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Why Having an Epidural Should Count as Having a Natural Birth

Oct 06, 2014

Three things happened when I went to my first Lamaze class: I was forced to slow dance to "Just Breathe" by Faith Hill (almost as horrifying as labor), I learned about the joys of episiotomies, and I was repeatedly asked if I'd made a birth plan. Actually, make that a natural birth plan. I quickly came to learn that natural birth is just like regular birth, only better because you aren't medicated while a watermelon-sized human mercilessly makes its way down your birth canal. I also heard that if you really want to get in touch with your body, popping out a baby in an inflatable kiddie pool definitely earns you extra mommy-points.

Most people define a “natural birth” as delivering a baby without the aid of any kind of medication. But maybe the definition of "natural" needs to be broadened so that women don’t feel like second-class citizens for requesting an epidural.

A 2012 CDC study found that out-of-hospital deliveries (arguably the most natural of natural births) have a lower risk profile than hospital births, while a 2013 CDC study found that the c-section rate has declined to just 32.7 percent. All good news, but with the growing trend toward organic birth comes a growing (and misplaced) judgment toward mothers who embrace pain relief with open arms. I was met with more than a few side-eyes at Lamaze class when I flirted with getting an epidural, but what's so terrible about having medication shot into your spine during the most agonizing moment of your life?

The Natural Birth Movement is becoming increasingly in vogue among millennial mothers, and of course this isn't a bad thing. The CDC ran a 2008 survey of epidural and spinal anesthesia use during labor, and 39 percent of documented vaginal births in the U.S. were natural. This implies that somewhere around 61 percent of women had "unnatural" (read: medicated) births, and I'm guessing they didn't feel less connected to their birthing experience.

For some natural birth enthusiasts, it's the fear that pharmaceutical drugs will increase the likelihood of an emergency Cesarean section that makes them go med-free. For others, it's the fear that drugs will cross the placenta and harm the baby. Both are frightening possibilities, but the American College of Obstetricians and Gynecologists released a statement in 2006 (reaffirmed in 2013) explaining that epidurals do not increase the chances of C-section and a 2011 English study found that there's no difference in the Apgar scores of babies born via medicated vaginal delivery and babies born au naturale. Of course, sometimes it's impossible to avoid a C-section, but the delivery of a baby through medical intervention doesn't make a mother's birth experience any less natural. One way or another, she's still going through labor, welcoming a child into the world, and entering parenthood –– one of the most fundamental, and yes, natural, experiences a human body can go through, whether you indulged in drugs or not.

By classifying Cesarean and medicated vaginal births as unnatural, mothers who prioritize natural delivery are potentially put in a position of feeling inferior if their birth plan is unexpectedly thrown out the window. An unplanned emergency C-section is stressful enough without worrying that your birth experience was somehow less legitimate and authentic than you'd hoped.

"I wanted a low-intervention birth, but that changed when my daughter was delivered via emergency C-section at 25 weeks due to severe pre-eclampsia," says Adele Oliveira of Santa Fe, New Mexico. "A high degree of medical intervention saved both of our lives. For many women, natural birth just isn't an option, but that doesn't make our experiences less valid or valuable."

While medication-free labor is certainly a cause for celebration, new mom Lucy Foma believes we can simultaneously embrace the natural birth experience while also welcoming hospital births. "To me, a natural birth is one in which I used as little intervention as possible: no medications, no inducing, and very little help from the midwife," says Foma. "I chose to do this because I believe that my body is built to perform this task and medications would inhibit my intrinsic ability. I wanted my own experience of this process, as well as my baby's, to be intact and fully conscious so that we could embrace the moment when we first met each other. However…ultimately I think the only thing that matters in birth is that the baby and mama are ok."

The health of mother and baby is certainly paramount, and the natural birth movement does its part to educate women in the benefits of vaginal delivery (The American College of Obstetricians and Gynecologists says an estimated 2.5% of births in the U.S. are elected C-section), and encourage mothers to assume more control of their birth experience –– both great things. But the idea that women should prove their physical and mental prowess by grinning and bearing pain seems outdated, and the implication that choosing medication is unnatural is divisive. More importantly, restricting the definition of "natural" to only encompass un-medicated birth has the potential to alienate those who fear the pain of labor and want help managing that pain.

I myself felt alienated by the natural birthers in my Lamaze class, but didn't hesitate to ask for an anesthesiologist as soon as I arrived at the hospital to deliver my son. I received my epidural straight away, but after a few blissful hours of napping and watching The O.C., my medication bag sprung a leak and I spent the last six hours of my labor drug-free. The majority of my delivery fit the current definition of natural, yet being drug-free felt decidedly less organic than lying in bed with my epidural while Seth Cohen and Marissa Cooper lulled me to sleep. In fact, watching my favorite high school drama and lounging around with my boyfriend felt familiar and comforting, while being suddenly catapulted into pain felt scary, foreign and completely unnatural.

Whether you have an epidural (or a partial epidural, in my case), an emergency C-section, or an un-medicated birth, every mother's experience is special and unique. But the one thing we should have in common is permission to define our labor experience as natural. This can only happen once the term's currently restrictive definition expands to include medicated and unmedicated births, regardless of whether a child was delivered with the help of doctors, or delivered by a doula to the dulcet sounds of Sting playing a lute.

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