Natural Birth at a Hospital: Making it Work for You

Last weekend, when discussing childbirth among women at my husband’s firehouse, mostly girlfriends and wives, I was shocked when most of the women discussed wanting a natural birth. It was a pleasant change—one that I have been working so hard toward!

I started doing some research after my discussion and came across a quote on natural childbirth in The Official Lamaze Guide that really struck a chord:

“In spite of evidence, U.S. maternity care continues to sabotage normal birth rather than support it. In 2002, the Listening to Mothers survey learned that among nearly 1,600 new mothers across the U.S., 44% had labor induced, 71% did not move freely during labor, 93% had electronic fetal monitoring, 86% had intravenous lines, 74% gave birth on their backs, and almost 50% of their babies spent the first hours after birth with hospital staff. Only 1% of the women experienced all six care practices that promote normal birth, and none of these women gave birth in a hospital.”

Lots of alarming statistics in there. This first-ever national survey of U.S. women’s childbearing experiences gives us a look into the way women are giving birth today in spite of evidence showing that these practices are outdated, unfounded, or harmful rather than helpful. Let’s take a closer look into each of the statistics listed and learn ways you can try to avoid becoming “one of the statistics” when birthing in a hospital:

44% of women had their labor induced. (!!)
That is a huge number for labor induction, especially since labor should only be induced for necessary medical reasons. Letting labor begin on its own is key for a healthy birth experience for women. It is also the way our bodies are meant to work in the natural stages of pregnancy. Labor induction is not a procedure that is risk free—it can increase the risk of premature birth, cesarean section, abnormal fetal heart rate, fetal distress, shoulder dystocia, and increase the risk of your baby needing to be admitted to the NICU. 

To reduce the incidence of unnecessary induction, find a provider with a low labor induction rate, and research the policies of the facility where you plan to give birth. This may be tricky, as many hospitals do not publicly advertise their rate of induction, cesarean surgery or other interventions. You might be lucky enough to find it on your hospital’s Web site. Or perhaps your hospital’s rating and feedback is listed on The Birth Survey. If not, take a hospital tour and be sure to ask LOTS of questions. Knowing information ahead of time gives you the opportunity to change your place of birth if you’re uncomfortable with their practices.

71% of women did not move freely during labor.
Being confined to a bed while laboring is not ideal by any means. Not only does it decrease the size of your pelvis, but it also can cause lowered blood pressure and fetal distress.  Better positions to give birth in and labor in include:

  • Standing
  • Hands and Knees
  • Side Lying
  • Knees to Chest
  • Squatting
  • The Sitting Position

93% had continuous electronic fetal monitoring.
This is a high number despite the fact that several studies have shown no improved outcome to mothers and babies with continuous electronic fetal monitoring. Also, recently, there has been a number of controversial articles about fetal monitoring and how medical professionals are reading the fetal heart tones.  Many think that the over-analyzing of small decelerations in fetal heart tones is leading to a higher rate of unnecessary cesarean births.  There are situations where monitoring may be a beneficial procedure, but in most birth situations, intermittent monitoring is safe. 

86% had IV Lines.
 Having an IV line in place in a laboring mother means that hospital staff has easier access to administering fluid and medications if needed. However, being attached to an IV line also restricts a laboring mother’s movement, interfering with her ability to change positions. Something that may help is requesting a “hep lock” in place of an IV line. A hep lock is a device that is inserted into a mother’s hand or arm so it is ready in case an IV line needs to be hooked up. Also, drinking and eating during labor will help to eliminate the risk of needing any kind of IV fluids during labor.

74% gave birth on their backs.
Laboring and giving birth on your back is pretty much the worst position. I recently wrote about this in two posts, Positions You Should Be Giving Birth In Part 1 and Part 2. Decreased pelvis size, blood pressure complications, lack of gravity to help with the birth itself are all huge factors in the supine (back-lying) position.

50% of babies spent the first hours of life with hospital staff. (!!)
Many mothers are not familiar with the benefits of skin-to-skin contact with your baby after they are born.  The first few hours are critical for mother-infant bonding. Unless your baby is experiencing complications or needs NICU care, babies should be kept with their mother in the first few hours — baths, weighing and measuring, etc. can all wait. Babies who have skin-to-skin contact after birth:

  • Cry less
  • Have more stable temperatures
  • Have more stable blood sugars (with the lack of skin-to-skin contact with my second son, because of my cesarean, made a change in his blood sugar which resulted in a 30-hour NICU stay)
  • Breastfeed sooner, longer, and more easily
  • Are exposed to normal bacteria on the mother, which can protect them from getting sick from unhealthy, or other types of bacteria, especially if birthing in a hospital
  • Have lower levels of stress hormones

Only 1% of these women experiences all 6 Lamaze Healthy Birth Practices.
Having a birth plan, and being an advocate for yourself and what you want for your birth experience in a hospital is key here. Communicate with your care provider and create a written birth plan to share with your care provider as well as the hospital staff when you arrive for baby’s birth. Make sure your partner knows about your birth preferences so he/she is comfortable talking with and reiterating to your provider and hospital staff on the big day.

When it comes to birthing in a hospital, being an empowered patient is critical to having a healthy and happy birth experience. Read, do research, take a Lamaze class, interview care providers and hospital settings — learn all that you can to be informed and make the best choices for you and your baby.

Photo from Inexplicable Ways

Avatar of Danielle ElwoodAbout Danielle Elwood
Danielle is a mother of two young boys, Camden and Benjamin, born born via cesarean section under very different circumstances. Since the birth of her first child – a failed induction – Danielle realized the heavy need for childbirth education in her local shoreline community in Connecticut and has dedicated her time towards blogging and writing for local publications on the issues. Read more from Danielle at www.momotics.com.

Comments

  1. Sherry Riener says:

    That is why I am an out of hospital birth attendant….Birth with a trained and qualified midwife has been proven to be not only safe but highly satisfying to mothers choosing this option. Look at the CPM 2000 study in the British Medical Journal.

  2. Avatar of Cara Terreri Cara Terreri says:

    Hi Sherry,

    Thanks for stopping by and sharing your perspective! Do you think there are ways for moms to bridge the gap between modern obstetrics and natural birth, such as hiring a birth attendant like yourself?

  3. I am amazed how strong the “get it done” attitude is in the hospitals. I often attend births with friends as their support person and on every level there seems to be a prejudice against women who want to birth naturally. It seems this is due to timing but it may actualy have more to do with lack of knowledge. I would be curious to know what the standards are for OB providers, nurses, etc to keep current with research. Maybe we need to design classes for them as well. Would they be willing?

  4. We are part of all creation who share the primal act of being born. It is natural, with its own rhythms. and as humans we give each other companionship – I think having a doula in the hospital with you is the best step to stay connected to the beauty and spirit of giving life.

  5. Erin says:

    Unfortunately I think that the only thing that will change the culture of birth at hospitals is a market-driven response to significant numbers of women refusing to birth in them. That, or the ACOG finally takes a real stand in insisting that its providers actually follow its recommendations, as well as medical evidence. Otherwise hospitals will continue the way they are because they are market and profit driven, rather than care-focused. I had two hospital births, one that began in a birth center inside a hospital but ended in a transfer (at the birth center, I could have had a water birth, no IV, labor and push in any position, doppler monitoring), and the second in a conventional hospital, but one that is mother-baby friendly and the birth midwife attended. The midwife in that case was well known and respected by the nurses; because the midwife never left my side, she completely controlled the room and made sure that I was able to labor any way I wanted in an atmosphere of quiet, calm, and dark. (In fact neither she nor the labor nurse ever spoke unless absolutely necessary, and when they did it was in very quiet tones.) So natural positive births ARE possible in hospitals, but it requires the coming together of a number of factors (an open-minded hospital combined with a birth-friendly provider, preferably a midwife). The second hospital actually had a snack room for laboring mothers – the only hospital I’ve ever heard of that “allowed” laboring women to eat and drink at will. It occurs to me as I write this that one of the clear reasons hospitals don’t like natural birth is that these births are unpredictable and “take too long” (it’s more cost effective to have more births, right? So they have a vested interest in pushing births along as quickly as possible). But at the same time most hospitals admit women way too early. Now if they all had a general policy (though not a hard and fast rule, since we all know all labors are not the same) of not admitting women before say 5 centimeters and active labor, then fewer women would be cluttering up L&D floors. In my experience, most first time mothers especially are encouraged to be admitted at 2 or 3 cm then the OB gets impatient because their labors are “taking too long” – then the pitocin comes out, followed by an epidural, and perhaps a C-section.

  6. Diana says:

    Hello,
    I hate hospital birth because of all that was mentioned. When I delivered my first baby I was induced doctors orders, because I was 40 weeks and 2 day pregnant and he didn’t want to wait. So I was admitted given something to induce my labor virginally when that didn’t work I was given pitocin followed by epidural. This was forced by the nurse telling me that if i didnt get it then i will be screwed and sense i had no idea what was happening to me i said yes! I had n IV n antibiotics because of an infection I had months before that made no sense to me. Anyway, every time I wanted to move they told me I can’t I had a HORRIBLE experience! To top everything off, I have an unsupportive spouse n mother. They think because I want to go all natural I’m crazy and selfish because the baby could be in harms way. So my question would be is it true after 40 weeks pregnant you have to be induced because the baby might poop? What types of question should I ask a doctor and hospital!?! Do I even have a right to say no I don’t want an IV or to be monitored the whole damn time I there (I’m super clustifobic) could I say no? Please help I wish I could get a doula but have no money for that I’m super worried that my second experience was as bad as my first! Please help thank

  7. Pretty nice post. I simply stumbled upon your weblog and wanted to say that I’ve really loved surfing around your weblog posts. In any case I will be subscribing to your rss feed and I am hoping you write again soon!

Trackbacks/Pingbacks

  1. [...] you choose to give birth in a hospital, there are a few things you should be aware of. Many hospitals routinely rely on medication and [...]

Speak Your Mind

I confirm that my comments are constructive to the present conversation, my words are neither inflammatory nor defaming toward an individual or to the community as a whole, and I understand that deletion of my comment is at the sole discretion of the Community Manager, should I disregard the above-stated policy.

CAPTCHA Image
*


4 + four =