Natural childbirth – A myth?

I doubt there is much more a discussion generating topic in obstetrics right now than that of natural childbirth.  It seems like this is the rally cry for those activists that hate everything about the medical system.  The unproven gesticulations and pandering that are oft empty and yet they cause discord amongst many women.

In my earlier days I was teaching a childbirth education class at Reynolds Army Community Hospital.  The purpose of the class was pain management in labor.  I had set a number one on the floor and then on the other side of the room I placea number ten.  I then asked the women who were definitely planning a medication free delivery to stand on the one and those definitely planning an epidural to stand on ten; those in the middle to arrange themselves accordingly.  I was a bit suprised back then when all but one of the 15 women aligned themselves on the side of the room with the number one, no pain medication.  Call it my naievity or the fact that I was projecting the fact that I would want pain medication in labor.  Either way, I was being educated that there was  force at work here and I needed ot listen to it.

On the social media sites like Twitter and facebook that are countless doulas, birth activists, midwives, lawyers, pre-law students, SAHM, and others that are saying that we (modern medicine) are wrong for treating pregnancy like we do and that it is not a disease process.  I couldn’t agree more, but the mere fact that I am an OB-GYN makes these activists cringe when I agree with them.  The fact of the matter is most OB-GYN’s would agree with this statement and they are simply taking one side of the story and making grand generalizations.  You can’t make a woman take narcotics or an epidural.  Can you intimidate them or convince them to have an epidural?  Again, I doubt in most cases that there is any kind of intimidation and that most of these women are desirous to have the epidural but might be afraid because they would feel like a failure to this group of birth acitivists.  I would agree that the more invasive we become in labor the more we can increase the negative outcomes and that is why I do what the patient desires.  My induction rate is not reflective of my desires, bit of those of my patients.  My repeat cesarean section rate again is the decision between my patient and myself.  it is ludicrous to think that anyone is trying to manipulate patients into doing something they don’t want to do, and if a physician is indeed doing this then there are medical boards to look after them.

Natural childbirth is no myth.  it is a wonderful process that the many in the medical community embrace.  I want my patients to feel empowered and that they always have the first and last say in what happens to their bodies.  I ask them not to laminate their birth plans and to try and be flexible with themselves and I will be flexible with my paradigm.  it is all about teamwork not fear.