Women of a previous generation may feel as though it's arrogant of today's moms to think that their wishes are that important. After all, only 35 years ago, there were 20 deaths per 1,000 live births. That number has dropped to 6.9 deaths in 2000, according to provisional data from the US Department of Health and Human Services. Women 50 years ago were taught that the doctor's word was law, and that requesting another option was paramount to putting a baby's life in the balance. Medical advances over the past decades have improved labor and birth situations for the majority of women.
While doctors' years of medical training prepare them to assist in labor and delivery, many women today are returning to the viewpoint that childbirth is natural and that they have instincts about how to have a baby. Sara puts it this way: "I realized that birth is a normal process, and that the vast majority of the time one doesn't need help. Women's bodies are designed to grow babies and give birth."
Pacovsky feels awed every time a mother brings her baby into the world. "Childbirth is very intuitive ... women innately know what they need. I think women need to be taught to respect their own desires and intuitions," she says.
As an example, Pacovsky shares that some women intuitively know that they want to be up and walking around during labor. But frequently, someone tells them that they need to labor in bed. "Typically, if a woman wants to be up and walking it's because the baby needs to rotate a little bit to get in position—by getting up, the mom helps herself along in labor. So I think it's empowering for women to listen to their instincts," says Pacovsky.
It's vital to find a practitioner with whom you see eye to eye about issues such as labor, pain management, and breastfeeding. Labor and delivery can be emotionally and physically difficult enough without butting heads over optional intervention or pain medication.
Sara believes that having a practitioner who supports your childbirth philosophy helps everything go better during labor. "It's one thing to debate a few issues with your practitioner, but ultimately, I want my practitioner on my side; I don't want to be fighting about major issues, especially not during labor. When I'm in labor, I want to know that everyone around me is on my side, supporting me, helping me work toward a goal, not fighting with me."