Congratulations, you are pregnant! You may be feeling a million things-some positive, some not so great. Regardless, I bet you have concerns over the birth of your baby. In fact, you may have already started planning for the birth. Chances are, you are also getting inundated with other people’s birth stories or unsolicited advice. There are all sorts of guide books and websites talking about birth. Let’s not even start counting all the social media influencers who preach on this topic. All this information can be overwhelming. Fortunately, there are only five things you really need to know to have the best birth possible.
1. Accurate Information
I’ll start here because this is fundamentally the most important piece. SInce birth has been going on, literally , since the beginning of time there is a lot of talk around it but little accurate information. Moreover, it is the most transformative thing you will ever do. Therefore, people have a lot of opinions and like to share them. Unfortunately, these thoughts are typically either inaccurate, only applicable to a set person with a specific set of circumstances, or outdated. Moreover, they usually are based on western medical practice which are relatively new in the history of birth.
Now, don’t misunderstand–I see nothing wrong with following a typical western medicine approach if that’s what you want. I’m just encouraging you to ask questions and learn all the options. Did you know breech babies CAN be born vaginally? You just need to find a provider who knows how to help you with that. Perhaps, you are terrified of hospitals. A tour of the labor and delivery unit may calm your fears.
Here are some websites that may be helpful:
North American Registry of Midwives
American College of Nurse Midwives
American College of Obstetrics and Gynecology
I know this is overwhelming but I want you to feel empowered. Don’t let others’ experiences determine the most important event of your life.
I don’t care how you give birth, as long as you have full and informed consent.
– Sharon Fisher, PMHNP-BC, PMH-C
2. The Right Provider
Generally speaking, there are two types of providers who can care for you during your pregnancy and birth. Midwives and OBGYNs are the two most common providers who attend births. Below is a very generalized description of these two types of providers.
Midwives
Midwives come in three main flavors. Certified Nurse Midwives (CNMs) are licensed nurses who complete graduate training (masters degree or doctorate) to become an advanced practice nurse as a midwife. Certified Midwives (CMs) also follow an academic path and receive a graduate degree but may not necessarily have a nursing background. Certified Professional Midwives (CPMs) follow a more fluid path and take coursework but mainly follow an apprenticeship program. You can learn more about all three types of midwives here.
In general, midwives view pregnancy and childbirth as healthy, natural processes that you were literally made to do. They tend to monitor and observe more and intervene less. Often, they view the birthing person as the one in charge.
Midwives work in hospitals, birthing centers, and some do home births.
OBGYNs
OBGYNs are medical doctors (MDs or DOs) who receive specialized training in managing pregnancy and birth. They follow the medical model which some feel is based more on disease than wellness. They typically are more intervention based than midwives. Additionally, OBGYNs can perform C-Sections and handle more complicated cases that may be out of the scope of a Midwife. As an aside, please, please, don’t assume you are “high risk” because you are over 35! You can learn more here. But I digress, OBGYNs typically work in hospitals. However, there is a growing movement of community obstetricians like Dr. Flores.
Please be aware that each and every provider is a unique individual with their own worldview and style. Therefore, you may find a midwife who practices “like” an OBGYN and, conversely, a doctor who is more “midwife” in style. The most important thing is to figure out what is important to you and if that provider can meet your needs.
3. The Best Setting
Most women in the United States birth in a hospital, however you have options. Some areas have birth centers. They can be either independent or affiliated with a hospital. Some people prefer to give birth at home. There are advantages and risks to all settings. Again, this is a personal choice.
4. Good Support
No matter how great your provider is, you will benefit from support. This may be your partner, a friend, or even a doula. With possibly the exception of a home birth midwife, you will definitely not have your provider with you the whole time. Therefore, it is essential to have some backup help. If you have a partner, discuss with them your expectations and their needs. Yes, even though you are the one giving birth, your partner will have to meet their own needs during this time as well as support you. For instance, if the labor lasts longer than a day, they will need to sleep. They may also need to get food, shower, etc during this time. That is why you may want an additional person there.
It is imperative to choose wisely. Don’t just have your mother there because your sister did. Choose someone who keeps you calm, is generally positive in life, and is differential to your wishes. They don’t need to know anything about birth but they need to be reliable and respectful.
5. Be in Shape
Birth is physiologically more challenging than completing a triathlon. This is why you need to train for it. Contrary to the popular belief that your doctor delivers the baby, YOU actually deliver your baby. Unless you have been instructed by your provider otherwise, keep active during pregnancy. Simply walking 20 minutes daily is great. Also consider yoga, the flexibility and mental benefits will be helpful during labor. If you are struggling physically, swimming or water aerobics are great options.
Giving birth is the most sacred and transformative thing you may ever do. Just like you plan for your education, career, wedding, etc, you need to plan for your birth. This certainly does not mean everything will go as expected. In fact, more likely it won’t. However, due diligence during pregnancy will help things go in the direction you like. This can have lasting positive effects.
Have you planned for postpartum? Spoiler alert, that is important, too! Read more about creating a postpartum plan that can help reduce your chances of postpartum depression here.
Sharon P. Fisher, MS, PMHNP-BC, PMH-C is the founder of Nurtured Well, LLC where we passionately support women through all stages of their adult life.