I am continually amazed by the things my friends tell me they hear from their obstetricians and even midwives, ideas that straightforward statistics and basic anatomy have repeatedly proven false. It may seem unbelievably pompous for me to say I know better than a health professional about anything health-related. Doctors slave away for nearly a decade of school to earn the title of expert and deserve respect for their knowledge and dedication. I don't claim to know a hundredth of what they do, just to know that some of them have a faulty idea or two.

I have nothing but sincere respect for most doctors. The vast majority of obstetricians and midwives get into delivering babies, especially initially, because they are awed by the miracle of birth, want to participate in it as often as they can, and aspire to deliver healthy, whole babies to happy, safe mothers. Why else would they put up with the soaring insurance premiums and ridiculous hours involved?

It's hard for me to understand why these dedicated people seem to get some ideas wrong on a regular basis. Maybe looking at some of the misconceptions medical science tends to propagate will help explain both what I mean and why they are so often wrong.

What Medical Professionals Get Wrong about Labor #1: Their Opinion Is Always Right

To be fair, most maternity care providers don't think they know everything. They just have strong opinions that they feel are right and often don't mention to their patients that what they are declaring as truth is just their opinion.

Kellie's obstetrician, for example, said that she had to perform episiotomies on all women, which is certainly not necessary in all cases. Some doctors even feel they are unnecessary in all but the direst of emergencies.

Had Kellie not known better or researched it herself, she might never have known to refuse the procedure. Many doctors feel that if you are hiring them for their expertise, they should simply tell you their expert opinion without offering other options. To use an analogy, a car mechanic is unlikely to tell you three possible fixes for a squealing sound and then leave it up to you. He'll more probably tell you he thinks it's a belt and then tell you how he's going to fix it. After all, you're paying him to give and act on his expert opinion.

Nonie had a similar experience with her midwife. "She said that they did not want newborns to nurse before the placenta delivered because nursing would cause the cervix to close (and thus trap the placenta inside). Say wha? No way, no how. Nursing causes the production of oxytocin, which causes uterine contractions, which would assist in passing the placenta. But she was sure on this point. Since I didn't want the cord clamped or cut for a goodly long while, and I did not want assistance (read pulling on the cord) to birth the placenta, she did not want me to nurse until the placenta was delivered. But it would have been okay to give me pitocin, as was done with Sayer's birth, to assist with the placental delivery. So...synthetic oxytocin is okay, but natural oxytocin is not?"

It's up to you to research so that you know whether or not to disagree with a medical professional. It's also up to you to stand up for the care you want and even switch practitioners to get it.

What Medical Professionals Get Wrong about Labor #2: Your Body Is a Lemon

Western medicine is overwhelmingly based on pathology. By that I simply mean that doctors are trained in medical school to find out what's wrong with you and fix it, not to keep you well in the first place. That's wonderful news for the women who genuinely need surgery or medications, but not so great for the overwhelming majority of us who don't.

Birth has been mythologized by movies and dramatic friends to the point that many women see it as a horrifying ordeal to be survived, just barely, with medical help. When a midwife then brings up everything that could go wrong, along with a long list of rules about due dates, time limits, and standard procedures, it plays into the pregnant woman's hazy idea that most women need significant help to deliver babies. Most, in fact, don't. Ina May Gaskin refers to this idea that there's something wrong with our bodies as the idea that the body "is a lemon."

Take, for example, the oft-repeated belief that it's practically impossible to birth larger-than-average babies, in spite of the fact that the pelvis is designed to expand and the baby's skull to compress to allow large babies to pass through small spaces.

Julie says of her obstetrician, "when he heard that Jere's [birth weight] was 12 lbs he freaked out and told me to prepare for a huge baby. I was terrified the entire pregnancy. He even did multiple ultrasounds and made sure I knew that she was going to be at least 9+ pounds. She ended up being under 6 pounds and I wanted to beat him with a stick. I now know that I am perfectly capable of birthing a baby that is 9+ pounds and that there is no way to estimate a baby's weight before they are born!"

What Medical Professionals Get Wrong about Labor #3: We're All The Same

Moms love averages. We feel safe when our babies fit perfectly into growth charts and terrified or guilty when they eat just fine and seem completely healthy, but are in the fifth percentile for height. We seem to forget what we learned in math class about averages being the mid-point between extremes. While weighing less than average is definitely cause for further investigation, it can still be perfectly normal.

Health care practitioners love averages, too. More problems occur in not-average situations, so statistically they're better off avoiding them. They do so by having practices in place that are designed to keep labors from lasting longer than average, pregnancies from going past their estimated due dates, and small women from delivering babies that may be large (although that's nearly impossible to determine accurately during pregnancy).

From a general practice standpoint, having policies against unusual situations seems a wise bet for everyone. The problem is that sometimes women with perfectly safe, healthy labors that last longer than the midwife's arbitrary time limit may end up with a c-section that they don't want or need, or a small woman like my 100-pound sister Rita may end up pressured to have a c-section for her 10+ pound babies (she birthed them vaginally anyway).

Averages are a mix of unlikely extremes as well as more usual experiences, and women should know that although extreme situations may merit special care or monitoring for safety's sake, they aren't necessarily emergencies.

What Medical Professionals Get Wrong about Labor #4: They Can Predict You

If I had seen a hundred women have babies, I might start to feel knowledgeable about birth. That's only to be expected, isn't it? I might even start to get pretty strong ideas about how women react to labor. The danger then would be that I might begin predicting what one woman is capable of, even if I don't really know for sure.

Both Kellie and Sheila report that their doctors didn't believe they would be able to give birth without pain medication. Sheila says her obstetrician "told me that if I said I didn't want any drugs, I was setting myself up for failure. Whenever I tried giving him my birth plan, he said, 'you don't need that. Of all the women I see, the ones who have birth plans are the ones ending up with C-sections.' He refused to even LOOK at it."

Don't let a condescending smile or claim of insider knowledge discourage you from your birth goals (especially if you can change practitioners). You are a dynamic, strong woman, and, no matter how many times they've been through this, they can't predict you.

While it's unwise to go against a medical expert's opinion simply because you don't like what they're telling you, it's equally unwise to accept everything they say without ever looking into the facts yourself. Most medical professionals won't be threatened or upset if you bring up informed questions or even decide to disregard their advice based on what you believe to be right.

Believing anyone blindly is dangerous, even a dedicated professional with your best interests at heart. So do your research, stand firm for what's best for you and your baby when you need to, and maintain a respectful, friendly relationship with your care providers.

And don't worry! You're going to do great at this.

This was a really wonderful summation of a lot of thoughts I've had about Dr.s and birth.

My doctor did the whole condescending smile, "Sure you're going to give birth without an epidural." thing and it was really aggravating. However, he did listen to my birth plan and did respect my wishes about interventions and the like.