Improving Your Chances of a Natural Birth In-Hospital

Sometimes there just aren't many options available for women who want a natural birth. While we in America do have home birth midwives, birth centers, and the legal option (for now) to birth unassisted at home, those options aren't available or workable to many women. Some of us find ourselves facing hospital birth, and possibly having to jump hurdles set up by policy and the personal biases of hospital staff in order to reach the goal of having a natural birth.

But a hospital birth doesn't have to be an unmitigated disaster. Even in a hospital without "birth center" amenities, natural birth can happen and be a wonderful experience. Here are some ideas to help navigate a natural birth in hospital.

Know your stuff. Forums and blogs and friends are a good jumping off place, but if you anticipate objections to your birth plan, you need to be able to meet them with facts. And you need to know the difference between facts presented to you in an honest and unbiased way, and facts that are being filtered through hospital policy or fears of liability. For example, "I need to tell you that certain risks rise slightly when a pregnancy passes 41 weeks. I am uncomfortable with letting you go beyond that point because of the risks to the baby and the liability to me if something happens" is at least an honest and factual statement.¹ You have the right to accept risks and refuse induction, but at least your doctor is being honest. However, some women hear "If you don't induce at 40 weeks, there is a big chance that your baby will die or be permanently disabled. Don't you care about your baby more than your 'birth experience'?", which is dishonest and is manipulative, using woman's fears and her maternal instinct.

Be politely assertive. You can't be afraid to be a "pain in the neck". If you object to something on the basis of fact and reason, then you need to speak up. Do this from the beginning of your pregnancy, so your OB knows that you aren't a pushover. At the same time, it is not necessary to be snotty or rude about anything. As with most human relationships, a great deal can be resolved with a calm, respectful and firm manner.

Listen. If you are choosing to use a hospital and an obstetrician for your birth, then you acknowledge that their presence, education and experience have some value. Your wishes are important but be willing to listen even when what's being said is really not what you want to hear.

Be Flexible. A hospital birth simply isn't going to be exactly like a home birth. So there are going to be things that aren't considered ideal by natural birth advocates. Go into this understanding that things might not go your way totally. On some things you may find it beneficial to accommodate hospital policy, or find an acceptable alternative, rather than stress yourself and your doctor out by declaring all-out war on it.

Although I am a big fan of natural childbirth, I have given birth to all of my children in hospitals. With my first son, I was with an obstetrical practice, and it was unpleasant, to say the least. With the second and third sons, I was more confident and knowledgeable, and I was attended by wonderful midwives who provided a buffer between me and hospital policy and the occasional freaked-out doctor. I went past 42 weeks with those pregnancies, and grew babies well past the point where they get labeled "macrosomic", and I'm fat, so the doctors were indeed completely freaked out by me. The four points detailed above are the things I found most helpful in the hospital birth experience. I'm not a confrontational person at all, but I learned to say "No" when it needed to be said (in response to "Induce now or I guarantee I will see you on the operating table because you can't possibly give birth to a baby this big", for instance). I also learned to listen and accommodate...in my case that meant a willingness to go in for fetal non-stress tests multiple times as my pregnancies got closer and closer to 42 weeks, and accepting a "just in case" hep-lock in lieu of an IV during labor.

Ultimately, it is true that the most important aspect of birth is an end result of a healthy baby and mother. But that doesnt' mean the other aspects are unimportant. And you can certainly make a difference in your care and treatment by the way your present yourself and the preparations you make for your arrival at the hospital.

¹WebMD, Post-term Pregnancy