the experiences of women who didn’t have the means for a midwife, unicorn tears, or whatever. That kind of thinking disempowers women.

  2. Aimee Hadden

    I could not agree more. I’ve had 3 c-sections (ironically each one for different reasons). The ONLY reason the first one was not a positive experience was due to the doctor and her lack of communication and discussing options with me. The next 2 I felt empowered as my doctor made it clear that the delivery was entirely in my control and presented me with options and allowed me time to process and decide what was best for our child. Good post!

  3. Dalia

    Thank you! This could as well be titled “Mom matters too”. I had a fairly normal, induced hospital birth, but I hated it. I was treated as if I was a cow with whom there is no point of talking, as if I had just a baby-carrying body but no brains or free will. And if I dared to say anything I got an eye roll or a “but you do want a healthy baby, don’t you?” These idiots nearly gave me an injection that was meant for someone else. And I felt very disempowered during birth, they did not let me get up and I was pushed back down when I tried to shift.
    I left with my baby a few hours after he was born. I felt like I had PTSD, I cried for weeks thinking about it. And every time I tried to talk about this, I would be told “But you have a healthy child.” My experience matters too.

  4. Thea

    Hello! This is a wonderful post, and your experience very much mirrors my own. First baby was born in the hospital; smooth 12 hours, with epidural, and nice recovery. Second baby born at home with a midwife, all natural, after 4 long hours of labor; slowly recovery as I was more sore and tired. Then third also born in a hospital in 5 hours. I found this third labor and delivery frustrating as many things were done without consent! I am a healthcare worker (an OT) and would never do something because “that’s what we do” without at least talking to the client about it! Although money is not an issue, we are still figuring out why we have some charges that the insurance is not covering, that I didn’t consent to while in the hospital, and what we do about them now. Thanks again.

  5. Louise Ellen Dotter

    “giving birth is the most powerful experience a woman can have.” Sorry, the emphasis on the intense and emotional start to parenthood obscures the REALLY powerful experience for every parent – raising a healthy productive child to adulthood. Putting the emphasis on birthing is much like saying the ride up the ski lift is the most powerful (fun) part of downhill skiing! With that caveat I would like to thank the author for a wonderful article that should be read by every parent BEFORE becoming pregnant!

  6. Amalia

    I just needed to pipe in a little tidbit. Because there are so many people who err on the side of midwives and natural care.. Whether or not even intending to, they are even *just a bit* more cynical of medical doctors and hospital birth settings; than they are of midwives and homebirth.
    There is so much talk of “being educated” and those same people*often* (maybe not you, but very often), will tout how being educated leads to natural care sans ultrasounds and without monitoring and “trusting your body”.
    You commented how ‘in a high risk setting the miwife would send to an ob’.
    That’s not true.
    I live in one of the most progressive natural care/midwifery based birth states in the country, and for my first child I chose the highest-regarded, most influential midwives in the state. They work hand-in-hand with excellent obs and are highly recommended.
    They have met, and trained with, the “gurus” behind the popular film “the business of being born”.
    They have a great background and seem so trustworthy, eh?
    BUT.
    They NEVER caught my severe preeclampsia.
    I had all the five most common symptoms for weeks. I kept complaining of them and sharing with great detail how much I hurt.
    My blood pressure was taken, observed, and I was always told that It was “simply my bodies way of telling me to slow down”.
    Short of getting an optional catheter so I wouldn’t have to get up to pee, I couldn’t slow down any further. Anyone who has gained in excess of 6 gallons of fluid filling the “extra spaces” would tell you it’s impossible not to “slow down”. It’s impossible to move hardly at all.
    In regards to the fluid? I was told to swim. “It would make me feel better at least”.
    Ridiculous.
    My son lost almost an entire trimester safe inside his momma because everyone was “trusting my body”. He was born a preemie and even after all was said and done, the midwives still didn’t believe that I was preeclamptic.
    If you’re going to be skeptical of care providers, then also be SKEPTICAL of midwives.
    Very, very much so.
    The easiest pregnancy scare to detect was un-detected.

    1. Tina

      Not to mention not all midwives are created equally, some are very medically minded and don’t even spend time with you when you are in labor! I learned that one the hard way. People also thing being “Educated” means having read “what to expect when you are expecting” haha not even close….That book doesn’t even touch on it.

  7. Lauren

    Thank you for this article. My husband and I have different opinions on what an ideal birth would look like when we eventually have kids, and you have summed up my biggest fear- that I might end up laboring in a hospital for lack of options in our area; and then that I would not be listened to, my preferences pushed aside because ‘the doctor says…’ or ‘the hospital policy is…’
    Of course, yes, the most important thing is that the baby is healthy- but how Baby gets here is also important. And during the most vulnerable and challenging situation I may ever experience, I need to feel supported and respected.

  8. Bin Ban Banda

    Let´s promote together in our girls, boys and families, a different life style through the family union and the taking games as protagonist of this great adventure, where they are going to learn by having fun ; values, idioms, their rights, and care of pets

    What if we join and promote together the games, the great adventures, the union family and the family learning

    https://www.youtube.com/watch?v=pmMdqUjCT8o

  9. Sam

    I do think you make some great point and I don’t want to undermine your message because I think it’s a great one. But just something to consider: I had a c-section at 29.5 weeks to deliver my twin boys after being on strict hospital bedrest for a month after they tried to come at 25 weeks. When they DID come, I put the doctor in the driver’s seat because we were dealing with something beyond my expertise. I educated myself as much as I could, but I felt most comfortable letting the doctors do what they thought best.

    That being said, it was ultimately MY decisions to allow the doctors to take control, and I think women should definitely speak up if they aren’t ok with that b

  10. Amy

    As a mother of three children, two of which were very complicated births, I find it very important for people to make informed medical decisions. But I found this article very condescending to people in my position who had NO choice, due to major medical issues.

    I tell myself it does not matter how my babies arrived, as long as they were healthy, because my other option was that they died, or I could have.
    Please don’t make the generalization that everyone has or should have these options. I applaud all of the choices people make, they should do what feels right for them. BUT for people like me, I chose to do what kept us all alive.

    1. Post
      Author
      Annie Reneau

      Amy – I apologize if this post came across as condescending. Ideally, women should be given as much choice as possible, but as with every rule, there are exceptions. I’d say that your situation is the part of the driving analogy where the car is on fire. There are times when there truly is no choice, and in those cases empowerment is going to look different. In fact, the phrase “It doesn’t matter how you give birth” can be seen as an empowering statement when faced with that situation. But even when there is no choice, I would argue that the way you are treated by your care providers and the respect given to your experience matters. In fact, I’d say it might matter even more in those situations. The experience matters, regardless of the means. That doesn’t mean every experience is going to be peachy and perfect; it means that as some of the most significant events of our lives, our birth experiences matter. Does that make more sense?

  11. Trelani Chapman

    Interesting. I’m a woman who had a C-section and then a VBAC (Vaginal birth after C-section). I had a horrendous experience with the delivery of my first child, for lots of reasons, but the main one being that the doctor on-call didn’t believe in C-sections and only relented after a long and awful labor and a nurse swearing at him to do one. The birth of my second child involved a month long stay in the high-risk pregnancy ward of the hospital before going into labor and the doctors agreeing that I could have a very brief trial of labor. (I pleaded with them because I was terrified to have another C-section because of my experiences with the first one and the fact that my whole family and some of their friends had all held my first baby before I did by the time I got back to my room from recovery). Well the second baby was born quickly, it was reasonably positive, I felt like I could have walked home right from the delivery table, and the recovery was a breeze in comparison.

    During the first delivery, I was robbed of any autonomy or empowerment because of a medical model system and archaic procedures that are not done anymore (at least I hope not!). Also, I was caught in strange politics given that I needed a C-section and wasn’t given one until I was a wreck. In the second delivery, there was a lot of fear and concern because I was very sick and yet it was somewhat of a joyous event.

    Childbirth should be as natural as possible because the woman (typically) isn’t sick. And women should feel in charge of their birthing process. I never had an option for a home birth – I often wonder what it would be like. But I caution you that in my case, I needed a medical procedure and it was withheld because the doctor believed (and said so!) that women had been having babies vaginally since the beginning of time and that I should too.

    1. Post
      Author
      Annie Reneau

      Thank you for sharing. It’s definitely not empowering to not have proper care! As much as I am a fan of natural childbirth, I also wouldn’t trust a provider who was totally against c-sections as a rule. That’s just ridiculous.

  12. Megan

    Actually, Dave, the people most often saying how you give birth doesn’t matter are mothers who have had their children via c-section. They say it to women who want midwife care or home births, or just more control over how they birth. Usually “it doesn’t matter how you give birth” comes with a dire warning about how if they had been at home they would have died, without noting that had they been at home with a midwife they would not have been induced, they would not have had an epidural, and they would not have been forced to labor on their backs – all interventions that lead to a greater risk for c-section. Nor do they ever acknowledge that if they were high risk pregnancies a midwife would have sent them to an OB. Then they wrap up the whole story by saying, “there are no medals for natural childbirth.”

    Recently I read a comment from a woman who had two children via planned c-section, she told a woman who said that giving birth to her children was one of the most amazing things she’s done in her life, that she was pathetic for feeling that way.

    When I said that I didn’t want an epidural with my first child, the doctor called me stupid.

    The army nurse husband of a friend of mine told me his favorite place to work in the hospital was labor and delivery because it was like a machine. Induce them at 6, and if there’s not a baby by 4 do a c-section. Runs like clockwork, he said.

    I’ve had 4 children. 3 in a hospital and 1 at home. Different doctor/midwife each time.

    Baby 1: water broke, but was a slow leak. I was told I peed myself and not to come back unless there was a gush of fluid or contractions 5 min apart. 2 days later, no gush, still a slow leak, no contractions. Went back to the hospital anyway, got yelled at for not arguing when they sent me home. Pitocin. Baby in distress. Episiotomy as a matter of course, because that’s just what the Dr did. Painful sex for the next year.

    Baby 2: baby is born, they tell me it’s a boy and then take it away, with no bracelet, to suction his lungs. 30 minutes later they bring me back a girl and say oops. Luckily my husband had gone with the baby as I asked instead of staying with me as he intended.

    Baby 3: Dr spends 16 weeks telling me my baby is inter uterine growth restricted. Sends me to weekly sonograms and tri-weekly stress tests where nurses and technicians say, why does she keep sending you here? Dr puts me on a super high calorie diet and convinces me I’m going to be lucky to have a 4 pound baby and my womb is a hostile environment. Induces 2.5 weeks early. Long, horrible, intense delivery of a 6lb 11oz perfectly fine baby, who at 12 is still just a petite person. The day she was born she screamed for hours and couldn’t nurse for two days. I was exhausted and had to send her to the nursery. Neither one of us was ready for her to be born.

    At each birth I was told that just prior to pushing I told everyone who would listen that I was done, and I was going home.

    So when baby 4 rolled around, I stayed home. I had two amazing midwives who monitored my nutrition and water intake and general well being much more closely than any Dr ever had. Start of labor to holding a baby took 2.5 hours vs 6, 7, and 14. No one took my baby from me until I was ready for her to be weighed, etc. She nursed well and easily. And I had the best post natal care I had ever received. And I did feel incredibly empowered.

    For me, the home birth experience was by far the best. Honestly, if I had known it was an option with baby 1, I doubt I would have taken it – too granola, babies are born in hospitals, yuck – because that’s what I had been told. In hindsight however, the How of birth mattered very much to me, and I imagine that it matters very much to women who choose elective c-sections, or epidurals at the first opportunity, or women who have delivery rooms full of friends, mothers, and sisters, or women who schedule inductions around work deadlines — none of them are wrong, and it matters. It may not be what I would choose, my choices may not be yours, but it matters that they ate available. And yes, in the end we want a healthy baby, but a whole (physically and emotionally) momma should be the very closest of seconds.

  13. Dave

    I also believe that giving birth is the most powerful experience a woman can have. And here’s the BUT……. what group of pregnant women do you actually believe “it doesn’t matter how you give birth” is being said to? And how far along during the pregnancy is this advice usually given? Isn’t it more likely to be given to women that have moderate to serious complications nearing the very end of their pregnancy? Women that have a plan but their professionals are suggesting that their plan may not be appropriate for them– based on their professional experience? So at this point they would have already educated themselves, have chosen their birth place and professional assistance. So then, what is the point of this article other than to place guilt upon those heavily pregnant women whose pregnancy has not gone the way they wanted or planned and now are willing to follow the suggestions of the men and women that have dedicated their adult lives to decreasing danger in what was at one time a leading cause of death for young women?

    1. Post
      Author
      Annie Reneau

      Dave, the “it doesn’t matter how you give birth” statements I was referring to are ones that come up in philosophical discussions about birthing methods. It’s not about advice for pregnant women, but about the statement in general that the birth is inconsequential as long as the baby is healthy. Regarding the scenarios you describe, there is a difference between trusting your provider and following their suggestions when those suggestions (or even straight up “this has to be done” statements which sometimes are necessary) are delivered in consultation with the birthing woman and in an atmosphere of respect and empowerment, and having a provider who takes control of your birth without respecting your process and your input. Paternalism abounds in the birthing world. And I don’t mean that in a sexist sense—after all, it was a female doctor who I felt was making choices for me that were unnecessary and a male doctor who I felt was the most respectful of my experience and the birthing process in general. I’m 99% sure I would have felt the same about his care even if things had gone wrong and I’d needed interventions. Doctors and midwives can dedicate their lives to decreasing danger in childbirth (although arguably some practices are more about convenience than decreasing danger—another discussion for another time) and still go either way when it comes to how they treat birthing women. The point of this article was not at all about placing guilt on anyone, other than maybe birthing providers who need to be reminded that respect and empowerment are a crucial element of their care.

    2. Rachel Self

      Actually it’s said to many women early on in pregnancy. I planned for an all-natural birth from the beginning. 90% of the time when someone found out my plans, they said this to me. They would start talking about how they had an epidural and how in the moment I’d probably want one anyway. Then they would talk about how they had all the interventions and their baby was fine, so it just doesn’t matter which way is “healthiest” as long as you have a healthy baby in the end.

  14. Rachel Self

    Excellent post. When my first child was born, my midwife tried her hardest to give me the all-natural birth I wanted, and things went horribly wrong. Birth went badly and I ended up going under general anesthesia for a cesarean. My body did not recover until after my 2nd child was born. I even remained the same weight as when I was 9 months pregnant until my next pregnancy, when I lost weight during morning sickness and then gained back to the same full-pregnancy weight again. My son ended up in the NICU for 5 days with severe infection from waiting too long after my water broke. And breastfeeding got off to a bad start, and never was fully successful. Honestly, my midwife should have suggested MORE interventions during labor and birth, but she tried too hard to give me the natural birth I wanted. I felt defeated.

    With my second son, we scheduled a cesarean with one of the best surgeons in our area. I was awake for the birth, heard his first cry, and was able to breastfeed within an hour of birth. I’ve gone on to exclusively breastfeed him with no issues whatsoever. I was also healed up nicely and back in my normal clothes within a month. It was empowering. :)

    I still believe that natural birth is safest and healthiest for most women, and I encourage most new moms to aim for that. It’s not for me, though. I wanted to say thanks for this post though. Because even though I’ve had two c-sections, I nodded in agreement to everything you wrote. It does matter! I’ve experienced a traumatic birth, and an empowering birth. And it definitely matters….even in the months following delivery!

    1. Post
      Author
      Annie Reneau

      Thank you for your comment! I’m glad you shared your experiences so we can see these points through another perspective. You’re right – there’s a fine line between respecting a woman’s choices and desires for her birth and making sure that care providers provide the best care for your situation.

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