Elective C-section?  Ocean waterbirth?  Seriously, go nuts.

You may think that because I chose (and fought) to give birth with no drugs in a hospital, I think everyone should.  Or, that because I rant and rave about our bloated surgical birth and artificial induction rates, that I would do away with these medical interventions.

Absolutely not.

First and fundamentally, I believe that it’s your body, your baby, your birth.  There are many options around birth, and I hope you avail yourself of them–and when you do, it’s none of my business.  There is no one-size-fits-all birth.  I have friends who have given birth across the spectrum from homebirth with no access to pain medication, to a planned epidural at 2 cm dilation, to full-blown elective “convenience” surgery scheduled months ahead, and I stand firmly behind each of those women in their human right to make their own decisions.

For me and my baby, a drug-free birth was of the utmost importance.  It was for personal reasons, really, not because I’m some flaming hippie who doesn’t believe in hospital voodoo.  It was a choice I made and prepared for because I knew it was the best thing for both of us–mostly my baby–that had absolutely nothing to do with being anti-medication or anti-establishment.

Second, these medical interventions save lives when used appropriately.  That is why they were created in the first place.  Sure, their overuse contributes to more dangerous conditions for moms and babies, but when they are used prudently and out of necessity, they preserve life.  In the U.S., in theory, we have the resources to have the best possible outcomes.

What IS important, and what I care deeply about, is that you go into birth with your eyes wide open; that your decisions are based on full and accurate information; that you understand the risks, benefits, and alternatives of your various birth options; that you work with your care provider, and that he or she respects and supports your wishes.

Birth doesn’t always go according to plan, which is why it’s not enough to create a “birth plan” and call it a day.  Sure, most of the time it is safe, but that doesn’t mean it’s predictable.  It’s very possible, even likely, that you and your support team will be called upon to make decisions during labor.  It’s these gametime decisions that can make the difference between a positive experience and a traumatic, dangerous, or disappointing one.  There may not be time at that point for in-depth explanations about the risks, benefits, and safety of various interventions or procedures, so you’ve got to be informed ahead of time of what might come up.

And, probably even more important, you’ve got to have a support team who is on the same page.

If you go into birth unprepared, you are placing your dignity and the safety of your self and your baby directly in the hands of people you may have never met and who may or may not respect you and your wishes.  It could go either way. It’s a huge risk to take.

A good example of this is my own birth story: when my care provider was strongly suggesting to me a procedure (an artificial induction at close to 42 weeks pregnancy) that was NOT the only or even the safest option.  I was lucky enough to have better information that allowed me to make a different decision, for a different outcome, that I firmly believe was the safest for me and my baby.  But a little less preparation on my part, and it never would have happened.  What happened with my care provider happens all too often.

I say all this to say that what is truly important, and I think a lot of “birth advocates” would agree with me about, is that you are prepared, informed, and supported in whatever you desire.  You can’t make decisions about what’s best and safest for the two of you if you aren’t informed and supported.  And information and support don’t happen on their own.

When you’re educating yourself about these decisions, you might be surprised at what the evidence shows: surgical birth increases your chances of death by six times, but it can also save your life.  Epidurals can prevent a surgery, just as they can increase the odds of your having to have it.  Natural, unmedicated birth can be the safest option, or it can be impossible.  Every one of these things has lasting effects.  How will you navigate these choices?

Remember: “If you don’t know your options, you don’t have any.”

So, no, I don’t care how you give birth, as long as it’s your way–and I trust that, as your baby’s mother, you’ve made certain that “your way” thoughtfully considers the best scientific evidence, supported and vetted by your care provider.  (Here is a wonderful summary of the current best evidence for common birth practices and procedures.)  The final decisions about your baby and his or her birth lie with you, the person who is ultimately most invested in your own and your baby’s safety and best care.

And I hope you have the safest, most wonderful experience you can have, bringing your baby into the world.

Author Cristen Pascucci is the former Vice President of ImprovingBirth and is the founder of Birth Monopoly, co-creator of the Exposing the Silence Project, and executive producer of Mother May I?, a documentary film on birth trauma and obstetric violence.  She is dedicated to promoting the rights of women in childbirth.

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  1. Stella says:

    I agree with you; access to safe birth options, and the information to make informed choice, prior to and during birth, is a fundamental right all women deserve.
    However, please be aware that when you make the comment “Sure, their overuse [cesareans] contributes to more dangerous conditions for moms and babies, but when they are used prudently and out of necessity, they preserve life” you contradict yourself and you alienate women who choose a cesarean that is not “medically necessary”.

    If a woman makes a free and informed choice that an elective cesarean is best for her and her baby, that choice is one we should all defend, and she should be able to make it without having to fight for it. Assuming these women don’t know what is best for them is infantilising, demeaning, condescending and anti-feminist. The fact is, cesareans are acceptably safe to those women who choose them, and the medical community. The only reason you are able to say that cesareans have higher morbidity/mortality than vaginal births is because in the developed world, emergency cesareans are performed to reduce maternal and infant mortality and morbidity otherwise associated with vaginal birth. Yet, emergency cesarean is vastly more dangerous than elective cesarean – and is one of the potential complications of vaginal birth women consider when making birthing decisions.
    Women should be able to choose the birth they want, and have easy access to high quality information about all their options, whether, as you say, that is an ocean water birth or elective cesarean.

  2. Sarah says:

    Love this!! I will be sharing this on my fb page and on my blog. As a future midwife and someone who hates passing judgement, this is a lovely post about embracing women’s choices and ensuring they are informed of their choices. Thank you!!

    1. Cristen says:


  3. Mo says:

    Thank you for this! Families must be informed in order to make reasonable decisions- so often, even doctors aren’t even up to date regarding true risks of the medical interventions they are recommending. We can do so much better!!

  4. Melissa Main says:

    OMG that is the cutest baby I ever saw!!!

  5. Julie says:

    I agree! Pick any type of birth you want but be INFORMED about your decision! All too often women just do what the doctor says and as we have seen that isn’t always a good idea. Do your research and pick what works for your family.

  6. Jenifer says:

    Wonderfully written and spot on. This is my philosophy in birth as well and what I promote to clients. Be informed. The decision is yours, but please be informed.

  7. Hobar says:

    I totally agree. My family thought i was nuts to want an unmedicated birth. But, my husband and I talked about all eventualities. When my water broke and labor did not start, we were prepared and knew we wanted to wait 8 hours and then allow an induction. When my 2nd child was breech, we knew (even though it made me very sad)that we would have a c-section. After researching our options, we had a failed version and a successful c-section. If I had not known what I wanted, I would have felt so powerless.

  8. Kathy says:

    Well said, Cristen. However, I sense a great deal of caring. Your caring
    enough to write/open the door for parents to be educated about their options, encourages them to peek behind that door for an AMAZING view at the possibilities. I totally get that you don’t care how they give birth, just that they do it with their eyes wide
    open. What a wonderful opportunity the web gives to our parents to be.
    No, make that opportunity for all of us. Thank you.

  9. Beth says:

    I couldn’t have said it better. Thank you!

  10. Cristen says:

    Thank you, Kathryn!

  11. Kathryn Julia says:

    Very well said Cristen…..It is a fundamental Human Right for the woman to choose the circumstances in which she gives birth………
    and it is important to know the options. as well as the pro’s and con’s of all the options.
    Thank you for writing this.

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