Priorities for Childbirth

By Penny Simkin, PT

Most women or couples agree with the following priorities for their birth and baby:

Healthy Pregnancy

Full-Term Pregnancy

Spontaneous Onset of Labor

Normal Labor Pattern Without Need for Interventions

Use or Non-Use of Medications as Planned
(and no undesirable side effects if medications are used)

Spontaneous Vaginal Birth in Desired Location

Successful Breastfeeding

? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?

Healthy Mother and Baby

? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?

Unfortunately, childbirth is not always controllable or predictable, and some of these priorities sometimes do not materialize. This can be surprising and disappointing for parents and caregivers. For example, premature labor sometimes occurs unexpectedly. Sometimes risk factors develop during pregnancy or labor in mother or fetus, and induction, medications, forceps or vacuum extractor, or even cesarean delivery become necessary. If pain medications are planned, a very fast labor or an anesthesiologist who has other women waiting for anesthesia may mean the woman does not get medication when she desires. If an unmedicated labor is planned but labor is extra long or complicated, pain medications may become necessary. Challenges in breastfeeding, such as weight loss in the baby or insurmountable problems for the mother, may mean the baby needs formula.

Sometimes, women or couples cannot have all their other priorities met because the most important priority – a healthy mother and baby — might be jeopardized.

The key for parents is to know if the chances of a healthy mother or baby are improved by interventions or deviations from their priorities and how. If yes, they willingly give up some priorities. If no, they have room for choice.