Dr. Amy’s 6 steps to a joyful birth


It seems like every natural childbirth blog or book has a list of “Steps to a Joyful Birth.” I find this surprising since I never considered that there was anything necessary for a joyful birth besides a desired baby.

But since everyone else is doing it, and since I’ve witnessed thousands of joyful births, as well as had four exceedingly joyous births of my own children, I thought I’d offer my set of steps.

1. Don’t read the NCB literature

One of the most striking things about women who are disappointed in the birth of a healthy, wanted baby is their disappointment is usually connected to the fact that their birth did not meet the arbitrary “standards” set by natural childbirth advocates.

I’ve read a lot of the natural childbirth literature and I can tell you that most of it is guilt-inducing lies. In the first place, NCB has no basis in either science or reality; its fundamental claims are nothing more than stuff that advocates made up to valorize their own personal choices. Moreover, NCB was fabricated by Grantly Dick-Read, a white, male eugenicist whose goal was to trick women of the “better” classes into having more children by telling them that the pain of labor was all in their heads.

Reading the NCB literature to find out what your birth ought to be like is the equivalent of reading Vogue Magazine to determine what your body ought to look like. It’s almost guaranteed to end in disappointment.

2. Don’t make a birth plan

Birth plans are worse than useless. They’re useless because they are as effective as making a “weather plan” and for the exact same reason. You have no control over how your labor will progress (or not progress) and you certainly have no control over how well your baby will tolerate that labor.

As I’ve noted in the past, birth plans engender hostility from the staff, are usually filled with outdated and irrelevant preferences, and create unrealistic expectations among expectant mothers. But the worst thing about birth plans is they don’t work. They don’t accomplish their purported purpose, make no difference in birth outcomes, and, ironically, predispose women to be less happy with the birth than women who didn’t have birth plans.

3. Don’t make any plans about pain medication until you feel the pain

Sounds obvious, right? You wouldn’t make demands about how much pain medication you will or will not take after your root canal; you’d wait until you experienced the pain and then tailor the amount of pain medication, if any, to whether you felt you needed it. Why on earth would you decide to refuse pain medication for labor until you’ve felt the pain? I know why; because once you feel the pain you’ll want the medication and the only way that NCB advocates can get you to mirror their choices is to convince you to refuse pain medication before you have any idea what the pain will be like.

Making an important decision like this, before you have accurate information is a set up for disappointment.

4. Don’t hire anyone, midwife, doula or childbirth educator, who values process over outcome

They will try to convince you that there is one BEST way to give birth and that you should feel disappointed if you don’t meet their arbitrary goal. Who needs that?

5. Don’t expect to be immediately smitten by overwhelming love for your baby

Let’s see. You’ve just spent the past 40 hours suffering an agony that you never even dreamt was possible. You haven’t slept. You haven’t eaten. You’ve thrown up repeatedly. Your nether regions (or your abdomen) feel like they are on fire. You are so tired you can barely lift your head off the pillow. And now you’re supposed to feel overwhelming love for someone you’ve never met before? It might happen, but don’t count on it.

It doesn’t matter whether you feel overwhelming love for your baby immediately after birth. That’s just another one of those NCB fantasies. You might feel that way, or it might take days or weeks to develop. That’s okay. It doesn’t need to happen immediately for you to form an ironclad bond with your baby.

6. Don’t take a good outcome for granted

This is by far and away the most important step. Any baby, especially a healthy baby, is a miracle. When you are counseled to assume that there will be no complications, and your baby will be healthy (“trust birth”) your joy, wonder and gratitude are inevitably diminished.