Is it selfish to want a good birth experience?

It’s interesting how this question recurs in both popular and professional discussions about childbirth. It comes up when the topic is women making choices, seeking control in the childbirth experience, or wishing to find beauty, joy or transformation in birth. In the past, women were said to be selfish when they sought “natural births” or asked to have their partner present in a system that routinely put women “to sleep” for childbirth. Currently, the same opinion is often expressed when a woman chooses a home birth or, conversely, a Caesarean section.

What is “selfishness” in childbirth? Pregnant women are almost defined by altruism: wondering what to eat, if their anxieties and stresses will affect the baby, if they are doing too much or too little. These concerns cross cultures and classes. Research tells us that most women will readily accept risks themselves to diminish potential risks to the fetus. Some speculate that this lack of selfishness is part of what is driving rising rates of intervention. Women are vulnerable to the suggestion, evidence-based or not, that interventions will benefit their babies. Pregnant women are perhaps in danger of too little selfishness.

Women who actively seek choices in childbirth often believe that what is good for them is also best for their babies. I just returned from Iqaluit, where Inuit women and midwives want to bring birth back to remote communities — a choice that has been considered selfish and dangerous. And yet the evidence increasingly supports this approach as safest, not only for themselves, their babies, their children and partners, but also for their culture and community.

Birth is a profound life event with broad personal and social impact. Memories of birth are long lasting. A good birth experience can inspire confidence and create bonds that support parenting. A traumatic birth can leave a woman struggling.

What is a good birth? Research shows that satisfaction in birth is not outcome based. For many women, the core is care and support that diminishes fear and encourages understanding and confidence in the birth process and in their ability to give birth. This is not selfish. This is good, evidence-based, ethical care that grows out of the relationship between women, families and their care providers.

The desire for a good experience has inspired childbirth reform and made birth more humane, more social and more inclusive of families. And it isn’t just women who are seeking beauty, joy and goodness in birth — many of the obstetricians, family doctors, midwives and nurses who love “catching babies” do so because they have a deep respect for birth and the meaning it can have in the lives of women and their families.

Whether or not beauty, joy and goodness are always achievable in childbirth, it is not selfish — but understandably and wonderfully human — that we seek the best of life and of ourselves through this experience.

Vicki Van Wagner has been practising midwifery for 25 years in Toronto and in the Inuit villages of northern Quebec, and teaches in the Ryerson University midwifery program.