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Epidural or natural? No matter what kind of birth you plan for, don’t forget this!

DELIVERING
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Researchers have found that a woman's peace about childbirth has a lot less to do with pain medication than anyone thought.

I used to joke — except it wasn’t a joke — that when my baby was full term, I wished they would just knock me out, and wake me up when she was born. Giving birth is frightening and my pain tolerance is not fantastic. How quickly can we get this over with?

I assumed that the more pain you feel, the more awful your birth experience is. It seems logical, right? It turns out though, that pain isn’t always the deciding factor in whether or not we look back with peace on the way a birth went.

Researchers tried to figure out whether first-time moms who get epidurals always have better experiences giving birth, and actually found that it has a lot less to do with pain medication than they thought. The real deciding factor was the emotional component, specifically, the sense of “caring, connection, and control” that the mother felt.

“Regardless of pain management method,” it concluded, it was those three factors that determined whether a woman was satisfied with her birth experience.

That surprised me. Caring, connection, and control seem vague and unimportant compared to something as concrete and un-ignorable as physical pain. Then I thought back and realized that as bad as pain can be, emotional suffering is usually worse. I’d take a broken leg over, say, prolonged loneliness any day. I’d rather have a week of the flu than a week with depression.

If you’re trying to figure out what kind of birth you want, these “Three Cs” are something to keep in mind. In a normal birth, the evidence suggests that the kind of support you have matters at least as much as your other choices.

None of this is to say that an epidural isn’t helpful. It’s just that an epidural won’t necessarily make you feel less scared and helpless. In my case, and I think for a huge number of women, the epidural did help. It was what allowed me to feel a sense of control. It alleviated my fear, and helped me feel connected. But that’s not the case for everybody. If you’re not comfortable in a hospital setting, and you’re well educated about how your labor might go, you might get your sense of control from giving birth in a birthing center, or even at home.  

It’s not the details that matter, it’s the way the details make you feel. Your support might be your awesome OB-GYN, or your midwife, or your husband, mother, or friend. But you do need support.

And don’t make the mistake I did, and assume that pain medication and having good emotional support are at odds with each other. I always thought that I wouldn’t want a doula, or need a doctor who was present for more than just the moment of delivery, as long as I wasn’t in terrible pain. I was totally wrong. Even if you’re getting an epidural, and all the pain meds in the world, and even if you’re scheduled for a c-section, support is crucial. (Did you know you can absolutely still get a doula if you want an epidural or are having a cesarean?)

When you sit down to plan your labor and delivery, ask yourself about those Three Cs. Who will make you feel cared for? What do you need in order to feel a sense of connection to your body, your partner, your baby? What do you need in place so that you don’t feel helpless, to make sure your voice is heard and respected? That might make the most difference of all.

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