The Lamaze Guide to Getting What You Want out of Birth

We share top communication and negotiation strategies

If you want a normal birth, chances are at some point during pregnancy, labor or postpartum, you'll find yourself discussing and negotiating your care with a powerful, perhaps intimidating healthcare system. Even if you've chosen your caregiver and birth site carefully, you'll still face the reality that normal birth isn't the norm in the United States.

To make real-life decisions that you believe are best for you and your baby (as opposed to hypothetical decisions that are statistically best for mothers and babies collectively), you need complete, accurate, up-to-date information. You need confidence in your knowledge, your body and your rights. You need to be aware of the potential obstacles to normal birth so you're not caught by surprise. And of course, you need to be able to communicate clearly, honestly and respectfully.

Be Alert
Getting caught off-guard can put you at an emotional and practical disadvantage. To avoid unpleasant surprises, be aware of the following issues that tend to pop up around pregnancy and birth. Many caregivers and hospitals in the U.S.:

-- Assume all expectant mothers want a full range of prenatal tests
-- Induce labor before 42 weeks, sometimes as early as 37 weeks
-- Speed up labor when they think it's taking too long
-- Routinely use continuous electronic fetal monitoring and intravenous fluids
-- Separate mothers and babies after birth
-- Restrict movement and position during labor
-- Support elective cesarean surgery
-- Do cesareans when they think labor has gone on too long
-- Discourage vaginal birth after a cesarean (VBAC)

You should also be prepared for pressure to go along with the options presented to you. Your caregiver or hospital may use "safety" to persuade you, suggesting risks you incur if you don't go with the program. Or you may be promised less pain or a shorter labor.

Remember that the specific risk for you and your baby '- unique individuals in unique circumstances '- is different from the statistical risk for all mothers and babies collectively. Remember, too, that usually the easier, healthier way to give birth is with nature in the driver's seat. Make your decisions calmly and deliberately, according to best evidence and careful consideration of your situation and your values, not by reacting emotionally.

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