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The First Birth Matters (More Than You Think)


Birth is sacred.  It is the transition from couple to family, from woman to mother, from one to two.


Birth is also, for most of us, a touch scary.  It is still, after all these millennia, a mystery in many ways.  And so, it is somewhat natural to dismiss the first birth.  People often say things like, “Well maybe with the next one I will…(try to go natural, have a home birth, take a birth class, hire a doula, etc.) but with this birth we will just see what happens.”


While I understand the sentiment I must issue a warning cry against simply dismissing the first birth as inconsequential.  Perhaps more than any other birth that a women will experience, the first is deeply life changing and has a lasting impact on the rest of our births.  


Why does the first birth matter?





The emotional impact of birth is one that simply can’t be explained, it must be experienced.  A joyful and triumphant birth can make a woman feel like she is capable of anything.  Yes, thousands of women do it every day;  birth though, is by design life changing, overwhelming and it leaves a deep mark on our souls.  


By contrast, a woman who feels violated, dysfunctional or like a failure because of her birth experience will find it hard to move past those emotions.  Keep in mind too that often the words that care providers use to describe what is happening, (ie, “You are failing to progress, your pelvis just isn’t big enough to birth, you don’t go into labor on your own”) will become the voice in your head.   


The emotions surrounding birth can cut deep for either the negative or the positive,  Never underestimate them or the power of your care provider’s voice of support - or negativity.



Many first time moms who are ill prepared for birth (and many who are well prepared) will find that their birth will impact them not just emotionally but physically also.  How can the physical impact of a birth influence your next birth?


Think for a moment about a cesarean scar.  Cesarean scars don’t actually occur in nature despite their constant presence today.  While the surgery to perform a c-section can be done quickly and rather safely, that doesn’t mean it is without consequence.  


Women who have a cesarean section run the risk of many more birth complications (and those risks only increase the more cesareans she has).  All too often I speak to women who went into their first birth with some hope for the best but little other preparation.  They leave the hospital with a scar on their tummy they weren’t expecting and a great big surprise awaiting them when they attempt a VBAC with their next baby.  


Sadly, VBAC is difficult in our current obstetric climate and that first cut can make it much harder to avoid another one.  That is a travesty, but it is the truth.  (Personally, one of my favorite resources concerning the many risks and benefits of VBAC is found on this birth blog and written by a VBA3C mom, Abbey Robinson, whom I have also had the pleasure of meeting.)


Sadly, sometimes when we dismiss the first birth as just a “trial run” it sets up all of our future births to be much more difficult and our ability to find a care provider to attend us more complicated.  


I distinctly remember preparing for the birth of my first child with trepidation and a little bit of fear.  What did I fear?  For me it was simply the great unknown.  What would happen?  What would it feel like?  Would I be able to do it?  How would this all play out?  There was a lot that was just beyond my understanding.  


I also remember preparing for my second birth.  I had a little fear- but fear of very different things. Subsequent births often bring of fears of repetition of what has happened in previous births. Those emotions and those physical consequences can’t be erased.  They live on with us.


Do yourself a favor and prepare as much as possible for that first baby.  EVERY birth matters. EVERY.  SINGLE.  BIRTH.  MATTERS.  But perhaps none more than the first.  



Sarah Clark is a mother of four, a blogger, a natural birth teacher in Sonoma County, and a teacher trainer for Birth Boot Camp, a company specializing in online and in person natural birth classes for couples.  You can find her at www.mamabirth.blogspot.com


(Photo courtsey Birth Boot Camp, all rights reserved)

Comments (26)

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I read this article from my viewpoint.... A first time mother who will give birth anytime soon to my baby, whom will not live for very long once born. I found out two weeks ago he/she is incompatible with life. I have had the choice to terminate and induce early, which I still haven't completely dismissed, but after having 2 weeks to get over the shock, I am mostly now set on having labour start naturally as I originally planned and have always believed in. Your article is so relevant to me, because in my situation there is that temptation to try hide from the utter sadness of this birth by medicalising it, going into hospital and having all the drugs and numbing possible. But I realise that this may not be the way 'forward' and through this, for me. It might even be more traumatising. This is still a birth and it still matters. It's been hard to swallow that, but I think in the long term, sticking to my heart's beliefs on birth and trust in my body could be a better way to process my grief and move onwards to future births.
I will be thinking about and praying for you, clovebucket. I cannot comprehend going through something so difficult. I really wish I could do anything at all to help ease your pain.
Love from the DDC, clovebucket. <3
Thirty-two years ago, I attended a talk by Suzanne Arms.  A part of her conclusion pointed at this dilemma.  Many women now and then say they will go to the hospital, hope for a natural birth and then try for a home birth, birth center, or some other mode of birthing. 
Suzanne told the audience that a woman's first birth is extremely important and the hospital is not the place to "see how it goes".  The first birth should be celebrated and welcomed and prepared for in a place a woman prefers to labor.  There is nothing wrong with the first child a woman delivers that the act of birthing needs to be in a place that is designated for illness.
This was a bit discouraging for me.  I was VERY prepared for my first birth, I had a midwife, a doula, going all natural, and still ended up with a C-section.  I DO hope next time will be better, and I DO have a list of things I want to do differently.  The link you have to the VBA3C was inspiring though.  thanks.
I couldn't have read this at more poignant time in my life. I just experienced a traumatic birth and couldn't feel more depressed about the outcome. I feel terrified that I will end up with another C section and a little discouraged to attempt a VBAC.
Very insightful comments. My heart goes out to you all. The first birth is so important. It affects your view of birth, your feelings regarding its competency, affects your fears and expectations, and as you know, has affects on not only you but your baby and your infant-feeding experiences. I will highly recommend some reading at the following sites:
1. about a midwifery initiative called "your moment of truth": http://midwife.org/ACNM/files/ccLibraryFiles/Filename/000000002594/Affiliates_OMOT_Toolkit_PrintableFactSheet.pdf
2. the brief handout called "your moment of truth," compiled collaboratively by the three major midwifery groups in the US: http://ourmomentoftruth.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000003184/NormalBirth_ConsumerDoc%20FINAL.pdf
3. a great website called "Childbirth Connection." they are chock-full of evidence-based information regarding birth and birth options. It is sad that a lot of women are not getting this information from their providers. One of the best documents available on this site is called "Evidence-Based Maternity Care." It is quite lengthy, but details how far off birth practices have gotten in this country, along with what practices should be. http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf
4. I will highly recommend this outline about the midwifery model of care: http://cfmidwifery.org/mmoc/brochure_text.aspx
5. Lastly, for dear clovebucket, there is a well-written booklet called "Silent Birth." It is written by a woman who has been there. It is brief but very insightful, and echoes many of the sentiments you are voicing. Unfortunately, I did not see a link for it, but would be happy to mail one if you would like. Please let me know. My experience with this scenario is that it has been helpful for many women to go through the experience, as you have described. I am very sorry.
I really appreciate this venue to talk about these things. Thank you.
clovebucket - I felt the same way with my first birth and was under huge pressure by all the delivery staff to medicate myself so it wouldn't be so bad (emotionally). But to me it didn't matter that I wasn't going to get to take my baby home with me, it was still my first birth and I wanted to experience it, not tuck it away to be forgotten. This would be my only first birth, first baby, etc. Thinking back, I'm able to remember everything clearly, without the fog of drugs. When a mother has only a little bit of time with her baby, how wonderful to be able to experience it fully instead of recovering from an epidural, cloudy from drugs, or worse--stuck on an OR table watching baby from the sidelines. I definitely encourage you to continue with your conviction to do it the way you'd planned before two weeks ago, but no matter what you choose to do i pray for strength and peace for you and your family.
Thank you very much Autumngrey for your supporting and poignant words, and to ultrafighter & genniemom <3
clovebucket - my heart goes out to you. I too wish you strength, peace and healing.
To add my penny's worth: I prepared as well as I knew how for my first birth (hypnosis tapes, yoga, swimming, birth plan, CDs), only to be told at my last visit to the doctor, two weeks before the due date, that she didn't think my pelvis would expand enough for the head. As she put it, you can have a scheduled C-section, or an emergency C-section... There followed X-rays, more internal examinations, ultrasounds, and an operation date two days later. I was in floods of tears - until I called my mother, who reminded me that she'd had 48 hours of agonising labour for *her* first birth in 1967, before an emergency C-section (her pelvis wasn't expanding enough for my brother's head....).
This is not to refute Sarah's article, but to present things from another perspective. One can prepare as much as one likes, but sometimes things are out of our hands. My two beautiful daughers were born by C-section with their father beside me, and my scar is a reminder that we all survived. They spent their first couple of hours on daddy's bare chest, then I was able to breastfeed them. If we have the blessing of healthy children, then the manner of their birth is perhaps not as important in the long run.  
Thanks, LochLomond. "One can prepare as much as one likes, but sometimes things are out of our hands." My little one was born premature. My one and only :) Her birth was scary. I felt violated by most of the medical staff. I've accepted that my birth experience was *absolutely necessary* to save both mine and my daughter's life. I'd rather go in well informed, yet suffer a traumatic birth, than think I could go through a homebirth and leave my husband to mourn the loss of his wife and daughter. My midwife was awesome, and reassured me I was making the right decision to use the medical interventions I did. The trauma of that experience has made me reconsider my original plan to have multiple kids, though I won't say anything is set in stone. ...everything in its own time.
I'm due to have my sixth birth in two months. With my first, my husband really wanted to have a midwife-attended birth in a birthing center. I took the position of, "Maybe next time. I don't know anything about birth this time, so I want to be in a hospital where they can tell me what to do."

It's not exaggerating to say this was the biggest mistake of my life. Not only did I set myself up for an over-medicalized and traumatic birth experience by going in unawares and expecting my doctor to "teach me," I cemented for myself that I will never be able to have the kind of birth I want. That completely unnecessary scar on my uterus forced me into one difficult (and dangerous) situation after another, until I was so traumatized by the medical care available in my city that I will never be able to give birth without fear and mistrust. I will never be able to go into a hospital without terror that they are going to hurt me.

I have nothing but sympathy for those who have commented here that they were prepared, educated, and informed, but whose births did not go well and required medical intervention. I'm very sorry for that -- I've actually been there, too. But it's not the same thing. It's like the difference between getting sick with a terrible disease, and getting mugged and having your guts slashed open in the subway (only worse, because you trusted the attacker with your life). I'm not saying one situation is harder or worse than the other, I'm just saying that they are very different. Warning women not to go into their first birth with eyes closed, blind to the potential for abuse (or just the poor treatment that comes with assembly-line birthing) should not be a slight to those women who genuinely need medical assistance. I think pretty much everyone agrees that access to emergency medical care in childbirth is just as important as access to low-intervention assistance. It's all about the right care for the right birth.
LochLomond you typed my thoughts. I hope articles like this reach those who would take their first birth for granted, but they are also painful for those of use who know full well the importance of a natural birth, of a first birth, and tried, intended, dreamed of a perfect, peaceful first birth and it simply didn't go that way. More emphasis on how to mitigate the possible negative outcomes of "imperfect" births would be helpful, and so many of these risks are not necessarily so. My girl was unexpectedly born by c-section and we bonded quickly and easily, milk flowing, nursing strong. Knowing the importance of a natural birth did make us very sensitive to her high-needs so months after the birth we stayed very attuned and surrendered totally to her need to bond and feel grounded. Maybe she would have needed this anyway.
I would not have chosen her birth and will try try try to make sure any other children we have are birthed naturally, but there is a lot more to motherhood and the baby's life than birth. There is a lot more work to be done after the birth has happened, however it did.
I think it is so important for mothers and mothers-to-be to realize just what modern medicine has done FOR us, not solely focusing on what doctors do to us. One hundred years ago, 1 in 100 women died in childbirth and 10-30% of infants never saw their first birthday. Today, maternal death rates have declined 99% and infant death rates have declined 90%! While I understand the desire to have the "perfect" birth, surely having a healthy baby is much more important. I was lucky enough to have a very easy and uneventful pregnancy up until 36 weeks. At that point, I was measuring rather small for my dates and an ultrasound showed that my baby was lagging behind in the growth of her body. A week later, she hadn't gained any weight and met the criteria for IUGR. Another week later, blood flow to the baby and amniotic fluid had both declined to the point that my OB felt like the baby needed to be delivered or risk intrauterine death. I went straight to the hospital and began the process of induction, knowing I had a reasonably high (20-30%) chance of needing a c-section. Now, prior to all of this, I had visions of waking up my husband, telling him I'm in labor, timing contractions, rushing to the hospital, calling our family & friends, pushing for an hour, then holding and nursing my baby as soon as I delivered her. Obviously, this wasn't exactly the way it happened, but did I spend my time grieving over my fantasy that didn't happen? No, of course not- I spent every minute of my induction and labor praying that my baby would be ok. At that point, when your child's life is on the line, how he or she arrives ceases to matter, or at least it should. I can't say that I particularly enjoyed the induction- sitting in a hospital room, wearing uncomfortable monitors, having to stay still to keep the baby on the monitor, having to drag cords and IVs with me to the bathroom, but if that's what it took to have a healthy baby, I would do it ten times over. And despite the induction, we had a WONDERFUL birth. The OB even let my husband deliver our baby. He often tells our little girl that he was the first person in the world to hold her. Doctors are not monsters trying to rob mothers of a positive birth experience. Most of them want to honor the wishes of the mother, as long as they are reasonable and safe. Proponents of home births criticize physicians for "medicalizing" childbirth, but it is through these medical interventions that the death rates for mothers and infants have dropped so drastically. What would you do if you were having your baby at home and something went wrong- bleeding, prolapsed umbilical cord, the baby was stuck, etc. In most cases, you couldn't make it to a hospital in time to save the baby and doulas & midwives aren't equipped to deal with serious problems. Women transitioned to giving birth in hospitals years ago for a reason! It will always be better to mourn the loss of your birth plan than the loss of your baby
I don't think the writer was intending to disparage those births that end up in the hospital with interventions.  Stuff happens, we all know that.  I think she was just trying to encourage the women who aren't giving much thought to how they want their first births to go to give it some thought instead of a "well, I'll make the next one awesome after I make it through this first one."
Thank you all for your expressed opinions. I thankfully came to the realization the childbirth is something to celebrated and respected before becoming pregnant and delivering my first child July 2013.
I intended a completely natural vaginal delivery in a hospital with a MW (no OBs in my area support homebirth anymore - to much legality and liability), but thankfully my OB office has a wonderful team of midwives and OB/GYNs that believe in the best birth experiences for all of their clients. And that is what I got...
At 37 weeks 2 days, my MWs agreed with Docs that induction was the best course of action for my preeclamptic condition. I only had elevated (not high) blood pressure, but protein in my urine was increasing. They encouraged me to accept an induction by foley bulb cathiter w/ pitocin drip (not in my birth plans!) to jump start labor since I was not at all effaced nor dialated. I accepted this with the perspective that my LO and I were both still healthy and my MW agreed I could successfully deliver vaginally. And deliver vaginally, I DID!! To keep blood pressure controlled I was given magnesium sulfate which made me a bit groggy and my visions became unfocused at a short distance. This didn't bother me too much until I had to get out of bed (nearly impossible). On the negative... my LO had to be taken to NICU and stayed for several days. This delayed me getting to hold my LO and even pump milk for the first 24 hours. I didn't even get to hold LO until he was 3 days old and finally got to attempt BF on day 4. Honestly, I did feel the effects of this on our bond. But I know that this was the right course of action and the experience we were destined to have.
Next time, I will pursue a home birth AND PLAN AHEAD for that new experience. It was definitely worth the time and effort I put into researching the current conditions and practices of the medical community in regards to childbirth. But I also know not to overlook the necessity of experienced medical personnel who can still provide a safe way to bring my LOs into this world. And will remember to soak up every moment I could like I did with this first LO and cherish those tiny memories forever (by writing it down)!
I'm very glad I decided to go with a midwife-attended homebirth for my first. She turned out to be two weeks late, nine pounds, "sunny side up" and born after I begged for drugs and after three hours of pushing. Perfectly healthy, just not an easy birth at all.
In other words, I would have almost certainly ended up with a c-section and wouldn't have been able to have my other three at home, too.
And, Zanb, if "something goes wrong", as you described, a competent midwife can handle it. 
I will say that I was prepared for birth, had a completely natural home birth with midwives with my first, and felt like a failure afterwards anyway. My first birth was traumatic, for me, for many reasons, but many of those reasons were due to me having too high of expectations of myself, and feeling like a failure for not meeting those.
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