Natural births make up a very small minority of births in the United States. Couples who desire one deserve to take a class specially geared towards helping them achieve that goal. It's no small feat, not because natural birth is so difficult (even though it certainly can be) but because in our culture women women know little about the normal birth process and have many misconceptions about birth in general. So, that's why there is a class designed for couples desiring a natural birth. However, what about the couple who does not desire or cannot have a natural birth... what do they deserve?
They deserve absolutely everything that a couple desiring a natural birth deserves.
During my time as a natural childbirth educator I have been approached by several couples saying "We already know we will have to have an epidural for medical reasons," or "We really don't desire a natural birth, but we wan't to avoid a cesarean," or "We are undecided, we want to keep our options open," and they wonder if my class is right for them. Not only have I told them that it was, but I've taught these couples, and they have loved their births.
If I teach a natural childbirth curriculum, how could the same information appeal to couples with different plans?
No Birth is Shamed, Ever
I vilify no intervention and there is no such thing as a failed birth... which I remind my classes of often. I am very honest about the risks of every intervention. We role play getting every aspect of an epidural set up (the IV, blood pressure cuff, oximeter, bladder catheter, etc) and discuss how these interventions can effect birth... but I'm very aware that even if everyone in the room is planning a natural birth, someone may need or choose medications in labor so there is no doom and gloom in this discussion. A couple planning a medicated birth should feel very comfortable. This information helps them to know what to expect so they are truly making an informed decision. No matter what a couple is planning, we thoroughly discuss how to minimize any negative effects of any intervention, how avoid additional unwanted interventions, or how to avoid an unwanted cesarean birth.
Interventions are a Fraction of Class
I've read natural childbirth books where I feel like their main approach is to try to scare people into a natural birth by mainly focusing on risks of interventions. That is valid information, but that's not the focus of this class. A couple planning a medicated birth will still need information on keeping their pregnancy low risk with nutrition and physical fitness, they will still need tools to help them in labor before they get whatever medical pain relief they desire (and they will learn those medication options), they will still have to push out their baby and decide how they want to do that too! They still have lots of decisions to make about their birth place, what newborn procedures they want done after the birth (there are lots of them), how to breastfeed their baby, bringing baby home, establishing sleeping arrangements. And we don't just mention all this in the midst of a long lecture, we dedicate a lot of time, activities, sometimes whole classes to these topics so every couple feels very prepared. I don't want anyone to feel blindsided at their birth or postpartum! Even a couple planning a cesarean birth, or that finds out they will need a cesarean during pregnancy, will gain a wealth of valuable knowledge to prepare them for their birth and life with their baby.
A Positive Birth
I don't want couples to believe that only a natural birth is a good birth. I don't believe that. I've birthed naturally and with medications and my most powerful birth was actually a medicated birth. I think it was a great birth and I'm proud of it. What I desire for all my couples is that they have a positive birth that they feel good about. If a couple desires a natural birth, I will do everything I can to help them reach that goal. I will also prepare them for departures in their birth plan in a way that doesn't undermine their ultimate goal. Not everyone who plans a natural birth will have one, so helping each couple learn how they can have a positive medicated birth or a positive cesarean birth is really important to me. For a couple who desires a medicated birth, medications might take away the sensations of birth (also might not!) but may not help a mom with all the emotional aspects of birth. Fears of either the birth process or aspects of the chosen interventions might make even a birth with excellent pain control very unpleasant. A positive natural birth, a positive medicated birth, and a positive cesarean birth all deserve thought and careful preparations.