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As I’ve noted in the past, birth plans engender hostility from the staff, are usually filled with outdated and irrelevant preferences, and create unrealistic expectations among expectant mothers.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.

144 Responses to “Dr. Amy’s 6 steps to a joyful birth”

  1. missM
    June 14, 2013 at 1:05 pm #

    Thanks for bringing a logical sobering view to this argument. I commend you for seeing through the arrogant and dangerous notion that a woman has control over all aspects of her labor/birth. The reality is the only person who is totally in control of a woman’s labor and delivery is God. All one can do is hope for the best, make conscientious logical plans for the worst, and pray that the outcome is a healthy Mom and baby in whatever way it happens to occur :-).

  2. Not convinced
    June 3, 2013 at 7:15 pm #

    does anyone actually use this woman as their doctor? She is so dismissive and snarky–what a sorry excuse for a bedside manner! I am also missing any statistical data supporting the majority of her arguments…

    • DelaLuna
      June 3, 2013 at 8:04 pm #

      Read more of the posts. Many link to and explain supporting studies. Dr. Amy’s style can be off putting, but her knowledge and expertise speaks to many of us. Come in with an open mind and you may end up liking the site.

    • Ashley
      October 8, 2013 at 12:35 am #

      I dunno, I think the advice about not taking a good outcome for granted is really good advice…

  3. Ducky
    May 22, 2013 at 12:31 am #

    This post is excellent- so glad I found this blog! You’ve hit the nail on the head here….

  4. svangerskap
    May 21, 2013 at 3:32 pm #

    I’m early in my first pregnancy and I have of course been digesting every bit of information I can get my hands on. Unfortunately, it has been quite distressing because most of what I can find is anecdotal, unsupported, or just plain weird. The expectations for feelings towards an embryo/fetus/infant were making me feel like something is wrong with me. Furthermore, the natural birth advocates had me paranoid that every doctor was going to wheel me in, induce labor, give me a C section and then an episiotomy just for laughs.

    Thanks for giving me exactly what I’ve been looking for, evidence-based advice from someone with both a solid education *and* experience. I <3 this blog.

  5. Mama to 2
    May 19, 2013 at 4:47 pm #

    Hmmm-I actually really disagree with the idea that you shouldn’t have a birth plan. I don’t think it should be a prescription of exactly what should happen (i.e. “I will spend early labor walking the halls, transition in the tub, and birth on the floor in a squatting position”) because it’s ridiculous to think you’ll know what you want ahead of time, but I do think it can be valuable to list preferences. The two main things on my birth plan for my second birth were “Do not ask me to give a number on the pain scale for my pain” (I find this incredibly annoying the last time around-I actually find the pain scale annoying even when I’m not in the middle of a contraction) and “Please introduce everyone who comes into the room if I am coherent” (last time the doctor came in to talk about how they’d be inducing me and brought a girl with him who he did not introduce-and it irritated me because she was hearing personal medical info and I had no idea who she was). I think those are both very reasonable requests.

    Other reasonable requests for a birth plan I can think of off the top of my head: A woman who has a history of sexual abuse wanting minimal vaginal exams-all the people who might be examining her should probably be aware of this and be extra patient and gentle with her. Food allergies/intolerances (this should also be in the chart but as so many people I’ve talked to can attest you need to repeat it over and over again for medical staff to get it). A friend of mine was fairly high up in a professional medical organization and was pretty well known in certain medical circles she didn’t want her chart to be able to be accessed by anyone but her doctor-because she had some medical history she wanted kept private. I also know people who have a crazy mother/mother-in-law/ex who they do not want at the birth and I feel hospital staff should be aware of this and run interference. I knew another woman who had an epidural with her 3rd son and the anesthesiologist had her husband hold her down until it was over (through contractions and all), while she was screaming the entire time-with her 4th she wanted an epidural but she requested a female anesthesiologist if at all possible and she requested they stop working during contractions. All of these things seem perfectly reasonable and important for staff to understand.

    I also feel that a birth plan can be a good conversation starter between mother and provider (provided both stay professional). IE “So, I see you have written that you don’t want your labor augmented with pitocin. I can understand why, it definitely makes for stronger contractions and shouldn’t be used with every labor. Here are the situations where I feel pitocin is warranted and would be beneficial.” That way the doctor acknowledges the mom’s feelings and also tells her about his/her philosophy of labor. I truly feel if more doctors would just talk with mothers without shaming, talking down to, or belittling about their philosophy and what would happen in what situation-so many more mothers would be satisfied with their care.

  6. Elaine
    May 19, 2013 at 12:59 pm #

    My birth plan boiled down to “Please ask before doing anything if possible, even routine procedures” and “Don’t ask me if I want pain meds, I will tell you if I want them.” I figured there wasn’t much sense putting much else in the birth plan because we didn’t know what was going to end up happening. I did read up on birth and take a Bradley class, and I am glad. Though I did have some woo to unlearn, knowing what was going on and what to expect, and knowing that my care providers would be involving me in conversation about what was going on rather than just coming at me with some medical device, made me more able to be comfortable during birth. I really don’t like feeling like I have to do what a medical provider (or anyone) says. Of course if it were an emergency I would go with it, but there’s a big difference between “We’re going to do x” or just grabbing me and doing it, versus “We would like to do X now, is that all right/are you ready?” From the provider side it doesn’t really get in the way of providing care and it makes a difference from the patient side.

    • Susan
      May 19, 2013 at 2:17 pm #

      I don’t have a problem with those things on a birth plan. I’ve had a lot of patients ask that meds not be offerered unless they ask. I used to be a Bradley teacher though, and unless you had a teacher who wasn’t teaching what the Bradley leadership is teaching, you were set up to think that you had to protect yourself from the hospital. That the attitude one learns from the Bradley leadership, that they KNOW the truth about birth that the professionals don’t. I’ve had far too many parents who came from Bradley classes ( not the only classes that create this but they often do ) where it really does get in the way of providing care. What it gets in the way of the most though is truly having a good birth experience. Because who wants to give birth in the midst of an adversarial negotiation?

      • Elaine
        May 19, 2013 at 11:35 pm #

        I got a little of that from the class, and probably a little more in material we didn’t focus on, but we mostly just focused on being really confident in our own knowledge about the process so that when it came to game time we wouldn’t have to fish for knowledge about relaxation, possible labor positions, what happens in each stage of labor, and stuff like that. We would know it really well because we had been over it a bunch of times. Stuff like where the book says for the dad to fill out a “coach card” and show it to the hospital staff to let them know he’s a certified Bradley coach, all of us including the instructor laughed and agreed that was a bad idea.

        I was mainly glad we did the class because getting my husband to read about birth was pretty much impossible and I wanted him to know the basics cold and know how to advocate for me. And I do think that while assuming the medical staff will be your adversaries is a bad idea (and I probably wasted a lot of energy worrying about how I’d deal with this situation), knowing how to advocate for yourself and knowing the basics about what procedures might be done/suggested is good for a patient in any health care setting.

        And while I am less woo-ey now than I was then, I still plan to try to avoid an epidural for my next baby. I hate the idea of getting a needle stuck into my spinal column, and I don’t like rolling the dice on drug side effects if I can help it. Up to a certain point I would rather work through the pain, a known quantity, than take the unknown quantity of the epidural. I never got to the point in labor where it really seemed worth getting an epidural. If my next labor is as short as my last one I figure I’ll probably be able to handle it. If it ends up taking longer or something goes haywire, well, I’ll cross that bridge when I come to it.

  7. Daniele543
    May 18, 2013 at 4:56 pm #

    I would add to this: The birth is one day in your child’s life. It will be an important memory, but just one in what will hopefully be years to come. I seldom think about that day when cuddling my baby. I do wish some things were different and will be more confident when having my next one, but the outcome is what matters. If you find yourself getting worked up about a “negative birth experience,” breathe, shut down the computer and stare lovingly at your little one. If it gets bad, seek help from a credentialed psychologist without a bone in the issue.

    About pain relief – the video in our childbirth class included a woman taking shots of narcotics to ease the pain. My husband and I were like, that’s crazy! Then, once the pitocin hit but it was too early for an epidural, they offered me a morphine-like drug, and I agreed instantly. My induced labor (at almost 42 weeks) had stalled and they were preparing for a c-section (according to my doctor after the birth), but within a couple of hours of relaxation with the epidural, my body was able to progress. I had a slight complication with the epidural in which spinal fluid leaked and caused bad headaches for a couple of days, but even so, I’ll take that over recovering from surgery any day. If I had gone along with the trend of refusing all interventions, I hate to think about what could have been.

    • emily
      September 30, 2013 at 11:04 pm #

      THIS. sometimes the ‘cascade of intervention’ is really just a myth – a timely and simple intervention can pave the way for a natural birth more satisfying for mother and baby than obstinately continuing on until the point of exhaustion and foetal distress

  8. ol
    May 18, 2013 at 4:05 pm #

    about NCB literature and “guilt-inducing lies”. I thought a lot about what I feel as the difference between NCB (or other pseudoscience) literature and science popular texts. The way of writing is different – it is full (in NCB) of estimates and judges and marks what is good and what is bad, the texts are full of adjectives, there are not just nude facts, they have been already judged as good or bad. I may show the difference in one phrase: “A mother should breastfeed her baby” and “A good mother should breastfeed her baby”. If I as mother don’t breastfeed who am I? The first variant – of course, I’m a mother; the second I’m not a good mother, I’m a bad one.

    • Squillo
      May 18, 2013 at 7:20 pm #

      In other words, the measures are subjective and based on characteristics that are important to the writer/investigator but that may not be to every–or even most–women.

      • ol
        May 19, 2013 at 12:23 am #

        Yes, and for the reader no place has been left for his/her own conclusion, the different aspects of reality are marked as good or bad so you can agree or disagree with the author, with his marks, it’s touches the author much. Every opinion about such text is perceived as personal.

        • Eddie
          May 20, 2013 at 1:46 am #

          Good point. If you attack scientific facts, it’s not personal. If you attack someone’s intuition, you are attacking that person even if you’re not. (At least, that’s how they’ll see it.)

  9. Not My Normal Nym
    May 18, 2013 at 11:53 am #

    I can’t link to the article, but the NY Times has a story about a Preakness-winning horse that developed a life-threatening infection after giving birth. So much for trust birth.

    At 2:30 a.m. on Feb. 12, Rachel produced a filly with a marking on her head resembling a heart. It seemed an uneventful labor, and the birth was announced with a picture of mother and baby on Twitter.

    What was unusual was the foal’s size, the biggest at Stonestreet so far in the season and 15 pounds heavier than her first foal…

    The next afternoon, a caretaker noticed something amiss and called Dr. Bonnie Barr, an internal medicine specialist at Rood & Riddle Equine Hospital, who discovered fluid in Rachel’s abdomen, signaling an infection. Dr. Brett Woodie performed more than six hours of surgery, discovering that part of her small colon was damaged, allowing bacteria and fecal material to leak into her abdomen. He put away thoughts of his patient’s celebrity, knowing her survival chances were slim.

    Also, so much for breastfeeding being easy and instant bonding after birth.

    Barr cited the need for the foal to live apart from her mother as she has bonded with the nurse mare. She added: “A lot of times, too, the mare is so sick that she is using all of her energy and all her reserves to heal that she’s not making enough milk for the foal. The more important thing is for the mare to get better.”

    Banke said Rachel was raised by a nurse mare after her mother, Lotta Kim, rejected her.

  10. OBPI Mama
    May 18, 2013 at 6:24 am #

    I’ve only felt immediately smitten (for me that means ooey gooey love in the first day) with 1 out of my 4 babies (can you believe it was one of my c-section babies and not my all natural birth baby?). The rest took 3-4 days before that ooey gooey feeling set in. I remember with the others: commenting that one looked like a turtle, scared for a whole day that my 4th was gonna have “that” nose forever but it perked up, and with my vaginal birth baby I was just too exhausted and in after-pain due to tearing and broken tailbone to really bond for a bit. It takes time, mamas!
    I did have to prepare myself for not wanting pain meds though with my first and how I would deal with the pain instead. Like a marathoner mentality and doing all the prep work to prepare.

    • AmyP
      May 18, 2013 at 11:29 am #

      Fresh newborns just aren’t very pretty. They’re purple and beat up and all covered with cheesy stuff. They get prettier and prettier, though!

    • auntbea
      May 18, 2013 at 10:08 pm #

      Ha! I was convinced that I had birthed the most beautiful baby in the world, and it was only several months later that I looked back at the photos and noticed that she was actually quite funny looking.

      • May 19, 2013 at 6:59 am #

        My first daughter was gorgeous. I have a very good photograph of her in her incubator, taken before I saw her for myself. No wires or scary bits, and I still think she was gorgeous. With my second, I blurted out: she looks like a frog. A nice frog, my frog, and she did improve, but I still squirm when I think of it.

  11. j
    May 17, 2013 at 10:33 am #

    #7 to birth “professionals” (my CNM) – don’t come into my room and say “you’re sorry” I had a c-section…congratulate me on a beautiful HEALTHY LIVING baby!

  12. theadequatemother
    May 17, 2013 at 8:55 am #

    For those who are interested…the current issue of the Lancet is all about third world maternal mortality and morbidity.

  13. Anh
    May 17, 2013 at 8:46 am #

    Yes. After my daughter was born I was remarking to my friend who is an ob that I felt guilty, because I’d required pitocin, and then an epidural. I felt like I’d failed because my body had needed help to get my baby out. She answered that sure, I’d eventually have been able to get my daughter without the pitocin, but it might have taken days and I could really have damaged my pelvic floor.

    Ladies! be flexible.

    • The Bofa on the Sofa
      May 17, 2013 at 10:27 am #

      …and without the epidural, it would have hurt like a sonofabeech

  14. rh1985
    May 17, 2013 at 4:13 am #

    If I get pregnant my birth plan is I want a healthy baby, I want to be healthy, I want an epidural, and if my doctor thinks I’m going to probably need a c-section, I’d rather plan it ahead of time instead of having to have one after 10 hours of labor – I have a fear of surgery and being awake during surgery and I don’t think general anesthesia is offered anymore, so I’d rather just know ahead of time and plan for it if there’s a good reason to expect a c-section will be needed, I think I’d panic more from an emergency one. My doctor made a comment that seemed to indicate she’d be ok with an elective c-section if I really wanted one, so I’m sure she’d have no problem scheduling one at 39 weeks or whatever the current standard is if there were a medical reason to expect I’d probably need one. If general anesthesia were still used for c-sections, I’d honestly have an elective one without a second thought, but I don’t want a major surgery I have to be awake for unless it’s medically indicated.

    • Wren
      May 17, 2013 at 7:39 am #

      I found being awake for the C-section easier than going under for some other operations I’ve had. The idea of it is kind of scary, but the reality was a lot better than I feared. My blood pressure dropped twice, but both times it was fixed very quickly. I spent most of my C-section discussing cats with the anaesthetist.

    • Dr Kitty
      May 17, 2013 at 8:15 am #

      Talk to your OB.

      GA might be an option for a planned CS, although not the preferred one.

      I know OBs and anaesthetists here who have done elective CS under GA because the woman had a strong desire not to be awake during surgery, but a lot would depnd on your individual risks for anaesthetic.

      Personally, I don’t like the paralysis of a spinal, but found the surgery itself to be not at all uncomfortable or unpleasant.

    • hph
      May 17, 2013 at 1:34 pm #

      I had 4 c-sections. Not what I wanted. Recovery is rough, etc.

      First two were emergencies and so I was rather heavily sedated and practically asleep. Didn’t remember much, and so I felt sad and cheated out of a great birth and bonding, blah, blah, blah.

      So the next two were scheduled c-sections, as I was no longer a VBAC candidate. The doctor wouldn’t do sedation even though I expressed my concerns over being awake. It was awful!!! But I’m a wimp like that. I know there are many women who are fine with it. I can take straight up pain (had 20-40 hours of labor with #2), but not being AWAKE for surgery. So that’s when I realized that the emergency c-sections and no warm fuzzy memories were actually much better! Of course, being in an emergency situation is not good – it’s not like I want the baby at risk. Anyway, I was freaking out so badly, the second the baby was out they sedated me. Sweet relief. With baby #4 I was more prepared for my terror, and so I actually did a little better. I got the dr. and anesth. to let my husband come in earlier to help calm me.

      That’s just what my experience was. I know it’s not the same for all.

      So if you have a choice, I would still go for the vaginal birth. If not, maybe they will let you have sedation instead of general, as a compromise.

      • May 17, 2013 at 8:06 pm #

        I felt sad and cheated out of a great birth and bonding

        As often happens when reading comments, I have read this line several times trying to relate it to my own experience. And I can’t. I am not being snide. I understand that we are all different, and that if that is what you felt, part of me understands it quite well, understands that it is fairly normal and understandable to feel that way, that it is my own reactions which are unusual.

        But. Part of me simply cannot get the expectation that birth should be “great”, an unforgettable, unmissable experience or that sadness should be any part of the aftermath of starting your life as a mother of a whole new, miraculous individual you will love for a lifetime. And absolutely nothing will convince me that the quality of the moment of birth has anything at all to do with bonding. I had two CS, both extremely interesting experiences. The first was horrible, the second a very positive, happy experience. I learnt how kind and involved strangers can be, did a lot for my faith in human nature. I do of course feel sad that the outcome for my first daughter was negative, and has had lifelong consequences. Sad about missing something? Hardly! The moment of birth for me was a nothing, a blip. My feelings during the turmoil of that moment of not very much consequence. (My feelings when my second daughter was handed to me were on the cool side – Hello, is that who you are, glad to see you, relieved you are fine, now can someone take her off me? I’ll get to love you soon enough.)

        I was ecstatic and as high as a kite for days afterwards, but those feelings were about me, at bottom. I had achieved what I wanted, I was the mother of two daughters, all was right with the world.

        Simply, I find it easier to identify to those whose thoughts turn to a cheeseburger than those who grieve as you do. Can we decide it takes all sorts, and that moment is not of supreme importance for everyone?

        • Eddie
          May 18, 2013 at 1:52 pm #

          I think of people where something goes wrong in their wedding (or in the reception), and this “flaw” taints their marriage forever after.

          • Dr Kitty
            May 18, 2013 at 3:33 pm #

            I lost my voice completely the night before my wedding. A table collapsed at our reception. It rained. Some of my friends got lost on the way to the ceremony and arrived in the middle of the service. I forgot to put my veil down walking up the aisle.

            None of it mattered. I married the love of my life in front of my favourite people.
            How could we not have had a wonderful day?

            I don’t get Bridezillas and I don’t get Birthzillas, in that I find it almost impossible to empathise with a mindset that values process so highly over outcome.

            Life is unpredictable, messy and out of your control, acting as if it isn’t is crazy, so you need to suck it up and roll with the inevitable punches.

            It might

          • Dr Kitty
            May 18, 2013 at 3:34 pm #

            It might not be ideal, but so little in life is, and yet we manage.

          • Eddie
            May 18, 2013 at 4:06 pm #

            Yes, that is precisely how I look at it.

          • Daniele543
            May 18, 2013 at 5:03 pm #

            That’s a perfect analogy.

    • Mac Sherbert
      May 17, 2013 at 2:09 pm #

      I’ve had 2 c-sections and it’s funny how everyone has their own fears and concerns. I freaked out around the time for my 2nd because there was a chance I would have to have GA due to some blood work issues. I didn’t want to miss seeing my baby the second it came out! It was a good thing I got a spinal because if I been put under I would have requested a DNA test for the baby! (Did not look anything like my first child or us and surprisingly large)

      The nice thing about a planned c-section is that there is no rush to get the baby out. So, they can take the time to make sure the spinal is working properly and convince you it is working.

      I’m sure you know this, but you can’t see anything during the surgery. Also, I really hate the feeling of coming out of GA. I don’t like the uncounted for time…I felt way more in control being awake and I got to hear that first cry.

      Everyone is different, etc… So, you really need to talk with you Dr. when the time comes and make the best choice for you.

      • rh1985
        May 17, 2013 at 10:28 pm #

        I’ve had general anesthesia twice for other surgeries with no side effects. It just felt like I just woken up after falling asleep for a couple of moments. I guess I feel I’d be too distracted and nervous by the surgery to even notice the baby was out. If it seems likely, I’ll definitely talk to my doctor about my fears.

  15. Esther
    May 17, 2013 at 2:23 am #

    My birth plan with all 3 kids was a succinct “We’ll see how it goes and take it from there”.

  16. Marguerita
    May 16, 2013 at 11:04 pm #

    When I was pregnant I wanted to read a book instead of taking the hospital birth class. I read on Babycenter that there are two types of classes: Bradley and Lamaze. So I picked up a Bradley book and was shocked by the stupidity. I’m not from any scientific background but nothing made sense in that book! Ultrasounds are not to be trusted, lying on your back is bad but the only good position is some arbitrary and extremely uncomfortable position that made my arm fall asleep… So I signed up for my hospital class and they showed us a VHS tape of NCB types giving birth stark naked.

    • Sue
      May 17, 2013 at 3:16 am #

      I hope Amy’s new book might fill some of this obvious gap in the market for myth-busting, non-woo information for rational people.

    • Christy
      May 17, 2013 at 10:20 am #

      Where you in Montreal? The hospital birth class I was signed up for also showed a VHS tape of NCB types giving birth stark naked. Even the instructor was embarressed when she realized what was on the tape.

      • Marguerita
        May 17, 2013 at 10:52 am #

        It was in Houston and she did seem a little embarrassed. She said “The people in this video are completely naked but don’t worry – you will get a hospital gown”.

    • The Bofa on the Sofa
      May 17, 2013 at 10:39 am #

      I guess I don’t understand this. You can call me crazy (here’s my number: 2.71828), but I would think the point of a “hospital birthing class” would be to help you prepare for what to expect when you give birth in that hospital. Here are the things that you can do, here are the things you can’t do, here is (the best we can do to show you) what it is like if you do it this way, here is what it is like when it is done this way.

      I know our pre-natal class showed videos of vaginal births with and without epidural (although it is pretty useless, since you can’t really see the difference in the pain. We talked about what was involved with a c-section, but I don’t think there was any video.

      We didn’t even talk about pros and cons of NCB vs not, because that wasn’t the point of the class. We did talk about feeding options, and although the instructor is a LC, and BF was the main focus, there wasn’t any demonization of formula. It’s just that, when it comes to formula feeding, there isn’t much to say or teach. We also talked about baby care.

      It was a great course because it taught us what to expect at the hospital and for life with a baby. It didn’t presume to tell us what to do, only here’s what it is going to be like.

      • Marguerita
        May 17, 2013 at 10:58 am #

        I oversimplified, obviously – she did talk about the hospital policies. One strange thing though, in retrospect for me, was that she asked “Who is planning a C section?” and since no one wanted one we hardly got any information about it. The possibility of an emergency CS was not discussed. Also I got this false notion that once transition is over the hard part is over. It was actually quite the opposite for me! We saw a model of a skeleton pelvis and she showed us the baby going through it and said “It’s a tricky dance but it always turns out OK”. NOT.

        • Daniele543
          May 18, 2013 at 5:06 pm #

          That seems irresponsible. Ours asked something similar, and when no one raised their hand, she explained that probably 4 or however many of us would have one because emergencies and issues do come up, so we should be prepared. It made me read that chapter in my book, just in case.

  17. AmyM
    May 16, 2013 at 9:12 pm #

    Totally OT: Remember the discussions about the craziness of “no hatting?”

    Now there is a movement against swaddling, apparently it is illegal or becoming illegal or something like that in CA and PA.


    According to the article, this really pisses Dr.Karp off, and he fears that parent depression and infant abuse could increase if the movement really takes off. (on the grounds that colicky/fussy babies often do well with swaddling and if you take that tool away from their parents, the parents may be driven to depression or worse, abuse.)

    Someone in the comments noted that there seems to be a sadistic trend towards making things as difficult as possible for parents, by pointlessly creating taboos with no basis in reality.

    • AmyM
      May 16, 2013 at 9:13 pm #

      woops…I meant in CA and PA childcare centers. It is not illegal for parents to do in their own homes, though the worry is that if it is discouraged in daycares, parents may take that to mean that it is discouraged at home.

      • Elizabeth Abraham
        May 16, 2013 at 11:58 pm #

        We sent our first child to daycare quite early (I was starting business school), and were very aware that our lives would be easiest if we adopted the techniques the daycare was using for use at home. Basically, doing what they did was our best shot for assuring consistency for the baby (and therefore our best shot of making sure that all of his caregivers could feed and soothe him). Swaddling happened to work well for our baby, but if that tool hadn’t been available to the daycare, I suspect we would have tried quite hard to give it up at home, in favor of whatever substitute could be used in all situations. Our lives would, indeed, have been much harder.

      • Jennifer2
        May 17, 2013 at 7:45 am #

        They don’t swaddle at our daycare, and it was absolutely told to us that those were just DHS regulations on them and that they wished they were able to swaddle sometimes. You could bring in one of those sleep sack blankets, or they could just nap without a blanket. They were allowed to use blankets when the babies were awake, which was great because a couple babies were really fussy and needed to either be cuddled with a fuzzy blanket or bounced in a bouncer seat with a fuzzy blanket pretty much up to their chin in order to settle.

        Our daycare is also not allowed to serve breakfast after 7:45 a.m. but I don’t take that to mean that I can’t feed breakfast later than that.

      • JC
        May 17, 2013 at 2:00 pm #

        That makes more sense! I was wondering how swaddling being illegal could be enforced in homes. I can see why it could become illegal in daycares after that recent awful story.

    • May 16, 2013 at 10:39 pm #

      Um, yeah if it weren’t for the fact that it worked so well. My 12 month old had to be swaddled until he was 6 months to sleep. Honestly, I think he’d do well with it now if I’d let him, but we had to move on. I was on a narcotic like medicine when pregnant with him and swaddling was what I was told to do if his arms shook a little after birth ( this was his only symptom, thank heavens). I would swaddled him up tight and nurse him and he was perfectly fine. WTH is wrong with people? This is such a comfort for babies, and especially babies who might suffer from NAS.

    • May 17, 2013 at 4:56 am #

      There’s a woman on Baby Center who’s baby died of SIDS while swaddled in a thick flannel blanket. The baby may have overheated and died. The mother was lamenting no one explained that could happen to her and maybe it should have been common sense, but it wasn’t to her at the time. Swaddling can be great, but people need to be taught how to do it safely!

      • J. Braidz
        May 17, 2013 at 6:40 am #

        Reminds me of when we bought a baby-safe for our son when he was around 6 months old, to ensure that he would stay warm enough. This was because he kept tossing off the blanket at night. But the first night, he cried inconsolably for two hours or longer, and nothing seemed to help, before he finally went to sleep. That first night I didn’t associate the crying with the baby safe, and thought he was now going through a difficult stage. But the second night I realized what was wrong. He was simply too warm Stopped using the baby safe, and that stopped the crying. Threw it away, as far as I remember, rather than give it away. Wasn’t going to let it harm anyone else either.

        I also learned that if the baby keeps tossing off the blanket, then the blanket is probably too warm and it’s best to choose a thinner one.

        As far as swaddling goes, I know very little about it. But if it helps some babies and if there are ways to do it safely as you wrote, then that’s great. I believe (as I think most of us do here) that families should generally do whatever works for them.

        • J. Braidz
          May 17, 2013 at 6:48 am #

          I should explain that the baby-safe which I was talking about here, and this was over 20 years ago, was a sort of all-enclosing sleepwear. Not a sort of baby carseat or something like that, which the word baby-safe apparently means today. It was AFTER posting that I googled the expression “baby-safe”, and I saw that baby carseats were what came up. So I may have caused some confusion, sorry.

          • Dr Kitty
            May 17, 2013 at 8:19 am #

            Is it like a Baby sleeping bag/Grobag?

            We used one of those (light weight, no extra blankets) until the kid was about 18 months old. Never swaddled because she didn’t like it, but she loved the Grobag.

          • J. Braidz
            May 17, 2013 at 10:04 am #

            Yup. After googling “Grobag” and “baby sleeping bag”, I see that’s what it was. A google search of “baby safe” yielded one baby sleeping bag among all the other baby carriers, carseats or whatever.

            Great that a baby sleeping bag worked for your family. We used no extra blankets, and ours was sort of medium thickness, still too warm for him. As I said, whatever shows itself to work for the individual family is (as a general rule) good.

          • Mac Sherbert
            May 17, 2013 at 2:14 pm #

            The halo company makes sleep sacks in different fabrics. There’s the fleece one (my baby loves) and a light knit one (my baby does not sleep in it). So, there are lots of choices today. I found I couldn’t sleep well just leaving a blanket in the crib, but then my babies are movers.

      • JC
        May 17, 2013 at 1:57 pm #

        I always used very thin blankets when swaddling my babies. And if it was cold outside I would put one more thin blanket on top of the baby. But I always put the second blanket down low where it was nowhere near the baby’s face.

    • AmyP
      May 17, 2013 at 11:14 am #

      Isn’t it just banned for daycare?

      I can see the point of that, actually. Swaddling makes babies sleep. You don’t really want to send your infant to sleep all day at daycare and then come home and be up all night.

      With my most recent baby, I had a policy of putting her in a SwaddleMe for the night ONLY (initially with vibration and heavy rain noise) and then having her take her naps during the day at will, with no SwaddleMe. I wanted to get across to her that day and night are different.

    • JC
      May 17, 2013 at 1:53 pm #

      If swaddling became illegal, how the hell would someone enforce it? Are police officers going to do surprise 3 a.m. visits at your house to see if your baby is swaddled?

      This is ridiculous. What those daycare workers did was child abuse. They basically bound the children so they couldn’t move. That isn’t swaddling.

      Neither of my kids would take a pacifier, but they loved swaddling. So I did it as long as they wanted it and as long as they didn’t bust out of it. But both my husband and I were very careful to make sure the swaddle was not too tight. My husband was so paranoid that his swaddles were usually so loose that the babies got out of them very quickly.

      If and when I have a third baby, you’d better believe I am swaddling him/her!

      • Amy M
        May 17, 2013 at 2:50 pm #

        Yes, just at certain daycare centers…not illegal for parents to do at home. Sorry for the confusion.

        We swaddled our babies, and they were fine. Sometimes we didn’t swaddle and they were fine then too…they didn’t really seem to care. One of my favorite pics of them is when they are about 5days old, they are both swaddled up to their chins, and they are both angled the same way in the bassinet thing. They appear to be phototropic, and it’s especially funny because one has his hand up by his chin, so it looks like he’s giving it serious thought.

  18. Courtney84
    May 16, 2013 at 8:08 pm #

    I am expecting my first at Christmas time. I will be sure to spend the next 32 weeks reading this post on a regular basis.

    • Amy
      May 16, 2013 at 10:11 pm #

      One word. Don’t. This woman is a twisted, sadistic moron and anyone who listens to her rubbish is an idiot.

      • Courtney84
        May 16, 2013 at 10:17 pm #

        I’ve been following this blog for years, in anticipation of the time when I would be becoming a mother. My college degree is in biology. Her demeanor is often abrasive, but the information she shares is not rubbish. It’s usually shocking, and sometimes horrifying, but that doesn’t make it untrue.

        Every woman has the right to choose how and where to give birth to their baby. After a long struggle with infertility and repeat loss I will be choosing science, medicine, and doctors for the prenatal care and birth of my child… With out those three things I wouldn’t be having a baby at all.

        • Karen in SC
          May 16, 2013 at 10:20 pm #

          Congratulations Courtney84! Keep us all posted. We love evidenced based birth stories.

        • Susan
          May 16, 2013 at 11:36 pm #

          Good luck and congrats Courtney!

        • Sue
          May 17, 2013 at 3:20 am #

          Best wishes to you, Courtney

      • Eddie
        May 16, 2013 at 10:27 pm #

        If so, Amy, then why are you here listening to it?

      • May 16, 2013 at 10:41 pm #

        Anti-intellectualism at it’s finest. Don’t listen to the Harvard graduate and Harvard Professor–do yer own reeeeserch on teh internets o.o

      • Bomb
        May 16, 2013 at 11:26 pm #

        Well if that isn’t the response of a well informed, highly educated poster, I don’t know what is.

      • May 17, 2013 at 8:29 am #

        Double ad hom!

        You totally win the internets today.

      • BeatlesFan
        May 17, 2013 at 12:17 pm #

        You’re absolutely right- she should be reading message boards and blogs which advise such peer-reviewed recommendations as HBA4C of breech twins, the Brewer diet, having a perfect birth via positive thinking, and using cinnamon candy to stop a hemmorage.

  19. Whatever name I used last time
    May 16, 2013 at 6:57 pm #

    Dr Amy, you are fabulous. Once again, I wish I’d had this knowledge when my first child was born. But at least I had worked out some of it by the time my second one came along – and yes, it was a far more joyful birth. 🙂

  20. Val
    May 16, 2013 at 5:51 pm #

    Lovely post. Thank you!

  21. May 16, 2013 at 5:37 pm #

    “A much wanted baby” is not all that is needed – it is essential, but not sufficient. I got the much wanted baby with my first delivery. I also got a case of PTSD, a feeling of complete betrayal and abandonment, an absence of adequate pain management, and felt as though my right to make medical decisions was completely disregarded in favour of the NCB agenda. I’m not saying that birth plans are overly realistic (particularly in regards to the vagaries of planned vaginal delivery) – but there’s a range of decisions that should be respected and facilitated as they are reasonable (ie. a woman’s decision to have a planned cesarean delivery, or access to epidural pain relief).

    I would substitute #4 with “Only hire someone who is qualified and adequately trained to provide care for full range of childbirth outcomes. Someone who is unprepared for the wide array of adverse events that may happen during childbirth is not adequately trained to provide care as there is no way to determine prospectively if a woman will have an uncomplicated birth.”

  22. Denton
    May 16, 2013 at 5:28 pm #

    7. Lower your expectations. Then you won’t be disappointed.

  23. auntbea
    May 16, 2013 at 3:18 pm #

    “I never considered that there was anything necessary for a joyful birth besides a desired baby.”….who, by electing to come out the right orifice, can magically erase the effects of a lifetime of psychological injuries.

    That’s what you meant, right?

  24. Rochester mama
    May 16, 2013 at 2:42 pm #

    I did labor without pain meds not because of NCB, but because every time I’ve had pain meds in the past I’ve been sick as a dog for days afterwards. I had three prior surgeries and each time spent the first two days throwing up. I had a colonoscopy 3 years ago and still was sick for days from the sedation.

    • FormerPhysicist
      May 16, 2013 at 4:46 pm #

      Perfectly good reason. And if the pain was so bad that you felt it was worth two days of throwing up, you could have taken the meds.

  25. May 16, 2013 at 2:13 pm #

    Thank you for number 5. My first was about three months before those powerful emotions (the ones that make you learn that you could indeed kill someone if they hurt your baby) came. I loved him, but it grew over time. The other two were easy because I knew it was coming thus it happened even faster and I just welcomed them in to an already estalished adoration for their siblings. But it needed to be said

  26. Mom of 2
    May 16, 2013 at 2:12 pm #

    On birth plans: exactly! You can’t plan labor. You can’t plan complications that might necessitate induction, augmentation or c section. It’s fine to HOPE for an easy, fast labor that won’t require an epidural, but to plan for it? Nope.

    On my unit we jokingly refer to birth plans as a ticket to the OR. NCBers think this means that we purposely try to make them end up cut, but the reality is that they bring it on themselves. Very often the interventions they refuse, whether induction, AROM, Etc are what could allow a vaginal birth. Instead, they refuse everything until c section is the only option left.

    • theadequatemother
      May 16, 2013 at 2:35 pm #

      “Very often the interventions they refuse, whether induction, AROM, Etc are what could allow a vaginal birth”


      • Sue
        May 16, 2013 at 9:23 pm #

        THIS is something that needs to be promulgated widely. The term “unnecessarean” should be applied to surgery that was required because the recipient refused all the simpler and less invasive measures that could have circumvented it.

        • Cascaritas
          May 16, 2013 at 9:43 pm #

          Allow me to add another meaning for unnecesarean. The type of cesarean section that wasn’t really necessary because the mother rather have a stillbirth than a c-section.

    • Bombshellrisa
      May 16, 2013 at 4:10 pm #

      “birth plan” otherwise known as the “ideal birth scenario”.

      • Mom of 2
        May 16, 2013 at 4:49 pm #

        Yes. No point in writing it down, it will either happen or it won’t.

    • Ob in OZ
      May 16, 2013 at 9:13 pm #

      “Very often the interventions they refuse, whether induction, AROM, Etc are what could allow a vaginal birth. Instead, they refuse everything until c section is the only option left.”
      I feel like starting a conversation with ” we can do a c-section, but if you prefer to avoid that then why don’t we try x,y, or Z. We have thus far tried a whole lot of nothing, and if it had worked I would not have been asked to see you”. I won’t mention how many times this happens at 3am when it could have been 6pm and she could already have her healthy baby in her arms.

  27. Staceyjw
    May 16, 2013 at 1:39 pm #

    I cannot even keep count of how many people I have heard say:
    “I was so happy wih my first birth, I even sent a thank you card. I was so ignorant to how awful it really was- now I know better!”

    NOTHING changed about the birth, just their perception of what is considered good. They got this new definition of what a good birth (and good mom) is from NCBers.

    It reminds me of children who are happily eating a meal, enjoying it and saying it is yummy, until someone mentions it contains a hated ingredient like mushrooms. Once they hear that the food has the mushrooms in it, they spit it out, pretend to puke, and refuse to eat it. They even say “no, I don’t like it!”, even though 2 minutes prior they wanted a third helping.

    • Happy Sheep
      May 16, 2013 at 2:06 pm #

      It’s funny, I wasn’t happy with my first birth, and I blamed myself for how it went down, then falling into the Internet woo trap, I started blaming my epidural and demerol and lack of exercise, and don’t forget about the eeevil pitocin.

      It was actually finding this Site when my first was a few months old during an all night crying session that I started actually understanding what happened and I’m actually more happy with my care, since we both were alive and pretty much unscathed. I still think the whole thing sucked, but I now know that’s because labor sucks, not the care I had

      • KarenJJ
        May 16, 2013 at 8:33 pm #

        ” know that’s because labor sucks, not the care I had”

        That’s such an important distinction. Like pregnancy, how you feel during labour can’t be planned. There seems to be little control over whether you get hypermesis.

        It’s similar to those that have a difficult time after their first birth, fall into NCB and make some superficial changes, an then second birth is better and voila – it confirms their NCB was right all along. Nothing to do with second births being easier in general and expectations more in line with reality.

    • The Bofa on the Sofa
      May 16, 2013 at 2:16 pm #

      No, I spit out the mushrooms long before anyone mentions it….

  28. LovleAnjel
    May 16, 2013 at 12:52 pm #

    Here is the current iteration of my birth plan:

    1. Live, healthy baby
    2. Live, healthy mother
    3. No pain
    4. Someone else cleans up
    5. A large margarita upon finishing

    • Aussiedoc
      May 16, 2013 at 6:36 pm #

      Heree, here.

      Except mine has a large glass of wine and some Camembert at number 5 🙂

    • Aunti Po Dean
      May 16, 2013 at 11:04 pm #

      No pain…elective epidural? Otherwise there WILL be pain

  29. Eddie
    May 16, 2013 at 12:39 pm #

    #5 (Don’t expect to be immediately smitten by overwhelming love for your baby)

    This is so important. I find the concept that immediate bonding matters at all to be cloying and insulting, and yet another way for new mothers to feel bad about something that just doesn’t matter at all. If it mattered at all, then no adopted kids would never feel bonded to their parents, no foster kids would ever feel a bond to their foster parents.

    The concept of immediate bonding happening “if things go right” and being important is yet another damaging myth. I don’t see that it (the myth) provides any value at all, just harm.

    • The Bofa on the Sofa
      May 16, 2013 at 1:12 pm #

      I have said before, I am one of those who immediately fell in love with my kids, from the moment they were born. I was completely overrun with love that has not stopped since.

      But 2 things…

      1) I realize that not everyone responds this way, and

      2) Since I am not their mother, it obviously has nothing to do with how they were born

      • theNormalDistribution
        May 16, 2013 at 1:24 pm #

        I wonder if it isn’t easier to immediately bond with your children when you get to watch them be born rather than give birth to them yourself.

        • Jessica
          May 16, 2013 at 1:28 pm #

          My husband is the one who cried when our son was born, not me. I was just so relieved that I was done pushing that I couldn’t really feel any other emotion.

          • Sue
            May 16, 2013 at 9:29 pm #

            Same here – my husband was unable to take photos because he was overcome with emotion. He was the first to hold and spend time with her and became deeply besotted, despite not having gestated or birthed her.

            Neither of us had instant skin-to-skin at the time of birth, because she was wrapped, but we certainly caught up during her babyhood and childhood – no shortage of cuddles and hugs.

          • Eddie
            May 16, 2013 at 10:22 pm #

            I was really more fascinated with everything about my daughter than overcome with love. It could have been the exhaustion as well.

            And how many NCB mothers confuse exhaustion and relief that it’s over with love? Really. I don’t suggest this to be insulting, but we’re talking about very exhausted people who have just been through an ordeal. People regularly confuse all kinds of emotions with love. And since they do obviously love their kids, the memory of the first moments gets overlaid with the actual love that came shorter after. I wonder about this.

            My wife and daughter didn’t have immediate skin-to skin contact. (We didn’t consider it important.) Right after the delivery, my wife went to get a tubal ligation, since she already had the epidural in place. So I stayed with the baby. She was unswaddled, bathed, and put under a lamp. I noticed every time she cried, if I put my whole hand across her tummy, gently, for maximum skin coverage, she would stop crying every time.

          • Sue
            May 17, 2013 at 3:24 am #

            Many fathers of Cesarean babies treasure the time they get with the newborn while the mother is being stitched up and in recovery…moments they never forget.

          • Dr Kitty
            May 17, 2013 at 3:42 am #

            Yup- My DH walked around recovery singing to her. He loved those minutes he had alone with her (we got skin to skin immediately despite the CS because my gown was opened and she was lifted straight onto my chest and I held her for about 5 minutes). I did get the instant love, but I wasn’t exhausted (no labour for me), or in any pain at all, so those clearly aren’t prerequisites.

          • Box of Salt
            May 18, 2013 at 3:14 am #

            “Many fathers of Cesarean babies treasure the time they get with the newborn”

            My husband definitely does. That was when he became “daddy.”

          • May 16, 2013 at 10:46 pm #

            Count me in with a crying DH as well. I have a lovely picture of him withe our first, a gleaming tear on his cheek while out the back window you can see the sun just starting to rise on our first day as parents *sigh*. I love having all the picture because honestly, after a hard labor, drugs or no, you tend to forget a lot of it.

        • May 16, 2013 at 2:19 pm #

          Because exhaustion does nobody good.

        • theadequatemother
          May 16, 2013 at 2:37 pm #

          I completely agree. Birth is exhausting. Heck, even the third tri is exhausting. There is nothing wrong with wanting to hand off the baby to the other parent, eat a large snack, roll over, have a nap and then regroup.

    • attitude devant
      May 16, 2013 at 1:14 pm #

      It is perhaps the cruelest NCB trope of all. Do they have ANY idea what kinds of feelings of fear and failure they’re setting people up for when they promote the instant love thing? Guess what: didn’t happen to me. I had vaginal births that were uncomplicated but I found my newborns alarming in their tininess and utter dependence. But within a few weeks (and they BOTH had colic, so those weeks were not fun!) they had wrapped their tiny fingers around my heart. They still have not let go.

      • Jennifer2
        May 17, 2013 at 8:44 am #

        I was definitely enamored with my son right away. Then the epidural wore off, I realized how tiny and weird-looking he was, the feeding difficulties started, and no amount of loving him made me not develop PPD. He’s a pretty well-adjusted 2 1/2 year old now, so I’m going to say we managed to bond okay.

  30. Alison in Ottawa
    May 16, 2013 at 12:38 pm #

    I was just thinking about this, problem is, is that there is a huge lack of science-based pregnancy and birthing pages out there, even the mainstream ones incorporate a lot of Woo….

    • Staceyjw
      May 16, 2013 at 1:27 pm #

      I just didn’t read ANY of it. Really, it can be done. I limited my reading with Ds to the website that shows their size by gestational age. That was cute.

  31. theadequatemother
    May 16, 2013 at 12:30 pm #

    My plan:

    Let’s try to get this kid out vaginally.
    I want a plan to decrease the chance of this one coming precipitously outside of the hospital and away from resources.
    At the first sign of trouble, cut me. If the signs of trouble are ambiguous, cut me.

    • Happy Sheep
      May 16, 2013 at 2:00 pm #

      That was my plan for number 2 back in Feb: no screwing around, if things look bad, get him out via the escape hatch. And an epidural ASAP
      With my first there were some issues with his heart rate, then I got a fever etc etc, they chose to have me push instead of surgery (baby friendly hospital), they had the conversation in front of me if I should have one or not before I started pushing and then when his hr skyrocketed 45 min in, had to use the vacuum to get him out. Turns out he was acynclitc (sp) with his arm around his neck and his elbow up, so he wad hauled out with his head crooked to the side. He was clearly in pain and he was miserable for 2 weeks, he also couldn’t open his jaw wide enough, which the nurses and LC said was due to the vacuum being on the side of his head.
      So for #2, I decided if anything looked even the slightest bit off, we’d push for a c section, I would gladly take the hit of post surgical pain over the misery my poor first suffered for weeks.
      Of course, it turned out that I had precipitous labor and was only at the hospital for 45 minutes before he was born, so I only had IA and worst of all, no meds.

    • Laural
      May 18, 2013 at 9:14 am #

      Can you detail the plan to reduce a precipitous out of hospital birth? I need a smart, reasonable outline. The current climate is so anti-induction it leaves those precipitous labor moms in a risky predicament.

      • theadequatemother
        May 18, 2013 at 12:15 pm #

        There are only two options: schedule a c, or schedule an induction.

        Where I live the LDRs run at 100% capacity almost all of the time and it is quite difficult to get an induction unless you are post dates or medically complicated because of staff shortages. This leaves precip labor moms rolling the dice so to speak, hoping a mad dash to the LDR wont take too long. You need to find an OB that will advocate for you and really fight with the LDR nurses to let your induction go ahead.

  32. Suzi Screendoor
    May 16, 2013 at 12:28 pm #

    Due in two weeks and here is my “birth plan”
    Goal 1: Healthy baby ends up outside of my body.
    Goal 2: Minimal damage/pain for me.

  33. PoopDoc
    May 16, 2013 at 12:04 pm #

    YES YES YES!!!
    Sadly we did Bradley method, mostly because we run with a very crunchy crowd.
    We did have a birth plan, which consisted of the following:
    1) Unmedicated if possible.
    2) With medication if I want it – and don’t try to talk me out of it please.
    3) Hell yes an IV, because I need antibiotics for my GBS.
    4) Monitoring, because ignorance is NOT bliss – and I find the whoosh whoosh doppler noise soothing.
    5) Healthy baby, whatever it takes.
    I had pain meds, because I had a c-section and you’d be a moron not to.
    There was no overwhelming love for either of my kids during infancy, mostly just relief that they were finally out of me. My first was a terrible baby, so we just powered through her infancy. Number two was a calmer infant, mostly just a boring bump for the first 6 weeks.
    I love the hell out of them now and consider them the greatest gift I could ever receive.

  34. moto_librarian
    May 16, 2013 at 11:37 am #

    “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.”

    THIS!!! I felt overwhelmingly exhausted and out-of-it when they placed my first son in my arms. They hadn’t wiped him down yet, and his cord was still pulsing. I actually remember feeling rather freaked out by the umbilical cord, and I was kind of glad when they took him to clean him up. And then I had my pph, my son was admitted to the NICU for TTTN, and I didn’t see him again until 10:00 the next morning.

    I will always remember holding him for the first time in the NICU, and while I did love him, in those first few weeks, it was more of a sense of obligation than anything else. He was my responsibility, and he needed me. I was having a difficult recovery compounded by breastfeeding difficulties and a baby who had a yet undiagnosed cow’s milk protein allergy. It was a rough transition. The sense of being bonded with him took place over a couple of months, and by the time he was 4 months old, I utterly adored him. I still remember feeling some guilt because I didn’t think that we were bonding the way that we should. Looking back on it, it seems ridiculous, but at the time, I was putting a lot of pressure on myself to have the perfect “experience.”

    With my second, things were much easier, and I would say that I felt the bond much earlier with him. I credit this to several things: an easy delivery with excellent pain management, no postpartum complications, a child with an easy-going personality, and, most of all, the knowledge of how amazing a child really is, which I only gained because of my experience as a mother to my older son. Watching him grow and develop has been (and continues to be) a source of delight for me, and the realization that I was going to get to see it again with his baby brother was such a delight.

    • EmbraceYourInnerCrone
      May 16, 2013 at 1:12 pm #

      I’m glad I’m not the only one who felt this way. I remember feeling a combination of fascination, obligation and terror(went something like: I made a person, how cool…shes a cool little person that I only want good things for….oh dear FSM she is a completely helpless person entirely dependent on me, what the hell was I thinking!) It didn’t help that she was in fetal distress and had to have an NICU team get her stabilized. The falling in love with her happen gradually over the next couple of days/weeks.

      Edited to add, the lack of immediate skin to skin and the fact that I did not breastfeed does not seem to have hurt her or our relationship. I loved feeding times but also liked the fact that her Daddy and grandparents could enjoy the snuggling , feeding times and I could rest up and heal, 2 tears AND an episiotomy were NOT fun. She is in honors college and studying Physics and Environmental science (all due to HER hard work and her luck in being born to a family that could help send her to college and live where she had a good school system)

      • Amy M
        May 16, 2013 at 3:10 pm #

        Yeah, I too felt the overwhelming responsibility, and I was very concerned about the babies, but I didn’t feel the overwhelming love until they started smiling at me, about 2mos after they were born. I wasn’t bothered though—somewhere I’d already heard that the amazing immediate bonding doesn’t happen for everyone. Also, I was too exhausted to really care. They showed me the babies right before they took them for assessment (36wkers), and I needed a couple of stitches. I remember whatever nurse was holding one (maybe both?) and shoving him in my face and saying “Kiss him! Kiss your baby!” and I wasn’t in the most comfortable position to do so, shaking like a maniac and just wiped. So i gave him a peck, so she’d leave me alone.

        • Mac Sherbert
          May 17, 2013 at 4:36 pm #

          2 months seems to be the magic age. I always tell people I loved my baby before he was born, but I didn’t like him until he was 2 months old. Ha!

  35. May 16, 2013 at 11:31 am #

    Sounds like a good plan to me. For my thrid birth I had a doula and a birth plan, however, for one reason. I live in the Netherlands and the birth plan said: “If I can’t tolerate the pain, I’d want pain relief”, and my doula helped me get just that. The doula is more of the natural kind, but she never judged me for my choices and supported me perfectly! Maybe birth plans are actually helpful when you’re giving birth in a more naturally inclined environment? Just a thought.

    • Staceyjw
      May 16, 2013 at 1:45 pm #

      I think birth plans can be helpful to lay out your preferences, but at the same time, I don’t see how you will know what you want pre labor. Example: pre labor you decide you are going to have a water birth, but once it starts, you find you cannot stand the water after all.

      I guess if you are somewhere with many choices, it can help to narrow them down to the most likely ones; where I had Dd you could have wireless/waterproof monitoring, but you only got it if you were planning or going to walk /use the bath.

  36. Karen in SC
    May 16, 2013 at 11:27 am #

    These Six Steps are perfect!

    Twenty years ago when I was first pregnant, I attended La Leche League meetings for breastfeeding tips. The other mothers were mostly into extended & tandem nursing, co-sleeping, and homeschooling. There were a few homebirthers and a vaginal breech birther, too. Many times I felt out of place but the leaders always emphasized to take the information and use that part that works – there was no “right way.”

    However, I did come to believe that:

    1. epidurals drugged the baby
    2. epidurals interfered with breastfeeding
    3. all you need to succeed in an unmedicated birth is commitment

    4. supplementing causes nipple confusion

    In hindsight, I wish I would have been more open-minded and considered these six steps. My first labor was hellish with triple peak contractions and OP presentation. However it was relatively short (4.5 hrs) and I did have good doula support. So I did it again and it was much easier (no surprise there). Since visiting this sight I am very supportive of my friends who choose epidurals (and whatever) and I gently encourage the NCB ones to be flexible and aim for a healthy baby first.

  37. Gretta
    May 16, 2013 at 11:25 am #

    You know..I said that exact thing about pain medicine and both times my doctor gave me a surprised look. I felt like maybe I said something wrong.

  38. Adrianna
    May 16, 2013 at 11:24 am #

    I have a birth plan: go to the hospital, (maybe) get an epidural, have a chat with the OB or nurse, and chill out. I may or may not have my partner watch the whole thing. It depends on how we both feel about it and we’ll make that choice when we get to it. So that’s up in the air. My plan B is to have interventions. I think that sounds about right.

  39. PollyPocket
    May 16, 2013 at 11:23 am #

    #2: I made a birth plan for my second child that I think was pretty helpful

    1. Living baby, at any cost
    2. Living mom
    3. A cheeseburger within 3 feet of me as soon as the OB cleared me to eat. And a brownie.

    • LibrarianSarah
      May 16, 2013 at 11:44 am #

      Damn it you shouldn’t post something like that this close to lunchtime…And I’m only having a salad too. *sad face*

    • Amy M
      May 16, 2013 at 12:03 pm #

      Ha! I had a Csection “birth plan” which was basically the same as a vaginal birth plan I would have come up with—-aside from the “do anything you need to do to keep my babies and I safe”, it was “I would like my husband there,”, “he doesn’t want to cut the cord,” “no, I don’t want a mirror,”…more preferences really, than a plan.

    • Dr Kitty
      May 16, 2013 at 12:27 pm #

      I think I’ll steal point three next time.

      I sent my husband out after my C Section with instruction to “get me something nice to eat” and he came back with a packet of plain crackers and a bottle of water.
      I’d been thinking more of a Chinese takeaway and a carton of Ben and Jerry’s, and I think it was the closest point I have ever come to enacting physical violence!

      • theadequatemother
        May 16, 2013 at 12:31 pm #

        My parents came over the night we were discharged. I asked them to bring dinner. My mother brought a salad. I’m still mad at her.

        • EmbraceYourInnerCrone
          May 16, 2013 at 1:04 pm #

          The food at my hospital wasn’t too bad and they brought me a menu I could choose from (for what I wanted in the morning, I delivered at 1230am). I picked bacon, eggs, toast jelly, OJ and coffee. I was STARVING. Salad nnooooo! I actual smuggled lemon drops and gummy bears in my hospital bag, lemon drops to suck on during labor and the gummies for after.

          • theNormalDistribution
            May 16, 2013 at 1:18 pm #

            Yeah… I would never leave something as important as food for someone else to decide. Maybe moms would be happier with their birth experience if they focused on a birth menu instead of a birth plan.

            mmmm… birth menu…

          • Eddie
            May 16, 2013 at 1:36 pm #

            ROFL! That’s perfect! I don’t even remember what the first thing was that my wife had to eat, after. Then again, almost immediately after delivery, she had a tubal ligation, which was easy because she already had the epidural in place. (We were still charged for a second anesthesiologist.) So that interfered with her ability to eat, right after.

          • Laura
            May 16, 2013 at 4:22 pm #

            The fear with that is some crunchy moms would want their placenta served up with some lovely sea weed for all those beneficial properties….and I’m not kidding….

          • AmyP
            May 16, 2013 at 5:32 pm #

            That is brilliant.

          • theNormalDistribution
            May 16, 2013 at 5:53 pm #

            I use to fantasize about finding a way to scream “You bastard! You did this to me!” at my spouse while I’m in labor. I don’t think I’ll have a chance to do that, but a fat slab of cheesecake may make up for it.

          • theadequatemother
            May 16, 2013 at 2:39 pm #

            The food in our hospitals is pretty close to what you would get at a correctional camp for boys in the 1950s.

          • Laura
            May 16, 2013 at 4:21 pm #

            With my last baby’s birth, the hospital had a large Korean population of patients. They even have a Korean menu for those patients. The American food was so bad at that hospital that I’m guessing kim chee for breakfast would have been a remarkable improvement to what I was served. I should have reminded them that it was not a veterinary hospital – humans need people food – not dog food!

          • VeritasLiberat
            May 16, 2013 at 11:22 pm #

            My husband brought in Quiznos for baby #1… by the time we had baby 2, the hospital had completely redone food service, and it was tasty. So he came in and shared my meals (I was allowed two entrees per meal). Chocolate lava cake…

      • desiree
        May 16, 2013 at 1:10 pm #

        Oh my gosh, do we have the same husband? My BFF brought me an amazing burrio when he came to meet the baby, but he didn’t know I wasn’t cleared to eat yet. I’m not sure which was worse–nothing from my H, or the burrito I couldn’t eat.

    • Certified Hamster Midwife
      May 16, 2013 at 2:13 pm #

      Also a peanut butter milkshake. You know, for the protein.

    • Laura
      May 16, 2013 at 4:18 pm #

      Here in Southern California we have In-N-Out burger. It was close to the hospital, right next to the fabulous bagel bakery. Not hard to guess what I ate the day my 5th baby was born….yum!

      • auntbea
        May 16, 2013 at 8:03 pm #

        I am the only person who has ever lived in SoCal who does not like In-N-Out. I would much rather have McDonalds,

    • drsquid
      May 16, 2013 at 7:39 pm #

      I had a birth plan cause the hospital made me. It was epidural as soon as possible. My mom to cut the cord. That is it. Ob knew I preferred to try to deliver the twins vaginally but that healthy babies was more important and I was fine with a section. Ended up with a vacuum for twin b. oh and my 2 boxes I checked off on the hospital plan…
      Followed perfectly 🙂

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