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Thursday, March 12, 2015

Why would a sane, rational person choose Natural Childbirth? A simple answer, told with pictures

Natural childbirth: the practice of giving birth with the bare minimum of medical or technological intervention, and especially without the benefit of any pain-reducing medications.

I gave birth to my daughter naturally. It was the most challenging and rewarding thing I have ever done. Now I'm pregnant again, and once again I'm planning on pushing the kiddo out of me the old-fashioned way. 

Pretty much just like this.

If you're thinking something along the lines of "well that's the dumbest f***ing thing I've ever heard in my life, and I listened to the 'Fifty Shades of Grey' audiobook," then you're not alone, and you've come to the right place if you're interested in learning why an otherwise-rational and intelligent person would choose to do something like this.

Before I was ever pregnant, I thought natural childbirth was stupid. "Why the hell would you put yourself through that without pain medication? Would you also get a root canal or an appendectomy without pain medication? What are you trying to prove?" I thought.

One time, the dentist offered to numb me a little while she cleaned my teeth. I said no and soldiered bravely through my semiannual cleaning like a champ. I didn't even scream while she was flossing the molars!

But then I got pregnant. I started doing my research, and it didn't take long for me to be sold on the whole thing. 

My decision to go for it the old-fashioned way encountered a lot of resistance ... resistance from people who basically said the exact same things that I had said myself a few years prior. I've answered the question enough times now that I think I have my whole spiel memorized. Now I've finally drawn the pictures to go along with it.

My hope is that this post helps people to understand why anyone would do this to themselves. You don't need to agree, you don't need to support my decision, and you certainly don't need to make the same decision for yourself. Hopefully you just come to understand.

Why no epidural?
To avoid the 'cascade of interventions.'

First of all, before we even start this explanation, we all need to be on the same page about one thing: that all other things being equal, a C-section is not the ideal outcome. If I gave you a choice right now between having a major abdominal surgery and not having a major abdominal surgery, you would choose "not having it," if the outcome was the same either way. 

If you disagree with this and feel that all other things being equal, abdominal surgery and recovering from it is f***ing awesome and you love it and would choose it in a heartbeat, well then just close this tab in your browser because none of this is going to make any sense to you.


An epidural on its own is not the worst thing in the world. In fact, many women would argue that it's the best thing in the world.

It was a beautiful ceremony. The groom's sister did a reading and while it wasn't the most original thing I've ever heard, it brought a tear to my eye just the same.

The epidural numbs your entire lower body, with the result being that you can't really feel your contractions. This is appealing, because contractions don't feel all that great. It's understandable that a person would want to avoid feeling them if possible.

BUT ... epidurals have this nasty tendency to slow labor down. Labor is sort of like those few seconds before you sneeze -- you know the sneeze is coming, so you prepare yourself and set down your water glass, put your hand over your mouth, and turn away from your date so you don't shoot phlegm onto their eyeballs. But just like a sneeze, labor can be derailed. And in some cases, an epidural is the equivalent to someone saying "bless you!" while you're still winding up.

Not a jury in the world would convict.

Why does this happen? A few reasons ... but mostly because the epidural immobilizes you. If labor is your body slowly moving the baby down so it can come out, then you're gonna want gravity on your side to move this process along. This means standing up, walking around, dancing the macarena, etc. Once your legs are numb, your walking around days are done. Back to the bed you go, where your baby may lose interest in exiting your body. This is known in the medical world as "failure to progress."

"Failure to progress" is no good. Eviction papers have been served; baby needs to get OUT. This means that now your epidural is going to be joined by his good friend Pitocin.

Although ever since that trip they took to Jamaica together, they've been acting kind of funny ... like maybe something happened there and they're not "just friends" after all.

Pitocin is medicine's answer to oxytocin, which is a hormone the body produces that prods labor along. If we stick with our sneeze analogy, Pitocin is like sniffing ground black pepper, or looking at the sun. That asshole who said "bless you" and derailed your sneeze doesn't stand a chance against Big Bad Pepper, which will have you sneezing hard enough to shoot brain particles out your nose in no time.

Pitocin is not a nice guy, though. He's kind of the last person you want to invite to your party. He's rude, he's rough, and he frankly doesn't give a f*** about your well-being. He also doesn't give a f*** about your baby's well-being. He has a job to do, and that job is to get some LABOR going up in this biatch! Bring on the contractions, motherf***er, let's get this baby OUT!

... and sometimes, Pitocin gets a little too crazy, and baby doesn't like it.

Dude, come on; it's a baby for chrissakes. Way over the line.

Labor is hard on a baby. Every contraction is the strong uterine muscles giving that little bugger a bear hug and shoving him a little farther down the birth canal. If you give those uterine muscles steroids, they might start squeezing baby too hard, making it difficult for him to get enough oxygen. And then his heart rate will start to drop whenever you have a contraction, and oh shit motherf***ers, now we've got ourselves a case of FETAL DISTRESS.

I call this "Fetal Distress" and you can buy a copy printed on the back of a Thai food delivery menu for a mere $1 million.

Do you know what the cure is for FETAL DISTRESS? It's an emergency C-section. 

I get really squeamish looking at photos of actual C-sections so I drew what I assume happens in the O.R. Was I close?

C-sections are life-saving surgeries and I'm very thankful they exist ... but a C-section isn't ideal. If you had to choose between A) trying to take care of a newborn baby, or B) trying to take care of a newborn baby while SIMULTANEOUSLY RECOVERING FROM A MAJOR SURGERY, which would you prefer? I literally ripped my asshole open giving birth to my daughter, but I'm still terrified of C-sections. Especially the emergency kind, which add a nice dose of stress, drama, and fear to the whole major-abdominal-surgery thing.

Do epidurals always lead to Pitocin? No. Does Pitocin always lead to C-sections? No. But does it happen often enough to be considered a legitimate possibility? YES.

Many women will tell you, therefore, that the reason they pursued a natural birth was to avoid the cascade of interventions that ends with a C-section. Because C-sections are great, but the thing is, they also suck. They're like ... the fleshlight of surgeries.

Want to learn more? Read about how "failure to progress" is the #1 cause of unplanned C-sections here on Evidence Based Birth, which includes a link to this study showing that epidurals tend to increase the time spent in labor.

Oh, and also, just a little footnote on this one: when it comes time to push out the baby, you're supposed to push only during contractions, pushing your very hardest when the contraction peaks. Otherwise, it's like trying to push out a poop while clenching your sphincter shut at the same time -- it isn't going to work. But if you have an epidural and you can't feel your contractions, then how do you know when to push? Well, people watch on a monitor and sort of tell you when, and you just kinda listen to them instead of listening to your body. The result? More difficulty pushing out the baby.

Why not other drugs besides epidural, then?
Because you don't know how they'll affect you or the baby.

There are a ton of other narcotic drugs that you can have during labor. Some of them have the same negative effects as epidurals, in that they confine you to the bed which could stall your labor.

They might also make you feel totally loopy, sleepy or nauseous while doing nothing to actually help with your labor pain. Wow, what could be better than being in miserable agony from strong uterine contractions, while also feeling weak, loopy, and nauseous from narcotic painkillers? THAT SOUNDS LIKE THE PLOT SYNOPSIS OF A HAYDEN CHRISTENSEN HORROR MOVIE.

I couldn't even watch this movie because it was too scary. His terrible narrating had nothing to do with why I had to turn it off, nope, no sir.

Also, narcotic painkillers can cross the placenta and get into your baby. Do they harm the baby? I dunno; probably not? But if you've spent your entire pregnancy saying "no" to caffeine and hot dogs and sushi and alcohol and goddamned turkey sandwiches, it's a bit of a jump to suddenly be like "f*** yeah HEROIN ME BRO" while you're in labor. 

This one has had too much heroin.

So to recap ... narcotics might not work at all, and might even make you feel worse, and they probably cross the placenta and affect the baby in some way. None for me, thanks.

Your body's natural painkillers are way stronger than any hospital drug

I can tell you this from personal experience. By the time I was actually pushing Audrey out, and the ... things happened to my body ... I felt no pain. Zero. Nada. Just kind of a pop, squish, bam, done.

(the "things" I am referring to is a fourth-degree tear, which I described in my birth story here)

Meanwhile, other women who had the same birth complication as I did -- while receiving pain medication -- have described it as "the most painful thing I have ever experienced."

How is this possible? Am I just a hero?

The B is for ... ummm ... Birth Gal? I am not good at this.

No. The human body is the only hero in this story.

The blood-brain barrier prevents any foreign chemicals put into your body (like, say, YUMMY PAINKILLERS) from affecting your brain. But the painkillers your own body produces -- say, when confronted with something like an hours-long labor -- can mingle all up in that brain and you get all the happy brain chemicals that make you feel things like euphoria and love and mmmm chocolate and such.

And that is how you can rip your asshole open and feel nothing.

Natural Childbirth is empowering as f***. You will learn what you are really made of, and you will be AMAZED what your body can do.

Have you ever done something that you felt really tested you to the core of your being? Maybe you ran an ultra-marathon, or you fasted for a full week or longer, or you fought cancer, or you got clean after years of addiction to something.

If you've gone through something like this, then you know what I'm talking about. You know yourself in a deep and meaningful way. You know what you do when you're at the end of your rope; when you've endured as much as you ever thought you could, but then you still endured even more. You know how much you can truly take, and odds are it's a lot more than you might have thought originally.

Surviving natural childbirth is just another way of taking that intense journey of self-exploration. For most women, there will come a point where they think "I cannot do this anymore. I tap out. I cry 'uncle.' Please give me the drugs. I am not strong enough for this." But if you're really committed, and you have the right kind of support, you will find that you ARE strong enough, and you CAN do this. You'll hit that point where you cry "I can't do this," but then you'll dig deep within yourself and find a reserve that you didn't know was there. And maybe you'll make it through the rest of your labor without that epidural after all. 

And this holds true even if you do end up getting the epidural -- because at that moment of "I can't do this," the epi isn't going to be delivered to you immediately. You're going to have to hang on for a few more minutes, a few more contractions. And you'll see that you are a lot stronger than you give yourself credit for. Any woman who attempts natural childbirth -- even if she doesn't make it all the way to the end -- will know a lot more about herself afterwards than she did before. And that knowledge is in-f***ing-valuable for the next time life tosses live grenades at you.

Bragging Rights

I'm sure there are women who have given birth naturally and don't feel like it's anything to brag about.

And those women are far, far better people than I am.

When you do something that's really hard and that most people opt not to do, you can be proud of yourself afterwards. This is why people put 26.2 stickers on the back of their cars after completing a marathon. If it was socially acceptable to put a sticker on my car that said "I DID IT WITHOUT AN EPIDURAL SO SUCK IT HATERS" I would totally do it.

And I would superimpose it on this picture of Stone Cold Steve Austin, which would make it really confusing because he's a man and men don't generally give birth.

... generally.

You can swagger out of that hospital, knowing you did something impressive. When people ask about how your birth went, you get to give them a little smile and a shrug and say "oh, you know, I did it all natural, no biggie." And then watch their eyes widen a little bit as they realize that maybe, just maybe, you're one tough motherf***er that they ought to take a bit more seriously.

But here's the biggest reason of all:


There is absolutely no downside whatsoever to planning on a natural birth. None. The only possible downside I can even think of is that if you don't make it, you might feel kind of disappointed afterwards.

Some women aren't able to receive an epidural at all. Some women get one, but it doesn't really work for them. Imagine if you had not prepared yourself mentally for labor to actually hurt, because you were going to rely on the epidural, only to have it not be an option for you? THAT WOULD SUCK. You would find yourself forced into either an unplanned natural labor for which you were utterly unprepared, or you'd find yourself screaming for a C-section and all the fun that comes with that operation.

Now instead, imagine that you've done your research on coping mechanisms for labor pain. You know all about the different labor positions you can try, and about the shower, and the birth ball, and the bath. You've brought tennis balls, heating pads, and aromatherapy oils with you to the hospital. Your partner is 100% ready to support you and coach you and tell you you're incredible. All of this preparation has taken naught but a few hours of your time, and because of all the research you've done, you're no longer afraid of giving birth.

What downside could there possibly be to this? I mean really??

Even if you find that the shower and the birth ball and the tub aren't helping at all and the aromatherapy oils made you throw up and you want an epidural anyway and to hell with Ina May and her horsesh*t, how are you any worse off than if you hadn't done the preparation?

The worst case scenario is that you feel a bit disappointed with yourself, but ultimately understand that labor turned out differently than you expected, and you move on.

That seems like a lot better outcome than heading to the hospital with no idea what to expect and finding yourself screaming for a C-section after your epidural only numbs your left side while the right side continues to feel everything. People get PTSD from that sh*t. They really do.


Who knows what will end up happening with the baby that's currently inside me. Maybe it'll turn out to be breech and I'll have to have a C-section despite my best intentions. Maybe labor will take 5,000 years and I'll tap out and have an epidural at hour 26. But no matter what happens, I'm going to head to that hospital prepared to last as long as I can. Because it's a teensy bit better for baby, but mostly because it's better for me.

To summarize: Natural childbirth allows you to reduce your risk of having a C-section while keeping your baby free from harassment from Old Man Pitocin; doesn't pump your baby full of heroin after nine months of refusing soft-serve ice cream because of the "risks"; makes people's eyes bug out a little when you tell them how nuts you are; and most of all, allows you to rip your asshole open but feel nothing because the human body is f***ing incredible. All of this for a cost of zero dollars.

This ain't no root canal, bitches. This is real shit.

If you'd like to learn more about natural childbirth, please read "Ina May's Guide to Childbirth" because Ina May is the queen of this stuff and her book is incredible. And also make sure to read Evidence Based Birth, which is an amazing resource if you're into facts and figures. Especially if you read this whole blog post while wondering "where in the hell did she get that information because it sounds wrong but I don't know enough to refute it." They'll back me up, I swear!

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