Does Birth Ever Go Smoothly?

Currently trying to conceive, and getting a little scared from all the horrible birth stories of my friends. Can you tell me what percentage of births occur without interventions being needed? It seems like everyone I know either ends up in emergency C-section, induction, tearing, preeclampsia, or some other injury or issue. Does birth ever go smoothly?
—Everybody Hurts?

In Cribsheet, my book about early parenting, one of the first chapters is on childbirth recovery. I talk in reasonably extensive detail about vaginal tearing and overall recovery. My college roommate, upon reading a draft, texted me that I should put in a warning about this chapter: Do not read until you are ready! So I hear you.

I feel strongly that we should be talking about the hard parts of pregnancy and birth — the complicated and messy parts — but I want us to do this so people are prepared, not so they are afraid. It sounds like in your case, maybe there is so much information that the fear is dominant.

It may be useful to look at the data, and also to be clear on what we are most worried about.

In my upcoming book, The Unexpected, we talk through a lot of the more serious pregnancy complications, looking at risks of recurrence and treatments. These include things like preeclampsia, miscarriage, gestational diabetes, severe trauma in birth, preterm birth, and others. About half of all pregnancies are impacted by one of these complications, which in many cases are moderate and treatable.

This means about half of pregnancies are not impacted by serious or moderate complications. Many of these pregnancies and births will still have some degree of intervention or mild injury. Induction for labor is very common — generally, this is a choice made by your medical provider, and not something that we think of as a complication. Some degree of vaginal tearing occurs in most first births, although it is often minor. These are the kinds of complications that I think we want to be honest about — not because we want to scare people but because it is the reality.

If your question is how often a first pregnancy and birth has no complications and a spontaneous labor and no vaginal tearing — that can definitely happen (actually, it did for me on my first birth, though not my second), even if it is a smaller share of births. But serious complications remain rare.