The Fantasy of “The Birth Experience”

Um, what?  I’m sure that’s what you are thinking right now.  What does the title even mean?  What is a birth experience?  Aren’t you just pregnant, go to prenatal visits, show up at the hospital, have your baby either vaginally or by c-section, and go home?  Not quite, my friends!

In my business, the so-called birth experience is all the rage.  When you think of what us OB/GYN’s do every day, you probably think that we talk to pregnant women, answer questions, look at ultrasounds of cute little babies, listen to little baby heartbeats, and bring new life into the world.  Well, I do that, and many other things, but the majority of my time spent with pregnant women is dedicated to answering questions, alleviating concerns, and dispelling myths regarding the events surrounding birth or “The Birth Experience”.

My motivation to write this post stems from this excellent piece that was linked to by one of my fancy OB/GYN friends.  I don’t know the person that posted the piece, but she captures the main responsibility of obstetric providers–MANAGE EXPECTATIONS.  She perfectly sums up this topic that not everyone realizes is a big deal. We can’t just present one option (a beautiful, natural delivery, just the way you planned) for birth and then expect moms to be okay when it doesn’t turn out that way.

One of the main concerns of patients is whether or not they will have a C-section. There are various reasons for this concern, but an important one is that somewhere along the way, women that have C-sections are made to feel less than because they didn’t achieve a vaginal delivery.  Obviously, women that have C-sections are still mothers and are not less than, but perception is reality. No one wants to feel less than, so they look for someone to blame (doctors) and a way to change the outcome (birth plan). Many women have this fantasy of a perfect vaginal birth without pitocin or an epidural that doesn’t hurt and they become fixated on having this.  They have heard from friends, family members, articles on social media or elsewhere on the internet, documentaries, or random people that ALL doctors want to do is place IV’s, put monitors on you, put wires inside you, pump you with pain medicine, and do a C-section to get your baby out.  First of all, not true! Second of all, this starts off our doctor-patient relationship with an us vs. them mentality.  It is not ideal for you to distrust the person taking care of you at one of the most important times of your life!  When a patient states that they don’t want to have a C-section, I simply say that I cannot predict what will happen and there a lot of factors that influence the type of delivery you will have, but as long as mom is healthy and baby is head down, the plan is for vaginal delivery unless other factors occur (such as heart rate problems or labor not progressing as expected) that may change that plan.

Other common concerns are whether they will have to be induced, have internal monitoring or receive pitocin during labor.  Again, I simply state that I cannot predict what will happen, but there are certain issues with the pregnancy that may require induction and it is not a requirement to have internal monitoring or pitocin during labor, whether induced or spontaneous. There are many factors that influence the need for these interventions, many of which I cannot predict prior to admission to the hospital!

The list goes on.

There is not a one size all approach to having a baby and there are many variables. Women are all different and every birth experience is different, so they can’t be compared.

There is NOT ONE THING you can control about pregnancy and this creates tremendous anxiety for moms to be.  There is an unbelievable amount of information out there and for some, taking in the information and trying to control it by making a birth plan and creating an expectation of how the birth should happen makes them feel better.  Sometimes it works, and women get exactly what they expected and they are happy.  Sometimes, women don’t have any expectations and they have a baby one way or the other and are happy.  And sometimes, women have the complete opposite experience of what they envisioned to be their birth story, and because expectations were not managed, they are still upset, EVEN THOUGH they have a healthy baby. So as this post states, we as providers have to educate patients about all possible outcomes, and patients have to plan for the birth they want but be prepared for a different outcome and be ready to deal with that.

So glad that I read that article to stimulate me to write down my thoughts about something I deal with on a daily basis.  Let me know what you think!


6 thoughts on “The Fantasy of “The Birth Experience””

  1. I agree with you as long as positivity is always the primary thought. When I was a doula, I always helped my people write a birth plan. I felt that the birth plan helped them focus on things that were important and things that weren’t. I also helped them remember that they were in charge, for the most part. It was their birth experience.

    At the same time, I ALWAYS made them consider every other option. What if you do have a C-section, what are your choices and preferences then. If controllable. I would educate them on the fact that if there is an emergency, a lot of these choices may go right out the window and they have to follow protocol and what the doctor or Midwife says. I would even have them consider what happens if there is a stillbirth, have the partner consider what happens if there is a maternal death. None of it is things that you want to think about. Of course everyone wants ooh ah delivery, but I always felt it best to prepare for everything.

    That all being said, after writing the birth plan, we would go back to focusing on positivity. I did see a correlation between people who wanted a positive birth experience (the one they hoped for) with the ones that more likely got one, versus the ones who were scared and apprehensive and always thought the worst, and them not getting what they hoped for.

    Now from a personal standpoint, my first pregnancy I assumed I would have an amazing birthing experience (I didn’t take my own advice), a vaginal birth with no pain medication. I did go without pain medication, until the C-section. And then after the C-section, I almost died from bleeding out! So yeah, my ideal birth experience went out the window.
    With my second pregnancy, I lowered my expectations. I thought positive thoughts and hoped for my VBAC, but I was ready for all of the realm of possibility. I ended up with an amazing VBAC and birth experience!

    I believe there is so much mental connected with the physical birth experience. Both the support staff, family, nurses, doctors, midwives, and the mother herself. While there are things that are out of our control, I do believe that we can’t completely leave out the positivity or negativity surrounding the experience with having some effect on the outcome.

    1. Jen, while being positive is important, it cannot guarantee you the birth that you want and that is exactly what I am trying to convey in my post and also what is being stated in the blog post that I linked to. It is doing a disservice to patients to simply say that having a positive attitude, thinking you are in control, and having a birth plan will get you the birth that you want. Patients are not in charge–the baby is. There are so many things that can’t be controlled or predicted about what will happen when you have a baby, so we have to prepare patients for that. Some people have fast, easy labors and some people have long, arduous labors that end in c-section. For the most part, neither can be predicted in advance. For women that have fast easy labors, its easy to promote going natural and being positive, because they have never struggled. For women that have had long and hard labors, its easy to blame everything and everyone around them and focus on one thing that they feel should have been done differently and then they would have had the birth that they envisioned. We have to see both sides and realize we aren’t in control. For both of your births, nothing was in your control–you can’t predict whether you will have a c-section, whether you will hemorrhage, or whether you will have a fast, easy labor. Nothing you did influenced either outcome. So that’s what I am getting at about the fantasy of the birth experience. Patients should be involved so that they know what can happen, but a wise man once told me, “Women plan and Mother Nature laughs”. That sticks with me daily!

      1. I agree 100% I’m sorry if I did a poor job conveying that. I wouldn’t say NOTHING was in my control (I had a better chance for a better outcome with my first if I wasn’t as obese. By being healthier in my 2nd I do believe it bettered my odds. Me doing yoga I think increased my odds for a vaginal delivery…).
        But you never know because it’s not like you can go back in time and say “wait, let me do that again but this time I’ll do things differently and see what happens”.
        But yes, I was trying to agree with you in that every woman should be aware of all possibilities and that birth is a normal and healthy thing most of the time but you NEVER know what can be thrown at you by good old mother nature…

  2. You are right. Managing expectations is key! Healthy baby was my goal and with you we got just that! Ty! #bestobgyn

  3. Great post! I didn’t have a birth plan for either pregnancy. I had an idea of what I didn’t want, but no actual “plan”. I want crazy about the thought of internal monitoring. It wasn’t a big deal in the end. I certainly didn’t want a c-section but ended up with one for the second pregnancy. Sure I was disappointed, but in either experience, it still ended with the same – a healthy baby. In fact, I had a better post delivery healing after my c-section than I did from my vaginal birth and would hands down sign up for another c-section vs VBAC of I ever were to have another baby. So even though things didn’t go as planned, I liked it better in the end!

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