Thirty-three days ago, after nine grueling hours of utter exhaustion and unbearable pressure and pain, I was initiated into motherhood.

I held my perfect baby girl, Olivia, on my chest and instinctively uttered the words “I love you” over and over again. She cooed. I cried. I felt overwhelming pride at the incredible feat we both accomplished.

I remember thinking: That’s my baby. I did it. I birthed her. And I did it on my terms. I know now I can do anything.

I knew how I brought Olivia into this world was equally as important as the act itself. I had my heart set on an unmedicated, vaginal birth. I wanted to surrender, ride the waves of labor, and trust my body and inner strength to guide me—listening to my intuition above any other voice in the room. Most importantly, I wanted both of us to feel held, loved, and supported. 

And while there were pivots from “the plan,” with the help of my support team—my husband and doula—I fulfilled my vision for my birth experience. I chose my labor positions based on what my body needed, accessed extraordinary inner strength, and trusted my body’s signals for when to start and stop pushing, all of which resulted in minimal natural tearing and a smooth postpartum recovery. 

Why birth preferences matter

No matter whether you are induced, deliver vaginally, or have a cesarean, giving birth is completely unknown territory for first-time mothers and can be equally terrifying, miraculous, vulnerable, and empowering.  

My birth experience went by fast—first-time moms typically labor 12 to 19 hours. I woke up after midnight already four centimeters dilated, followed by hours of vomiting and contractions. Within three hours, I was nearly fully dilated and faced unparalleled levels of fatigue. 

Dehydrated and drained, there were moments when I was unable to advocate for myself. Over the course of my labor, there were about 10 nurses’ and doctors’ voices in the room—some with strong opinions about what positions I should labor in, what medications I should take, what routine procedures I should partake in, and when I should start and stop pushing. 

It became clear that if I didn’t speak up, there would be little room for choice in my own delivery. I was not prepared for the utter exhaustion I faced and having my support team reaffirm my preferences and advocate for my wishes was the kind of specialized care I needed. 

It became clear that if I didn’t speak up, there would be little room for choice in my own delivery.

What birth choices to consider

As a first-time mom, it’s hard to know what rights and choices you have. Can you choose what positions you labor in? Or does the doctor decide? Can you decline a cervical exam? What decisions can you make so the hospital room does not feel so sterile?

You can use the following as a birth preference framework:

Support team – Who will be present with you? What is their role? 

Delivery room environment – What room requests do you have (e.g., dim lighting, music, candles)? Will you wear your own gown? How do you feel about interns attending? 

Labor and delivery preferences – How do you feel about mobility, monitoring and IVs, cervical exams, and laboring and/or delivery positions? Episiotomy? Forceps and/or vacuum? Cesarean? Pitocin? Who will cut the umbilical cord? 

Pain management – What are your preferences on medications (e.g., epidural, nitrous oxide) and whether they are offered? What alternatives, if any, would you like to use (e.g., acupressure, hypnobirthing, birthing ball)? 

Baby arrival – What are your views on skin-to-skin contact, cord clamping, and newborn procedures? If the baby needs to go to the NICU or leave the room for testing, who should accompany them? 

Postpartum – What are your preferences for feeding (e.g., exclusively breastfeeding, formula) and bathing baby? 

Cesarean, if applicable – Who will be present with you? How would you like the procedure communicated with you? Would you like a transparent drape for visibility? Sedatives? When would you like skin-to-skin?

Documenting birth preferences empowers mothers-to-be to create the birth experience that is right for them. Sharing your vision with your birth team before labor can ground and guide you so your voice is heard and honored, especially when your stamina is tested. Remember, mama…it is your right to have the birth experience you choose. 

Originally appeared in Golden Gate Mothers Group Magazine.