What makes a natural birth "natural"?

I read an interesting article in our local paper today and it got me thinking about childbirth and birthing options and what women consider a natural childbirth. I have birthed two children in the past 4 years. And I have always considered my births for both of these little people to be natural. Yet lately, I have come to realize that some might disagree. What constitutes a natural childbirth these days? Is a vaginal birth a natural one even if you have some kind of medical induction or form of pain relief?

My first pregnancy was a complicated one. I developed gestational hypertension (very high blood pressure) at around 26 weeks, was in and out of hospital on bed rest for a few weeks and then put on strict bed rest at home. Because of the hypertension, my son also had intrauterine growth restriction (IUGR) and was not a very big baby. We had weekly ultrasounds to chart his growth and at 35 weeks he had stopped growing completely and the decision was made to induce me.

Because of the complications throughout my pregnancy we were prepared for whatever needed to be done during the birth, but my preference had always been for it to be a vaginal birth with minimal interventions. We had hired a doula and were all set for our Monday morning induction.

The method of induction chosen was with a Cervidil (prostaglandin) vaginal insert to ripen my 35 week pregnant cervix. I was told that this could take anywhere from 12-24 hours to take effect and that I could also expect that it may have to be repeated. What actually happened was that within 2 hours I was having mild contractions, within 5 hours I had entered transition (read puking and passed mucous plug) and within 8 hours my water broke, I was fully dilated and I WAS PUSHING! This was all of course VERY much to the surprise of the nursing staff that had refused to believe that I was in "active" labour this whole time and that all of my contractions where 'pre-labor' ones.

My son was born about 5 minutes later, after 3 big pushes and with nary an obstetrician in sight!! Needless to say, within about 3o seconds of his birth we had a full room of about 17 people, including the team from NICU that whisked him away for further assessment after a quick peek and a kiss from mommy. Natural birth? I sure think so.

My second pregnancy was the complete opposite. VERY normal, no issues with my blood pressure at all or any IUGR. I was 41 weeks pregnant when the decision was made with my obstetrician to induce me again. I was extremely uncomfortable (read - big as a house!) and really just wanted to have this baby. We went the Cervidil route again since it worked so well the last time.  I was about 2-3 cm dilated already at this point, so it did not take long for me to be in active labour again. Thankfully, this time everyone believed me! I had a very specific birth plan this time around and did not want ANY interventions. We had our original and might I add, rather amazing doula with us again as well as our back-up doula. I don't think my labour was significantly longer with my daughter, but it was definitely harder. I managed to make it to 8.5 cm on my own, sitting on the birthing ball in the shower with my husband directing the hot water on my back the whole time.

And then I needed some help. And yes, at that point I BEGGED for an epidural and uttered those famous words....

"I can't do this!"

But you know what, I did not get the epidural and I did DO IT! Why? Because I had an amazing birth team that knew what I really wanted and supported me and helped me through that last hump. I did suck back on some nitrous oxide to take the edge off of those last few really tough contractions and 9 hours after my Cervidil induction I was fully dilated and after 20 minutes of pushing, my beautiful baby girl was born. And again I have always considered hers a natural birth too.

What do you think? Did I have "natural birth" experiences? Did you? Is the whole concept of birthing naturally on more of a spectrum or is it very black and white?

I'd love to hear your thoughts....

Natasha~