Natural Birth in Hospital - Worth It?

JCWhitey · February 2013

Here's the situation thus far...

I found a homebirth midwife that I love that is letting us use her assistant's house as a birth center for our birth. We will be staying with my parents for all of this (long story) and they live an hour away from a hospital so we decided that we weren't comfortable with that situation. Luckily the midwife has a place and I was very happy with the arrangements. My parents even offered to pay!

But lately my Mom has been doing a lot of reading and talking to people about this. She has a friend who is a maternity RN at the hospital and she keeps telling my mom these horror stories of women coming in from having homebirths and almost losing their babies. She's becoming more and more uncomfortable with the idea and asked if we would be willing to birth in the hospital if she hired a doula and dealt with the hospital politics for me. We've watched BOBB together and I've voiced my fears of the hospital to her so she understands all of that and is willing to learn to help me out so I can have the birth I want.

The upside to this is that a birth in the hospital would be covered by insurance. While my parents are very gracious to offer to pay the $3800 for the homebirth and are more than able to afford it, it's a huge number to ask of them. H and I could pay on our own but things for us are tight since we're both still in school and I'm the breadwinner and will be taking off work from June on so H can start his job, which means we'll have a month there with very little income. Financially speaking I do see the benefit in having the baby in the hospital.

Now I'm just wondering if all this trouble is worth it to have a natural birth in the hospital. I just hear so many stories from friends who delivered there about crabby nurses, rude doctors, etc. I feel like if I'm doing all of this work to have a natural birth I'd rather be around those who are supportive of this, which they don't seem to be from past accounts. And making my mom and a doula fight with them seems a little off-putting to me. So I guess my questions is, did anyone else plan a natural birth and then just decide to get the epi and not deal with the pressures from hospital staff? Or do you think it's worth it to get everyone involved and onboard with my plans? I definitely see the benefits in natural birth for sure, but not if it's going to cause me stress.

meltoine · February 2013

Does your midwife have hospital privileges, or would you have to transfer care to an OB?

I'd sign up for a hospital tour and talk to the nurses. See if they seem NB-friendly. If you'll have to transfer care to an OB, see if the any of them on staff at your hospital are willing to do an initial consultation appt with you to answer some questions. If you can find an OB who truly supports your plan and the nurses at the hospital seem supportive, I'd consider hiring your midwife as a doula for a hospital birth.

If they don't seem supportive, I'd explain that to your mom and see what she says. You can expect her to pay for a decision she doesn't support, but if she's still willing that's great.

FWIW, I planned on a HB with DS1. We were under mandatory evacuation from our house at the end of my pregnancy and staying with my parents. I didn't feel comfortable having a HB in their house, so we ended up in the hospital. I regret how it all went down because I ended up with almost every intervention in the book, short of a section, but I think that if I had had a doula and done more research into the real risks of GBS (which I was positive for) things would have turned out a lot differently.

pixieprincss · February 2013

I did not find the hospital a relaxing enviornment during my birth with DS1 despite coming in very prepared and with 2 doulas. Even with monitoring just 15 min. of every hour, that meant time out of the water and in a bed or on a ball, but focused on keeping the monitor beeping. Each one of those episodes took me out of relaxation which expended energy. Plus all of the other little battles like semi-hiding that I was eating and drinking, fighting to not have pit once baby was born, etc.. While many women can certainly have a great hospital birth, it was't the right fit for me. I have always known that non-hospital was the best path for my style and I let money get in the way ( $0 hospital vs $4k midwife, like you). We did the CPM route for DS2 and it was so, so empowering. Keep in mind that prenatal care with a CPM vs. OB also will be very different: nutrition and emotional focus vs. tests and comparing to stats (as a gross generalization). There is no right or wrong answer, just what feels right to you and your DH, provided you are low risk and a good candidate for HB. As for the horror stories, ask your MW about her emergency transfer stats. Of course what an RN remembers about HB babies is going to be dramatic--that tiny % are likely the only one she sees!

cattynine · February 2013

I think you're going to get mixed responses on this. Some people birth at home and wouldn't be comfortable any other way and some people can have a successful natural birth in a hospital. I guess some of it depends on the attitude of the doctors and nurses in the hospital.

I had a natural birth in a hospital and didn't have to fight anyone for it (except trying to avoid a HEPLOCK, which I was able to do kind of by accident). The nurses asked if I planned on an Epi, I said NO and it was never mentioned again. But my labor was pretty straight forward, so I'm sure that helped.

Could you try to feel out the hospital and staff beforehand to find out the attitude towards NB? Unless you know that they are going to give you grief, I wouldn't automatically assume the worst.

luvmyducks · February 2013

There are so many successful homebirths. Sure there are scary stories but there are some in hospitals as well. I think you need to try to have the borth experience that you want and that makes you the most comfortable.

That being said, natural birth in the hospital isn't horrible. It of course depends on your hospital. Mine is very natural birth friendly and I had zero issues with the nurses and staff for my natural birth plan with an OB at a hospital. I have the same plan for this LO as well. Personally, I do not feel comfortable with a home birth or midwife situation so that is why I found an OB that worked with my plan and I'm fortunate to have a great hospital where we live.

Maybe plan a hospital tour soon so you can get a feel for it.

principessa81 · February 2013

I agree with the pp about checking out the hospital, doing a tour, meeting with the nurses and the OBs (if possible) and trying to get a feel for the place. Also, I would bring your mom. If you're getting the sense that you're going to have to fight for every last little thing from getting a heplock instead of an IV to laboring in a position that's comfortable for you to telling the nurses for the hundredth time that NO you don't want any pain meds...I wouldn't deliver there. Your mom may be willing to hire a doula and advocate for you, but frankly she shouldn't have to. Not to mention, while having a doula there is certainly beneficial for a woman in labor, there are no guarantees that she would be able to advocate for you. Mine won't (it's a non-issue, since I'm delivering at a freestanding birth center), and it's even specified in her contract.

Even though my L&D didn't go the way I had hoped, I still had a wonderful experience in a natural-birth friendly hospital with an amazing staff. It's very possible to have a great birth experience in a hospital, but you definitely have to do your research. Oh, and tell your mom not to listen to any more homebirth/birth center horror stories. I promise, for every home birth disaster story, there are a hundred home birth stories with positive outcomes. Not to mention, tragedies can just as easily happen in a hospital.

Haley.Beth · February 2013

Here's the thing about OB nurses. The only home birth moms and babies they see are the rare ones where things go wrong. They never get to see the great success stories of home births, overseen by responsible midwives and caregivers. They see the unattended home births, irresponsible caregivers, and precipitous births. There are certain complications that require hospital care, and whether you birth in a hospital or at home, it will be an emergency, no matter where you are.

I had an extremely disappointing hospital birth. I was extremely prepared, and had my birth plan set and approved by my natural-friendly OB. But hospital policies that I had no prior knowledge of kept getting in my way. I still managed to avoid pain medications and other interventions, but it was augmented with pitocin after several hours of bullying by hospital staff. They were not as natural-birth friendly as I had been led to believe on the tours.

Do what feels right for you. Try having your mother come with you to meet your midwife. The midwife should be able to go over in detail her emergency plans, and explain to your mother very well how safe home births are. She can share her success stories and statistics. Maybe that will help alleviate your mothers fears.

ncbelle · February 2013

I firmly believe that natural birth is possible in a hospital setting and moreso that it needs to happen in hospitals if we ever want to change the overall culture of birth in our country (as in hospital based providers need to see and attend natural births). In your situation, I would definitely choose hospital simply based on cost - I wouldn't feel comfortable having my parents foot that sort of bill nor would I want to go into debt for birth if I didn't have to. I think homebirth is a wonderful option but I personally am not willing to pay more for it. I did have a great natural hospital birth with Callum. Of course much depends on your provider. If you have a provider who is on board with and supportive of your plans (and really supportive not lip service supportive) and you have a good support team - it's totally doable.

mel1987 · February 2013

I had two natural hospital births, and there was no fighting with the staff. They asked if I wanted an Epi and I said no, that was that. They were great with letting me walk around and try different positions to labor in. oh, and labor and delivery can be stressful, so don't plan to have a completely stress free time just to be let down.

footnotegirl · February 2013

I had to be induced, but had otherwise med-free birth in the hospital. Our hospital was very supportive in this choice, every nurse and doctor I dealt with backed me on it 100% and the nurse that I had assigned to me on the day I actually delivered had been a midwife before becoming a nurse.

In part that was because this hospital is always supportive in these things, and also because I had some medical complications (on blood thinners, allergic to lidocaine, clotting factors in my blood) which meant that all my doctors (family, OB, perinatologist) were really really invested in a birth with as little intervention as possible because NO ONE wanted me having a c-section for any reason. Also, due to the lidocaine allergy, I couldn't have an epidural at all, only an interthecal.

I had to be on an iv two of the three days I was there (any time I was on a medication, first cytotec/cervidil and then on the day of delivery, pitocin) but they made sure that I had a rolling iv pole. They also wanted me monitored as much as possible, so they got me waterproof, wireless monitors. These meant that I could move around all I wanted. I had a birthing ball and a squat bar in my room, and they started a hot bath for me just before I went into transition and I soaked in that throughout transition.

tokenhoser · February 2013

My hospital birth was fine. There was no pressure from staff, as my doctor was good with my birth plan and I laboured at home. I arrived at 10 cm, so no one had time to push anything on me. It was not stressful, although I can see the advantage to not having to do that car ride to the hospital. That sucked.

aylafsu88 · February 2013

Haley.Beth:
Here's the thing about OB nurses. The only home birth moms and babies they see are the rare ones where things go wrong. They never get to see the great success stories of home births, overseen by responsible midwives and caregivers. They see the unattended home births, irresponsible caregivers, and precipitous births. There are certain complications that require hospital care, and whether you birth in a hospital or at home, it will be an emergency, no matter where you are.

I agree with this first part. I had a natural birth in the hospital and it was great. I had a wonderful experience and got everything I wanted. The big thing is to find an OB who is supportive of a natural birth. My OB was so positive and supportive and never pushed unwanted things on me, not even a Heplock. I had wonderful nurses who helped my doula wipe my brow and never made a negative comment. The big thing is do what feels right for you. This is your birth and your L&D. Think about what you want and where you will feel most comfortable at. It is important to have positive people surrounding you. Talk to your mom about the situation. Have her meet your doula and the MW, tour the birth center, all of these things will help her become more comfortable with the situation so she can support you.

FairyDuster003 · February 2013

pardon me for only skimming pp comments... I'd just like to add my experience to help you decide.

I had a natural birth in a hospital with an OB. I had a midwife for my regular OB however she no longer does deliveries. The other doc in her practice delivered my LO. They were well aware that I wanted to have a natural birth.

I arrived at the hospital at 4cm, was offered epi by the doc and declined. The nurse that came in also assumed that I'd be getting the epi so she asked if I was ready for it and again, I declined. I was offered again by my doc at 7ish cm and told it was now or never and opted for never. The OB offered to break my water and I said no thanks, not yet. It broke on its own.

I delivered at a large hospital that has a 98% epidural rate and 40% c-section rate so I was a mini celeb while being wheeled to the postpartum room!!

Bottom line: It was offered intervention but I had a really quick labor (arrived at 3:30pm @ 4cm and delivered at 6:30pm) so I didn't get hassled at all. The nurses didn't have a clue how to help me with pain but they left me alone! I just stayed very firm when I said no intervention!

JCWhitey · February 2013

Thank you everyone! I plan on sharing this thread with my Mom to give her an idea of what we may face. The big thing is that I am not going to be able to really tour the hospital or even meet my OB or midwife in person until my third trimester. H and I live in California now where I'm seeing by a wonderful group of hospital midwives whom I adore. I would love to deliver here, but H got a job opportunity that we cannot say no to. I also have been offered a job there and will be able to work until I have the baby and then they're going to allow me to work from home. So it's a fantastic situation for us. This baby was quite the unexpected surprise so we weren't in the place in life we wanted to be yet when we started having kids, but it's working out. Unfortunately it's not working out until the last week of May.

So my parents, who live there now and who I will stay with once I have the baby, are going to be meeting all of these people and touring the hospital. I have one friend who had four natural births at the hospital who recommended her OB and said he was awesome, but I am worried that by the time I arrive in town I'll just get whoever is available at the time and the rest of the stories I hear coming out of the hospital are a little less than ideal for me.

But, we have a few months yet to figure things out. My mom has agreed to meet with the midwife and tour the birth center so we'll see what she says there. And if we do end up in the hospital I know that won't be the end of the world, either. H just said we'd write a note explaining I have no desire to have an epi and to not even ask and stick it to the door. Maybe that'll work. I know that in many cases they don't take birth plans seriously, but maybe a big sign on the door will be seen and recognized.

JCWhitey · February 2013

I actually just realized that I have another option. If we drive another 10 miles away there is a hospital that has a newly renovated birth center attached to it. Complete with tubs and whatnot. They *seem* more HB friendly although I don't know anyone who has delivered there. Worth taking a look at?

erb82 · February 2013

Natural hospital birth doesn't have to be a struggle. I've had two and had minimal problems. Take a hospital tour and ask lots of questions. Ask your midwife about any hospital procedures that don't sound okay with you. If you have your provider's okay, the nurses will just let things slide. Honestly the nurses left me alone 95 of the time and only occasionally popped in to check on us.

principessa81 · February 2013

JCWhitey:
I actually just realized that I have another option. If we drive another 10 miles away there is a hospital that has a newly renovated birth center attached to it. Complete with tubs and whatnot. They *seem* more HB friendly although I don't know anyone who has delivered there. Worth taking a look at?

ABSOLUTELY!!!! Does this hospital have midwives on staff? (Could just be my experience, but I've always found that hospitals that have a decent number of midwives on staff tend to be much more NB friendly).

abell77 · February 2013

No two hospitals are the same. Some hospitals are very natural birth friendly. The hospital I delivered both of my children at (and plan to do so again for #3) was so supportive of natural birth that it was almost like being at a birth center. I realize this is probably not the norm, but my point is that I think you should really do your research about all of the hospitals in your area. I drove 30-60 minutes, depending on traffic, to be at the hospital that would be most supportive of my birth goals. Good Luck to you.

yessiree · February 2013

I had an unmedicated quasi natural birth at a hospital (vassar brothers hospital), I labored at home for the most part not realizing how fast I was dilating fully expecting to get drugs when I got there, but got to the hospital at 4:30 and was 10cm by 5. Unfortunately my daughter was face up and had to be "coached" out with a vacuum after 2.5 hours of pushing and she just wouldn't budge. The hospital staff was wonderful. My friend was "that horror story" sometimes even being at the hospital, with the best doctors can't save you, but they did save her daughter. So I guess its a decision everyone needs to make on their own, weigh the pros and cons and know your options. Trust that if you use a home birth midwife or whatever that they are 100% ok with dialing 911 at the 1st sign of trouble and not later. For my pregnancy now, I will be running to the hospital for the epidural at the 1st contraction Big Smile

Good Luck whatever you choose!!!

babyalex124 · February 2013

I am having a natural birth in a hospital. I had a nice talk with my OB about it, and she's completely supportive and says that anyone that gives me trouble will be kicked out of the room!

I also hired a doula to help if any crabby hospital staff issues arise when my OB isn't available. I feel with a good support system, I will do just fine in the hospital.

I definitely do not feel comfortable delivering at home. We are too far from the closest hospital in an emergency, and I just feel more at ease knowing that a NICU team is in waiting as I push. You never know what complications may arise, and I feel it's in my baby's best interest to be in a place where complications can be addressed IMMEDIATELY.

pdilly2b · February 2013

Definitely look at the birth center one.

I think what matters a lot more than location (hospital vs. birth center vs. home) is the care provider, their philosophy regarding birth (medical emergency vs. normal part of life), and their willingness to support you. Of course you find more natural birth friendly providers delivering at home or a birth center, but you can find ones that do hospitals too.

I had a hospital birth with a midwife and had 0 fighting (after transferring from an OB at 32 wks that I would have had to fight against constantly). No doula - just my husband and mom for support, who were both on the same page as me. I was able to have a hep lock to get antibiotics for GBS (my choice, which my midwife supported though I could have declined) and for my intermittent monitoring they used a dopler while I stayed in the jacuzzi tub. She was OK with me eating during labor (though I didn't feel like it), supported me in pushing in multiple positions, and was cool with me forgoing the routine pitocin shot after delivery because my uterus was clamping down fine. We did delayed cord clamping and declined Hep B, both with no argument at all. I have no complaints and will definitely do the same for any future children. Don't get hung up on hospitals as bad because not all are.

mexicolombiana · February 2013

FairyDuster003:
pardon me for only skimming pp comments... I'd just like to add my experience to help you decide.
I had a natural birth in a hospital with an OB. I had a midwife for my regular OB however she no longer does deliveries. The other doc in her practice delivered my LO. They were well aware that I wanted to have a natural birth.
I arrived at the hospital at 4cm, was offered epi by the doc and declined. The nurse that came in also assumed that I'd be getting the epi so she asked if I was ready for it and again, I declined. I was offered again by my doc at 7ish cm and told it was now or never and opted for never. The OB offered to break my water and I said no thanks, not yet. It broke on its own.
I delivered at a large hospital that has a 98% epidural rate and 40% c-section rate so I was a mini celeb while being wheeled to the postpartum room!!
Bottom line: It was offered intervention but I had a really quick labor (arrived at 3:30pm @ 4cm and delivered at 6:30pm) so I didn't get hassled at all. The nurses didn't have a clue how to help me with pain but they left me alone! I just stayed very firm when I said no intervention!

Good for you! Your story sounds a lot like mine BUT I was offered an epi 1,394 times from the moment I entered the hospital. Probably because my hospital had a 98-99% epidural rate too and I was in a LOT of pain so the poor nurses didn't know what else to do but offer me an epi. I don't blame them, they just wanted to calm me down, but instead of offering to have me go in the shower, walk around, get a birthing ball, etc. they just kept offering me an epi. I wasn't as strong as PP above and I DID let the OB break my water (again it was so stupid this was offered) and I did get very hassled about an epi. I REALLY thought I could have a natural birth w/my OB the first time but I see now that I was doomed from the start. They also did constant monitoring which was awful and pretty much nobody was on board w/my "silly" natural birth but me, so that failed. Although I will add that I still had a very good birth and didn't get an epi til I was more than 8 cm dilated (yup they didn't care at all) and I was pushing 30 minutes later.

Anyway for birth #2 I was prepared. My DH was very against a home birth so instead I went for these awesome midwives with hospital privileges at a regular hospital with an Alternative Birth Room. The room is right in the L&D wing but it's a "special" room just for the midwives and their crunchy natural birth moms. The room has a birthing tub and all the natural birth gadgets that were NOT available to me the first around. For example one of the most important things is that they did NOT to constant fetal monitoring so you weren't strapped to a machine the whole time. That made a world of difference. They encouraged me to get into the shower and labor in the shower (this was awesome). They had a birth tub (that I didn't even use) and this little squatting stool that looks like a kid's potty but with no bottom. I ended up birthing on this stool and it was great. I pretty much "pooped" out the baby.

I felt very empowered my 2nd time around because an epi was never mentioned and the MW and nurses were extremely helpful with pain management vs. the nurses the first time around who were distraught I was in so much pain and screaming and kept offering me an epi. Also NO interventions were even offered my 2nd time around and it was a much more calm experience.

So, a natural birth can be done in a hospital setting but you MUST have people's support, including the OB, your partner, AND the nurses. And I would encourage you to go with midwives or an OB who has specifically had experience delivering babies naturally w/out any pain meds. I can pretty much assure you that my first OB had never delivered a natural baby w/no epi.

aintmeamanatee · February 2013

A hospital birth does not have to be the horror story that BOBB portrays. (I love BOBB, but it does prepare you for the worst). I had a natural birth in the hospital and it was amazing. I think the key is to find a supportive OB or CNM that you really trust. I asked for a nurse that was educated on natural childbirth upon my arrival and was given a WONDERFUL nurse that never pressured me or yelled, "PUSH!" I labored at home and arrived 9cm dilated, so I didn't have the pressure for an epi. Too late at that point

I hope you find a situation that you are comfortable with! Congrats!

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