Fellow Doulas,

I found it very interesting that some of our "hospital" providers and nurses believe that if a "patient" is INDUCED, let me repeat that again, INDUCED, via AROM and/or Pit, but no pain meds are used, that they are discussed and documented as having a "natural labor". They believe "natural" defines no pain meds.

I personally believe that "natural" or "pure birth" is defined as NO interventions whatsoever to include: I.V, AROM, Pit etc. etc. etc. I don't understand how people can essentially redefine the term "natural". ?

1. How do you define a "natural labor & delivery"? It seems that "natural" is widely defined amongst women, providers and caregivers...

2. Additionally, how do you communicate with clients when they believe "natural" is just no pain meds...but you disagree?

Breathe.Birth.Bond

I define natural birth as a pain medication free birth. That's how our culture seems to define it, that's how most birthing women define it, and I think it's an accurate description.

The reality is that most women, somewhere between 40-70%, are induced in some way in their labour. Now let's say a woman has really planned for a natural birth, but due to the birthing place she's chosen, or pressure from her doctor, or a real medical issue she needs to be induced. What if she carries on, through super intense pit/synto contractions and doesn't ask for any pain medication. You better believe she has earned her right to say she had a natural birth. And who are we- as doulas, or doctors, or nurses- to decide what she can claim her right to? I would NEVER say to a woman, "well if you hadn't let them break your water we could have called that a natural birth."

I know someone who thinks that if you walk into a hospital to have a baby it's no longer a natural birth. I mean, seriously.

I work 99% in hospitals. We have over 90% epidural rate in our city for first time moms. My clients are more like 40%-50% natural births. If I considered that any intervention would negate a natural birth then so far this year that percentage would be .04%. Meaning 1 client had a totally natural birth.

I would define natural as unmedicated: free from chemical induction/augmentation or pain medication. This is usually what my clients mean when they say they want a natural birth. However, I realize that some medical staff call any vaginal birth free from pain medication 'all natural', and if this makes a client happy to refer to her pitocin-induced labor this way, I'm certainly not going to disagree. But having personally been through both an induced labor and a spontaneous labor, I'd say that induced contractions are very unnatural (i.e., not what your own body would do to you).

personally? i believe that a truely natural birth would be unassisted, no intervention at all, be it mechanical or chemical.

but then, whatever a client wants to call their birth, you should let them do so. and, that's why when someone tells you "i want a natural birth" you must ask what exactly means natural for them? go over step by step all their options and ask their opinion on them and don't go just by the label...

Good question!

I always ask it at the intake to make sure we are speaking the same language. I have found with my clients that some mean natural birth to be intervention free while others simply want to avoid pain meds, and still others will be somewhere in the middle. Once we understand each other, I encourage them to them to get the same clarification with their health care provider so that they speak the same language, too.

A natural beginning to labour, a natural labour (no augmentation, pain meds, anything) and a natural third stage = Natural birth. To me, that is the only "natural birth". Everything else isn't. Not many think like this, and I'm aware it's more down to personal terminology than anything else, but I refuse to call either of my labours and births natural.

I confused a few doctors/nurses with that haha - they asked if I had a natural (or normal) birth, I said no, they said "oh, so it was a caesarean?", I said no again I knew they meant had I had a vaginal birth, but I was difficult on purpose to prove a point.

That's why I rarely use the term "natural". I use medicated or unmedicated to indicate if an epidural was used or not. If we are calling an unmedicated birth "natural" then that implies a medicated birth was "unnatural" and I am not going to label a woman's birth as unnatural. It's up to the parents to determine how to label their births.

I'm now revising my answer after watching a totally natural, unhindered, undisturbed birth turn into a 'problem' within seconds after mom is no longer 'allowed' to follow what was working perfectly before. Luckily, no severe damage was done, but I'm still shaken by being totally unable to influence something that should never have happened.

Natural birth is more complex than just not having drugs or instruments involved. From the provider standpoint, it's an attitude of respect, patience and assuming that mom will move and act in ways that facilitate labor. Keeping a close eye on things and making helpful suggestions is fine, but if everything is looking great, BACK OFF. Yelling at mom that she can't do this or that because it's bad for the CLEAN-UP CREW is not facilitating a natural birth.

I now don't even believe a totally natural birth is possible in a high-intervention hospital with a high-intervention practice. Even if you show up with the baby ready to fall out, they will still find a reason your birth is abnormal, as not needing their 'help' and instruction is unacceptable.

Even medicated vs unmedicated doesn't always work though. I was induced with pitocin but other than the IV, pit and EFM I had no other interventions. I've been told my birth wasn't unmedicated because I had pitocin.

Frankly I don't get caught up in the semantics. When a client tells me they want a (insert word here) birth I ask them to tell me what that means to them.