What is normal birth?

I’ve just read an article in the latest issue of ‘British Journal of Midwifery’ discussing women’s ideas about what is a ‘normal birth’ and whether these are the same as health professionals.

The WHO defines normal birth as “Spontaneous in onset, low risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously in the vertex position [i.e., head first, not breech], between 37 and 42 completed weeks of pregnancy. After birth, mother and infant are in good condition.”

The study only included 4 women, so I don’t really think any meaningful conclusions can be drawn about what they said, but what I found interesting was that it made me think about MY opinions about what is normal and what isn’t. What I think a ‘normal delivery’ means that the baby was born vaginally, without forceps or ventouse.
Any different ideas?

One a hospital doesn't want you to have. (Says the cynical and jaded freebirther-to-be.)

*MY* idea of a normal, natural birth is spontaneous labour, zero interventions during the labour (no drugs, no strapped on monitors, no internals), no forceps or assisted delivery, no episiotomy, delayed cord clamping and physiological third stage. That's *MY* standard and I get everyone has a different idea on what they consider normal or natural. By my views, I did not have a natural birth; I had a penthrox stick in the ambulance, one internal upon arrival at the hospital and dd's cord was clamped soon after her birth due to mec in her lungs, all with my permission/at my request.

Hmmm will need to ponder this for awhile first me thinks. ....

My idea of natural birth is no internals, no intervention need to turn baby, no intervention to induce labour, no equipment used to get bub out, no c-section, mother able to birth freely/move as she pleases so no monitering that would get in the way of that. Also delayed cord clamping (yet Lotus birth practices are way more natural again) . No drugs for mum to birth the palcenta, and absolutely no drugs/vaccination for bub even vit K. In my mind bub should go straight into mums arms for skin on skin and breastfeeding. And I'm very happy to say that I had all of the above and in the water to boot :D Oh and home birth is also way up there on the 'natural' list too. I was in a beautiful private hospital with amazing midwives and ob's who respected all of our decisions including letting us go to nearly 42 weeks (and beyond if I had of chosen that). Funny that you started this thread as just yesterday I commented on the 'natural' birth of that lady who gave birth to a very large baby. I wanted to know what their idea of natural was, I have a suspicion it was a vaginal birth not a natural birth.

carolinaw - if you are wishing to conduct research, there is a forum especially for this.

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carolinaw - if you are wishing to conduct research, there is a forum especially for this.

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Yep and as you will see most bb members will be happy to give you their opinion :) while you are here you may also find that bb is a great community and if you have an interest in birthing etc you may find some great friends here along the way if you join in.

there are differences between normal and natural birth. what has become normal in our society is not natural.

Here is Abstract to the Article

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Do women's ideas of 'normal' birth match those held by professionals? (439kb)
Alison Edwards, Jacky Conduit
British Journal of Midwifery 19(11): 720 - 728 (Nov 2011)

Aim: To explore the definitions of normal birth held by women who have not given birth, what influences that perspective, and compare it with those of health professionals. Background: Available evidence provides conflicting definitions of normal childbirth. The majority of available evidence encapsulates the views of the health professionals themselves or women who have experienced childbirth. Little evidence exists that reflects the views of women yet to experience childbirth.

Method: Six participants were identified via purposive sampling to undertake a small exploratory qualitative study utilizing semi-structured interviews and thematic analysis. Ethical approval was obtained.

Results: The definition of normal birth is individual and complex. The absence of complications and use of interventions influenced this definition, which in part agrees with health professionals' current definitions. Birth was perceived as a scary prospect; a view largely constructed from negative stories from friends and family.

Conclusions: The findings suggest that working within the confines of a definition of 'normal' childbirth is far from straightforward. It highlights a need to encourage women to view birth more positively. Expanding this research further would explore these issues in more detail, providing more conclusive evidence to support practice.

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there are differences between normal and natural birth. what has become normal in our society is not natural.

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So very true! :(

oh to true! my brain must have gone straight to natural as that is what should be normal to me :think: normal is actually the very opposite. The birth of ds was actually abnormal! Normal today is monitoring, internals, induction and loads of intervention to 'get bub to do what they want' even induction to fit into time schedules. c-sections are normal, breach etc is normal, pumping newborn babies full of drugs and mothers for that matter for unnecessary things like birthing the placenta and vit K and Hep B, wtf?? Normal is everything that mainstream medicine does in their hospital system! Yeah.... Goodluck with that research carolinaw ;)

This is an interesting topic. Personally I would define a 'normal' birth as one that didn't require intervention. I know many will disagree with me, but I also don't necessarily consider internals to be intervention, or even gas and maybe even pethidine :hide: This is because these are options the woman can take that don't necessarily impact negatively on her ability to birth her baby. An epidural is different, it renders her bedridden which does impact on her ability to birth.

In my book, a natural birth is one that involves no intervention and no drugs.

But on a side note I was chatting with a friend the other day who had her bub a few months ago. She was saying, that aside from herself, she only knew one other person who had had an unassisted birth. I found that staggering. But then when I started to think about it, I can actually say that she and the person she was referring to are the only people I know (IRL) that have had an unassisted birth (among our peers, not necessarily parents generation). So out of about 20 (30 tops) that 2 women. Now that is scary!

Some days i consider leaving home (a safe place) to go to hospital to birth your baby to be the first intervention that prevents the birth being 'natural'.

(but i also realise that some days i am incredibly jaded and cynical as a result of my experience fighting to attempt even a semi-natural birth in a hospital)

Honestly...I am not a mom. so sad...because of my heart disease. I don't know if i could be a mommy. I am consulting my doctor. Maybe there is some of danger. Soo...every mom, please prey for me.

I consider a "normal" birth, as the normal variations within a vaginal birth. I don't consider Sections "normal". I mean, usually it's an emergent situation that arises that causes you to need a C Section. But, I don't mean that if you have a CSection, you are abnormal. I just mean, that I consider normal to be what the body is intended to do, and the range of things that happen along with it.

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Some days i consider leaving home (a safe place) to go to hospital to birth your baby to be the first intervention that prevents the birth being 'natural'.

(but i also realise that some days i am incredibly jaded and cynical as a result of my experience fighting to attempt even a semi-natural birth in a hospital)

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Couldn't have said it better myself!

I distinguish between natural and normal...

I say normal is anything that gets the baby out safe and sound and the mum isn't traumatised by the experience.

I personally think it's unhelpful to constantly talk down about any birth experience that doesn't occur in the comfort of your own home. For the millions of women who choose a hospital birth, it's a perfectly acceptable and desired birthing experience. Why judge other women's choices? This I can assure you, there are equally millions of women who would love to have the luxury of access to medical assistance for birthing that we do, it's nothing to be scoffed at.

Birth where and how it works for you to have peace of mind and a successful outcome. That's only normal.

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Jude 07/10/08 | Lilac 16/06/11

I liked internals while in labour, it was an encouragement to know what was going on. It doesn't intervene in the natural process of the body, so why does it automatically render a birth unnatural?

I also think you can have perfectly natural breach births, why is head down a determining factor? Hmm?

Natural is by definition not allowing any interventions.

A normal delivery is one that results in a healthy mum and bub at the end of it all...

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I liked internals while in labour, it was an encouragement to know what was going on. It doesn't intervene in the natural process of the body, so why does it automatically render a birth unnatural?

I also think you can have perfectly natural breach births, why is head down a determining factor? Hmm?

Natural is by definition not allowing any interventions.



A normal delivery is one that results in a healthy mum and bub at the end of it all...

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Very well said.
Birth is different for everyone and I find the blanket statements often made to what 'is and isn't' really unhelpful to mother and their choices.

I always say I had a natural birth - no drugs or intervention at all to assist my labour or getting bub out. I did have the shot to prevent bleeding when birthing the placenta as that is what my OB wanted - that was after i had a beautiful naturally delivered (big) baby in my arms and I really wouldn't not call my birth natural because I had the syntocin after the fact, nor would I not call it not natural if the cord was clamped early (i requested delayed but i honestly don't remember if that happened lol). Natural birth to me is about laboring and birthing the baby until it is in the outside world (and preferably on skin to skin with Mum). I worked really hard to have the birth I did and would feel sad if some didn't define it as natural, as it was to me - completely and beautifully. I loved my natural birth experience and truly believed I had one.


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I don't think anyone was judging anyone elses choice to birth in a hospital. It's just that some of us were so disrespected, so mistreated, so traumatized by our experiences, it's hard not to voice the impressions we were left with.

In saying that, my next baby will still be born in a hospital. I'm reasonably confident that things won't spiral out of control quite like last time, but am prepared to fight for my right to a dignified experience.

To answer the original question:
I believe a normal birth is vaginal. That is all. What happened to my family was so unnatural, anything short of a c/s would be satisfactory to me, in conjunction with feeling respected and in control. My CS could have been avoided. That eats me up inside. There is nothing normal about dangling a c/s in front of an exhausted, fearful, vulnerable first time mum. My definition of normal is simple, for very complicated reasons.

Thanks for a thought provoking thread!

And the standard disclaimer ***my views are my own and not intended to offend anyone***. I seem to upset someone every time I speak about my son's birth. If anyone has a problem with my participation in birth discussions, well, tough.

I personally feel we should do away with natural and normal and look at "optimal" for the circumstance.

There is no use talking about how unnatural a birth was, if the intervention saved the babies life and was the safest option and best available option.

Many optimal births won't measure up to the natural standard, but I will always opt for optimal rather than natural.

I don't think people's *own* views or *own* standards are a judgement call :confused: So what if I hold my experiences to a standard others don't...who the heck am I to have other people want to measure up to what *I* think is normal, natural, red, boring etc. Not every positive opinion on natural birth is a judgement against those who didn't have one. Just as I hold myself to my own standards as a mother, a wife, a member of society. Some have higher expectations of themselves, some have lower. Doesn't male anyone better or worse, just different in their perceptions. For example, some people like internals and don't see them as harmful. I see them as a potential problem, in the way that a woman may hear she is 'only' 3cms and feel incredibly disheartened at that...and up go the mental blocks and barriers. Psychological impacts on labour can be just as jarring as physical ones.

As for optimal...I agree and I disagree. I transferred to hospital because DD's water was mec stained. So an optimal decision for her health, but I'm still allowed to feel and express a small sense of regret in not achieving my homebirth. To say that we should only focus on a healthy outcome takes away the emotional outcome of the mother, and the ramifications that holds. I'm not saying that is more important than the babies health, but it is valid and shouldn't be dismissed. An incredibly traumatic birth that results optimally (so an alive baby and mum?) I think is actually a really low standard and is unfortunately one that our medical system adopts regularly. And often unnecessarily. Which is why I think it's important to make our own calls as to what we hold as our 'golden' standard, and to strive for that.

And as always, that's just how *I* feel...I don't expect others to agree, and that's cool :)

I really like the idea of an 'optimal' birth!

I dont't know if I consider my DD's births as 'normal' becuase they were early but they were unassisted vaginal births. DD1 I had IV antibiotics and scalp monitoring due to prematurity and I had synto injection for delivering the placenta but no drugs, I dont know if this would be considered natural though. I enjoyed her birth but don't think it wasn't optimal but close to it

With DD2 she was earlier but I made an informed decision not to have antibiotics, I did have wireless CTG no pain relief and synto injection post as I tend to bleed. Hers was an optimal birth for me in our situation.

I think normal tends to reflect on how the majority of births are 'managed' and currently that is very different to what I would consider a 'natural' birth. I think the two most importnat things are the health of mother and baby and the families feelings towards their childs birth and that is different for everyone.

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So an optimal decision for her health, but I'm still allowed to feel and express a small sense of regret in not achieving my homebirth. To say that we should only focus on a healthy outcome takes away the emotional outcome of the mother, and the ramifications that holds. I'm not saying that is more important than the babies health, but it is valid and shouldn't be dismissed.

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I never touched on the topic of whether or not people can feel regret for not achieving what they consider to be natural/normal. I was only talking about the label / classification people want to give a particular birth. I didn't dismiss the emotional outcome of the mother. Quite obviously, a traumatic birth that resulting in a healthy mother/baby is not nice to experience and quite often is not the optimal that could have been achieved. The emotional health of the mother and her birthing desires should form part of what is considered optimal.

What I am saying is that we should focus on the best possible birth given the circumstance. If it is not possible for a particular mother/baby to achieve a drug free intervention free monitoring free vaginal birth... then that is not her golden standard, that is not her goal.

Unfortunately, for some women, an unnatural birth might be the best standard achievable. A vaginal birth for a woman placenta previa might result in a suboptimal outcome than a cs, for example.

I see a lot of people talk about the ideal natural birth, and feel awful if their own birth doesn't measure up to THAT standard. I can understand why they do it but I refuse. My golden standard is not a perfect natural unassisted unmedicated birth. My gold standard is the most natural, minimal interventionist birth possible for me and my baby and I outright refuse to feel any guilt because of the difference between my gold standard and the perfect natural unassisted unmedicated birth.

My opinion, of course :).

You absolutely should not feel any guilt! I think we're saying the same thing. Each individual women should set their own benchmarks and never feel like they didn't measure up to anyone bar themselves.

I dunno - my only benchmark was to be treated with respect and not have drugs pushed at me every two minutes. I didn't really have grand designs on birth. Sure, I'd be happier with fewer interventions, but sometimes they're necessary. And I was fine with that.

Now I'm not - and that's more to do with how I was treated than actual standards I hold for myself.

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You absolutely should not feel any guilt! I think we're saying the same thing. Each individual women should set their own benchmarks and never feel like they didn't measure up to anyone bar themselves.

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Well said & so very true!


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I think a normal birth is one where a mother is empowered and able to make decisions about what she would/wouldn't like to occur during her birth with the full knowledge of what each decision might bring about. A normal birth is one where the mother and baby's physical and emotional wellbeing take precedence. Only very, very few births if approached in a normal way would end up with an emergency outcome.

An abnormal birth is one where she is coerced, has information withheld from her (during pg and birth), is bullied, pressured to experience something that makes her uncomfortable, scared, or whatever situation she may find herself in that does not allow her to come to an informed and empowered choice. I also take this to mean information is not generally available in her culture (be it developed or developing!), so it may be superstition or medical in nature.

I do not think a normal birth needs to exclude medical assistance, just like helping someone who is sick doesn't mean the automatic inclusion or exclusion of medication, as well as natural remedies and helping your own body. But I think it's highly unlikely that most birth interventions are offered with the full knowledge of the mother as to all possible implications of those interventions. I don't think our culture is always conducive to having a birth that is not medical in any way.

Yes! Optimal should be the way to describe it. I also had no grand plans for birth. I just wanted to be left alone. Due to the synto though, I had the monitors etc and was stuck on the bed. And we all know constant monitoring means the constant presence of a stranger. The MW on duty. There were many obstacles thrown in my path from the onset of labour. I don't feel I failed, but I do know in a moment of weakness., I dropped my guard and succumbed to their 'timeline'. I do remember feeling disheartened being told I was 'only' 5-6cm dialated after 12 hours of vicious contractions.

I would have been ok with the c/s without all the complications which arose as a result of the surgery. I'm still paying for it now.

I think I'm getting lost in my ramblings. My point is, we should have our own standards. What's ideal for one woman might be my worst nightmare. I don't understand all the judgement and smugness I see in conversations about birth. (not here, just in general) Maybe because of my particular experience, I'm more sensitive to that kind of thing. I think the fact that none of what happened to me was neccesary really is my issue. Neither of us were in danger. Until they intervened. How ironic. Even if I end up with another C/S, I think I can make peace with that, as long as my emotional wellbeing is protected, and I'm spared the agony of being mistreated by those I'm supposed to trust.

Rambling again. :redface: I hope I'm making sense.

I like the word optimal too.

What is a normal birth?

What is a natural birth?

What is an optimal birth?

All 3 questions are asking different things, and the answers will be different to each question.

'Normal' is largely defined by culture and time. C sections or assisted vaginal birth are certainly 'normal' in Australia at this time.
e.g. it used to be accepted (i think in the 60s) that a birth lasting 48 hours was 'normal'. In the 70s, normal was redefined as a birth lasting up to 24 hours. Now, a labour over 12 hours is considered long and not 'normal'. (this last step was due to a Scottish dr at a very busy overcrowded hospital describing the 1cm dilation every hour rule to define normal).

And then there is 'normal physiological birth'...

I think 'natural birth' can be defined more concretely, but others may not agree. Not every woman wants a natural birth, even given the best circumstance not every woman will be able to safely achieve a natural birth.

Optimal birth is probably the most subjective term, what is optimal for me may not be optimal for you. What is optimal for the woman may not be optimal for society. What is optimal for me for this birth, may not be optimal for me next time.

F'chug &l

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F'chug &l

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Que?

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there are differences between normal and natural birth. what has become normal in our society is not natural.

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Thats just about it.

A normal birth to me is a vaginal birth without the intervention of any kind - as the OP has asked about "normal birth" and not natural birth.

The normal births that I see are those that progress normally with decent and dilation progressing as it should.

Everything else is a variation of normal.

I think as time goes on and women become more educated and more active in their own health care, variations to normal become normal. Things like posterior labours, VBAC's, epidurals etc.

So I guess its hard to pinpoint normal birth. It really all depends on your HCP, your own beliefs, your place of birth and the beliefs of those supporting you.

As for the article, I'm suprised it was even published given the lack of participants.

I consider the births of both my girls as normal, but only DD2 was natural.

I was however completely in control the entire way through. No one did anything to me I didn't want or approve of, so despite the less than natural progress of DD1's birth, I was still happy. The only thing I still wonder on occasion is what would her birth be like if she hadn't been induced, but given my health circumstances that resulted in the induction I can live with the wonder.

I like the idea of optimal too. If I have a third "optimal" birth I'll be a very happy mummy.

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F'chug &l

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Uhhhhh....love Isla?? :rofl:

Where did the OP go? Talk about stirring the pot then doing a runner... I feel like I am being watched from the wings.

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Where did the OP go? Talk about stirring the pot then doing a runner... I feel like I am being watched from the wings.

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sorry that i left here long time. happy that so many ideas here I heard. Now I am back after xmas. Hope you all have a good amazing holiday

I am upset and feel i don't belong to here coz my heart disease. So sad...and upset during my xmas days.

Haven't read all the responses but my opinion on what a normal birth is, is a labour that starts spontaneously and progresses at its own pace over a few hours building up in intensity gradually before transition then birthing the baby with enough time that your parts can stretch gradually as your baby enters the world in cephalic position.


anything other than that is called something else ie breech birth, posterior birth, c-section, emergency c-section, precipiate delivery the list goes on.