Are you hoping to avoid medication or unnecessary intervention but also want a hospital birth (or maybe you have no option but to give birth in hospital?)

Take a deep breath as you read the next line.

The odds are not in your favor. 

Did you know that having a natural birth in hospital is not unlike a Tough Mudder Challenge (Tough Mudder is an endurance event series in which participants attempt 10–12-mile-long  obstacle courses). But when you sign up for a Tough Mudder challenge you know where the obstacles are and can adjust your preparation accordingly.  You know that it’ll take mental and physical training. Most parents planning an unmedicated hospital birth don’t know the terrain or how many obstacles they’ll face mentally and physically.

A recent Australian study over 700,000 health first time parents found that only 15% did not experience some kind of medical intervention such as an epidural, episiotomy, forceps/vacuum or cesarean in a private hospital (35% in a public hospital).  That number can go as low as 6% in some hospitals. 

If you’re a first time parent you’ve probably taken a multitude of classes.  You’ve got the car seat, the crib – the ‘essentials’.  You have your heart set on an unmedicated birth.  You’ve read Ina May Gaskin’s Guide to Childbirth cover to cover.  You’re nervous but excited to meet your baby.  You’ve been glued to YouTube watching dreamy dimly lit birth videos with fairy lights and piano music imagining you and your partner swaying gently as your nurse smiles in the background offering words of encouragement.  Sounds like something out of a Michel Odent movie...  Doulas and midwives around the world are nodding knowingly reading this as we’ve had this discussion with many many clients to help them understand that labor can be hard enough without hospital polices making it even harder and unintentionally sabotaging your goal of an unmedicated birth as you and your partner navigate their labor ‘obstacle course.’

Some birth professionals equate trying to have a natural birth in hospital being like going to a Chinese restaurant and hoping they might have some French food on the menu.   Generally there’s a set menu and unless you know about the existence of the a la carte menu it’s hard to figure out what your choices are.

What your brain is doing in labor is just as important as what your body and baby are doing. 

Hospital Policies and Faulty Fuel Pumps

Think of oxytocin as the gas for your uterine (engine). Most of us have a full tank of ‘gas’ for labor. To get the gas to the engine we need a fuel pump -  but if the fuel pump isn’t working properly then the gas can’t get to the engine effectively… your engine might not even start, or it splutters or it loses power.   Most hospital policies unintentionally create faulty fuel pump scenarios (but we can also cause our own fuel pumps to malfunction too – that’s another blog coming soon). Birth is a hormonal process and your brain is the leading the ‘orchestra’ (with some help from your baby) and when it’s left alone to get on with it – just like most mammals – it does a really good job.  But your brain is very sensitive to the environment and is always on the look out for trouble.  Your brain is fixated on survival - for good reason so anything it perceives to be a threat will set off alarm bells and turn off the very hormones you need for labor. 

What are Some Known Causes of Fuel Pump Issues (oxytocin)?

• Perception of threat (fear)

• Presence of strangers when you are feeling vulnerable

• Unfamiliar space

• Lack of privacy

• Too much privacy if your nurse is busy with other moms

• Bright lights

• Medical procedures (vaginal exams, IV, induction)

• Unfamiliar sounds

• Restricted physical (depending on your hospital)

• Hospital policies (IV on admission, EFM, overuse of Pitocin etc)

  
  
  

  If you have a daily commute at the moment stop and stand in the train station for a moment and try to imagine that picture perfect birth now with the fairy lights.  It’s a little different isn’t it. For some expectant moms you might as well try laboring in a train station to understand how the environment can impact that delicate balancing of hormones.  

  
  
  

  Do Your Research

  A little homework that will either reassure you or help you realize that you may need to tweak your plans a little or maybe a lot.  

   

• Find out the epidural rate in your hospital

• Are there midwives on staff?

• Are doulas welcome?

• Is mobilizing in labor encouraged?

• Are there baths, balls, bean bags, wall ladders?

• Find out what position most moms birth in?

• Is EFM routine for all healthy well full term moms (electronic fetal monitoring significantly increases your risk of an unplanned cesarean).

  
  
  

What if you’ve already done your homework and you’re starting to realize that you may need to have more tools in your toolkit.  What else can you do to stack the odds in your favor of having an empowering positive unmedicated birth?

• Stay fit and healthy in pregnancy – for many, an unmedicated birth takes stamina and endurance.

• Hire a doula so you’ll feel more confident staying home longer.  Being admitted after 4-5cm means intervention is less likely.

• Written birth preferences and a confident partner.

• Talk to other parents who have had the kind of birth you want.

• Avoid the negative nellies.

• Take an independent childbirth class such as GentleBirth so your partner learns how to manage the environment to keep your fuel pump working effectively.

• Control the controllables – you can’t control everything in the environment but you can control your response to what’s happening (mindfulness really helps!).

Here’s the thing - you might get the A Team of nurses/midwives on the night you arrive into labor and delivery or you may have a really short labor and none of the above will apply to you.  You may get a nurse or midwife who loves volunteering to work with unmedicated moms as she really enjoys that work but there are also the nurses who are hoping you’ll take that epidural as she has another family she’s taking care of and they are needing quite a lot of her time.

And if you’ve already had an unmedicated birth in a hospital – I take my hat off to you and you DO deserve a medal for making it through the Tough Mudder Birth Challenge.

What tips would you share with parents planning an unmedicated birth in hospital?

Note: I used the word ‘natural’ birth in the title as it’s more searched for in Google - about 680,000,000 times more than the phrases ‘unmedicated birth’ or ‘physiological birth’. There’s no inference that if your birth included pain meds or intervention that your birth was ‘unnatural’.