Mindset Shift on Medical Interventions

Right after I gave birth for the first time, another mom and I were sharing our birth stories. The way she talked about her birth made it obvious she was disappointed in herself that things didn’t go as planned. She needed a medical intervention she didn’t want, and I could hear some hints of regret or feelings of failure in her voice when she talked about it. But, to me, she made a necessary and appropriate decision to manage a complication that was unforeseen and out of her control. 

Why does adapting to the reality of how a birth is unfolding sometimes feel like failure? Why do so many individuals who have experienced the unexpected in birth struggle with complicated feelings of regret for not staying the course on a route that was no longer truly navigable?

The way she talked about her birth was a lightbulb moment for me. I started questioning the way we talk about birth and all of its possible twists and turns. This moment was also one of several that was influential in my desire to later certify as a childbirth educator. 

I’ve come to realize we need a bit of a mindset shift when it comes to medical interventions.

It’s so important to understand that the medical interventions themselves are not the problem. They are actually really valuable tools to have available when needed. Access to medications, vaccines, screening and diagnostic testing, ultrasounds, cesareans, epidurals, NICUs, etc. is a privilege not available to pregnant and birthing people for most of human history. And, even today, not everyone (like pregnant women in Gaza right now, for example) has access to these medical interventions that give us options, prevent suffering, and save lives. 

The true problem lies in the overuse or misuse of medical interventions, which can look like:

• Medical interventions used without obtaining informed consent
• Using coercion to obtain consent
• Treating routine care (that isn’t always evidence-based) as a requirement
• Restricting access to alternative options

Medical interventions are unfortunately overused and misused in our imperfect maternity care system. As a result, childbirth educators and birth workers have done great work in educating pregnant people about their rights, their options, and the evidence.

However, I think the messaging may be getting lost in translation. As a childbirth educator, I’m realizing the way we speak about birth and the language we use is critically important. As a pregnant person, I want you to understand this important difference: the overuse/ misuse is the problem, not the medical interventions themselves. Why is this distinction so important? If you have a mindset that medical interventions are inherently bad or problematic, it can negatively impact decision-making and on how you process your birth experience later on. It can leave you with those feelings of doubt and regret, even when you ultimately made a sound and appropriate choice.

Three Tips for Making the Mindset Shift

Number One: Remember that a holistic pregnancy and birth can include any exams, procedures, medications, interventions, vaccines, testing, etc. that you choose. Look into your options. Consider the evidence. Have discussions with your care provider. Treat everything as an individual decision, rather than a blanket rejection of anything that isn’t “natural”. Embrace nuanced thinking. Take what you want and leave what you don’t. Birth planing is a great way to do a lot of this in advance. Look into all of your options when it comes to prenatal care, as well.

Number Two: Choose a care provider that respects your autonomy and role as ultimate decision-maker. This is one of the most important decisions you’ll make. If, while discussing your options during pregnancy, you find this to not be the case, please switch providers. I know insurance plans and where you’re located can limit options, so focus on finding the best fit for you among who’s available. Having a care provider you can trust and that honors your right to say yes or no (it’s your body, right?) is key to retaining some control even if nothing else is going to plan.

Number Three: Adapt as necessary during birth. Setting intentions and making plans is absolutely beneficial. But, in the moment, it may become necessary to take a different path if the one that you are on (and maybe even yearn to stay on) is no longer navigable. Letting go often takes and immense courage and strength that should be respected and revered. It’s also important to understand that medical interventions can sometimes prevent a cascade of further and more serious interventions and complications. 

Final Thoughts

Birth is a normal, physiologic process powered by strong muscle contractions of the uterus, facilitated by complex hormonal processes, and assisted by gravity and movement. Understand that physiology is foundational. I like to think of it as the default. Interfering in ways that are unwanted and unnecessary can have a negative impact. This doesn’t mean that medical interventions are never beneficial or that everyone has to birth a certain way. It just means they should be used with intention and with informed consent. It means no one should be requiring you to accept medical interventions that you don’t want or need.

If your version of an ideal birth involves getting an epidural and watching reruns of Schitt’s Creek, I love that for you. Go for it. If you prefer to experience birth unmedicated, I love that for you, too. You should be appropriately supported and not have to hear things like: “No one’s going to give you a medal for this.”.

And, while birth is a normal, physiologic process and something we hear our bodies our “supposed” to be able to do, I want you to understand that problems sometimes arise. While taking steps to prepare and plan for birth can help you “clear the path”, there is no way to guarantee everything will always go as planned. Medical interventions are there for us just in case. There is no shame in responding to our needs in the moment and adapting, as necessary.