While I was anticipating the birth of my first baby, I was repeatedly told by several people that not only it's nearly impossible to give birth without the aid of pain-relieving drugs, but that there was absolutely no reason to withstand such torture, apart from some vague irrational hippie back-to-earth ideals.
After doing a bit of research, together with my husband, I became firmly convinced that such beliefs, however common, are a dangerous illusion. Even simple common sense will tell that labor pains, however difficult to endure, are a natural part of the birth process and most likely won't lead to complications - while unnecessary medical interventions can and do.
I remember when we were studying human anatomy and physiology, one of the girls stated that when she has a baby, she will opt for a c-section because it looks much "safer" to her to have a fully controlled medical procedure than a normal birth where things can go unexpected. Obviously, she has not researched the statistics of maternal and infant mortality and morbidity associated with c-sections vs. regular births. Our teacher, who was an older, very experienced doctor and biochemist, gave her a stern look and said, "never opt for medical intervention when there's any way at all you can have a natural process." This is what I believe every decent doctor should tell his patients.
Every woman makes individual choices about how to give birth - and I'm a firm believer that said choices ought to be informed, made with no pressure, and truly weighing all the pros and cons.
Last week, I received a comment praising modern medical intervention and saying that, "giving birth with or without drugs honestly is a matter of romantic choice for a lot of women; it simply doesn't make any difference to a child's long-term, or even short-term, health."
To which I replied,
No one denies modern medicine has saved many, many lives of mothers and babies, and for that, we should be ever thankful. My first birth wasn't attended by a doctor, only midwives, but I was glad to know that should anything happen, I'm in a hospital and within quick reach of good doctors and any necessary help.
I think the key here is to distinguish between necessary and unnecessary interventions.
Giving birth without drugs isn't simply a romantic back-to-nature choice. It's a matter or keeping the mother alert and actively participating in the birth, which is statistically (and logically) associated with shorter labors, fewer cases of needing inductions and c-sections, more successful nursing and quicker postpartum recovery.
Inductions are seen as very routine practice around here. I was offered an induction simply because I was a few days "overdue" (a miscalculation that repeats itself this time, as my cycle isn't average) and my contractions slowed down. When I said I prefer to go home, wait (since I wasn't given any obvious medical reason against waiting), and let nature take its course, I encountered raised eyebrows. "Don't you want it to be over already?" I was asked. For me that was entirely missing the point - but not for the doctor, who had many more women to attend and wanted the delivery room free. He tried to act in his best interests, not mine.
Epidurals, inductions and c-sections are very staff-friendly. Doctors feel much more in control when they have the laboring woman hooked to pitocin and strapped to the bed with constant fetal monitoring, than to have her monitored while she's hopping on the birthing ball and the monitor keeps sliding off her belly. Of course if the woman can't freely move around and do things that make it easier for her, most likely the pain will become unbearable.
The doctors are emotionally detached from their patient, whom (at least here in Israel) they most likely don't know, have never seen before and will never see again. They don't care if their induction will lead to a rougher labor, tougher time nursing, more painful recovery, and possibly a c-section which might put the mother in higher risk during subsequent pregnancies. Doctors, generally, don't care about your future, they care about not getting a lawsuit.
Epidural and other forms of pain-relieving medication do carry risks. There are a few women who remain forever crippled because of badly performed epidurals, and there is a vast number of women who complain about back pains for months after an epidural. Inductions carry risks, and most certainly so do c-sections. All of the interventions above should be used sparingly, carefully, thoughtfully, and for purely medical reasons but that is not the case.
Doctors allow elective c-sections for no medical reasons. I'm not sure what the case is where you live, but here in Israel, hospitals are all government-funded and all get a hefty sum for each woman who delivers her baby there. Of course they are interested in a large number of deliveries in their hospital, which means abuse of inductions and c-sections. Personally I don't think c-sections for no medical reason should be allowed, just like no decent doctor would allow me to have my appendix take out just because I feel like it.
To read a great, informative post on the subject of natural birth, go here.
What about home births? Theoretically, I think home births, when handled by an experienced midwife, are as safe as hospital births for the majority of women, with the caveat that I do believe a hospital should be readily accessible in case of unexpected complications. Home birth provides the advantage of safe, familiar environment, without the pressure of having to go somewhere, wondering whether you might be too early or too late. The safe environment of home might even lead to shorter duration of labor - the emotional factor plays a huge role in the process, and progress may simply be stalled in an unfamiliar, detached place with lots of strangers and many invasive checks. That was what happened to me, and I can't thank God enough for the good sense that prompted us to grab our things, insist on being checked out, go to a safe place (my in-laws' home) and wait for things to pick up on their own, rather than opt for chemical induction.
Practically, a home birth isn't an option for us - hospital births are government-funded here and thus free, while hiring a private midwife and having a home birth would cost thousands of dollars. I truly can't think of a case when we would feel justified to go out of our way and pay so much money without being fully convinced it's necessary for my health. A natural birth is possible in a hospital too, though undoubtedly when you go there you have to firmly stand your ground, be informed, and question every "harmless" and "routine" intervention that is being offered to you.