What Makes a "Good" Birth?

As a Childbirth Educator, I strive to employ what I call the Three Es. If I’m doing my job correctly, my students leave class feeling educated, empowered, and entertained. At the closing of every course, I ask my students to share what they have found to be most and least helpful. I also have an open dialogue with many of our local Midwifes and OBs and ask them how my clients respond to labor and birth. Often times, I hear that the Moms are unafraid, bold, and ask lots of questions. This makes me happy, and here’s why.
Anne Lyerly wrote a book titled "A Good Birth", and I was fortunate enough to attend her lecture a few years ago. She interviewed hundreds of Mothers and asked them to share their birth stories and how they felt about the experience. Dr. Lyerly identified five themes – agency, personal security, connectedness, respect, and knowledge— common across women's stories. What may surprise many is that a woman's perception and overall satisfaction of her birth, had less to do with how she brought her child into the world, and more to do with if she felt heard.
I approach birth as a “Choose Your Own Adventure” experience. Remember those books as a kid where you chose to flip to various chapters to shape your story? It starts with who you choose as your Health Care Provider. Whether it is a General Practitioner, Obstetrician or Midwife, it is essential that Mothers feel listened to, safe, and on the same page with their provider. Before interviewing a potential provider, a Mother should think about what is most important to her. Knowing that flexibility is essential, what would be the ideal birth experience? Thinking about what is desired and then finding that fit in a provider is more empowering than hiring and fitting into an HPC’s philosophy. Baby Center has a list of thought provoking questions to ask, which can be found here: http://assets.babycenter.com/ims/Content/ob_gyn_interview_May_2010.pdf
Choosing where you give birth goes hand in hand with whom you choose as a provider. Most providers have privileges at only one location. Check both provider and hospital VBAC and Cesarean rates. Hospital rates can be found here: http://www.vbacfinder.com/2015/01/north-carolina-hospital-vbac-rates.html. Visiting the hospitals and taking a tour can also be insightful. If you are choosing a birth center, or are having a homebirth, being familiar with back up care is important.
Choosing the right childbirth class is critical to advocating effectively. Parents are paying a lot of money for the experience of giving birth- good service should be expected. Parents have chosen the care team because they respect how they practice, but Mom and Partner should always feel free to ask questions, and in fact, be encouraged to do so. A good childbirth class will help you understand what questions to ask.
Whether you are considered high risk, planning to use pain medications, or choosing to birth naturally, it is important that you understand interventions. Remember, this is an adventure, and birth is fluid. When plans change, it’s important to have familiarity with procedures. Using your “BRAIN” is helpful.
Benefits- What is the benefit of the proposed intervention?
Risks- What are the potential risks to proceeding?
Alternatives- What are our other options?
Intuition- What do our guts tell us?
Necessary- Is it necessary at this moment, or can we have some time?
For brevity’s sake, as I could spend pages discussing what is important to include in class content, I encourage Moms and Partners to ask the following questions to potential instructors
  • What are the instructor’s goals for the class?
  • What is the instructor’s philosophy on pregnancy, birth and breastfeeding?
  • What is their curriculum based on? What evidence-based information do they use?
  • How long is the class? What does it cover?
  • Will the class include hands on practice?
  • What interventions are covered?
Bottom line, birth is sacred. A laboring Mother deserves respect, support and has the right to expect collaboration with her providers. Setting one's self up for success is a personal responsibility and can easily be achieved with a little due diligence.