Hey there mama-to-be! So, you might be feeling a little overwhelmed with all the information (or lack thereof) about giving birth. The typical course of action once you find out you're pregnant is to schedule your first ultrasound with an OB. Did you know this is totally unnecessary, invasive, potentially harmful, and not at all required? Probably not, huh?! In fact, most of what we're conditioned to do during pregnancy and birth is potentially harmful and totally unnecessary. I know, that seems crazy and confusing. Don't worry, I’ve got you! Here are 10 things your family, peers, and even your doctor probably didn't tell you about having a baby:

1. Hospital birth is not your only option, (nor is it always the best one).

Other options include: Home birth with a medical midwife, home birth with an underground/unlicensed midwife, birth center birth with a medical midwife, or an unassisted/sovereign/free birth attended by a doula, birth-keeper, traditional midwife, or even no one at all.

For a little information on the less-common free birth, READ HERE.

This is SO controversial — so bear with me, and please read the resources provided for much more information. While there is a lack of conclusive evidence on home birth (assisted or unassisted) vs hospital birth, there is plenty of evidence surrounding the dangers of routine intervention. Unfortunately, obstetricians are taught medical birth practices and how to "manage" birth. What they don't understand is, normal pregnancy and birth does not need to be managed. It is not a medical event, and it certainly is not inherently an emergency. That is not to say there are never emergencies, because there absolutely are. And in the very small occurrence of such is when life-saving medical interventions do come in handy. The catch 22 of birthing in a hospital (yes, even with a medical midwife), is that the actual act of going to the hospital is, in itself, an intervention. Therefore the argument is: physiologic birth is impossible in a hospital setting.

Let me explain: Intervening means to occur between events. For example, you typically will go into labor (event A) in a comfortable environment (such as at home). If you then decide to leave that environment (event B), you have just disrupted, or intervened, the process of labor. Even though there was no medical intervention by simply getting in your car and driving, the hormones involved in starting and maintaining your contractions, such as oxytocin, more than likely dropped by disrupting your environment. This may also be true if you are planning to go to a birth center, hotel, airbnb, or any other destination you plan to labor in. This, while very small and insignificant, is indeed typically one of the first steps of inviting the cascade of intervention into your birth. If you are early enough or late enough in labor, this may not matter in the long run if you are heading to a place where you feel most comfortable. However, I do not know of any woman who would describe laboring in a hospital room or bed, in a hospital gown, and attached to IV's and fetal monitoring systems as comfortable.

Side note: Most hospitals won't even check a woman in to labor and delivery until she is 6cm and in active labor. Can you guess what that means? - cough cough - Hello, potential stalled labor, pushed intervention to move things along, and if all else fails: a failure to progress diagnosis leading to a manufactured "emergency" cesarean section.

Resource to note: Healthy Birth Practice

2. You don't have to do anything you don't want to do.

You can say no. Your doctor can't make you do anything you don't want to do! You don't want that ultrasound? You can say no. You don't want that vaccine? You can say no. You don't want cervical checks? You can say no. But keep in mind... If you do say no, you will likely be scolded, fear mongered, pressured or coerced, dropped from their care, or in worst case scenarios (but also not uncommon) illegally ignored and "treated" anyway. This is why it is imperative that if you decided to have a medically attended birth, you should always interview your provider with the proper questions, and hold them to their answers. If you are set on a hospital birth, please consider doing some research on your laws, rights, and every routine test and procedure, and maybe even purchasing the Rights Over My Birth Package by Sacred Birth Doula.

3. Elective induction (Pitocin) is risky and can disrupt mother-baby bonding, lactation and breastfeeding, and is linked to postpartum mood disorders (such as PPD, PPA, & PPP).

As mentioned above, oxytocin is the labor hormone. Pitocin is synthetic oxytocin. This drug is routinely given to "induce" labor, and it is insanely common for hospitals to put a mother on a "pit drip" to deliver the placenta, without even asking permission or informing the mother. As listed by the manufacturers of the drug on the inserts: Pitocin, along with overdosing concerns, can cause anaphylactic reaction, postpartum hemorrhage (ironically, this is routinely given to mothers to prevent hemorrhage), cardiac arrhythmia (abnormal heart beat), fatal afibrinogenemia (difficulty blood clotting), nausea/vomiting, premature ventricular contractions, pelvic hematoma, brain bleeds, hypertensive episodes, uterine rupture, severe water intoxication with convulsions, coma, maternal death, bradycardia, permanent CNS or brain damage, fetal death, neonatal seizures, fetal distress, low APGAR scores in baby, neonatal jaundice, neonatal retinal hemorrhage.

You can read more about its risks and ingredients HERE.

The use of synthetic oxytocin (Pitocin) can also affect your breastfeeding journey. By injecting synthetic oxytocin into your body, you are essentially telling your body to stop naturally producing oxytocin. Oxytocin is a major important hormone for milk production. The use of oxytocin can indeed delay your milk production. Read more about this HERE.

Side note: If your doctor is pushing for induction (medical or natural), please read THIS ARTICLE. Your baby's lungs release proteins called surfactant protein-A (SP-A) and platelet-activating factor (PAF) when they have fully developed and are ready to function outside the womb. This protein signals to your body to release hormones (such as oxytocin) that start labor. This is why unnecessary/elective medical induction (cervical gel and Pitocin) is dangerous. You are not only welcoming the Cascade of Interventions that may very well lead you to an unplanned cesarean section, you are also essentially evicting your baby from the safety of your womb prematurely; before they are 100% ready to sustain life "earth-side." This increases your baby's chances of needing emergency resuscitation immediately after birth (in conjunction with doctor's obsession with cutting off their oxygen supply by immediately clamping and cutting the umbilical cord), which can be traumatic for both mother and baby, and even the father.

4. Epidurals contain fentanyl (or other opioids), they don't always work, and they come with short term and long term risks for both mother and baby.

71% of mothers receive an epidural or other spinal anesthesia in their hospital birth. As listed by the manufacturers, epidurals contain opioids and can cause excessive plasma levels, restlessness, anxiety, dizziness, tinnitus (ringing ears), blurred vision, tremors, convulsions, drowsiness, unconsciousness, respiratory arrest, nausea/vomiting, chills, constriction of the pupils, depression of the myocardium, decreased cardiac output, heart-block, low blood pressure, bradycardia (slow heart rate), ventricular arrhythmias, headache, backache, fecal/urinary incontinence, ventricular tachycardia, ventricular fibrillation, cardiac arrest, urticaria (hives), pruritus (itchy Skin), erythema, angioneurotic edema, laryngeal edema, tachycardia (fast heart beat), sneezing, syncope (fainting), excessive sweating, eleveated temperature, anaphylactoid-like symptoms (including severe hypotension), persistent anesthesia, paralysis of the lower extremities, loss of perineal sensation and sexual function, paraesthesia, weakness, urinary retention, loss of sphincter control with slow, incomplete or no recovery, cranial nerve palsies. Read more about the inserts of this drug HERE.

Additionally, manufacturers have not conducted studies on the drug to see if it is potentially carcinogenic, the affects on fertility, or to see if it has mutagenic potential. With the drug being commonly used since the 1970's, why have they not studied this yet? What has been lightly studied, however, is the affects on your baby in their first three years of life. What did THIS STUDY find? That babies of mothers who were exposed to epidural analgesia during their labor were associated with neurodevelopment delays during the first three years after birth. We now know that drugs given to the mother during pregnancy and labor do in fact pass to the baby through the placenta. I don't know about you, but I feel that complete transparency in regards to quite literally giving your baby opioids at birth via administration of an epidural should be a bigger deal in the labor and delivery room. READ MORE about how the placenta transfers administered drugs to the fetus (yes, including those routine prenatal shots such as flu, Tdap vaccine, Rhogam, and other "recommended" injections by your medical provider).

An epidural works by numbing the lower half of your body so that you do not feel pain from each contraction. How does this affect your labor? You are limited to laboring positions in your hospital bed to either lying on your back (a supine position - which is the least optimal position in labor, inhibiting the decent of your baby), or side-lying (this requires assistance from your partner, doula, or a willing nurse). This will also keep you disconnected from your body's physiologic process of birthing your baby, meaning your body may be telling you to push, but you may not know it. Or your body or baby may not be ready for you to push, but because you are technically at 10 centimeters according to your provider, this results in "coached pushing" and can cause further trauma to your body and your baby. It is extremely important that we have the capability to listen to our bodies and our babies in labor. In normal, physiologic birth they are in communication with each other and they are working together effectively and efficiently, just as they should be. When we introduce drugs and intervention, it disrupts this process and can absolutely cause complications, physical and emotional trauma, further need for intervention, and in many cases result in medical emergencies. Take a look at the importance of labor and birthing positions HERE by Evidence Based Birth for more information.

Side note: Artificial contractions induced by synthetic oxytocin (Pitocin) are significantly more intense than your body's natural release of oxytocin induced contractions. This is important to note because often times mothers who receive epidurals do so because of the intensity of their Pitocin induced labor (whether they went into spontaneous labor or if they were medically induced, as often times hospitals will still stimulate contractions in a spontaneous labor to "move things along" for their convenience). Read more about the physiology of your body's natural release of oxytocin and how it communicates with your brain to make labor manageable HERE. Your body will not naturally produce contractions that you cannot handle. That is not to say that they will not be painful! A mother in fear of each surge will always result in more pain. Take a look at the fear, tension, pain cycle HERE.

Epidurals can and often times do affect the breastfeeding journey. With 71% of mothers receiving an epidural in labor, 60% of those mothers do not breastfeed for as long as they had previously intended. READ MORE HERE. Common reasons for ending breastfeeding include latching issues, concerns about the baby's weight gain, and concerns about medications (such as the epidural) while breastfeeding. A poor latch can be caused by an overly sleepy baby at birth due to the affects of an epidural, resulting in a poor or no feeding during golden hour (the first 2 hours after birth), which has been proven to significantly decrease the likelihood of a successful breastfeeding journey. Read more on that HERE. If a mother received an epidural, she also received intravenous fluids. These fluids are also passed along to the baby, and results in baby having some excess water weight at birth. Mothers who receive IV fluids during labor should wait at least 24 hours before measuring their baby's birth weight, as this water weight will shed and give the illusion that their baby has lost too much weight according to medical standards (more than 10%). Read more HERE. Lastly, mothers often believe that they can't feed their baby from the breast if they received an epidural. However, Dr. Jack Newman states that so long as the mother is coherent and able to care for her infant after the use of anesthesia, she is safe to breastfeed. Read more about medications and breastfeeding HERE.

5. Not all birth is traumatic, and birth is not inherently scary or dangerous.

What a wild concept! MOST undisturbed birth is far less traumatic, or not at all traumatic, than any medically managed birth. This does not mean a non-medically managed birth is possible for everyone. Sometimes there are real concerns that arise during pregnancy that warrants medical intervention (though they are much less common than we are led to believe due to many factors of prenatal "care"). However, in most cases, allowing birth to unfold in its natural physiologic process, undisturbed, results in the most satisfactory birth outcomes. Fear has no place in the birthing room, yet we are consistently fear mongered by medical personnel, horror stories, birth trauma survivors, the media and entertainment industry, and the overall stigma surrounding birth today. Read THIS to find out more about undisturbed birth and its physiologic process, and the importance of hormones in birth.

6. Ultrasounds are notorious for being inaccurate.

Ultrasounds are wrong about half the time. If your provider wants to induce you or schedule you for a cesarean because an ultrasound indicates a large baby, please read THIS ARTICLE by Evidence Based Birth. If your OB is telling you they are worried about baby's head not fitting through the pelvis: fire them. On the spot. Your baby's head molds to fit through the pelvis, no matter its shape. This is why some babies are born with "cone heads," which round out over the next few hours after birth. The idea that your baby's head is too big is proof that your provider knows nothing about physiologic birth. The actual concern would be a shoulder dystocia. However, even with larger babies, there is only a 7-15% chance of a shoulder dystocia (when the shoulder gets "stuck," otherwise known as a "sticky shoulder"). With that, shoulder dystocias are almost entirely manageable through positional changes or other non-invasive methods and techniques either you can learn or your trained provider can perform. Here's the kicker: it would take 3,700 unnecessary cesarean sections to prevent just 1 shoulder dystocia associated injury. If your provider is unaware of these statistics, that may be a red flag.

Click HERE for an easier read on the evidence based birth article.

7. The Cascade of Interventions: Birth is best left undisturbed.

Have you heard of this term? Picture this: your estimated due date arrives and still no sign of labor. Your provider began pressuring you to schedule your induction a week or two ago at 39 weeks, but you wanted to wait for labor to begin naturally first. You are exhausted, and uncomfortable, and you just don't want to be pregnant anymore! So, you decide to try a membrane sweep hoping that will kickstart your labor. It doesn't, and you are just left with cramps and even more discomfort. So, you go in for an induction. They start with a cervical gel to "ripen" your cervix, they insert an IV into your hand for fluids and Pitocin to stimulate contractions. They are intense and painful, but you try to breathe through each one. They tell you that you can't eat or drink, and they keep a monitor on your belly to track fetal heart rate. They continue to check on you, too, for several hours. Until, finally, you can't take it anymore. They ask you for the third time if you would like the epidural, and you say, "Yes! Give me the drugs!!" They check your cervix and you're only dilated to a 6. It's been almost 24 hours! You're discouraged and emotional, and you just want your baby to be here already and for this torture to be over with! You get the epidural and you can finally relax and get some rest. A few hours go by and one of the following happens:

1. Your labor has stalled, they diagnose you with "failure to progress," and tell you it's time to prep you for surgery.

2. Your baby is in fetal distress due to the intensity of your contractions and the combination of drugs now in your system: time for an emergency c-section!

3. They ask if you want them to break your waters to get things moving, and you say yes. You're put on a clock, they continue cervical checks, and nothing has happened. 24 hours go by and they tell you you have to have a cesarean section because your waters have been open for 24 hours now and it's hospital policy not to let you go any longer than that.

4. Your epidural fails and you're in more pain than ever from the artificial oxytocin coursing through your body. You're on your back and your body is saying it's time to push, but the doctor isn't there so the nurses are telling you "DON'T PUSH!" You can't control the fetal ejection reflex, but you fight your contractions anyway, causing pelvic floor damage and severe tearing, and you're wholly dissatisfied with how your experience has gone.

5. You're fully dilated but your body isn't ready to push. They lose track of fetal tones and tell you they need to do internal monitoring (insert a tiny screw into your baby's head). Your doctor artificially ruptures your membranes, gives you an episiotomy, tells you when you push, and uses forceps or a vacuum to pull baby out of your vaginal canal causing damage to your baby's face and pelvic floor, they immediately clamp and cut the cord and begin resuscitating your newborn.

Does any of that sound familiar? Did you experience on of these or some variation of them? This is the all-too-common experience of mothers in the western medicine world. The unfortunate truth about birth in this day and age is that due to routine intervention, hospital policy, and the fear surrounding birth in its entirety, the United States is the most dangerous place to give birth in the Global North. Let that sink in.  We have been raised to fear labor and birth, and we have been taught that trusting the experts (OB's and medical midwives) to manage our pregnancies and births will save us from the evils of childbirth. Another unfortunate truth is that Obstetricians know very little about physiologic birth. They are surgeons. They are trained to medically manage all birth, not just the ones that truly require intervention.

Psst: most birth doesn't require intervention.

While the modern medical model can save lives, there is an overwhelming amount of birth trauma and maternal and fetal fatality caused by medicalized birth. It is truly an epidemic.

8. Elective induction and cesarean section is not without risk.

This one is touchy, because women birthing with an Obstetrician / in a hospital will be given the option to induce at 39 weeks gestation unnecessarily. This truly is a dangerous, yet doctor friendly practice. It is not in the best interest of mother-baby by any means. There is no reasonable medical reason for an elective induction or cesarean—hence, elective.

Why is this practice so dangerous? Not only is it, to put it bluntly, evicting your baby from the womb before their lungs are fully developed and ready to function outside the womb (see next paragraph), this practice is very young. There are many instances in obstetrics where the standard / routine care has since been deemed harmful and dangerous. Obstetrics in itself is very young. There simply is no evidence to support these routine interventions, just as there are no studies showing the short term and long term effects of these interventions. In every case where they stopped doing "xyz" harmful and dangerous routine practice / procedure, it was after they finally connected the harms done to the intervention. Check out this clip from The Business of Being Born documentary for a little more information.

Why are obstetricians routinely advising women to induce at 39 weeks? Babies aren't ready until they begin labor themselves. To put it simply, when your baby's lungs are fully developed and ready to function outside the womb (breathe), they release proteins that trigger the labor hormones. Read more about these proteins and their roles in beginning labor, click here. When we apply this knowledge to the common complications associated with inductions, is it a wonder why so many women end up with a "failure to progress diagnosis," an emergency cesarean, or a baby who needs resuscitation or a NICU stay directly after birth?

Elective cesarean sections are also not all they are cracked up to be. The recovery time for a cesarean section delivery is far greater than a vaginal delivery. You miss out on many important hormones with a cesarean delivery, and your baby also misses out on many of the benefits of a vaginal delivery. When your baby travels through the birth canal, they receive important bacteria from the vaginal fluids that facilitates the development of a healthy gut flora in your newborn. You can read more about that here. A vaginal delivery also naturally acts to suction fluids from your baby's lungs as they move through the vaginal canal. Cesarean section is a major abdominal surgery, and it is the leading cause of maternal death. Over a third of women birthing within the medical system will end up in a cesarean section, whether it is elective, caused by the cascade of interventions, or a true medical emergency. The risks of a cesarean include, but certainly are not limited to: infection at the incision site, ruptured uterus, injury to baby, disruption of important hormones that contribute to mother-baby bonding and breastfeeding, blood clot disorders, postpartum hemorrhage, newborn respiratory distress, and much more. Read more here. Do not take the decision lightly when planning your cesarean section, and make sure you have an adequate support system both during and after delivery. Research your options regarding a cesarean section delivery so that you may best counteract any disadvantages you will have versus a vaginal delivery if a cesarean is absolutely necessary. Find a birth and postpartum doula to help walk you through and support you in your birth plan, options, and postpartum plan. Remember: your hospital's policy is not law. You maintain the authority in your birth, and you alone.

9. VBACs are safer than repeat cesarean sections.

If you have had a cesarean and wish to have a VBAC (vaginal birth after cesarean), you most likely can! The risks of repeat / consecutive cesareans are much higher than having a vaginal delivery after cesarean. For more information on VBAC, head to vbacfacts.com for many articles, studies, and personal stories. The most common excuse for obstetricians refusing VBAC patients is that the risk for uterine rupture is higher for a trial of labor after cesarean (TOLAC). This is simply not true. Studies have shown that uterine rupture in a cesarean birth after cesarean (CBAC) is in fact much higher than a vaginal birth after cesarean section. For a repeat cesarean section, the risk for uterine rupture is 2.3% while the risk for a vaginal birth after cesarean section is merely 0.1%. Additionally, the risk for an emergency hysterectomy in repeat cesarean sections, which increase greatly with each cesarean, is 0.5%, while the risk for a vaginal birth after cesarean is again only 0.1%. For emergency blood transfusions after a hemorrhage, the risk for repeat cesarean sections is 3.2%, versus 1.2% for a vaginal birth after cesarean. Finally, according to the study referenced in Evidence Based Birth's VBAC article, "there was a much higher rate of infection in the CBAC group, 7.7% had endometritis versus 1.2% in the VBAC group."

10. Breech births are a variation of normal, and a vaginal breech birth is generally safer than a cesarean section.

Last but certainly not least: A breech baby alone is not an emergency! Visit Breech Without Borders to watch the many, many videos on safe, vaginal breech deliveries. The evidence is undeniable that a breech birth is not inherently dangerous or cause for an emergency cesarean section. Your baby is receiving oxygen through the placenta. Your baby will still go through the cardinal movements. Your body will still push your baby out. Obstetricians often are not trained in delivering a breech baby. It is simply much easier for an obstetrician to push for a cesarean section that takes mere minutes to perform than it is for them to remain patient in a breech vaginal birth. We must again ask ourselves: "Is this intervention in the best interest of mother-baby? Or is this simply serving the hospital / obstetrician?"

One study in 2005 discusses the risk trade-off shown in the Term Breech Trial (a popular study used to back up obstetric practice of immediate cesarean section for a breech baby, which has since been proven to be inaccurate, and is a source of controversy in its flawed clinical design):

"Between 2001-2005, 8,500 women in the Netherlands had a planned CS for breech. This increase in pCS saved an estimated 19 babies, but it also led to 4 direct maternal deaths, 9 additional babies dying in future pregnancies due to the uterine scar, and 140 additional life-threatening maternal complications in future pregnancies."

Another study showed that in order to prevent one neonatal death, 649 planned cesarean sections would need to be performed. However, it also mentions that the risk for a cesarean section is indeed higher than a planned vaginal delivery for the mother, the baby, and the mother's future pregnancies. All in all, it is our responsibility to make an informed choice on how we choose to deliver a breech baby, and you must weigh the risks on your own.

If you made it through this info-packed post, congratulations! You are in the minority of women truly seeking answers rather than blindly following the social norm and fully trusting your provider to have all of the answers. While I certainly don't claim to have all the answers myself, I am able to offer alternative prospectives and information that may intrigue you to do further study on a particular topic. I encourage you to dive into all of the resources listed in this post, as there is an endless amount of valuable information to be learned from all of them that I simply just cannot put into one post.

I leave you with this last bit of advice: Take a physiologic childbirth class not associated with a hospital! And above all else, listen to your God-given intuition when making decisions for you and your baby. After all, you are your baby's only advocate. You maintain the highest authority when it comes to decisions about your birth and your baby. Keep taking that responsibility seriously!

Your loving and faithful birthkeeper,

Sydney