Natural, Unmedicated Birth in a Hospital? Yes, You CAN Do It!
I have to start this entry with a disclaimer. I am entirely biased. After having had both a hospital birth and birth at free standing birth center (i.e. not attached to hospital), I never ever want to deliver in a hospital again, nor would I recommend it for with moms a normal, low-risk pregnancy desiring a natural birth. Okay, that being said, it is ABSOLUTELY possible to have natural, medication-free, low-intervention birth at hospital. If you do your research, make some preparations AND are low-risk AND don't experience any unforeseen true emergencies during birth. Here are some suggestions to help guide you if this is what you desire.
1. Know your OB
I am assuming that if you are delivering in a hospital you will have an OB. I know some midwives do have privileges at hospitals but they are usually required to follow a lot of the same hospital protocols or operate under the guidance of an OB. Therefore, I refer to OB for the rest of this hub. With an OB, you must remember they are surgeons. They are trained to be able to handle real emergencies and thank goodness for that! However, when you are trained for emergencies and surgery, doing things the way that nature intended can seem like a step backward. Find out what your OB thinks about natural birth. Keep in mind you are paying them for a service. If you don't like the "service", go find someone else. You wouldn't tolerate bad service on your car and keep going to the same mechanic if you didn't like how they were treating your car... why do women tolerate the same when it comes to our bodies and our babies?
2. Take Childbirth Classes - REAL Ones
Start to research what you are interested in early in your pregnancy. Classes will run on on selected dates and they can fill up. First you need to decide what type of class you are interested in. Then you need to find an instructor near you. You might think, well, I'll just take the class offered at the hospital! Well, here's a shocker, it's a lovely tour of the facilities, pamphlets on your anesthesia options because as the nurse running it will inform you... you WILL want an epidural, then maybe a quick peak at the adorable babies currently snoozing in the nursery. Probably the only useful info you will gain is where you should park and enter when you arrive in the middle of labor. Yeah, PASS! This baby is growing inside you for 40 weeks and just in case you weren't aware, most first time moms labor averages 15-18 hours. This is not something you can prepare for in the snap of a finger. I took Bradley Method classes and went into my labor feeling completely prepared. Another awesome option is HypnoBirthing. Aside from those two, my third choice would be Birth Works. Personally, I'd throw Lamaze out the window for how it has evolved as well as anything offered at a hospital.
3. Have Support
Hopefully, when you were taking that childbirth class you have a labor partner or "coach" to take with you. It can be your spouse or it can be your mom or your best friend or the neighborhood bum. Okay, not the neighborhood bum. The rest are all good choices. It just needs to be someone you trust and yes, someone who does not mind seeing your unmentionables for a bit. This is so critical for a hospital setting because you need someone who is not afraid to speak up and advocate on your behalf. Someone to run interference if needed. I lucked out with an awesome labor and delivery nurse, she never once suggested I get pain medication. She offered all sorts of alternative suggestions. But, if you end up with a nurse who is very rigid, you may need that support person to politely but firmly say, "Do not offer pain medication to her again. She does not want it. If she changes her mind. She will ask. Thank you."
4. Make a Plan
Hospitals expect women who are delivering without pain medication to be wild, out-of-control, screaming monsters. Part of the pain-medication era is they like a calm floor. I suppose anyone would. So, make a birth plan. Write up what you want. Be thorough but not overly detailed. Include copies in your pre-registration. Go over in advance with your OB or OB team. Bring copies with you. Once at the hospital, be firm in your desires but calm. Make sure your birth partner is completely aware of all aspects of the birth plan.
5. Your Rights to Refuse
Did you know they cannot do anything to you or your body in the hospital without your consent? Obviously, when it is true emergency, we readily consent. Or if we are unconscious, that is another matter. But, when you are fully conscious, you have a right to refuse "interventions". When I delivered my first, I was aware that if I had an IV in me that it would be very difficult to move freely. As I knew ahead of time I was declining pain medication, moving freely was key to maintaining comfort during labor. I also have this weird thing where I cannot stand the feel of the IV tip in my hand. It is a peculiarity to me. They went to put an IV in and I said, "Oh. No IV. Thank you. I will take liquids by mouth. I brought them with me." And I had. Turned out they had all sorts of beverages, and there was no need for me to bring mine. But I didn't know that and wasn't taking any chances at having to get that IV! I think they started in on standard procedure, what about just the Hep-lock and I said, "No thanks. I really don't like them. But, I understand you are doing your job. If you need me to sign a waiver or something, I can." They walked away and no IV for me. The next hurdle was the periodic monitoring. I did not like laying down and further my child did not seem to like it either. Every time they tried for 20 minutes of contractions on the "machine-that-goes-ping", baby would kick it off. I finally said "I am not going to do this lying down. It is uncomfortable. You are going to have to find some other way to monitor the baby." Low and behold, magical cordless monitors and a giant elastic stretchy belt were found for me to wear. I could sit and rock through my 20 minutes of monitoring!
Machine That Goes Ping
6. Ask for Alternatives
This can be something as simple as asking to use alternative positions to push from. I asked to squat to use gravity to my benefit and they brought out what I imagine is a seldom used “squat bar”. Since squatting can be tiring, having something to hold onto was a big help. I did not even know such a thing existed. Or, it could be for something more serious. Late in my active labor phase, during a monitoring session something caused the nurses to come running into my room looking very alarmed. They consulted that machine-that-goes-ping with very serious faces and then brought in my OB who looked equally serious. When I asked what was wrong, I was told that my baby’s heart rate was decelerating and if it continued, I would need a c-section. My OB very genuinely apologized as she knew this was not what I wanted. She was my favorite OB at the practice and very kind. I took a deep breath and then remembered my Bradley training to ask for alternatives before panicking. To my surprise, she offered that sometimes, just sometimes, the baby would fall asleep during labor, so we could try tickling the head as well as having me take an oxygen mask and see if that improved anything. Her tone told me not to get my hopes up. Well, the little monkey was indeed asleep. I know my heart rate slows when I am sleeping, babies are the same! If I had NOT asked, I would have been whisked off for a c-section due to mid-labor nap! All situations are not created equal and it is possible you may not have time to ask for alternatives. Just use your best judgment. Nothing is lost by inquiring.
7. Just Say No
It is your body and your baby. The less interventions to your birth, the less likely you are to have your birth plan go out the window. This may seem a lot like #6. But I am talking specific interventions here. One of the biggest interventions that leads to further complications http://www.babymed.com/bishop-score-induction-calculator. Aside from inductions*, avoid pitocin like the plague. Pitocin makes it extremely difficult to labor without pain medication. It is not impossible but the few women I have known that have done it have said “never again”.
8. Don't Pop My Balloon
At some point during labor your water will break on its own. Often during the pushing phase but possibly sooner. If it has not broken prior to your arrival at the hospital do not allow yourself to be talked into having it broken unless your labor has gone on for quite some time, they are running out of natural options to try or you are now ready to push. Even then, I would weigh the risks versus benefits of letting it break naturally. There is two big reasons for this. The first is this creates a floating cushion which helps keep the cord from becoming tangled or compressed and can lead to many of the emergency circumstances we would not otherwise see if we let nature run its course. The cord supplies blood and oxygen to your baby, if it becomes compressed you can have an emergency. If it becomes tangled around baby's neck, you again have an emergency. Second and rarely discussed with the patient, once they break your sack of waters, you have entered into a 24 hour time clock in which to deliver your baby. Now, if your labor has started spontaneously and it is active labor, hopefully you will deliver in this time-frame. But, no labor is identical and sometimes things do not fit the norm. Unfortunately, a labor sometimes lasts longer than 24 hours.
9. Stay HOME
For as long as possible, stay home during your early labor. Don’t even bother calling your doctor until about an hour before you plan to arrive at the hospital. Labors do not happen like they happen on TV and movies. They are not rushed with the baby popping out in an instant! You have plenty of time to get to the hospital. Rarely you will have a speedy arrival but that is far from the norm. If this is your first birth, your labor is especially likely to take many, many hours. Monitor your contractions. Wait for them to get longer, stronger and closer together. A funny but true rule of thumb, if you can still give a big smile for the camera when you are walking out the door, you are not ready to go to the hospital! Take a hot bath or shower at home. Plan some simple tasks ahead of time that you can do and take frequent rests while completing. EAT something, as you will not be allowed to eat for a while at the hospital. Then, when you and you birth partner feel it is time, take that drive to the hospital. I should be obvious, but just in case – do NOT drive yourself to the hospital!
10. Doula Yourself a Favor
Copied straight from the dona.org website “The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth”. If your budget allows you to hire a doula to act as an additional support person and advocate during your birth, they will be worth the money invested! Check out references and online reviews if possible and interview a few until you find one that is a good fit for you. Unfortunately, my funds did not allow for this during either of my births. However, the women I have known that were able to have a doula with them have raved over how fantastic they are and how much better their births went. I would highly recommend looking into this option.
Good luck and wishing you all a happy and healthy BIRTH-day!
*Some inductions are medically necessary for the safety of mother and baby. I am not by any means suggesting a mother with pre-eclampsiaor any other life-threatening emergency decline or try to avoid an induction. As with all of my suggestions, these apply ONLY to mothers who have a healthy, normal, low-risk pregnancy. I am not a doctor or medical professional and my advice should never be substituted for your health care practitioner’s advice. Thanks!