The Myth of the Perfect Birth

10.08.10: We need a reality check.


Childbirth has become super competitive. I don’t know if this is new to the last 50 years or if women have always judged how and where they give birth as a measure of maternal perfection. Maybe the Stone Age woman bragged her birth was better than some other cave woman’s birth because she pushed her little Neanderthal out on a rock; clearly making her more bad-ass, natural, and a better mother than those wimp moms who delivered in a cave.

We could argue that every birth that produces a healthy baby and a live mother is perfect. But that doesn’t seem to be good enough criteria to appease the negative chatter:

Home-birth is supposedly better because it’s more “natural;” Hospital births, because they’re “safer.” There are dozens of reasons why vaginal births are better than c-sections, but c-section Mamas can accurately argue their birth was better for lots of other reasons. Do women who breathe their babies out have more perfect births than women who get epidurals?

The high-point for maternal perfection seems to be the cliche mother who squats in a rice field, scoops up her baby, tosses the placenta over her shoulder and gets right back to work. Before anyone lambasts me with angry emails that I’m dissing their birth choices, let me just say: I’m being sarcastic here. Personally, I don’t think there is one model for Perfect Birth, though I’m pretty sure those poor rice-field Mamas (who don’t even get an extended lunch hour after giving birth) don’t think theirs is such a sweet deal.

I’m all for healthy discussion about making birth a safer, more positive event for every mother. I also value women’s needs to share and process their birth stories. I worry though when I hear “My birth’s better than your birth” stories. We’re creating a myth of The Perfect Birth that puts a lot of pressure on women and dings up their maternal self-esteem. They feel that if their birth was rough, then they made the wrong choices or are somehow to blame for not having total control. Take, for example, the reader email below.

Rachel wonders how she should deliver her next baby. Her first was an induced vaginal birth with an epidural and a 2nd or 3rd degree tear. Actually, the birth itself was, she says, “totally awesome. I was joking, laughing and having a ball. It was the aftermath that traumatized me! Healing took way longer than I expected. I felt lied to and pissed off at all the sisters and women I knew that insisted I'd be fine after 3-4 days, that a vaginal delivery was the best for me and baby and I'd be walking around doing my normal business in exactly that, 3-4 days! That was total and utter bull#*#*. I was barely ok after one month of constant pain and discomfort~ holding the baby, sitting down, standing up, going up and down stairs, going to the bathroom...I was "out of order" for a LONG time. Obviously I did not do sufficient research and I don’t want to repeat this same thing again.”

Rachel wonders if she should risk another vaginal birth and a tear, but this time go without the epidural? Should she have an elective c-section to avoid tearing? Maybe she should have an out-of-hospital water birth, even though her insurance won’t pay for it.

I seriously hope other readers won’t send a litany of negative comments that Rachel got the birth outcome she should expect with an induction, epidural, etc because I don’t think that’s true or helpful. I’m confident Rachel made good choices for herself and her child and frankly, it sounds like she had a normal if rough, first-birth experience. Rachel wants my two-cents though, so here goes:

Rachel, you don’t need a c-section. You need a reality check. First births are notoriously more difficult than seconds. No matter what you do for pain management, your second vaginal delivery is almost guaranteed to be easier. If the only reason you’d want a c-section is to avoid a tear, how do you think a 4-inch abdominal incision that cuts through skin, fat, muscle and the uterus will feel? The water birth sounds nice, but it’s no guarantee you’ll have a “perfect birth,” even if you pay cash for it. Natural versus epidural? Why don’t you go into labor armed with the best natural pain management techniques you can muster and see how you it goes?

Some women slide their babies out without so much as a whimper or skid marks. But let’s get real. The average baby’s head is about 13 inches around. The average vagina? Not that big. You’ll stretch and then, maybe, you’ll tear. A skilled doctor/midwife with a good track record for safe vaginal births is essential. Controlled pushing will help you avoid blasting out your baby and vagina. But when it gets right down to it, tears (and repairs) happen and birth is, by nature, not entirely under your control. Rachel, cut yourself some slack and plan on a month or more of healing time. Every mother (even the rice-field Mamas) deserve that.

I hope that soon, women can agree that the Perfect Birth isn’t a myth. It’s the one you have: Where your perfect baby is born to you, the very best mother you can be.

Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to and it may be answered in a future blog post.

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