Every patient and every birth are unique.
Every woman has a different emotional and physical experience of birth, and in each case, the wonderful journey of pregnancy and birth is a healthy, natural, and normal process. In light of this, however, the question is bound to arise, "If birth is so natural and wonderful, why meddle with it?" The true answer is that we should do so as little as possible.
My philosophy is to give my pregnant patients the least amount of medical intervention necessary and enjoy simply supporting and monitoring the health of my mom’s and their babies. On the other hand, if a complication does occurs, I will not hesitate to assist you and intervene in the most appropriate way.
The vast majority of women have normal, healthy pregnancies. These women have what I like to call a “Home Birth in the Hospital.” That is, a birth with no medical intervention but that takes place in the safety of a hospital setting. You don't automatically need an I.V., to be confined to your bed, or to have an epidural, just because you enter the hospital in labor! (See also our Birth Plan link). You don’t even have to wear a hospital gown, in fact, if you have a comfortable alternative that gives easy access (Example: Pretty Pushers Cotton Labor Gown, which is popularly sold online and loved by both patients and nurses alike).
I believe in providing the options but letting you and your partner make the decisions. If any medical issue arises, I discuss it with you so we can adjust our approach with everybody feeling comfortable and fully informed.
Patients who are planning to have their babies without epidurals will be supported in their decision instead of being asked over and over again if they have changed their mind.
I also strongly believe in walking and moving during labor. Having no I.V. at all or merely access to an I.V. makes this a lot easier. Standing in the shower and walking, squatting, or using a birthing ball are all excellent options.
We often provide “Intermittent monitoring” of birth patients, meaning we check in with you and your baby at regular intervals rather than monitoring you continuously. After each use of the monitor, as long as everything appears to be going well, we can take the monitors back off again.
One frequently asked question is "Will I need an episiotomy?" And, "Do I have to lie on my back while pushing?" My typical response is to reassure my patients that episiotomies are reserved for very rare occasions, when there is an emergency and we need your baby to come out quickly—and only when vaginal approach seems faster than when a cesarean would be in order.
As to position during pushing, I have no preference. It is, however, important that I have good access to the perineum so I can protect it during delivery. And many women are so tired by the time they get to pushing that they prefer lying down. But pushing can be done on your side, sitting up, squatting, on all fours, or even standing. I will adapt to your preference; just let me know what feels right to you.
I also give this advice to my patients: stay physically fit during pregnancy so you can have the most natural and best birth experience possible! Birth is a 3000-calorie workout and the best preparation is to stay active, drink plenty of water, avoid high-carb foods, and eat foods rich in protein and fiber.