Natural Birth

Birthing my way in a hospital?

I'm wondering if there is a happy medium between home birth and a hospital birth. I'm hesitant to give up the hospital completely but want to be in control of my labor. I want to be able to move around freely and not be confined on my back in a bed when I need to push. I was considering a doula but am also exploring the idea of a midwife. If we have a midwife, will the hospital allow her to be the primary attending 'physician' for the birth?

 What type of birth did you have or are you planning? How did you find a happy medium between your wishes and the rigidity of the hospital system? 

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Re: Birthing my way in a hospital?

  • There's a whole book called "Natural Hospital Birth:The best of both worlds". You'd probably like it a lot.

    I had a med-free birth in a hospital. Things that helped me achieve that were:

    -my doctor. I went with a family doctor, and she was very hands-off and supported my wishes

    -my doula. She gave me confidence and concrete physical support

    -labouring at home. I was 10 cm when I got to the hospital, which was later than I had planned but saved me from a lot of policies (monitoring, IV, eating/drinking, etc.)

  • I had two med-free hospital births and couldn't be happier with my experience.  

    The key is to find a provider who will be supportive and as pp said, labor at home as long as possible.  I had a MW and was at a hospital known for being natural birth friendly and I still labored at home.  With DD I labored at home for 10 hours and arrived at 6cm, with DS arrived at 10cm.  

     

  • LMCB12LMCB12
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    In my mind, when I think of somewhere in the middle I think of a free standing birth center. That's what I did last time and I plan to do it again.
  • The best thing you can do is shop around for a practitioner that respects your wishes, and treats them as if they are the norm. Usually these types of practitioners will deliver hospitals that are like minded.

    I switched 32 weeks and am due anyday. My plan is to have no iv, iintermittent fetal monitoring, able to eat and drink, access to a hydrotherapy tub, ability to walk around and change positions freely, and many other things that my midwife and hospital are totally ob board with.

  • I had a completely natural, intervention free birth in the hospital.  I had an OB who was very supportive of natural birth, a wonderful doula, and we took the Bradley class.  I labored at home as long as possible and arrived ready to push my LO out.  My delivery nurse was wonderful and I had a great experience, I actually enjoyed my birth.  Having a natural birth is possible in a hospital. Find a supportive MW/OB and educate yourself on childbirth so that you know what to expect.  In my area many MW work in pairs with an OB.  The OB is only called in if a emergency situation comes up or a CS is needed.  It is a great balance between the care of a MW and the expertise of a OB if you need it.
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  • I'm a high-risk pregnancy and should not deliver outside of a hospital. That being said, the practice and hospital I was originally supposed to deliver at is not the most supportive of med-free/intervention-free birthing. After much consideration, I changed doctors and hospitals (at 34 weeks), and I feel very confident that my providers will do everything possible to ensure I have the birth I want.

    Research your hospital's policies versus other hospitals' policies. Maybe you'd be better off switching, or perhaps yours is the best in your area. Many of my birth preferences are actually standard practice at my hospital. That makes me feel secure and supported in my decision.

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  • image sschwege:
    I had a MW and was at a hospital known for being natural birth friendly and I still labored at home.  

    This is key! Do your research and see what the birth climate is at the hospital you're interested in. ICAN is actually a really good resource - you can post on the local list serv and get an idea of which local providers support low-intervention birth. 

    I chose MW groups that had good reputations/low c-section rates with both my kids. I only had contact with a MW for most of my first labor (basically until it was decided I was going to have a c/s), and only dealt with MWs for my second labor. 

    This is a good post about specific questions to ask potential providers: http://birthsen.tmdhosting930.com/?p=769

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  • Unless there are any particular health concerns you need to have monitored during early labor, labor at home as long as possible. 
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  • image SarahinMD:
    Unless there are any particular health concerns you need to have monitored during early labor, labor at home as long as possible. 

     

    Definitely this. Even if you find a care provider who supports your desire for a natural birth, that doesn't mean they don't still have to follow hospital "policy" when it comes to "time limits", etc. Either hang out at home as long as you can or do a birth center where you are close to a hospital.

  • I had a perfectly natural delivery in a hospital. Just find a provider that has the same birth philosophies as you!!
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  • abell77abell77
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    I've had two natural births in a natural birth friendly hospital with a midwife.  To answer your question about what the hospital will allow, I think that only CNM's are allowed to work in a hospital setting and they must have hospital privileges (essentially be employed by) at the hospital you wish you deliver. There are midwives with other types of certification, but I do not think a hospital will allow them to come in and assist with your delivery in the same way that most hospitals will allow you to choose your own doula that is not employed by a hospital.  
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  • I had a natural birth in a hospital and was very very happy. I delivered with a midwife and never saw a doctor. The midwife let me do what I wanted to do and I was never offered an epidural or pressured to do anything I didn't want to do. My midwife said since everything went so well I should try a home birth next time but I was so happy with my hospital experience I'll go back for baby #2.
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  • image LMCB12:
    In my mind, when I think of somewhere in the middle I think of a free standing birth center. That's what I did last time and I plan to do it again.


    Yes, this. I am doing the same. This is not to say you can't have a natural, intervention free hospital birth. Especially if you labor at home as long as possible, as PPs have suggested. And no, you can't hire an independent MW to deliver at a hospital. They won't have privileges there.
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  • I had a natural drug-free birth in a hospital.  The facility has a practice of 4 CNMs (who I saw for all my prenatal visits) as well as its "normal" OBs, but all births happen within the same hospital setting.

    One thing I had to do, which seems counter-intuitive, was distance myself somewhat from the natural birth community.  I found that there were often such black-and-white viewpoints that even the most active supporters of natural birth seemed to shun anyone who didn't hire a private midwife out of pocket for a home waterbirth/lotus birth.  Once I realized that hospitals and doctors want healthy moms & babies just as much as midwives and doulas do, I realized that much of my worry and anxiety was self-imposed. 

    Another piece of advice is to make the conversation around your birth plan a two-way dialogue rather than your list of demands.  For example, I learned that due to legal/liability risks the hospital was not going to be able to agree to doppler-only fetal monitoring during labor, as I would have liked.  However, my CNM informed me women in the past had been able to request the nurses simply hold the electronic sensors up to their belly until they got a good reading, which gets around the whole "being strapped in, limiting movement, restricting labor" concern regarding electronic fetal monitoring, and is exactly what I did with my nurse when I was in labor, quite successfully.  Similarly, many hospitals have a policy not to allow any waterbirths, though there are certainly stories of "oops" deliveries, and some providers that are a little more sly than others.  :-) 

    For me, I guess learning which battles to pick, and where it was okay to compromise, was a really important factor.  Ultimately, I had a great birth experience and would absolutely repeat the experience were I to get pregnant again today!

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  • I do want to say, it's easy for it to go wrong if you aren't totally prepared.

    With my first birth, labor progressed WAY WAY faster than I'd anticipated. (I was expecting 18 hours of labor. I got less than 6.) I had hoped for a natural birth but it was just me and my partner and nurses who were happy to dole out meds. We were overwhelmed and I ended up with an epidural. (I wasn't entirely unhappy, but frustrated it went so differently than my goal.) My actual doctor was a family doc, not an OB, but she didn't even show up until it was time to push, which was long after I'd gotten drugs.

    For my next birth (Soon, I hope!) I am doing the hospital again, but with a midwife and a doula. I'm a lot more confident this time. Part of that is having done it before, but I'm also secure in knowing that our doula will help me go med-free, even if it's another very intense experience. You absolutely cannot count on the nurses to help you go natural. They are used to moms who want the drugs and may simply not know what to do with you.

    Bottom line: Be educated, and have good support (If not a doula, maybe a friend, sister, etc who has birthed naturally) 

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  • you basically just need to find out the hospital policies, and your ob's policies. EX: my hospital does not typically have you labor in the water after your water breaks. But, my ob told them that it was ok with him, so I was able to.

    As for the pushing, that is pretty much strictly your ob's preference.

    You need to check with the laws of your state as well. Last I checked, midwives aren't allowed to work alone in my state, they have to be 'under' an actual ob. I don't even have any midwives near me, so it's not something I have to think about, but I did find out that state law.

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  • As others have said, finding the right provider is key!  I spent MONTHS researching mine since I was switching at 30 weeks (due to a move).  I also did a lot of reading and educating myself on what will happen when I arrive at the hospital and what all of these protocols and interventions really do so I could be prepared for explaining why I do and do not want certain things. 

    But being open and honest with your caregiver I think is step #1!  Make sure they are really on board and not just humoring you.  Also having a well education birth partner is important, since you don't want to be dealing with these things when you're in labor.

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