Three suggestions for a better birth

Last in a series.

I’ll never forget the excitement I felt upon learning that I was pregnant with my first child. It didn’t occur to me at that moment, though, just how many decisions I would be making during my pregnancy that would impact my delivery and, later, motherhood. As I think back to that time, I am ever so grateful to God for all the ways He used people around me to help guide me toward wise decisions during my pregnancy.

Those early decisions truly had a huge impact on my life as a young mother and were the catalyst to becoming an advocate for educating women about God’s design for pregnancy and birth. Over the years, my husband and I have spent countless hours with expectant friends answering questions, encouraging them, and debunking fears with evidence. We came to realize that most people are naive about just how medicalized maternity care has become in the U.S. This all led us to create a space where pregnant women could gain information in a simple way to help them make informed choices rooted in evidence, and so Pregnancy by Design was born.

Here are three things we have learned that you can do to positively impact birth.

1. Your choice of birth provider is a bigger deal than you think!

I’ve come to understand that God’s design for birth (beyond being an awesome and physiologic miracle) is intended to be a way of bonding mother, father, and child. Many women think they will receive this care by default, but unfortunately that is not the case. Standard U.S. maternity care is problematic (with 1 out of 3 women having a cesarean birth). We know that being well-cared for during birth is important and sets the tone for how you step into motherhood—and we desire that to be a time of strength and encouragement for all moms.

Two models of care exist: the medical model and the midwifery model.

We came to realize that most people are naive about just how medicalized maternity care has become in the U.S.

Providers, generally obstetricians, who practice within the medical model of care view birth as precisely that—a medical event. Within the medical model, interventions are typically used at higher rates, and a similar or standard approach to care is given to every woman. On the other hand, providers, generally midwives, practicing within the midwifery model of care view pregnancy and birth as normal, physiologic processes. The midwifery model works to minimize interventions and provides a more individualized approach to care.

By understanding how these two very different models view birth, you can begin to see how you might receive different care based on your provider’s view of birth. To help our clients, we have developed the Birth Profile Assessment, which helps women discover which type of provider is the best fit for them personally. It also provides information that all pregnant women can benefit from, including how your personality traits can be best used to help you prepare for labor.

In most circumstances, your choice of provider will make a difference in what birth choices you have, the amount of autonomy you are afforded, and how likely it is that your birth will involve interventions like cesarean section.

2. Be aware of the cascade of interventions.

You may be thinking, “What exactly is the cascade of interventions?” As a quick background: routine maternity care practices in the United States tend to be intervention heavy. Often, the reason the first intervention is employed is because it makes it easier for the hospital staff and/or your provider to manage multiple patients at one time and stay on a timeline. The trouble is that once one intervention is utilized, it will often have side effects leading to another intervention, referred to as the cascade of interventions.

Think of it like taking a medication with unwanted side effects that require you to take another medication to counteract the initial one.

The top interventions that lead to a cascade of interventions are:

Labor induction.
Epidural.
Pitocin/oxytocin use in labor.
Stationary labor in bed.
Breaking the water (also known as artificially breaking the membranes).
Continuous electronic fetal monitoring (EFM).

Induction of labor is the number one preventable intervention leading to other interventions. Four out of every 10 births (41 percent) are medically induced [1]. Most women are induced because either they are getting close to their due date or their provider is concerned about them being overdue.

All methods of medical induction require labor to be monitored. (If you must be induced, request intermittent auscultation, which is not only less invasive than electronic fetal monitoring but also means you will have a 39 percent lower risk of a cesarean than with EFM. [2]

God’s design for birth (beyond being an awesome and physiologic miracle) is intended to be a way of bonding mother, father, and child.

Inducing labor when your body or baby is not ready for labor has consequences. Many couples who desire a natural birth and prepare to handle the intensity of labor without medication end up having to change their plans after induction. Labor induction is almost always harder on the body and the baby and very often leads to the need for pharmacological pain relief, which leads to its own cascade of interventions.

3. Learn as much as you can about childbirth.

If there was ever a time to be a student, it’s during pregnancy! If you’re ambitious, start learning even before you become pregnant. I say this because the more you know about how God designed the body to work in birth, the easier it will become for you to believe that you were made to do the hard and rewarding work of labor. The Bible encourages us to seek wisdom and understanding (Proverbs 3:13,4:5). I believe this applies in every area of our lives as believers, including childbirth.

There are a host of resources available for childbirth, but you will want to be sure that you tap into good, physiologic sources that are rooted in evidence. It is also very helpful to talk to friends that have had positive birth experiences as a way of encouragement and to build confidence.

Learn about your options and choices for your birth. Birthing author Diana Korte’s saying that “If I don’t know my options, I don’t have any” rings true. For instance, did you know that having a continuous support person such as a doula lowers your risk of cesarean by 25 percent? So, first learn about your options such as birth settings (homebirth, birth center, hospital birth) and labor comforts/support (waterbirth/hydrotherapy, peanut ball, hiring a doula, etc.). Next, you’ll want to create a birth plan, using a guide such as Pregnancy By Design’s Complete Guide to Writing a Birth Plan. You can then discuss your birth plan with your provider to see if they will accommodate and support your birth choices. This is best done early on in your pregnancy if possible.

Lastly—and I cannot stress this enough—while choosing a provider and writing a birth plan are important, remember that YOU are the most important aspect of how your birth will go. Think of it like training for a marathon: You can hire an amazing coach and have a great support team, but ultimately you are the one actually running the race.

Similar to training for a race, getting ready to give birth takes both mental and physical preparation as well as a good understanding of yourself in order to be best prepared.

The single best way to do this is by taking a thorough childbirth class that supports the physiologic design of birth, such as our comprehensive online Beyond the Birth Plan Childbirth Course. We are all uniquely designed by God, and so we designed this course to help each of you individually.

I hope you have found this information encouraging and helpful as you prepare to meet your new little one. I am confident that the time you put into your birth preparation will be well worth it.

Samaritan Ministries member Chandra Lattig is the creator of the Pregnancy by Design program.

The information provided in this article is for educational purposes and is not meant as medical advice. It is the opinion of the writer. The information is not meant to replace a one-on-one relationship with a qualified health professional.

Footnotes

[1] Declercq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Listening to Mothers^SM III: Pregnancy and Birth. New York: Childbirth Connection, May 2013.

[2] Dekker, R. (2021, October 20). The ARRIVE study. Evidence Based Birth®. See here.