By Sharon Muza, BS, CD(DONA), BDT(DONA), LCCE, FACCE, CLE
I have a question and maybe you can help me out? When I started working as a doula and a childbirth educator almost 15 years ago, I had a lot of terms to learn. In my doula training, I learned it was important to understand and use the same terms as my clients as they discussed their body, their pregnancy and even their identity and family structure. And I did. I am sure you do too.
When I started doing birth work, “natural childbirth” was an unmedicated vaginal birth, where the person gave birth vaginally without any pain medications, (epidural, narcotics, or nitrous oxide or others). Pitocin, forceps, vacuum, induction, etc all could be involved, but the baby came out the vagina and the parent did not use pharmacological pain relief. My clients considered this to be the definition of a “natural childbirth” and would refer to this type of birth as such. If the birthing person had pain medication, that was a medicated birth (and it was still vaginal.)
I believe over the past decade and a half, this definition has changed in the minds of my doula clients and the students in my childbirth classes. For the most part, the people giving birth today define “natural childbirth” as a vaginal birth. Of any kind. Simply, that it was not a cesarean section.
Take this short poll, and then check out the results. Are you surprised by the responses?
I have to say, it took me a while to realize that the type of birth my clients referred to when they used the phrase “natural birth” had shifted from my original knowledge of what a “natural birth” had meant some years ago. As a doula and a childbirth educator, like all of you, I support whatever birth my clients have a preference for, and I also know that desires and circumstances change. Flexibility is always helpful. I do not have a vested interest in how the baby is born but rather that families feel positive about their experience and that they felt heard and respected.
I need to remind myself when I am talking with clients and students to clarify what they mean when they refer to “natural” when talking about a birth experience. I use the terms unmedicated and medicated myself, but it is critical to understand what terms today’s parents are using. I imagine that this may be cultural, regional and be influenced by experience and history for each family.
Are you surprised by the responses so far? Let me know what you think in the comments section below.
I saw this change coming 25 years ago. Isn’t that wild? It started with that generation I think…I worked with teenagers from inner-city Cleveland at the time. Nurses would ask them if they wanted a “natural birth”. Pregnant people would say “Yes”. And to my shame, I had my own secret agenda of being glad they were not speaking the same language. I did come around and help clarify in time – but 25 years ago teenagers were calling vaginal “natural” and meds were not on their mind. That said – it has been more clear in California at least as a change in language starting about 1O years ago. There is still some question over it and clarification still happens. But when I hear natural now – I do check in on the meaning.
I can’t pick just one. The meaning varies from vaginal birth with many interventions to vaginal birth with no intervention. I’m sure there is a way to consider a c-section a natural birth. I generally can’t use “natural” by itself. I have to add some qualifiers to make my self clearly understood. It seems medical providers call any vaginal birth a “natural birth”.
I think this a very valid point, while attending to be the helper in achieving the best birthing experience. We should not change these trye definitions since no language is changing and therefore the facts are not changing. We can change our one on one with our clients to be more delicate towards the Mother without having to definitively change what a 100% Natural birth is and what the non sergical natural birth is to the person advocating. I think it would be unethical to change the realistic facts of informed definitions to what someone just wants us to say.
I think there are some regional differences on what people mean by “natural.” I hear a lot of chatter and variation from some birth colleagues in other areas, but in my corner of the Midwest, students and clients very much equate “natural” with an unmedicated, physiologic birth. In training doulas, I just note that there are differences in communities and lots of conversation and opinions in the birth world about the perfect terminology. As a side note, I recently had a Lamaze trainee ask me with much confusion what people meant by “physiologic birth.”
Sharon I love this topic. I find here in Birmingham that “natural birth” means anything from “a vaginal birth and not a c-section” to “NO medical interventions at all”. That’s why I say “avoid unnecessary medical interventions”. I like this way of talking about it because then nobody can “fail”, and everyone (nurses, partners, OBs etc) can all agree that it’s a good idea to avoid “unnecessary medical interventions”. Then the birthing person can decide if they feel pain medication is necessary. And sometimes interventions: epidural, c-section, induction, pitocin etc. ARE necessary. I find this is more helpful than talking about “natural birth”.
Thanks for bringing this up!
Hi Mother of 3 studying Maternity Care at Swansea University, South Wales, UK. About to start Midwifery degree in September.
In my opinion, a natural birth is beyond a normal birth. It’s a birth that is spontaneous, without medication, it can be at hospital, MLU, home or in nature ect, where women birth without any intervention at all.
If medication or forcepts ect were used, this becomes (for me) a normal birth rather than a natural birth.
Couldn’t really respond to the survey because the second question only allows one answer and it is no longer one-size-fits-all. “Natural” birth definitely means different things to different clients, so I always ask what they mean by it if they use the term. I try to avoid using the term myself both because it is now ambiguous and also because it seems to imply that any other sort of birth is “unnatural”, which feels pejorative coming from someone who has non-judgment as a key part of the job description.
As a nurse and nurse-midwife I have always understood that any vaginal birth is a natural birth because the baby exists as intended.
You are so right! On many occasions I had to stop and ask; okay, are we on the same page? 🙂
I think many women start off using the term “Natural” but most evolve to more demonstrative words such as “unmedicated” or “minimal interventions”; or use the term “Natural” in contrast with “Managed” to get the point across more clearly to the birth team. Asking “what does that mean to you?” when a mom says she wants a natural birth is a great conversation starter.