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My friend is a home birth midwife, and she told me that studies show that feeling empowered during l&d is a much stronger indicator of "positive birth experience" than things going as planned, or even going easily.

Was true for me, definitely.

I think it's more about being educated about your body and about birth and what options are out there. Frankly, at the end of the day, you *do* have to go with the flow - the flow of your body and your baby.

@Foodnerd81: I agree with you about choosing a provider who will work with you toward the best outcome. I think being able to communicate openly before and during labor is also so important.

@aprk: I also agree that ultimately, though its not everyone's definition of going with the flow, it's good to be open to interventions under certain circumstances and when they are necessary to reach the best outcome (healthy mom and baby).

I think the problem is that hospitals have it in their head is that birth needs to go this certain way, at this pace, and if it doesn't we need to fix it. I certainly believe in going with the flow of the body and once in awhile the body needs help, but sometimes it actually knows best and does things outside of the textbook to help itself out. Just one case: a friend of mine was home birthing, contracting pretty solidly for 24 hours, then the contractions pretty much stopped. This scenario would have made hospital staff pretty nervous. Water breaking, Pitocin, some kind if intervention would have been pushed. But the midwife just told her to go to bed, her body was telling her to rest. Baby was born uneventfully 4 hours later. Sure, breaking her water *might* not have hurt anything, might have had that baby out really fast. It may have actually done a lot of damage, considering her baby was pretty high and floating yet, could have resulted in cord prolapse. The use of Pitocin at that point could have stressed the baby to the point of needing a c-section. And then of course, the doctor would have saved the baby's life, maybe the mother's too. But in reality, going with the body's flow can avoid these situations altogether. Hospitals are businesses though. They really don't want women hanging out and laboring for 3 days. Get the mom in, get the baby out, send then out the door in 48 hours. Well, doctors aren't hospitals, they take the Oath to "First do no harm," but, from what I've observed anyways, this doesn't apply to the way med students are taught when it comes to birth these days. The prevailing line of thought seems to be, "You can't get sued for doing a c-section." and that birthing bodies are broken and undependable. It wouldn't cross many OBs minds that the reason a woman's labor is stalling because she's tired- except to recommend an epidural and Pitocin.

ETA: but I completely agree that being the decision maker, being presented honestly with the pros and cons of options, not having things "done to you" is most definitely empowering, even if you wind up with a different birth than you'd envisioned.
I personally am pretty positive that my body can do the whole birth thing, I'm a gung-ho natural birther, but my hospital birth plan didn't include much. Because if true complications present themselves, OF COURSE I want to take the best of the course of action for my baby, but I'm pretty damn educated about normal birth too and I wanna be informed should the need for an alternative course arise. I want to be given the chance to give consent when it comes to pretty much everything. I want to be talked to like an equal, not just told that my baby is going to die if I don't do _______. And nobody can't tell me that doctors don't play the dead baby card because I have heard WAY too many stories to believe that there aren't quite a few that don't.