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Like epidurals, c-sections, and breastfeeding.

April 08, 2016

As moms, we come up with countless reasons to feel guilty. (My motto as I was raising my four kids: I mother, therefore I am guilty.) But there are certain things that should never, ever cause you an ounce of guilt, including your childbirth choices, and the choices you make during your baby’s early infancy.

How do I know? As an obstetrician-gynecologist who writes extensively about natural childbirth, breastfeeding, and attachment parenting, I’ve read the scientific literature and know that it often differs dramatically from what new moms are told. Below, four instances in which feeling guilty is completely unjustified.

You had an epidural

Childbirth hurts—an unbelievable amount. Pain specialists have found that the pain of childbirth is among the worst pain a human being can experience.

What’s that you say? It’s good pain. No, there’s no such thing as good pain.

Childbirth pain is carried by the exact same nerves, along the same pathways in the spinal cord, to the same pain centers in the brain, by way of the same neurotransmitters as every other source of pain. Yes, the pain comes from a happy event, giving birth. But passing a kidney stone is also a happy event for a sufferer and you don’t notice men declining pain relief for kidney stones.

Epidurals “drug” the baby? The medication in an epidural isn’t injected into the blood stream. It bathes the nerves as they leave the spinal cord. So little of the medication gets into the mother’s blood stream that it doesn’t “drug” her. Even less crosses the placenta so it couldn’t possibly drug the baby.

Sure, epidurals like any form of pain medication carry risks, but those risks apply to the mother, not the baby, and if the mother judges the pain to be severe enough to accept the small risks associated with epidurals (like the 1% risk of spinal headache), it makes sense to accept those risks.

The pain of childbirth is empowering? Call me when they start telling men that unmedicated vasectomy is empowering.

RELATED: 16 Things You Must Know About Sex After Pregnancy

You had a C-section

Childbirth is dangerous. It is a leading cause of death among young women and the leading cause of death for babies. We’ve come a long way in preventing and managing deadly complications, but we can’t abolish all risk. Often the only thing we can decide is who—mother or baby—is going to shoulder that risk.

For example, when a baby is breech (bottom first), the risk of injury and death during childbirth is much higher than if it were positioned head first. If the mother opts to have a C-section, the additional risk to the baby disappears as mom takes on risk (from the surgery) to herself. Women who choose a C-section to protect the baby are behaving selflessly and deserve our admiration, not condemnation.

What about the harms of C-sections to babies? Most of those purported harms are either short-term breathing issues that resolve by themselves or purely speculative, like claims that a C-section can disturb an infant’s gut microbiome (the population of bacteria that lives in the digestive tract). We don’t yet know what constitutes a normal gut microbiome in infants, let alone what a disrupted microbiome looks like.

You stopped breastfeeding (or never started in the first place)

The biggest risk of infant formula comes from making it with contaminated water. In countries with clean water, that risk disappears.

How about the benefits of breastfeeding? The only benefits supported by solid scientific evidence are fewer colds and fewer episodes of diarrheal illness across the entire population of infants.

What about claims that breastfeeding prevents obesity, allergies, and other illnesses? They’re based on evidence that is weak, conflicting, and doesn’t correct for confounding variables like maternal education and socioeconomic status. Women who are more educated and wealthier are more likely to breastfeed. Most of the claimed benefits of breastfeeding are really benefits of having more money and access to high-quality healthcare.

RELATED: Myths and Facts About Breastfeeding

You didn’t feel bonded to your baby right away

Some women feel love at first sight when they meet their future partner, but most don’t. That’s because it takes time for deep and abiding love to develop. The same is true for many mothers and their infants. Love isn’t instantaneous; it grows slowly.

Babies are not ducklings. They don't imprint on their mothers shortly after birth. Human bonding is a long process that happens spontaneously and inevitably. Everything we know about mother-infant attachment tells us that skin-to-skin contact isn’t necessary. Breastfeeding isn’t necessary. Even being born from the body of your mother isn’t necessary (as any adoptive parent could tell you).

The reality is that being a good mother is NOT about specific parenting choices. The most critical ingredient of good mothering is love. And that love is what makes for a healthy child.

Amy Tuteur, MD, is the author of the new book Push Back: Guilt in the Age of Natural Parenting ($27; amazon.com).

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