Your birth philosophy

An old friend recently asked me — while sorting out her plan for birth and postpartum doula support — if it was possible to have an unmedicated birth without a doula.

She knew she wanted to birth without narcotics or an epidural, but she also wanted to maximize her postpartum care and was dealing with a limited budget.

I told her she could absolutely have whatever birth she wanted without a doula, within reason and bearing in mind the element of surprise. A doula is a support person, after all, not a magic key to a drug-free birth.

Though I value both birth and postpartum doulas and the unflinchingly noble work they do, I also believe parents should feel empowered when it comes to birth.

This is your baby, your life. Were you, as an emerging mother, to find yourself in labor alone in the woods, you would have your birth. You would have your baby. Though it wouldn’t be the optimal situation, animal instincts would kick in and you would get it done.

I truly believe that. You need to believe that, too. In the end, I told my friend:

  • She needed to believe in her ability to birth.
  • She needed her partner, who would be at the birth, to be a firm advocate for her birth plan.
  • She needed to be clear about her birth goals — but also flexible and, in the end, gentle with herself, should things NOT go as planned.

That last bit is particularly important. Parenthood can at times feel like a life sentence of second-guessing your choices, of blaming yourself for that which you cannot control.

The best laid plans often don’t come to pass. And that’s OK.

“Birth plan” is sort of an umbrella term for how you would like your ideal birth to be.

I think “birth philosophy” is really more appropriate — and allows for that necessary flexibility. Your birth philosophy might include something like, “It would be my preference to have an unmedicated birth, but should I decide that I want medical pain management intervention, I would prefer epidural over narcotics.”

It might say something like, “Except in emergency, I would like all newborn procedures and tests to be postponed or accomplished with the baby in my arms.”

These are ideas and wishes, rather than hard and fast rules.

Questions to ask

Your birth plan or philosophy can be put to paper. Some nurses, doctors and doulas do actually read birth plans.

While it’s not necessary to type it all up, a written birth plan can be a good exercise in making decisions and knowing, with fervor, what you want.

It can help you decide so many things in advance, such as:

  • Who will I allow in the room during labor (and during the birth)?
  • Would I like the freedom to move around?
  • Would I like access to a tub or shower?
  • Do I want Baby to be born in a birthing tub?
  • How do I feel about Pitocin? Am I prepared to postpone a medical professional’s suggestion that labor be artificially facilitated?
  • Do I prefer episiotomy or would I rather risk a natural tear?
  • What position do I imagine myself birthing in? What’s my second choice? My third?
  • How do I feel about narcotics? Epidural? Laughing gas?
  • What other pain-management methods will I have in my bag of tricks?
  • Who will cut the umbilical cord? Will we wait for it to stop pulsing? How do we feel about cord blood banking?
  • When it is appropriate to move to a C-section? Have I made it clear that a “gentle C-section” (alert mom is able to hold baby after) is preferable, should the operation be necessary?
  • Am I saving or encapsulating the placenta?
  • How do I feel about possible in-hospital, post-birth newborn interventions such as antibiotic eye ointment, a vitamin K shot, the Hepatitis B vaccine and/or circumcision?
  • Will I exclusively breastfeed?
  • Am I OK with Baby taking a pacifier?
  • Am I OK with Baby going to the nursery?

Jen Wittes is a certified postpartum doula and writer who now works in marketing and communications. She lives in St. Paul with her two kids, her two cats and her husband. Send comments to