My last delivery, just a few months ago, was to boy/girl twins.

I started my pregnancy with a new-to-me doctor I disliked, who was ready to schedule a cesarean in my first trimester. About halfway through the pregnancy, we moved, and I found an absolutely wonderful doctor. I expressed to him my desire to do everything humanly possible to deliver these twins vaginally. I had never had a c-section before, and really didn't want to have one.

He respected my decision, and agreed to only mention a c-section if an emergency situation occurred.

At the start of my third trimester, I had the opportunity to tour the hospital I was to deliver in. While on the tour, I asked if twin deliveries were required to be in the operating room, which is standard in most hospitals, and the touring nurse said to me, "How else would you have a c-section?" She seemed shocked that I would even consider giving birth to twins in any other way.

On the delivery day, I was able to labor in a birthing room and was transferred to the OR for the delivery only.

I had a normal labor, and they finally wheeled me into the OR. There were about six medical personnel in the room, busy preparing for the delivery and awaiting the doctor. I was concerned that the first baby was on his way out, and kept saying to the nurses "I think the baby is coming", but for the most part, they ignored me. I said this maybe five times. Finally, one nurse told me not to worry, that they would catch him should he decide to make an appearance.

Amidst all this activity, I suddenly had a thought, and announced, "Oh, by the way, under no circumstances whatsoever do I want an episiotomy."

Immediately, the six people in the room froze, and dropped everything they were working on to turn and look at me. So I repeated myself. They looked at me as though I was growing horns out of my head. Finally one nurse told me that she would make sure that the doctor knew.

The delivery went well. The second twin decided to turn breech at the last moment, but my doctor, respecting my decision to do everything possible to avoid a c-section was able to manually turn her. I avoided the episiotomy as well, which proved to be completely unnecessary.

The next morning, as I was walking around trying to regain my strength, I saw several other new mothers sitting on ice packs, moaning and groaning. They had not realized the episiotomy was a choice.

All the nurses who cared for me after the delivery treated me oddly. It was as though I were some sort of celebrity. Finally, one nurse spilled the beans. It seemed that I was the first mother to deliver twins vaginally in that hospital in over ten years.

Ten years.

It amazes me how much hospitals and doctors take certain situations for granted. No vaginal twin deliveries in a decade? How many of those mothers were lead to believe their bodies wouldn't do what came naturally to them? How many of them had unnecessary surgeries, higher risk of infections, and major recover for nothing?

You have a lot more control over the birth of your child in a hospital setting than you are aware of.

--An episiotomy is optional, but if you do not speak up and vocalize your desire not to have one, it may happen to you.

--A c-section is optional in some cases. There are circumstances where it is necessary, but many are done for convenience when other options are available.

--Pain medications and even IVs are optional. If you chose not to have any pain medications, then you do not need to be hooked up to an IV at all.

--Lying flat on your back in a bed is optional. If you do not have an epidural, you do not need to remain in bed through labor and delivery. Feel free to move about, take a shower, and try different labor positions that you would like to get more comfortable.

The birth of your baby should be a happy experience. It should not be one of fear and disappointment. Simply talk with your doctor and hospital staff about your desires. Do this early in the pregnancy. If it seems like your doctor does not take your concerns seriously, find a new doctor.