How to Increase Your Chances of a Natural Hospital Birth |
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How to Increase Your Chances of a Natural Hospital Birth

nina February 21, 2013

naturalhospitalbirth

Image by Natural Birth Evangelist

By Nina, Modern Alternative Pregnancy editor

I walked into the hospital shortly after 6 am, checking in for my induction. At 36 weeks, I had been diagnosed with pre-eclampsia and pre-term labor and my doctor wanted me to have my baby as soon as possible. Regardless of the induction, I had hoped for a natural childbirth, but ended up with IV pain medications and, eventually, an epidural.

Unfortunately, this outcome is common for many women hoping for a natural hospital birth. They enter expecting to have a drug-free birth, and experience something drastically different. What is going wrong here?

In order to get a better understanding, I approached my long-time friend, Amber, a labor and delivery nurse in a local hospital. I explained that I would love to get a nurse’s point-of-view to help women as they prepare for a natural hospital birth.

Here’s what she had to say about what she sees with her labor and delivery patients:

Do you regularly see laboring women who ask for a natural birth, but end up with some kind of intervention (IV meds, epidural, c-section, forceps, etc.)?

Women who desire a natural child birth end up with some kind of intervention 9 times out of 10 for a multitude of reasons, including but not limited to:

  • She is not educated on the birth process or the process and requirements that are legally placed on the hospital, doctors and the nurses.
  • The patient has unrealistic expectations about birth, has no plan or very little labor support from family or friends.
  • The patient and doctor have not spoken about the patients desired birth and plan or potential complications or changes to that plan.
  • Patients are routinely inpatient and do not allow their bodies to make the natural progression to labor, many instead opt for induction because they are tired of being pregnant or are uncomfortable- this in itself can increase the interventions and risks by at least 2 fold.
  • Many patients are also unaware that they have the right to say no and ask questions about anything that the doctor or nurses do or say – patients do not feel empowered.
  • There is no way for us to to be 100% accurate on how a labor will progress or how a baby will react to and tolerate labor. These variables are something that cannot be controlled by anyone. Labor complications run from mild to severe and usually require some kind of intervention. Being flexible on everyone’s part can help make any interventions needed for complications go much smoother and may decrease the degree of intervention required.
  • The patients that I am seeing are sicker and sicker and have more medical complications themselves. It is very important to be fit and healthy before you become pregnant and to continue that lifestyle during the pregnancy to help promote the health of the baby and mother and decrease potential complications during labor.

Have you noticed any common factors?

In my opinion, the patients that received interventions despite their initial request/desire for a natural birth are not educated about their bodies, labor process or fetal responses. They tend to also be unaware that they have a voice and a choice as a patient. They tend to have unrealistic expectations about the labor process and their role in it.

Have you noticed any common factors in women who want a natural birth and have one?

They are very well educated about the birthing process and their role in it. They are not afraid to ask questions of their doctor or the nurses and they know they have a voice. In my experience these women are also flexible and are not rigid in their birth plan.

Does having a birth plan help?

No, having a written birth plan does not help in my experience. Usually those birth plans are unrealistic and are void of any flexibility on the patient’s part or the nurse’s part. The best thing to do is talk about the plan with your support person and your doctor or midwife and your nurses.

Patients need to communicate with everyone that participates in their care. I would also encourage these patients to be flexible and know that as nurses we are there to support them in their desired birth experience, we just need to know what that is and be allowed to be their advocate.

As a nurse, what steps do you think a woman should take to prepare for the labor/birth she wants?

Mothers should take a child birth class of some kind. They should also discuss their plans with their spouse, support person and their delivery professional. Mothers also need to know that births do not always go as planned and to be flexible.

Please communiate with your nurses so we can help you in any way that we can. Remember we are there to be your liason between your birth professional and you. We are your advocate and we want to help you make decision that you are comfortable with and still have the kind of birth that you desire.

What are the best treats to bring for the nursing staff? 🙂

We of course love chocolate, but are very thankful for any treats that patients send. We really love pictures of the new baby and the family, that is what we really look forward to. And having them stop by and see us a few weeks after delivery is always nice.

Any other thoughts?

Educate, educate, educate!

Thanks so much for your time, Amber, and for answering my questions. I know this will help many women who are preparing for a natural birth in the hospital to increase their odds of that outcome.

Have you had a natural hospital birth? How did you prepare?

This is the writings of:

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  1. I have seen the difference in how those with and without a birth plan are treated. The birth plan ABSOLUTELY is a benefit in our hospital. Your statement is too general. Our hospital takes great care to chart and honor the wishes of the mother. OF COURSE, things may need to change. Because they have taken care to write their wishes out does not mean a mother is naive to this fact.

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  2. I had a natural hospital birth (and also a homebirth) and took Bradley classes. I agree that education is the key as well as an educated support person/coach/husband! I feel the staff was generally supportive (albeit skeptical that I would achieve my desires). We did have to keep our eyes open and SPEAK UP for various procedures that we did not want. In the nurses defense, they were just doing what is standard procedure for every other birth.

    Just last week I was asked by a friend to be labor support for her natural hospital birth. I saw first hand how a lack of education on the parents’ part led to a very unhappy birth experience. The nurses were wonderful, but the on-call Docs had no patience to let her body do what it needed to do. They still ended up with a healthy mom and healthy baby. That is the most important thing.

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  3. I’ve had two hospital births, both pretty incredible considering I was at a hospital. First birth, I wasn’t as prepared with knowledge, but had my amazing MW, husband and doula supporting me and I knew I wanted a natural birth, in the water. And that’s what I got! Second birth, again my MW, husband and sister were there supporting me. Both births were waterbirths AND I caught my babies myself and my son was born in the caul. I could walk, wear my own clothes, eat, drink, refuse fetal monitoring, refuse vaginal checks and basically do what I wanted during labor. Afterwards, baby stays with mom as long as you want to nurse, have skin-to-skin, etc. No pressure to ‘ clean off baby’ or weigh them. They know babies do best with their mamas. 🙂 Sending babies to the nursery is also highly discouraged. I didn’t get any heat for my choices as they are very normal in this hospital.

    Oh, and she’s right on about the birth plan. My MW said to have a birth plan, but don’t hand it out when you get to the hospital as more than likely, it’s more of an insult. Not right, but the nurses feel like someone is telling them how to do their job. She said it’s better to just communicate with them. I haven’t seen much good come from the distribution of birth plans.

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  4. This summary seems to place nearly all the “blame” for the failure to birth naturally on either the patient or circumstances the hospital had nothing to do with. I’d like to suggest that the hospital atmosphere and the doctor/midwife attitude also has a lot to do with it.
    A woman walks into the hospital room and it’s bright, often clinical, nothing like a homely room where you would sit and relax, despite the fact that being relaxed and feeling safe during labour helps labour progress and be less painful. The bed is right in the visual focus as you walk in the door, reinforcing the stereotypical movie birth scene of the woman screaming in labour, lying on the bed, when lying down on the bed is a very unhelpful position to give birth in.
    I would love to see an experiment with two separate hospital rooms in one hospital, one lit by dimmed electrical lights or candles, with an exercise ball or a birth pool as the visual focus as you come in the room, with a curtain you could draw for privacy and a “please knock and wait for response before entering” sign you could hang if the woman preferred it, as well as a waist height, padded bench the woman could lean over if she wanted to stand, and soft, but simple, washable rugs on the floor, with the hospital bed hidden away in a corner of the room (not innaccessible, just not obvious to the first glance), and then another, typical hospital room. I would love to see the percentage of uncomplicated natural births compared in the two rooms!
    I would also like to see a goodie bag from the hospital during ante-natal appointments include a book by Ina May Gaskin, and education through the hospital through leaflets or pamphlets instructing the future parents that during the labour they have the right to decide on each and every intervention that happens and to hear risk/benefit explanation before deciding and to decide without being pressured. Also for midwives and doctors to learn to rephrase things- so many of my friends were “informed” that they “needed” to be monitored, induced, etc, etc, when actually, they had the choice whether to be or not. I think in many cases it’s a deliberate attitude that makes it seem like they don’t have the choice.
    There is a major reason that homebirths and hospital births vary dramatically in the percentages of uncomplicated births vs. births with interventions, from the same population of uncomplicated pregnancies with no extra risk associated with the women’s labours.
    That said, I know there are some wonderful midwives and I know most of them probably do what they do with good intentions, but I also think many of them are mistaken and haven’t seen many good, natural, empowered births, which is really an indictment on the training they receive!

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  5. Also I would just like to suggest that I would add to that list of things to help you acheive a natural hospital birth- surround yourself with stories of wonderful, natural births and how they can be totally different; long, short, standing, squatting, in the bath, on the floor, leaning on a partner, etc, etc. Also take with you things that will make you feel more at home- favourite blankets, rugs, pillows, make yourself a private little place out of instant view of the door so that you feel you can relax and let yourself do the things you need to to. Walk around a lot, move your hips, don’t assume you need to be on the bed. Also bring heat packs for pain relief and use hot water (shower or bath). When a midwife or doctor informs you they “need” to do something, tell them “Thank you, I’ll have a think about that, can you please come back in five minutes?” So you have time and space to make your decision without pressure, even if you feel like it’s a “small” intervention (like the strap-on monitoring).

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  6. I had two unmedicated hospital births. I think the factor that helped the most was laboring at home where I was comfortable. I had taken the hospital’s childbirth classes and read about the Bradley method, so I knew what was happening and the pain was quite tolerable. I could move around and eat or drink at will because there was no one around to tell me otherwise. I was fully dilated when I arrived at the hospital with my first child. It was too late for an epidural. I knew the pain would be manageable with my second child because of the confidence gained from having the first one naturally.

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