Here are three powerful things you can control.
Birth is notoriously difficult to control. The most thought-out and detailed birth plan can become a lost cause, but there are three powerful things you can control.


Your birth experience will affect how you feel about yourself, your child, and your ability to parent.

I have a working theory regarding birth experience and mothering. When I ask mothers to think of their most difficult child to parent, we find that this child's birth was also the most difficult experience for the mother. It's not what happens that determines how you feel about it. How you feel about it determines what happens as you take that baby and that experience home.

Here are three things you can actually control when it comes to your birth experience:

1. Where and with whom you give birth.

Where and with whom you give birth is the most important decision you will make this year.

If you are a vegan, you don't go to a steakhouse and expect them to whip you up something edible. If you are hoping for a vaginal birth, it's not just your rotten luck if you go to a hospital with a 54% cesarean rate and end up with a cesarean.

You want a provider who regularly attends the kind of birth you want. If you hope to minimize interventions, it doesn't mean anything when your doctor says, "Yes, of course we will minimize interventions." He thinks that's what he always does.

If you want a drug-free birth, can you be assured of a nurse who regularly works with people laboring that way? What's the doctor's cesarean rate? Episiotomy rate? What's the protocol in the practice for people who go over 40 weeks?

It's very difficult to fight or think in labor. You're extra persuadable. It's not the time to find out the answers to those questions.

You should have a provider who you trust would pretty much make the decisions that you would.

When I had my VBAC, I picked a midwife who I trusted implicitly. If she told me we needed to go the hospital or have a cesarean or be induced, I'd believe her and do it without any agony.

We don't make these decisions to be special or have a nice experience to tell people about. We make them because we believe they are the best and safest for our babies and ourselves. You can have a safe birth and a positive experience at home, at a birth center, or in a hospital. The best place for you is where you feel most comfortable giving birth.

Since it's the love and cuddle hormone, oxytocin, that causes contractions, it's imperative that you are in a place you feel very comfortable as long as possible.

2. How soon you go to your birthplace in labor.

When you leave for your birth place in labor can mean the difference between a cesarean and a vaginal birth.

Leaving home is the first intervention. If you want a birth free of intervention, stay home and hire a knitting midwife.

If that's not an option for you, you're most people. The next best thing is to have a provider you trust and go to her when labor is already well advanced.

Your oxytocin works best at home. Unless you have an unsafe or extremely chaotic home environment, or you are markedly afraid of birth, your body will feel and work best at home.

Early in labor, your oxytocin sort of plips around, causing shorter, milder contractions. As it moves along, the oxytocin snowballs, and it becomes a train you can't stop. This is when it's best to leave home - before it gets to be its most intense, but after you already feel 'zoned' by the intensity.

Clinically, active labor is 6cms. Most places would rather not have you until then anyway. Make sure you discuss ahead of time with your provider when you should come in.

Taking a birth class will help you be comfortable being uncomfortable at home in labor for longer. It will also help you determine when to leave for the birthplace.

Even if you plan to get an epidural, the opioids involved are far less dangerous to your baby and your labor when you get it after 6cms.

The longer you're in labor, especially in a hospital, the longer they have to run tests, get impatient, and mess with your laboring rhythm. This is especially true with induction.

In addition to helping you choose an appropriate provider and feel comfortable staying home longer, a birth class should profoundly increase your ability to feel positive about birth.

3. Your ability to feel good and stay positive.

People who feel good and calm in labor have the safest and most positive births.

Your ability to relax makes a difference in your hormones and the way your mind and body respond to the stress of labor.

Labor is absolutely stressful. It's mega intense and it's meant to be. There is no bigger transition - and transitions are hard.

Your challenge is to feel positive about it. Like a marathon, a competition, or doctoral thesis.

I've noticed that what happens in birth is not a good indicator of how a mother feels about it. I know a woman who had a straightforward and very fast birth and felt tortured by the intensity of the experience. I also know a woman who had a long and grueling labor ending in an episiotomy she desperately wanted to avoid who felt triumphant. Both chose excellent care providers, took a birth class, and felt confident going in.

Is it your habit to feel positive about your body? Do you have a solid foundation of positive birth stories to draw on? How do you feel about your ability to handle the unexpected?

Try not to make a birth plan with elements that you can check off as being successful or not. It really wreaks havoc on the in-labor psyche.

If you expect to be able to control it with your classes, your plans, your books, your doula, and your practice, you're setting yourself up for failure.

Surround yourself with people and thoughts that will support you and help you feel good. This includes your provider, your partner, and anyone else who will be there - in person or in your head.

You can't control birth, but you can set yourself up for a positive experience by picking an appropriate provider, staying home as long as possible, and going into it with a positive, flexible and resilient spirit.