What to Expect When You Go to the Hospital for a Natural Childbirth

Sep9

I’ve been debating about whether to share this post or not. I’m concerned that it may come across as unnecessarily negative, pessimistic, or even “combative” or “anti-hospital.” However, I do think it is honest and I’ve decided to share it. There is a fairly “normal” course of events for women having a natural birth in a hospital setting. In order to be truly prepared to give birth in the hospital, it is important to be prepared for “what to expect” there and to know how to deal with hospital procedures. All hospital procedures/routines can be refused, but this requires being informed, being strong, and really paying attention to what is happening. I hope this list of “what to expect” with help you talk with your medical care provider in advance about hospital routines and your own personal choices, as well as help prevent unpleasant surprises upon actually showing up in the birthing room. This list is modified from material found in the book Woman-Centered Pregnancy and Birth. I am not saying that is how your specific hospital operates, but that many American hospitals function in this manner.

Expect to have at least some separation from the person who brought you to the hospital, whether this separation is due to filling out admission paperwork, parking the car, giving a urine sample, being examined in triage, etc.
Expect to remove all your clothing and put on a hospital gown that ties in the back.
Expect to have staff talk over you, not to you, and to have many different people walk into your room whenever they want without your permission and without introducing themselves.
Expect to have your cervix examined by a nurse upon admission and approximately every hour thereafter. Sometimes you may have multiple vaginal exams per hour by more than one person.
Expect to have an IV inserted into your arm, or at minimum a saline lock (sometimes called a Hep lock).
Expect to be denied food and drink (at best, expect clear liquids or ice).
Expect to give a urine sample and perhaps a blood sample.
Expect to have an ID bracelet attached to your arm.
Expect to have to sign a consent form for birth and for application of a fetal monitor that states that your doctor will be responsible for making the decisions about your care (not you).
Expect to have a fetal heart rate monitor attached around your belly—two round discs on straps that will often stay with you continuously until you give birth (or, at best, for 15 minutes out of each hour of your labor).
Expect to have your water manually broken at about 4 centimeters (or at least, strongly suggested that you allow it to be broken). After this point, expect to be encourage to have an electrode screwed into the baby’s scalp to measure the heartbeat and a tube places in your uterus to measure your contractions.
Expect to be offered pain medications repeatedly.
Expect to receive Pitocin at some point during your labor–“to speed things up.”
Expect to be encouraged (or even ordered) to remain in your bed through much of labor, especially pushing.
Expect to either have your legs put in stirrups or held at a 90 degree angle at the hips.
Expect to be told you are not pushing correctly.
Expect to hold your baby on your chest for a few minutes, before it is taken away to be dried, warmed, and checked over.
Expect the baby to have antibiotic eye ointment put into its eyes (without telling you first).
Expect to have your baby suctioned repeatedly.
Expect to be given a shot of Pitocin to make your uterus contract and deliver the placenta.
Expect not to be shown the placenta.
Expect your baby to be given a vitamin K injection.

I think it is important to note that what you can expect is often different than what you deserve and that what you can expect often reduces or eliminates your chances of getting what you deserve. In my classes, I’ve made a conscious decision to present what women deserve in birth and though I also talk about what they can expect and how to work with that, I think sometimes they are left surprised that what they actually experience in the hospital. At minimum, what you deserve are Six Healthy Birth Practices (as articulated by Lamaze):

Let Labor Begin on Its Own – Download PDF
Walk, Move & Change Positions – Download PDF
Have Continuous Support – Download PDF
Avoid Unnecessary Interventions – Download PDF
Get Upright & Follow Urges to Push – Download PDF
Keep Your Baby With You – Download PDF

As an example of what I mean about what you can expect clashing with what you deserve, consider the second healthy birth practice “Walk, Move Around, and Change Positions”—monitoring and IVs directly conflict with the smooth implementation of a practice based on freedom of movement throughout labor.

So, how do you work with or around these routine expectations and your desire for a natural birth?

Discuss in advance the type of nursing care you would like and request that your doctor put any modifications to the normal routines in your chart as “Doctor’s Orders” (if your doctor is unwilling to do so, seek a new medical care provider!)
Labor at home until labor is very well-established.
Go through the above list of “what to expect” and make a decision about how to handle each one on a case by case—you may choose to actively refuse something, you may be okay with accepting certain procedures or routines, and you can develop a coping plan for how specifically to work with any particular issue.
Take independent childbirth classes and learn a variety of techniques and pain coping practices so that your “toolbox” for working with labor is well stocked.
Hire a doula, or bring a knowledgeable, helpful, experienced friend with you. It can help to have a strong advocate with you (this may or may not be a role your husband or partner is willing to take on).
Another tactic is to “never ask permission to do what you want, but to go ahead and do it unless the hospital staff actively stops you.” (An example of this is of getting up and walking around during labor)
“Many people, if they can find no other way to get around a dangerous or unpleasant hospital policy, unobtrusively ignore it”—a good example of this is with regard to eating and drinking during labor. Restricting birthing women to ice chips or clear liquids is not evidence-based care. Bring light foods and drinks and quietly partake as you please.
Leave the hospital early, rather than remaining the full length of stay post-birth. This can minimize separation from baby and other routines you may wish to avoid.
For some additional ideas see my post, “Can I really expect to have a great birth?“

Finally, and most importantly, “birth is not a time in a woman’s life when she should have to FIGHT for anything,” so if you find that you feel you are preparing yourself for “hospital self-defense” I encourage you to explore your options in birth places and care providers, rather than preparing for a “battle” and hoping for the best. If you feel like you are going to have to fight for your rights in birth, STRONGLY consider the implications of birthing in that setting. Also, as The Pink Kit says, “hope is not a plan”—so if you find yourself saying “I hope I can get what I want” it is time to take another, serious look at your plans and choices for your baby’s birth.

Beautiful Homebirth Slideshow

Sep8

Today I was sent a link to a lovely homebirth slideshow (scroll down through the photos and story to get to the slideshow link—-the story is worth reading too. It has some good observations about why birth matters: “If you have scene the movie The Business of Being Born there is a seen where one of the OBs being interviewed states in so many words that the process of birth is unimportant that it’s the outcome that is important – a healthy baby and a healthy mom. And while he is correct that a healthy baby and a healthy mom are always the most important end result he is dead wrong about the process. The process matters – -immensely. Physically the birth process is extremely important for the long term health of the mother and the baby, emotionally and psychologically the birth process will affect a woman for the rest of her life.” Can I just say, Amen!)

I absolutely love the joyful expressions on the mother’s face immediately after birth. So beautiful! Plus, it brings that feeling from my own births back to me. On Labor Day, CAPPA posed the question:

“Happy ‘LABOR’ day from CAPPA. What I loved about labor was________________!”
My response was: The feeling of personal power at the end—the “I climbed my mountain,” I DID IT feeling. And that moment of ecstasy of holding my new baby and saying, “my baby, my baby, oh my baby” over and over 🙂 Brings tears to my eyes thinking about it!

Watching the slideshow above, also brought the memory of that same “my baby, my baby” rapture back to me.

Awakening Your Birth Power

Sep2

“If you have heard enough birth ‘war stories,’ advice, and medical information…

If you are beginning to doubt yourself and to feel confused and worried about giving birth…

It is time to focus on something simple, positive and inspirational.

It is time to come back to center and listen to your own inner wisdom.

It is time to Awaken your Birth Power.”

I recently received a copy of the book and CD set 25 Ways to Awaken Your Birth Power, by Danette Watson and Stephanie Corkhill Hyles. The book is a collection of 25 short breathing meditations each accompanied by a beautiful (and sort of whimsical) drawing. The enclosed CD has 3 tracks–the first is called “awaken your birth power for pregnancy” and consists of the relevant meditations from the book read aloud. The woman reading has a pleasant, soothing voice with a slight Australian (?) accent. The second track on the CD is “awaken your birth power for labour and birth” and consists of 48 minutes of the relevant meditations from the book read aloud. The third track is an abbreviated almost 8-minute guided meditation. This CD would be perfect to listen to while in labor. The book and its gentle illustrations is a nurturing, confidence-inspiring, birth-power-enhancing, reflective, time-out for use during pregnancy or birth.

Reading it got me thinking about ways in which women awaken their birth power during pregnancy? How did you awaken yours? I’d love to hear about it and to write more about this topic!

I reflected on the ways in which I awakened my own birth power and my sense of confidence in my own inner wisdom. Here are the ways that I came up with when considering my own pregnancies and births:

+I read like a maniac 🙂 During my second pregnancy, I read a lot of literature about unassisted birth–though I didn’t have an unassisted birth (my midwife was there for 5 minutes of my son’s birth), I found the philosophies of unassisted birthers to be very inspiring.

+I maintained a daily yoga practice that included affirmations about my ability to give birth.

+I had specific dreams that reinforced my confidence.

+I journaled daily.

+I created birth art–needle felted birth goddess sculptures during my first pregnancy. Later, I drew womb labyrinth drawings–the labyrinth is a powerful metaphor for birth and I really connect with it. There are pictures of both of these on a very neglected other blog of mine.

+I talked extensively with my very birth positive friends–no horror stories from them!

+I formed my personal philosophy about birth and its role as a sacred rite of passage.

+My mother had a blessing way ceremony for me (with both my pregnancies) that made feel special and also confident and secure.

+The materials and philosophy on the Trust Birth website. I love their “what we believe” statement. It gives me chills!

+The book Birthing from Within–one of my all-time favorite birth books and a great birth power resource.

Nothing really worried me about my second birth or my ability to do so. I feel like I had a deep and true and physical sense of confidence and trust in birth. During my second pregnancy, it became a *knowing* for me that I was a capable birth giver. I had complete trust in my body and my baby. With my first pregnancy, I remembering feeling like I was studying for the biggest test of my life–I did not yet have the deep and true sense that developed during my second pregnancy (actually, I think developed as I read voraciously during the interim between my pregnancies). I also earned my certification as a childbirth educator during the interim between births and that also increased my confidence.

I attended a performance of Birth, the play, in St. Louis last weekend. While there, I picked up one of ICAN‘s flyers called “ICAN Birth” (sponsored by Hypnobabies). I think the flyer is an excellent resource for awakening your birth power, particularly the back panel with a list of things that, “if you were my sister, I’d tell you…” I’m going to order a bunch to give away in my class packets.

How do you awaken your birth power?

Birthing Poem

Jul19

the woman speaks of birthing
After Langston Hughes’s The Negro Speaks of Rivers

I’ve known birthing
Before creation
And older than the labor of mankind
My womb is the mother of life
I carried Adam when seeds
In the garden were gestating
I pushed the head of Cronos from
Between my legs and swaddled
Him in the sands of time
I was midwife to the moon and
Made her crib in my lodge
I wailed with Demeter’s chorus
When armies stole children
Killed the land
And I’ve seen her barren lap
Turn poppy red with birth
In the spring
I’ve known birthing
Before god became a man

by Margaret Arabella Kenney

From Mothering Magazine (pg. 58, Sept-Oct 2008). I love to read this poem aloud at Blessingways. I thnk it is very powerful.

When birth doesn’t go as planned…

Jul3

Some time ago I was talking to a mother whose birth hadn’t gone as planned. She said that she knew that she needed a cesarean, but that she also knew she had missed out on a “very cool experience in life.” I think it is definitely possible to accept the need for a cesarean, while still honoring/recognizing the profound experience of giving birth vaginally. I also think it is possible to acknowledge the magnitude of becoming a mother, regardless of the what happened with the birth–having a baby is a big deal no matter what! Though I’m obviously a huge advocate of natural childbirth, I truly believe that cesareans are often an act of personal courage. I also think that all births are rites of passage and are profound transformations and initiations into motherhood. So, though while some women may have missed out on the sense of personal power that often accompanies a natural birth, they’ve all taken significant and meaningful journeys of their own.

Then, I came across a poem by an anonymous writer in the book Open Season. It reminded me in part of my thoughts above.

For Those of Us Who “Failed”

And what about us who “failed”?

The ones whose birthings were not the finest hour

of their womanhood?

The ones who did not defy all medical intervention?

Those who have no heroic defiant story to tell?

Where do we fit in?

We can’t all be the ones that change the system,

but are we less a part of the sisterhood of those

who have given birth?

To those that have shone at the hours of birth

remember those of us who have not.

Will we, like the Vietnam vets, be recognized

too little and too late?

We experienced giving birth too.

Less nobly than some maybe,

but a noble experience nonetheless.

You say you honor choices.

Can you really honor mine?

I will always honor the process which

brought forth flesh of my flesh.

I honor your births too.

Can you ever honor my experience, or will I

forever be a part of your statistics on

the way things shouldn’t be?

Remember me.

Pushing

Jun30

I have previously shared some thoughts about pushing. Today, I came across a helpful resource for first time mothers that really thoroughly explores the pushing stage of birthing your baby and has all kinds of information about “how to push” (really quick answer: with your body!). The technique shared is to “breathe the baby out”—but it really goes into how to do that and what that means. The article also talks about what your birth partner can do. Check it out: The Pushing Stage of Labor.

Skipping Birth Class?

Jun11

Yesterday, I watched a short clip on why people don’t take birth classes. The comment that I found most interesting from the expert interviewed was: “The instructors in a lot of these classes –are a little bit doctrinaire about their point of view. They made an issue out of saying ‘You’re not a real woman if you need drugs. She should go through labor and childbirth on her own with help from your spouse with breathing techniques. They made it a kind of a contest. A lot of mothers today don’t want it — they want to go in and have their baby with a pain free a time as possible.” I find this perspective about “a contest” sad and disheartening and inaccurate. It is also slightly amusing–seriously, I know NO ONE who would say to someone else “you’re not a real woman if you need drugs” least of all a professional person teaching a birth class! I think this might be an example of what someone says being different than what someone else hears: i.e. the instructor says, “all medications have an impact on the baby. Additionally, many women find a very satisfying sense of personal mastery from giving birth without medication.” The person hears, “you’re not a real woman if you need drugs.”

This reminds me of an excellent section I’m re-reading in the book Mother’s Intention: How Belief Shapes Birth about judgment and bias. The author also address how the word “balanced” is misused in childbirth education–as in, “I’m taking a class at the hospital because it will be more balanced.” Balance means “to make two parts equal”–what if the two parts aren’t equal though? What is the value of information that appears balanced, but is not factually accurate? Pointing out inequalities and giving evidence-based information does not make an educator “biased” or judgmental–it makes her honest! (though honesty can be “heard” as judgment when it does not reflect one’s own opinions or experiences). She says, “Every person has a lens. Every opinion is biased, including the ones you hold. The question is, what created the perception leading to a particular bias?…When it comes to childbirth and parenting, when someone dismissed information as ‘biased,’ what it actually means is the information does not fit their already held biases. It is our insecurities that bring up defensiveness in the face of judgment, or perceived judgment, as the case may be…You may never even have a thought in your head that the other person could have or should have done anything differently, but they are seeing your actions through their own lens and making assumptions.” (i.e. if a mother had a homebirth it may be assumed she hates doctors and hospitals). I think this is exactly what was happening in the video clip–because a birth educator shares the benefits of natural birth, the assumption is that she “hates epidurals” and thinks you’re “not a real woman” if you have one!

As far as the “contest” idea goes, I’ve mentioned this before–just because someone runs a marathon, for example, doesn’t make the person who opted out of the marathon bad or “less than” 🙂

The expert in the video clip referenced above also emphasized several times that the time investment in classes is just too much and parents just “don’t want to invest.” So, now perhaps this IS “doctrinaire” or unpleasant of me, but I also find it a little frustrating that people are apparently unwilling to invest the time in preparing for their children’s births–most people watch more than 8 hours of TV a WEEK, but 8 or 10 hours of birth classes total is too much to invest? I hope my classes are exciting and informative and useful to the parents that come to them. I also realize that week after week CAN feel like a lot, which is why I designed my single session classes. I get a lot of interest in the single session classes and I’m glad I came up with them, because I think it allows me to better meet more people’s unique needs! In fact, so far this year, I’ve done only mix-and-match classes (from 1-4 weeks), no full six-week-series’ (perhaps they are a thing of the past?). I find I get clients who are very well-informed and interested and that these classes “hightlight” the things they are most interested in learning about, though they often tell me at the end that they wish they had signed up for more classes!

Can I really expect to have a great birth?

Jun3

I received a comment via another blog asking “given my limited situation, can I really expect to have a great birth today?” (homebirth, midwife, and doula were all not options for the person asking the question). I think the answer is a qualified “yes.” The question really got me thinking about ways to help yourself have a great birth, when your overall choices are limited. I came up with a long list of ideas of things that may help contribute to a great birth:

Choose your doctor carefully—don’t wait for “the next birth” to find a compatible caregiver. Don’t dismiss uneasiness with your present care provider. As Pam England says, “ask questions before your chile is roasted.” A key point is to pick a provider whose words and actions match (i.e. You ask, “how often do you do episiotomies?” The response, “only when necessary”—if “necessary” actually means 90% of the time, it is time to find a different doctor!). Also, if you don’t want surgery, don’t go to a surgeon (that perhaps means finding a family physician who attends births, rather than an OB, or, an OB with a low cesarean rate).
If there are multiple hospitals in your area, choose the one with with the lowest cesarean rate (not the one with the nicest wallpaper or nicest postpartum meal). Hospitals—even those in the same town—vary widely on their policies and the things they “allow” (i.e. amount of separation of mother and baby following birth, guidelines on eating during labor, etc.)
When you get the hospital, ask to have a nurse who likes natural birth couples. My experience is that there are some nurses like this in every hospital—she’ll want you for a patient and you’ll want her, ask who she is! If possible, ask your doctor, hospital staff, or office staff who the nurses are who like natural birth—then you’ll have names to ask for in advance.
Put a sign at eye level on the outside of your door saying, “I would like a natural birth. Please do not offer pain medications.” (It is much easier to get on with your birth if you don’t have someone popping in to ask when you’re “ready for your epidural!” every 20 minutes.)
Work on clear and assertive communication with your doctor and reinforce your preferences often—don’t just mention something once and assume s/he will remember. If you create a birth plan, have the doctor sign it and put it in your chart (then it is more like “doctor’s orders” than “wishes”). Do be aware that needing to do this indicates a certain lack of trust that may mean you are birthing in the wrong setting for you! Birth is not a time in a woman’s life when she should have to fight for anything! You deserve quality care that is based on your unique needs, your unique birthing, and your unique baby! Do not let a birth plan be a substitute for good communication.
Cultivate a climate of confidence in your life.
Once in labor, stay home for a long time. Do not go to the hospital too early—the more labor you work through at home, the less interference you are likely to run into. When I say “a long time,” I mean that you’ve been having contractions for several hours, that they require your full attention, that you are no longer talking and laughing in between them, that you are using “coping measures” to work with them (like rocking, or swaying, or moaning, or humming), and that you feel like “it’s time” to go in.
Ask for the blanket consent forms in advance and modify/initial them as needed—this way you are truly giving “informed consent,” not hurriedly signing anything and everything that is put in front of you because you are focused on birthing instead of signing.
Have your partner read a book like The Birth Partner, or Fathers at Birth, and practice the things in the book together. I frequently remind couples in my classes that “coping skills work best when they are integrated into your daily lives, not ‘dusted off’ for use during labor.”
Practice prenatal yoga—I love the Lamaze “Yoga for Your Pregnancy” DVD—specifically the short, 5-minute, “birthing room yoga” segment. I teach it to all of my birth class participants.
Use the hospital bed as a tool, not as a place to lie down (see my How to Use a Hospital Bed without Lying Down handout)
If you feel like you “need a break” in the hospital, retreat to the bathroom. People tend to leave us alone in the bathroom and if you feel like you need some time to focus and regroup, you may find it there. Also, we know how to relax our muscles when sitting on the toilet, so spending some time there can actually help baby descend.
Use the “broken record” technique—if asked to lie down for monitoring, say “I prefer to remain sitting” and continue to reinforce that preference without elaborating or “arguing.”
During monitoring DO NOT lie down! Sit on the edge of the bed, sit on a birth ball near the bed, sit in a rocking chair or regular chair near the bed, kneel on the bed and rotate your hip during the monitoring—you can still be monitored while in an upright position (as long as you are located very close to the bed).
Bring a birth ball with you and use it—sit near the bed if you need to (can have an IV, be monitored, etc. while still sitting upright on the ball). Birth balls have many great uses for an active, comfortable birth!
Learn relaxation techniques that you can use no matter what. I have a preference for active birth and movement based coping strategies, but relaxation and breath-based strategies cannot be taken away from you no matters what happens. The book Birthing from Within has lots of great breath-awareness strategies. I also have several good relaxation handouts and practice exercises that I am happy to email to people who would like them.
Use affirmations to help cultivate a positive, joyful, welcoming attitude.
Read good books and cultivate confidence and trust in your body, your baby, your inherent birth wisdom.
Take a good independent birth class (not a hospital based class).
Before birth, research and ask questions when things are suggested to you (an example, having an NST [non-stress test] or gestational diabetes testing). A good place to review the evidence behind common forms of care during pregnancy, labor, and birth is at Childbirth Connection, where they have the full text of the book A Guide to Effective Care in Pregnancy and Childbirth available for free download (this contains a summary of all the research behind common forms of care during pregnancy, labor, and birth and whether the evidence supports or does not support those forms of care).
When any type of routine intervention is suggested (or assumed) during pregnancy or labor, remember to use your “BRAIN”—ask about the Benefits, the Risks, the Alternatives, check in with your Intuition, what would happen if you did Nothing/or Now Decide.
Along those same lines, if an intervention is aggressively promoted while in the birth room, but it is not an emergency (let’s say a “long labor” and augmentation with Pitocin is suggested, you and baby are fine and you feel okay with labor proceeding as it is, knowing that use of Pitocin raises your chances of having further interventions, more painful contractions, or a cesarean), you can ask “Can you guarantee that this will not harm my baby? Can I have in writing that this intervention will not hurt my baby? Please show me the evidence behind this recommendation.”
If all your friends have to share is horror stories about how terrible birth was, don’t do what they did.
Look at ways in which you might be sabotaging yourself—ask yourself hard and honest questions (i.e. if you greatest fear is having a cesarean, why are you going to a doctor with a 50% cesarean rate? “Can’t switch doctors, etc.” are often excuses or easy ways out if you start to dig below the surface of your own beliefs. A great book to help you explore these kinds of beliefs and questions is Mother’s Intention: How Belief Shapes Birth by Kim Wildner. You might not always want to hear the answers, but it is a good idea to ask yourself difficult questions!
Believe you can do it and believe that you and your baby both deserve a beautiful, empowering, positive birth!

I realize that some of these strategies may seem unnecessarily “defensive” and even possibly antagonistic—I wanted to offer a “buffet” of possibilities. Take what works for you and leave the rest!

Great births are definitely possible, in any setting, and there are lots of things you can do to help make a great birth a reality.

Personality and Birth

May6

From Sheila Kitzinger’s book The Experience of Childbirth:

In a normal, straightforward labour a woman’s attitude of mind, her approach to the task that awaits her, and her preconceptions concerning the nature of the work that her body has to do, are more important than any sort of physical preparation she can make in advance. Whatever athletic exercises she may essay, however controlled her breathing, however complete her muscular relaxation, in the last resort the thing that matters most is essentially the kind of woman she is, and the sort of personality she has [emphasis mine]. That is why preparation for labour cannot rest in purely physical training and in mechanical techniques of control and release alone. Controlled muscular activity can assist her in making of her labour something she creates, rather than something she passively suffers, but her capacity for achieving this physical coordination is dependent upon her mind–upon her fearlessness and sense of security, her intelligence, her joy in the baby’s coming, her courage, her self-confidence, and the understanding she has of herself. The experience she has of childbirth is a function of her whole personality and ideally the preparation should involve increased self-knowledge and a growing towards maturity.

While there is a certain element of “blame the victim” in this quote that I find distasteful (i.e. “she had XYZ intervention, must be her bad personality…”), I recognize something here that speaks to me. I have observed in some of my clients a certain “quality” of personality (or perhaps determination) that makes me feel secure that they will be fine with or without me–they have something that comes from within that will guide them through birth. There are others who are more ambivilant, who say they want to “try” natural birth. Sometimes they blossom into confidence as the classes proceed, sometimes nothing really changes. I do not really take responsibility for any birth outcome, because birth classes are just a piece of a much more multifaceted puzzle of a woman’s experience. However, I feel like you can see that some women just “have it in them” and in others, that “it” has to be nurtured and grown. I’m not sure exactly what this “it” is, which is why Kitzinger’s quote caught my attention.

Thoughts about Pushing

Apr29

Also from Fathers at Birth, some quotes about pushing:

Powerful, authoritative, and wise energies assist in releasing the baby from the womb. Go with them.

Many women experience the work of pushing and the sensations of the internal movement of the baby as it moves and rotates through the birth canal as intensely gratifying. But some women feel the sensation as painful. They may get exhausted or discouraged and need lots of encouragement. Many women need to move around and change positions. Some women roar and discover a power within they have never encountered before.

With my first baby, I found the pushing stage to be very intense and overwhelming. I had been fairly calm and focused during my labor, but pushing felt scary to me and I said, “I’m scared” quite a few times. I also said, “pushing is supposed to feel GOOD,” because that is what so many people had told me (that pushing felt good/satisfying/rewarding). It didn’t feel good to me! With my second baby, pushing was more like an uncontrollable wave that moved through me and was natural and spontaneous. It didn’t feel “good” really to me, but it was not scary.