Spontaneous Birth Reflex

Why do we, then, continue to treat women as if their emotions and comfort, and the postures they might want to assume while in labor, are against the rules?

- Ina May Gaskin (via Birth Smart)

I’ve  been intrigued for some time by Michel Odent’s description of what he calls the “fetal ejection reflex.” Personally, I would like to rename it the “spontaneous birth reflex.” Essentially, this reflex involves the spontaneous birth of the baby without coaching or conscious effort on the part of the mother. It is most likely to occur when the mother feels very safe and very private, which may be why we do not read descriptions of it occurring during many births. In an article about the fetal ejection reflex Odent writes: “During the powerful last contractions the mother-to-be seems to be suddenly full of energy, with the need to grasp something. The maternal body has a sudden tendency to be upright. For example, if the woman was previously on hands and knees, her chest tends to be vertical. Other women stand up to give birth, more often than not leaning on the edge of a piece of furniture. A fetus ejection reflex is usually associated with a bending forward posture.

Flicked forward hips?

In the book Optimal Birth: What, Why & How, which was heavily influenced by the work of Odent, the author frequently describes spontaneous birth reflex occurring with a swift “flicked forward” motion of the mother’s hips. I found the description curious at the time that I read the book, not really conceptualizing how one would flick one’s hips forward when pushing out a baby. However, following the birth of my daughter last year, I was completely amazed to hear my husband describe the pushing stage in these words, “…you were down on your hands and knees, but then you pushed up and moved your hips forward and suddenly you were holding her.” I would describe her birth as involving an authentic spontaneous birth reflex much like Odent and Sylvie Donna (the author of Optimal Birth) describe. This is what I wrote three days after her birth:

Shortly following a spontaneous birth reflex!

I was down on hands and knees and then moved partially up on one hand in order to put my other hand down to feel what was happening…her head pushed and pushed itself down as I continued to support myself with my hand and I moved up onto my knees, with them spread apart so I was almost sitting on my heels and her whole body and a whole bunch of fluid blooshed out into my hands… I didn’t realize until some moments later than both Mark and Mom missed the actual moment of her birth. Mark because he was coming around from behind me to the front of me when I moved up to kneeling…I had felt like the pushing went on for a “long” time, but Mark said that from hands and knees to kneeling with baby in my hands was about 12 seconds.

via Alaina’s Complete Birth Story « Talk Birth.

Birth without pushing?

I’ve been meaning to write about the experience for some time and then I received a comment on an older post I wrote titled Pushing the issue of pushing in labor… which addresses physiological pushing vs. coached/directed pushing. The mother wrote: “I would so love to give birth without pushing..I hope I can do this without pushing but is it really possible?? If it’s possible, why isn’t it practiced more widely?”

While I did not experience such a dramatic spontaneous birth reflex with any of my other births, Yes! It IS possible. There are a variety of reasons why it is not practiced more widely, two common ones being that many mothers do not give birth in the atmosphere of privacy that facilitates the reflex and secondly because many birth attendants ascribe to the notion that 10 centimeters of dilation = time to push, regardless of what mother’s body is telling her to do. With my own first baby, I was checked at 10 centimeters and told I could push whenever I felt the urge. While no one coached or directed me to begin pushing, I felt like I “should” be doing so and so start to experiment with actively pushing a little with contractions. It took a little over an hour before my son was finally born. I never felt an intense or irresistible or spontaneous urge to push. With my second baby, I felt literally driven to my knees by the force of the birthing energy. I did not consciously push him out, but it definitely took several pushes and maybe about 15 minutes to push him out. There was a process of pushing involved with his birth. With my daughter, as I describe above, it was like an irresistible force gripped my body and she just came flying out with no directed physical or mental involvement from me.

Trusting the urge

I shared the mother’s question with the CfM Facebook page in order to get some other perspectives on births with “no pushing.” I received several comments to share with the questioning mother-to-be. Most mothers referenced the idea of pushing when their bodies told them to. It is difficult to communicate this with someone who has not yet experienced it—how to recognize the “urge” and what it really means to “push when your body tells you to.” I also suspect it is frustrating for women who are honestly and courageously seeking “answers” in order to best prepare their bodies, minds, and hearts for birth, to receive responses like, “just trust your body,” which can feel trite or dismissive to the pregnant woman who hungers to know. However, then once on the other side of the birthing bridge, we discover there are really few better answers to give. I believe the capacity to trust that her body will communicate the unmistakable urge to push comes with an environment where the mother is treated with dignity and respect. She has her need for privacy honored and that she is mentally able to surrender to the birthing process and let her body take over—no attempting to wrestle with or control the birth, but to dig deep and then to let go.

Personal experiences in birthing without pushing:

ARA shared: “I will say that with my last birth I started out with having coached pushing. Then I felt my body take over. The nurse told me to stop pushing and I told her I can’t my body is doing it on it’s own. It was the most awesome feeling in the world.”

And AK shared: “I pushed when my body said to do so. It was relieving!! lol

EW wrote that she, “highly recommend physiological pushing over directed pushing. listen to your body. Consider hypnobirthing if you are wanting to birth without pushing, it encourages laboring down.

DF had this experience to share: “I don’t know if this is the same thing but with my first child, the nurse didn’t listen to me when I said I thought it was time and when my midwife came to check I was crowning, I had ‘labored down’ as she called it by my body doing the work. So I only actually pushed once on her cue and my baby was here. The second child the same happened automatically I wasn’t even aware it was happening…..maybe subconsciously?

NB shared that, “Because of my uterine prolapse issues, I do not push until the baby is essentially crowning on his own. I also don’t have anyone check to see how far dilated I am (since baby #1, that is) so when that burning feeling starts to get really strong I try a gentle little push to see what happens, and that usually initiates complete crowning… at which time, despite my best efforts, I CANNOT control the pushing urge any longer because I need to get that baby out!! ;) I think it does make ‘transition’ longer in the sense that perhaps birth would have happened earlier if I’d begun pushing before the baby slid down that far on his/her own, but it makes the pushing stage much shorter and is certainly better for the baby – and me, too, since I’m not putting that strain on my uterine ligaments until the very last seconds.”

JD shared her different experiences: “With my first baby, I felt the need to push waaaay too early. (Baby turned posterior; I had back labor contractions less than a minute apart for several hours.) I spent over an hour pushing, but I can’t blame the wonderful midwives who attended my homebirth. They told me several times that it wasn’t time to push yet. But I was in so much pain, and had exhausted all my coping strategies, and just had to get that baby OUT! Then we had a dystocia, and everybody ended up yelling at me to push even though I wasn’t having a contraction, and my very calm, collected midwife sounded worried, so I pushed some more. Lots of pushing, lots of pain, lots of tearing. My second baby was smaller and lined herself up better. I didn’t push until the very end, and she came in a big hurry and surprised everybody. Nobody told me to push, and I barely needed to. So, yes, it can be done, but there are more factors at play than your doctor/midwife. I had two very different pushing experiences, both at home with the same midwife.

G wrote: “Unmedicated, midwife-assisted home birth, pushed for 3 hours, never really got the hang of it. Baby was not quite lined up right and was stuck, crowned, for an hour. I was exhausted and basically checked out. Eventually it was gravity that got him out – they hauled me upright and he basically fell out of me. I look back and wonder if maybe I should have taken more of a break after dilation – I FELT like I was ready to push, but who knows if I actually was. Maybe he would have labored down on his own if I’d just zonked out.

Why isn’t it encouraged?

I’ve already addressed several reasons why and then LDM shared these important points: “It’s not widely practiced because the obstetric timetable doesn’t allow for it. The physiological urge to push will be there, for some women sooner than others. Most care providers are taught to coach pushing (after all we all know women just can’t do the job they were designed to do) and to have that coached pushing happen under certain conditions (wait for the dr! Ok, doc is here!) Some women say they never felt any urge- they may have had normal physiological signals quelled from drugs or other common labor practices and/or they were not given time to rest and sleep after fully dilating. There is such urgency to force a baby out once she reaches 10, but if she is tired and cannot feel her body pushing, then mom probably needs a nap & maybe a snack. Letting a woman take that break is unheard of in hospitals.

And additionally, Mommy Baby Spot offered this tip: “Stay away from “helping” drugs so that your body knows what to do and learn different positions so that your body puts itself in the prime position to get the baby out with the minimum of hassle (which is different for everyone).

I thank the women who shared their experiences for their thoughts and I wish the mother who posed the question the very, very best with her upcoming birth. May you birth smoothly, peacefully, and spontaneously in harmony with your body’s wisdom, cues, and urging!

(Note: personal experiences are reprinted directly as shared on the CfM FB page, but have had some spelling corrected for readability.)

49 thoughts on “Spontaneous Birth Reflex

  1. I like this post. There are a lot of bits and pieces that I relate to from birthing my son, and some good things to keep in mind for when we have another baby. I was particularly interested in the idea of resting after full dilation before pushing. This makes sense if you are only following your body’s urges to push, but never something I had seen (or remember seeing?) spelled out before.

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  3. I felt the urge to push (more like couldn’t resist the NEED to push) with my second, but not my first. My body felt like pushing starting around 7 cm. Finally, I told them that I could wait no longer and that they better come, because the baby was coming with or without a doctor there to catch him. I pushed one time and he was there! It was incredible! Less than 5 minutes.

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  10. I recently obtained my ‘Labour and Delivery’ notes from the birth of my 6th child nearly 18 years ago. I had a very peaceful, satisfying labour – about 2 hours ‘active’ during which I was kneeling, leaning forward on a beanbag. I mostly slept/relaxed between contractions and had a more vertical posture during. The duration of my 2nd stage was recorded as ‘0’ as it had just been noted that I was fully dilated when my son ‘surfed out’ in a huge gush of water. I may have pushed once! BTW, 3rd stage was 1 hour & 50 mins while we patiently waited (at my request) for the placenta to be delivered naturally.

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  12. Each of my labours got progressively better , as my body got used to what it needed to do .
    First birth was to be honest a bit of a nightmare , 31 hours of intense continuous contractions , being felt totally in my back,no stomach sensation , finally at ten centimetres given a pudental nerve block in my perinium , and the high cavity forceps applied and rotated to pull him out over 47 minutes , he came out heavily bruised on both cheeks , but thankfully breathing and weighing a whopping nine pounds and eleven and a half ounces , had so much pain for several weeks later with a huge sore episiotomy and heavily bruised coccyx, as i said a nightmare, all on Christmas eve , I was eighteen, I was so proud of us both though, felt real sense of achievement . .
    My second son was delivered in less than half that time , 15 hours labour, and as i chose to have an epidural after my bad experience three years earlier , I obviously did’n’t feel any pushing sensations , which I feel now was a shame , because I would have liked to have had the epidural allowed to wear off instead of being topped up an hour before Dan was born , birth was far less traumatic though with a tiny cut requiring only one stitch , and my recovery a lot faster, I was on my feet so much quicker than before.
    Toms arrival a few years later was a text book labour , lasting twenty hours , as he was another large baby , and I was put on a high strength drip as baby was distressed (as Ben my first baby was also ), after a mere ten minutes of overwelming pushing , five magnificent pushes and absolutely all my effort was concentrated on pushing my son into the world, I felt the head go down and then turn that corner to crown , the most amazing sensation in the world , it was euphoric and agonising all at once , no episiotomy this time but a deep tear requiring several layers of suturing , which took ages ..he weighed nine pounds eight and a quarter ounces . Each birth is different , but with my third I actually achieved the most satisfying labour , I felt active and empowered not just a passive recepticule for birth!!

  13. I was wondering if any of the mothers that had experienced a physiological birth found they were less exhaust through the proses? I ask because in recent years I have been diagnosed with Chronic fatigue and fibromyalgia, my husband and I want to have a baby, I am doing as much research into birthing as I can to see what would be best for my situation as I am at risk of exhaustion during labour. Ps this will be my second birth but I was healthy when I had my son.

    • I’ve given birth twice, both since I developed fibromyalgia. Although I haven’t got (or at least haven’t been diagnosed with) chronic fatigue I do suffer with fatigue. I loved giving birth and looked at it as a time my body could actually do what it’s supposed to :) I was booked in for inducements with both of them as I was diagnosed with ICP, my first though decided to come on her own, my waters broke so I went in but they said I wasn’t very dilated and offered me a bath, while I was in the bath I felt the urge to just push slightly with the contractions which eased the pain and I just dozed in the bath for a while until I felt I needed to really push, at that point my friend called the midwives and they rushed me to a bed and strapped the monitors on, they went to check dilation but found the top of her head :D unfortunately the rest was hard and I wasn’t on the same wave length as my midwifes but it still went quite quickly and at the end I forced her out hard. I ended up needing stitches for tearing in a couple of places. Afterwards I quickly became tired but during I was on a high of energy and felt I could have run for miles I didn’t sleep for hours though just cuddled her and talked to her. The first full feed gave me some of the energy back as well. I believe the reason the end was so hard though was because I was on my back and being told when to push.
      With my second I was induced so I wasn’t allowed in the bath and they insisted on continual monitoring, neither I nor baby would cooperate those as I insisted on moving around upright and he wouldn’t stay by the monitors so they insisted on attaching one to his head :'( once the contractions kicked in they were more intense than my firsts and I found I had to stop pushing at the height of the contraction and continue afterwards. However I was very lucky as the midwives changed at that point and the new one loved the fact that I wanted to do it naturally and basicly stood back and said you know what your doing I’m here if you want me :) so despite all the interventions at the beginning when it really matter it was me and my husband dancing <3 My best friend fetched water and rubbed my back and I reminded myself that each contraction was only for a minute, I had my arms round Paul's neck (standing leaning forward position) and I circled my hips and pushed when it eased the pain, after a while i moved to my knees on the bed and hugged Paul over the back of the bed and then all of a sudden he was there I pushed gently and he was out and in my arms. I felt amazing, no tearing or anything, soreness was gone in a day :D and I had loads of energy, it didn't tire me out at all, which is surprising as walking up stairs is exhausting normally haha. I really believe that saying no to pain drugs and listening to and trusting my body is the reason! It's a very hard thing to do when my body's already gone wrong so many times but it's euphoric when I do and give myself over to the labour!

  14. I can’t speak directly to your situation, but it seems to me that to give birth according to your body’s timing, with minimal interference would be less tiring. An environment of peace and quiet, trust and relaxation will likely result in a calm, smooth labour and the best outcome for mother and baby. I wish you well!

  15. Wow, that is exactly what happened to me with my second! It was a beautiful home birth and I was amazed by how fast he slid out (I was standing up) My husband was barely able to catch him in time! Also, the self led pushing made all the difference. Thanks for sharing!

  16. It always amazes me when these ‘discoveries’ about what the body does naturally come to light. Since when did someone inhabiting a body not giving birth at that time know what was happening inside the body that was? ‘Directed pushing’? Please. I never listened to any of them.

  17. I am a Mom of three children, my two youngest born at home. With my second, I remember the midwife telling me ‘not to push’, and I just thought, “No way!” and began pushing – the urge was so strong. Elanor was born after three easy pushes. My youngest was very different. There was an hour gap, at least, between being fully dilated and any urge to push. I am very glad that my midwife allowed me to listen to my body. That gap allowed me to rest, gain strength, totally open up and relax, to prepare. My third child, my son, was big – well over nine pounds – and had his hand resting next to his chin. Without this resting period, I don’t think my body would have been prepared to deliver such a big baby head with a fist next to his chin! Delivery went very well, once I felt the urge to push.

  18. My first was born in a birth center where I was comfortable on the toilet and my water broke. They wanted me to get on the bed and had me on my back pushing, which I hated. I wound up with low baby heart rate and an episiotomy to get him quickly out. My next three were all born at home into my husband’s hands and all were birthed without pushing. With two of them I felt the babies move down during two contractions and then they came out with the third. With the last baby, I had all regular contractions and never felt him move down, but then he was born during the last contraction! All were born either on or beside of a toilet, too.

  19. My first was born in a birth center where I was comfortable on the toilet and my water broke. They wanted me to get on the bed and had me on my back pushing, which I hated. I wound up with low baby heart rate and an episiotomy to get him quickly out. My next three were all born at home into my husband’s hands and all were birthed without pushing. With two of them I felt the babies move down during two contractions and then they came out with the third. With the last baby, I had all regular contractions and never felt him move down, but then he was born during the last contraction! All were born either on or beside of a toilet, too.

    • So sorry for the double post! I was having trouble logging on and didn’t mean to post twice. Please feel free to delete one. Thank you! :)

  20. I had a home birth. Just me, my husband, and my midwife. I was in labor for 30+ hours (contractions every minute for that long). My water broke 96 hours BEFORE my son was born. If I didn’t have coached pushing, I would of had to go to the hospital due to risk of infection because my water broke so long before that! I NEVER felt the urge to push!

    • Excuse me, but I had to interject here…….your comment ‘If I didn’t have coached pushing, I would of had to go to the hospital due to risk of infection because my water broke so long before that!”, is a very strong statement!! Every woman is different. Your experience is unique! But in my experience of over 2000 births, I have NEVER heard of an infection due to PROM (pre-mature rupture of membranes) IN A HOMEBIRTH! In a hospital, yes, the risk is possible!!! The key is to prepare yourselves…….PROM is not a complication at home. The baby will come when it is time……furthermore, pushing after a 30+ labor puts more trauma on that baby!! The point I want to make is please don’t publicize that PROM can lead to infection at birth………research shows that it has never happened at home.

  21. Well, I guess I am different. I had natural childbirth and it was the most excruciating pain I have ever experienced. I actually prayed to die, I just wanted the pain of the contractions to end. I was in labor for 16 hours so naturally I was exhausted. My blood pressure was almost stroke level. I had developed preeclampsia. Some years later I had a ureterotomy due to kidney stones and as painful as that was, I remember my labor to be worse as far as the pain level. With my future two children, I elected to get epidurals. Those births were much easier. I never felt guilty accepting the fact that not all women can give birth easier and quicker. Genetics is a factor. Though we are similar physically, we are not all the same. Don’t suffer needlessly!

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  23. I agree and having pre eclampsia changes your expectations , the whole emphasis with pre eclampsia is to get the baby born with as little effort ie pushing as possible . i wanted a natural Odent styie birth with my first , but I developed mild pre eclamsia at 37 weeks which went on to become moderate pre eclampsia at 38 weeks with induction a few days later , I had high bp , protein in urine ++, and swelling of hands , face and feet , from the outset I was told i would not be allowed to push.
    An induction was planned for the next day , Christmas eve, but luckily I pre empted that suggestion by going into labour the night before , waters breaking at Four o clock in the morning, and it was noted that the meconium was stained a deep green , a sign of distress , at the same time , the baby seemed to be turning cartwheels and tumultuous soumersaults inside me , another sign of anoxia
    At seven am , a fast syntociin drip was started and I was given a nice strong dose of analgesic pethidine,together with an injection 20 mg of valium to control the b.p , this was started the day before , I fell fast asleep only waking at ten to a nightmare of pain , gas and air was offered , and this together with another shot of pethidine , sent me back to sleep , I awoke about midday to the news that this would be a highcavity forceps delivery , I was ten centimetres but had no urge to push at all,and the baby was still high in the pelvis, my husband was sent out , i felt sorry for him , as he would miss the birth , but he rushed in at the last minute and caught a glimpse of his son being born , I vaguely heard a voice saying its a boy and briefly opened my eyes and caught sight of a lovely baby as white as marble covered in vernix laying across my belly waiting for his cord to be clamped , thats all I remember , until next morning 17 hours later when I awoke on Christmas morning to the realisation that I had a son !! Boy did I need that sleep !! Ben awoke on the 27th December , he only stirred for feeds until then , but three days after birth he finally excreted the rest of the drugs and awoke , he whole birth was complicated by the onset of eclampsia and a large 4..410 baby.

  24. Though I wouldn’t have known what to call this before reading the article, I do think I’ve experienced spontaneous birth reflex.With the birth of my 3rd child (hospital birth, VBA2C, all natural) my body began “pushing” for me with each contraction long before I was 10 cm. My OB is amazing and never tried to stop the natural process. I was on my hands and knees (I call it crouching tiger position) when she was delivered, that was what was most effective and how my body wanted to be. I don’t think I consciously at all had to push because my body was doing it regardless. I couldn’t have stopped it if I’d tried and I loved it. I think our bodies know what to do because all my children have been large babies and maybe they needed the extra Umph to be brought into the world. I am due in 2 weeks with my 4th and I hoping for another experience like that one where my body takes over and I’m just there for the ride.

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  26. I never actively pushed at all, and in fact, had to work very hard to resist the urge to when i felt my body telling me to. When i felt that pushy contraction coming i would begin to get tense and bare down, but then i would remember to breathe out, a big long breathe, my body would relax, i could actually feel a different part of my pushing the baby out, all on its own, and i would feel that baby SLIDE through me. It was actually obvious to my that when i was actively pushing, i was really constricting the birth canal, and my baby was just getting squoze! I think actively pushing Before crowning is completely counterproductive, doing nothing but slowing down the process.

  27. I had this experience with my first baby, now 5 months old. She came 8 days early and was 7lbs 2oz. I had almost 24 hours of early labour, 20 -30 second contractions every 5min which I found very painful towards the end. Got checked by a midwife and she said I was 2-3 cm dilated but almost fully effaced so we drove to our chosen hospital an hour away, and was in hospital for just over 2 hours before the baby came. I was lucky to access the birth pool which I really enjoyed. My midwife was supporting me to have minimal interventions. I sucked on gas during contractions and think it helped me control my breathing. I would take deep breaths in and blow the air out as hard as I could along with the contraction. I kept my eyes shut for the contractions and the midwife and my fiancé sat quietly by the pool. My water broke towards the end, and I think the baby crowned. The midwife asked if I would like to get out so she could see what was happening, so I made my way to the bed – got on it on my hands and knees and the next contraction the head was out. One more contraction and the baby came out! Exactly like is mentioned in the comment above, I felt like I was just along for the ride, my body was on automatic and I couldn’t have pushed… or stopped pushing. I wasn’t consciously doing anything – my body was just totally doing its own thing. A pretty cool experience really!

  28. This is amazing to me. I was told to wait. Try to “pant” because the dr/midwife was not there and ready for my baby to come. My body pushed silently. Quietly. When they were “ready” for him to come, I pushed twice and he was born. My body was ready and he was ready. I don’t think either of us cared who “caught” him. He was coming anyway. And he did, very quickly once they were ready.

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  30. This is for Joe……you say homebirths are at risk for infection………there is no fact to that statement……I have attended thousands of homebirths and known other midwives with good statistics of no infections. Especially in a waterbirth which is my passion.

  31. This is for Joe…..you say homebirth are at risk for infections as well as hospitals?? I don’t believe that as a fact…..I’d like to know where you get that idea?? I have assisted thousands of homebirths and known other midwives with good statictics of no infections at home……Especially with a water birth……no risk at all even with PROM. But a couple has to be responsible and prepare themselves adequately.

    • Just because you attend thousands of births with no infections, doesn’t mean it can’t happen. Bacteria is everywhere, viruses are everywhere including at home.

    • I personally believe that lowered resistance to infection contributes to infections , i caught a hospital acquired infection with my third baby , which led to rehospitalistion and treatment with two different antibiotics , very unpleasant and potentially dangerous, also had hospital acquired infection after a miscarriage followed by a D and C, different hospital , I definitely think home is safer

  32. My daughter fell out. Really.

    We were planning a home birth. I spent a lot of time preparing myself. I read lots of books, articles, research…everything. I did everything I could to visualize my labor and delivery and prepare myself physically, mentally, and emotionally. In all of my preparing I had visualized what might happen if the baby came before the midwife arrived.

    When I knew I was really in labor and contractions were picking up I called my midwife to let her know. We talked on the phone for 10 min, long enough for her to talk to me through 3 contractions. She ended the conversation with, “well, you are definitely in labor but it’ll still be awhile.” I hung up the phone and went to use the bathroom. I thought I was having a bowel movement and pushed a little bit and my water broke. I looked down and realized I could see her WHOLE head! I held her head for a minute, gave a very slight push and was holding her. :-) It was the most exhilarating experience I have ever had!

    The idea that this really only happens when the one is relaxed and has privacy makes a lot of sense to me. I am completely convinced that birthing doesn’t have to be what most women think it is! It was still painful, I still had a head come out of my vagina, but it was incredible.

    My first birth was not at all like that. I delivered in a hospital and had a nurse who thought I was a nut because I didn’t want painkillers. I treated like I was ignorant. My midwife (I used a different CNM the second birth) let the nurse run the show. I was forced to lay on my back and be monitored constantly for no reason. I was told to push before my body was ready and in the end they gave me an episiotomy because I was too tired to push more. It was still a natural birth but not the experience I was looking for.

    Now, I want to help women achieve their dream birth. Really though, it’s up to the woman. Whether or not she wants to educate herself and empower herself.

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