It has become clear to me in the past few years that there has been a shift in the meaning of some birth terminology that consumers use to talk about their births. Personally, I cannot pinpoint when the shift happened, but from my doula practice, my childbirth education practice and the doulas and childbirth educators that I train, the meaning of “natural childbirth” no longer means what I always assumed it did.

When I started doing birth work 16 years ago, natural childbirth meant a labor and birth without pain medications or “drugs.” The birth occurs without an epidural or narcotics and the birthing parent copes without any pharmaceutical support. Back then, people would say that they were planning a natural childbirth and wanted a doula to help them achieve an unmedicated (“natural”) birth.  Nowadays, people tell me that they want a “natural” childbirth experience and what they mean is that they are hoping and planning for a vaginal birth. Any sort of vaginal birth. A birth with an epidural, with narcotics, even with pitocin for augmentation, vacuum or forceps for the second stage, really any and all interventions that may occur as long as in the end the baby is born vaginally.

Please don’t misunderstand me. There is nothing wrong with birthing with an epidural. There is a time and a place for all interventions, and that is something that a birthing person and their health care provider decide together. I am just confirming what consumers now define as natural childbirth.

I think even Merriam Webster’s Dictionary has it wrong. They define natural childbirth as “a system of managing childbirth in which the mother receives preparatory education in order to remain conscious during and assist in delivery with minimal or no use of drugs or anesthetics.”  This is my original understanding more or less. But possibly not the intent of today’s birthing person. Unfortunately, when they use the phrase in two sentences, meant to provide examples of proper usage, the reader only gets more confused than before. Their two examples seem to support current trends of replacing vaginal birth with “natural childbirth”.

It is important for doulas and other birth professionals to understand what the pregnant person means when they say they desire a natural childbirth. The use of the term “natural childbirth” is my cue to ask some more questions to confirm that both my client (or students) and I are on the same page. Are they hoping to birth without pain medications of any sort or are they simply planning for a vaginal birth as opposed to cesarean delivery?

For the doula, it is important to consider what you yourself mean when you use the phrase in your marketing and website materials. Are you and your target market on the same page? Do you both understand the phrase to mean the same thing? I have had to shift my thinking and now internally insert the phrase “vaginal birth” until I can ask some clarifying questions.

What does natural birth mean to your clientele? To you as a birth professional and doula? How has the vernacular changed in your community? What are you observing from the consumers who are birthing today in your area? While we know that doulas support the choices of our clients in having the type of birth they are hoping for (and helping them when plans change, as is likely to happen during labor and birth), being on the same page as your clients with this important terminology is key to a success doula-client relationship. Please share your thoughts in the comments below.