Why There’s No ‘Right’ Way to Birth
After nearly ten months of midwifery care at a community birth center, my water broke before contractions began. A few days later we made the (then defeating) decision to accept a hospital cesarean birth after our baby’s heart rate plummeted. The surgery was largely unremarkable and family-centered. Still, some of my clearest memories include the surgeon’s comment that I would be the “perfect candidate for a VBAC,” or vaginal birth after cesarean.
Two years later, I was pregnant again and mentally prepared that a cesarean birth could be a possibility. Still, the social pressure to try for a vaginal birth had a strong hold on me. This was heightened by my professional experiences as a certified perinatal educator with a master’s in public health in maternal and child health. It was also encouraged by well-meaning advocates and providers, who assured me “my body was made for childbirth” and “people all around the world have safe births every day.” These stories proliferate in podcasts, books, and affirmations in many circles. I soon realized this kind of language centered unrealistic ideals that harm the growing group of people who can’t or don’t want to have these experiences.
After the surgeon anointed me as the “perfect candidate” for VBAC, I did everything in my power to prepare for a “natural” (the socially common descriptor for unmedicated, unassisted, vaginal) second birth. However, during labor, a test result showed that my body was not doing well. We transferred with our nurse-midwife to a hospital, and as the hours passed, our risks increased, and we again faced a c-section.
This time, surgery nearly killed me. Immediately following delivery, my blood pressure dropped to unimaginably low levels, and I hemorrhaged. My most vivid memories include the student-anesthesiologist cradling my head in his hands, pleading with his eyes that I stay with them as he asked me to talk about anything I could think of.
A few miracles and hours of savvy medical interventions later, my body stabilized and I met our second child. This time the surgeon advised that while I could endure additional pregnancies if I wished, I should not attempt additional vaginal deliveries as I would be putting myself and the baby at risk.
It further stigmatizes the pregnancies and births of marginalized groups, including people who are trans or nonbinary, choosing adoption, have disabilities, or have experienced past birth trauma.
Her tone was melancholy, but I was comforted. I hadn’t realized the guilt I was holding for experiencing another c-section. Her words were a warm, reassuring hug: “It’s not your fault.”
I knew it wasn’t my fault. But somehow, somewhere, I had internalized that I should be able to have a “natural” birth. And worse, that if I couldn’t, I had failed or my body had failed—or both.
Since then, I’ve had countless conversations with people who have carried similar shame or grieved their birth experience because it challenged the notion that they were “made for childbirth.” It breaks and motivates me to challenge narratives about who should be pregnant and how birth should happen.
If you need or want an intervention to make childbirth possible or to improve your and your baby’s health, that should be OK. It should be routinely explored during pregnancy and prenatal care by providers and incorporated into the social dialogue that shapes what it means to give birth. In my mind, it comes down to trusting and supporting birthing people—even (and especially) when things deviate from what was expected.
Prenatal care strategies have expanded to better include birth plans, but this isn’t yet supplemented with trauma-informed education that is inclusive of the full spectrum of interventions available to ensure safety and well-being. Instead, consent for unplanned interventions is often sought amid long labors or emergent circumstances, like when I signed packets of surgical documents after more than 36 hours of active labor for my first delivery.
Phrases like “natural birth,” “failure to progress,” and “failed VBAC” put an unhelpful onus on the birthing person. Yet this language proliferates in medicine and social circles alike. Following my first birth, I was encouraged to join a variety of cesarean and VBAC-related social media groups, and it didn’t take long for me to recognize the pattern of people shared about “failing” to achieve their birth plan or “giving up” their vision if they experienced cesarean birth.
This language also pits providers against birthing people while inspiring feelings of failure, shame, insecurity, isolation, and lasting harm for experiences for anything beyond unmedicated, unassisted, vaginal birth. It further stigmatizes the pregnancies and births of marginalized groups, including people who are trans or nonbinary, choosing adoption, have disabilities, or have experienced past birth trauma. And it leaves up to a third or more of the population vulnerable to worsened mental health that may be forever un- or misdiagnosed.
What if instead we summarized these circumstances in our everyday dialogue as a “safe birth” and “an ordinary need for medical support and a successful belly birth”? In medical care, what if we replaced “failure” language with more physiologically specific diagnoses like “lack of cervical thinning” with patient-centered education about what might have happened? Acknowledging that our words have power, these simple switches honor the wider spectrum of common birth experiences around the world.
Instead of insisting people were “made for childbirth,” we can ask questions like: How can I love and support you through this pregnancy and birth? Do you have a team that you trust to answer your questions and help you to feel prepared? Are you finding ways to learn about childbirth that boost your confidence? Are you feeling seen and safe when you think about childbirth? What stories have you heard about childbirth, and what do you expect yours will be like? What if it’s different from what you expect?
And, importantly, we must trust their responses.
Changing the social narrative requires that we demand more inclusive language and open-minded support of the decisions people make about their bodies. We need this now, more than ever, and it can start with our everyday conversations about pregnancy and birth.
