# A Natural Hospital Birth? Please share ideas!



## Melanie Mayo (Apr 1, 2010)

We're putting together an article to help moms who are having a hospital birth make sure they achieve their labor and birth goals.

If you had a child in the hospital what did you do to make the experience more "natural"? Did you have a clear birth plan? If so, what were your most important requests? Did you decline interventions, include family, bring your own personal effects or set a special mood? Did you face opposition?

Please share your experiences and tips to help other moms!!


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## CountryMommy (Jun 18, 2009)

I have had 2 natural hospital births and am currently planning a third in July. 

I laboured at home until contractions were 5mins appart the first time (went in too early) and 3mins appart the second time. Try to labour at home as long as possible.

To deal with pain in the hospital, I sat on a yoga (birthing) ball in the shower for comfort or sat backwards on the toilet with a pillow over the tank when I was exhausted. We kept the room dim which helped with relaxation. I never bothered with music before but I might bring my own music this time.

The nurses left my hubby and I alone only to pop in quickly to check my blood pressure, etc every 30mins or so and would leave right after so I could labour the way I wanted to. The nurse I had with my second baby, gave me suggestions on positions/movements to try to get my posterior baby to rotate. She was wonderful!

I was able to push however I wanted with my second baby (I didn't know any better to ask to try to squat or be on all 4s, etc with my first) They allowed the cord to stop pulsating before cutting (routine at many hospitals now) and handed naked baby up to my bare chest imediately after birth to allow imediate bonding and breastfeeding if everything is looking good. Baby roomed in 24/7 with me the entire stay.

Special requests I had were: no washing baby, I wanted any vernex to be rubbed in to protect skin. They did not have any objection to this.

I also requested no artifical nipples if my baby needed supplementation (which we did not need) but they said no problem and would either feed from a dropper or cup if needed.

If I had a c-section, I wanted baby on daddys bare chest after birth for warming. They actually suggested this during the prenatal classes I took, which were held at the hospital I delivered in.


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## AnaB (Jan 4, 2011)

I've had a natural birth at a hospital with my first, no interventions, no pain meds (a little about it here). I had my second at a small birthing center, water birth, would never go back to the hospital again if given the choice! In the hospital I just had to fight for what I want, it was so frustrating and not a pleasant experience. In the birth center it was so peaceful (I share my experience here).


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## effulgent7 (Mar 2, 2011)

I had a lovely natural hospital birth with my 2nd child 3 months ago. I was induced (as with my first) at 42 weeks so my experience was a little different than some.

My #1 thing is to have a doula! Even with all the research I did on my own, she was invaluable for advocating for me with the staff, suggesting positions and comfort measures, and in general allowing me and my husband to concentrate on the birthing process and not all the "details." I also had a very supportive doctor (and the others in her practice) who were totally on board with supporting a natural birth.

My #2 suggestion is to be informed and advocate for yourself. You don't have to be mean, just ask for what you want, and if they say no with good reason, accept it and move on. Not everything in your birth plan will turn out as you want.


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## eabbmom (Oct 22, 2011)

We planned a home birth and had to go to the hospital b/c my bladder got way too full and it ended up temporarly paralyzed. By the time we got there I told the nurses that I needed a catheter, then pain meds then some rest in that order. The nurses and cnm on call let me rest. Once I felt better I stood up at the cnm's suggestion. My midwife came w/ us to the hospital and while I stood up circling my hips and descending into laborland again she calmly talked me through it. The nurses and cnm never rushed me even though my membranes had been ruptured for twenty three hours and then some. While I was standing my monitor kept falling off and they didn't bug us to put it back on, when the nurse came in and saw I was pushing and crowning she took her sweet time telling the CNm, so my husband caught. I felt like the staff really tried to allow me my homebirth in the hospital. We had a brief birth plan that was really well received and the only problem we had was they tried to cut the cord early. I think mutual respect made a big contribution, the hospital staff knew I had educated myself and I knew they were there to help. The other half of my homebirth mw team(the half that wasn't with me at delivery) made my home experience traumatic and the happy memories of labor are all mostly at the hospital.


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## reikimama (Oct 17, 2007)

Our second child was born in a hospital and we had her as natural as possible, after having multiple interventions with our first hospital birth. I cannot say that having natural childbirth in the hospital was easy. I had to fight off the nurses, who wanted to just proceed with whatever interventions they thought were necessary. I wouldn't lie down for them to monitor me. I kept walking around the room. I asked them to put the bed where I could squat and they didn't know what to do. I did because I had been in the same room 2 months before when a friend was giving birth.

This was after I had thoroughly discussed everything with my OB during my pregnancy & thought that having a birth plan that I was determined to stick to would help. I was more informed this time around and knew that I had to stick to my guns. It is really sad that a birth plan doesn't mean anything to many nurses and OBs once you are in L&D. The only thing I didn't fight on, which I wish I had fought about was the OB performing an episiotomy. He said I "had to have one." Come to find out, she was 8oz smaller than my first child (and 9oz smaller than our 3rd - more later). I didn't need one and I felt unnecessary pain in that area for about 3 years.

The only person that came to my aid was an older nurse who had been there since 1960. She told the other nurses that I knew my body better than most women who come in to have babies and to back off. Then, she turned to me and said that if anything happened, she was going to do whatever she needed to and I wasn't going to argue. I thankfully agreed to those terms. I did have her longer than we had our first in my arms. They didn't take her away as many times and that was a good thing.

Please note: I got to the hospital an hour before our 2nd was born. I had to fight every minute of that hour to make sure that what I wanted to happen (or not happen) was what was going on. At this point, my husband was freaked out by it all and he was just worried that I was going to have the baby on the floor because I was refusing to get into the bed.

After she was born, I started my campaign to get out of the hospital after 24 hours. Many of them could not understand why I would want to not stay, "relax," and be taken care of. Of course, I would miss the celebration dinner! I just wanted to be home with our children and husband. I was able to be released early but I realize now that our child probably had the first round of vaccinations while we were there, which we had not agreed to. I was too tired to question all of that.

For our 3rd child, we had a U/C at home. We ordered the birthing kit, had the "cheat sheet," etc. and let our pediatrician know what we were doing. He said to have a Plan B. We did: Rush to the hospital. Luckily, none of that was needed and I was able to give birth easily with no one interfering. The only thing that happened was my husband told me to lay back and I said, "No, I am squatting because it will be easier." Our son was born with ease. No tearing whatsoever. We called the pediatrician's office and told them he was born. They asked how he was doing and we said, "Fine." They said, "See you Monday morning." It was Thursday evening. We could relax.

We are now expecting our 4th in May. We are having a CNMW come to our house for homebirth. She has an amazing birthing center about 20 miles from us, but with 3 kids at home, that would be more hassle for everyone than her just coming here. I have really enjoyed my prenatal care for the first time. She's thorough, yet she is not intrusive. If everything goes smoothly, within 3 hours of birth, she & her assistants will be gone and it will just be our family. I love this option.


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## sara_j (Apr 10, 2010)

We had a great experience at our hospital. First, we were fortunate to find a practice with docs that supported our desire for a natural birth. Second, we had a clear birth plan and on top of that, the hospital has a "Birth Day Wishes" program where you go in ahead of time and answer questions about your preferences. Thirdly, we had a doula. Beyond that, we had great nurses who just checked in on us and every now and then and respected our desire for space unless we needed something. I loved our experience and felt like we got the best of both worlds - the peace of mind of knowing the people and equipment were nearby if something went wrong, but with the ability to have space and let things progress on their own as long as everything went well - which it did.


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## merbear0929 (Apr 4, 2011)

I had a wonderful hospital natural birth with my second child. My recommendations for achieving this are:

1) be informed. Do your research. Understand what the possible interventions are and when they might be necessary. Know when you are willing to undergo them and when you are not. If you don't know, then you cannot make informed decisions.

2) talk to your midwife or OB team well in advance. Make sure they are willing to support your decision for a natural birth. If they are not, switch to someone who will!

3) hire a doula! This is the best thing that I did. My husband was wonderful, but my doula just had so much experience and was able to direct my husband and me toward measures of comfort. She was able to show him exactly how to put counter pressure on my lower back so that my back labor was bearable. She came to my house after my labor started, and that allowed me to relax and labor at home longer than I would have if she was not there. I still went to the hospital too early because my son was waking up and I was worried about him seeing me in pain. I wish I had stayed home a little longer.

When I got to the hospital, I was able to labor pretty much as I wanted. I requested a hep lock instead of an IV, and they were fine with that because I was Strep B negative. I also requested intermittent monitoring so that I wasn't strapped to the monitors all the time. They had to monitor my blood pressure, my contractions, and the baby for a few minutes every hour or so. I had some issues with my blood pressure being high throughout my labor. Fortunately, my doula was able to help me calm down and get it down enough to make the nurses happy. I do think if my doula had not been there, the nurses might have pushed me more for interventions based on my high blood pressure. I labored mostly walking around the room and leaning on a birthing ball on top of the bed, while rocking. Then toward the end I labored on the toilet. I actually was on the toilet when I started involuntarily pushing, then my water broke, and then my daughter was crowning and my doula sent my husband to go get the nurse! They moved me to the bed (still sitting up/squatting like I was on the toilet) and 10 minutes later I had my daughter in my arms! I did have pitocin after the birth because I think the doctor tried to hurry my delivery of the placenta and it tore, which caused me to start hemorrhaging. It was controlled with the pitocin, and the doctor was able to get everything out. (This was the most painful part of my whole delivery!)


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## VaDePaKo (Jul 7, 2011)

I have been a labor RN for 15 years and have had 4 unmedicated deliveries in four different hospitals. Your nurse is important to assist in making sure you have the freedom to have whatever birth you're planning, but the first important step is to try to locate a passionate CNM who can deliver in the hospital. This type of midwife will stand up for your birth desires and gently help you change plans if the small chance of a true emergency develops. I have loved every delivery that I've been present at in which a woman felt empowered to ask and to expect to have the beautiful delivery she desired.


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## ajmcallahan (Jul 10, 2012)

I had a planned homebirth that came too early and had to do an emergency hospital birth. I was able to birth naturally and at my pace. We had a wonderful CNM and nurse who were amazing advocates for me and I just met them. The only thing I had to "give in" on was an IV of penicilin as I didn't have a confirmed negative strep-b test. So it was me getting the antibiotics or the baby having lots more tests done...it was an easy choice for me. BUT the one phrase that I always recommend to other moms wanting a natural birth in hospitals is, "CAN WE WAIT A LITTLE LONGER, PLEASE?" I said this multiple times while they were pushing the IV on me. They will let you know when they can't/won't wait any longer and it's usually not when they first ask. So, push the limits as much as you can if you have to do something you don't want to because you're in the hospital. I was able to stall the IV for 2.5 hours from when they first wanted to hook me up. As soon as the IV was done, I started some real labor action and birthed within the right amount of time so I didn't need an additional dose. Which leads me to the most important point, doctors know a lot of important medical information, but they DO NOT know YOUR body. You do. Trust it. Your body was made to birth a baby.


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## Lizzysgot5 (Jun 24, 2011)

Yes, yes, and yes.







Eighteen years ago I gave natural birth to my large (8 lb. 9 oz. son) in the hospital for the first time after having a medicated awful hospital birth two years prior. Before going to the hospital I read lots of books about natural childbirth and connected with moms who had experience with it. I made a birth plan and gave a copy to my doctor as well as (and very important) took one with me to the hospital when I was in labor to give to the nurse for my chart. Because the doctor may or may not be there while you are laboring you need the people who are there watching over you to be informed of your wishes via your birth plan. Next, I stayed home with my labor coach as long as possible, maybe too long, and upon arriving he was born 45 minutes later. My baby never, and I mean never, left my bed. Everything that needed to be done was done in my bed with me there. I did have to deal with staff that wasn't too happy about my assertiveness and wishes for MY CHILD. I did my homework and I knew what I did and didn't want for my newborn. I knew what was best for him, not the staff. I think they think it's their baby, their property or something. I had to get in my head before going to hospital that this was my baby and I was in control not strangers (as long as everything was going normal and our health was never in danger or anything like that). They gave me a hard time about how I was making too much noise, oh well. My labor support person was important for making sure to stand up for me if I got too involved to do it. Everything worked out absolutely perfectly! One nurse actually said to me, "Why aren't you at home giving birth, you are a natural." I would have if my husband was up for it, he was not.

Then about 5 years later I gave birth again (12 years ago) to my daughter at a different hospital with a nurse midwife and that experience was even better. The reason I say this is because my midwife was my advocate for having the birth I wanted and she made sure of it from start to finish. The staff got scolded by her when she came in and they hadn't done what she instructed them to do over the phone. Then again after she was born and they wouldn't give her to me, she yelled at them that I wanted my baby. They want to whisk them away routinely, not out of necessity. Ugh! I hate that. This birth was much much longer and included a false labor, that part was frustrating after the speedy birth I had prior. Again, she never left my bed and all exams were done next to me. They accommodated me quite well, more mom/baby rooming in friendly. But, I was very determined to have it my way with my baby and I did. I think that is the biggest lesson I can offer to any expectant mom, remember this is YOUR baby and you CAN have a birth your way (under normal circumstances). If there were problems I would have reacted accordingly in the best interest of my baby.

To end my story, I went on to have two more beautiful babies at home. They were the best births I could have ever asked for and always dreamed of having a home birth. Didn't realize I would get to do it twice, but I have zero regrets.

Happy birthing mamas.


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## mom4 (Aug 20, 2010)

I have given birth to 4 kids in 3 states. All the births were natural. My last two children were born at home, so no complaints there 

My first two children were the challenge. My daughter was born in a hospital in Austin, TX in 2004. I remember showing my birth plan to my OB/GYN and she glanced at it and then sighed. She then proceeded to tell me that she would try her best to do these things but then went down the list explaining that some of them had to be done, like cutting the cord before it is clear of blood and being hooked up to an IV was necessary. This being my first child I was nervous and trying not to second guess the decisions I had made in the face of my Dr. but I agreed I would be flexible with my demands.

My membrane sprung a leak at 7pm. I was checked into the hospital around 8pm with no contractions just a leaky membrane. I was told by the on call Dr. that if I did not start contracting in an hour drugs would be given to induce labor. I frantically had my husband rub at pressure points known to induce labor. I wiggled in bed, much to the nurses chagrin because moving caused the baby heart monitor to lose track of the baby. An alarm would go off and she would have to come in an reposition everything, Fortunately, my contractions started and besides that fact that I was more mobile than the nurse would have liked me to be (because the darn alarm would go off) throughout labor I was ready to push but my Dr. was no where to be found. So, I had to "blow out birthday candles" until the on call Dr. showed up and I could push. By then it felt like I wasn't contracting at all when it was finally time to push. But I did my best with each weak contraction and my daughter was born at 1 am.

I feel like part of "getting it my way' had a lot to do with the time I gave birth. Over night in a hospital it is pretty empty and if you get a nice nurse, like I did, she will do her best to accommodate your decision to birth naturally or move around. I hated all the cords and monitor wires, the IV. It made it kinda hard to move around through each contraction, but I did my best to work around them.

Despite everything, I was pretty happy with my birth at the hospital. I felt like it had gone smoothly and as I said because of the time I was there I was allowed more freedoms I think than someone in labor during the day.

I was not so lucky with my 2nd child. At this time we had moved to Cerritos, CA. Just like my first child, my membranes sprung a leak before I had any contractions. I was told to check in at the Fountain Valley hospital and my Dr.'s associate came in to check on me. This was around 4 or 5 in the evening. Everyone seemed in a bad mood. The nurse had a hard time getting the IV in my hand and was grouchy. I was asked if I was in any pain. I said no. The nurse asked if I would like any drugs during labor and I said no. She held up the face chart they use to describe pain levels and said " You realize labor will be a 10 and the most excruciating pain you have ever felt?" I said yes and she said "OK" and left the room. My contractions started but they were weak and infrequent. I was told I needed to have my labor induced at around 10pm and I agreed. The nurses and Docs were very pushy. The drugs did nothing. I sat in bed all night doing my best to wiggle and move my hips. I asked many times to be allowed to walk and was told no that I would strangle my baby with the cord since my membranes were open. 
At 5 am the Dr. came in and said I had to have a C- section and someone would be in to prep me in an hour. I was so freaked out. I did not want a c-section and I begged the nurse to let me walk. Please I said I KNOW my labor will start if I can just walk. The nurse reluctantly told me no and changed my IV and gave me more labor inducing drugs. Another nurse came in to shave my surgery site and as she was shaving I felt it. That lightening pain that is early labor for me. I told her my contractions were starting. The Dr. came in he was all excited and asked if I was ready for surgery. "I can't do this" I told him. " if you just let me walk around I will give birth in 3 hours I told him" He scoffed and told me I was going to kill my baby. I insisted I would not have a c-section. He was very upset. He took a clip board from the nurse and scribbled something on it and shoved it in my face " Sign this" he said " I will not be responsible for your bad choices" I signed and he started to leave the room. The nurse asked what she should do with me and he said " I don't care I am washing my hands of this one"

It was all unbelievable. The nurse looked freaked out too. I turned over in bed to that I was facing the wall and kneeling I began to move my hips and the contractions were getting stronger. The nurse was not happy because again the monitor kept losing the babies heart beat. She said she would let me move if I consented to an internal monitor. I consented, worried the next step would be the hospital kicking me out entirely. The monitor was inserted and I moved around still only on my knees in bed. Before long I was in transition and when my husband told the nurse she said that was impossible. It had only been about half and hour since she left after inserting the monitor. She came in to check me and sure enough I was ready to push. I was wheeled into a delivery room being told not to push. The nurses were looking for a Dr. The one who had washed his hands of me was doing just that. The charge nurse came in and stood by me calling out to other nurses to call the ER and get any Dr. I started pushing and no longer willing to wait and my son slid out me my onto the table gently guided by the charge nurse.

I decided after that I would never give birth in a hospital again.

My last two children where born at home. One in Washington with the wonderful midwives of Puget Sound Midwifery and the other, believe it or not, in Austin, TX with the help of The Heart of Texas midwives. The Heart of Texas midwives were not covered by insurance, but after my last hospital birth I decided it was worth the expense to find a good midwife. I am very happy I had these wonderful women at my births.


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## erigeron (Oct 29, 2010)

I have no interest in home birth because there are no CNMs who homebirth in my area and I am not comfortable with the training and safety statistics of CPMs. I had a great hospital birth with my daughter and will plan another one with my next child. I delivered with a wonderful group of CNMs. They took time during my prenatal appointments to discuss what I could expect in labor, and we discussed various interventions. I also took a Bradley method class with my husband so that he would have enough knowledge about labor and birth to be able to support me. I was prepared to have to fight for a natural birth, and I was worried that I would be intimidated or feel self-conscious by stuff in the hospital like having to wear the gown or having someone come at me wanting to do X or Y. But when it came to game time, I didn't care about any of that. I had a very brief birth plan (which I reviewed with my midwives in advance) which basically boiled down to "ask me before you do anything, even routine procedures" and "don't ask if I want pain meds, I will ask if I want them". Nobody gave me any trouble about it and the staff were all really nice. I think many of us expect to have a terrible experience at the hospital but I think it's important to keep an open mind.

I chose my CNMs partly because they said they would stay with the laboring mom the whole time, rather than just showing up at the end. As it turned out there were several patients on the floor so she was not with me the whole time, although she had a student midwife who was there for most of the process. Both of them were there for most of the pushing phase. As it also turned out, I didn't care all that much about having her there all the time, because my husband was a great support, and next time I won't worry so much.

I didn't end up getting pain medicine, but I do think epidurals get a bad rap on MDC. They're not the big bad--if they help you relax and recover your energy so you can carry on with your birth, sometimes that can be just what you need. And I think the drawbacks are overstated by the natural birth community. That said, I'll still try to go epidural-free with my next birth, just because having to get hooked up to all those tubes and wires seems like a hassle, and I wasn't in labor too long with my daughter, but depending on how it goes I'll keep an epidural in mind as an option.

I stressed out about not being allowed food in labor, and planned to sneak some in, but we didn't make it to the hospital until I was in pretty active labor, and by that time I couldn't have cared less. (I discussed it with my midwife in advance, too, and she basically said that in her experience most moms don't want food in active labor.) My husband did give me water between contractions, though. After the birth, though, we didn't make it up to the post-partum floor until after lunch (she was born just before 11) and it took them forever to bring me any food which turned out to be a bag full of cookies and crackers. Pathetic. If I'd known it would take so long, I'd have sent someone out to get me a sandwich or two.

Post-birth was great. I got to hold her right away, even before the cord was cut, and relinquished her to get cleaned up when I was ready, and they were willing to wait to bathe her until we were ready.

We stayed the whole allotted 2 days, which I think was good because we were still figuring out breastfeeding, but with the next one I'll give serious thought to leaving sooner, so I can relax at home. Also we had people visiting all the time, I think because I still felt weird being alone with her, but with the next one I'm going to kick them all out so I can sleep! I should have slept more in those early days.


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## philomom (Sep 12, 2004)

Our hospital births were glorious all natural experiences with our beloved CNM. I stayed home until I was truly uncomfortable. Arrived both times already 9 centimeters dilated. No Iv, no pain meds, no intrusive monitoring... just intermittent checks with the doptone. I was in charge of my own pushing. I set the pace. There was no tearing and no need for stitches. Their waters both broke as their heads crowned, they slipped out of me like fish. The babies had their Apgar checks on my body and both nursed withing minutes of delivery and there was no mom-baby separation at all. We delayed baths until the next morning ( my babes were both born late at night) ... I only washed their faces just a tad to take pictures. We were back home in the master bed within 18 hours of them being born. Same hospital, same CNM, babies born two years apart.

Take Bradley classes. A well trained Bradley dad is a great doula. No need to pay a stranger to be beside you at this most intimate time in the birth of a family. I've seen doulas first hand mess up that loving couple connection that comes in at a baby's birth. No way was I gonna let that happen to my marriage. Men who are sidelined at birth may feel less capable and less like dads making them estranged from their newborns at the very beginning. So sad. Some of my best memories of birth are of my hubby holding them and touching them for the first time.

And really, the NICU was steps away. I'm married to a "just in case" kind of guy and we lost our first child. No way was I not honoring his feelings about the safety of homebirth. I'm the kind of birthing mother who could give birth while picking crops, strap the kid back on and go back to picking crops but he's the parent, too. We are in this together, my wishes do not outweigh his when it comes to our child. I got what I wanted. A natural childbirth with a caregiver I trusted.


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## marcib28 (Jul 10, 2009)

I have had 2 natural hospital births. I simply used a midwife that delivered at the hospital. My husband wasn't comfortable with me having my babies at home or a birthing center (which, I suppose he ended up being justified as I was rushed to the operating room after my first was born). The number one thing I would say to do is to find out what options your hospital offers. If you are constantly having to fight for everything you want, you are not going to have a birthing experience you love, even if they give in to many of your demands. I know I wouldn't want to look back and remember just arguing with the hospital staff the whole time. I suppose that could be helped by having a doula though  I didn't have a doula with either of mine as I didn't feel it was necessary with the MANY options I had.

With my first, I went to the hospital earlier than I probably needed to, but didn't really know what to expect. So, I was there for like 9 hours before he was born. My hospital allowed me to labor in the bathtub (but not deliver there), so I pretty much sat in the bathtub the entire time. They had me get out every 2 hours to check on the baby and switch out the water so it was warm again. It was SO awesome! My midwife had some candles going around the tub and had music playing, even though I had not asked her for either. I actually did not go with my heart set on a natural birth. I figured I would simply labor until the pain was too bad and then I would get an epidural. I never reached that point though thanks to the tub.

Secondly, I would say be informed! Know what you want and what your main priorities are because you probably won't get everything (if you don't have a super supportive doctor or hospital staff). While my midwife and hospital staff were COMPLETELY on board with my birth plan (mainly because I asked what my options were before I even wrote it, so I knew that they would at least "allow" me to do those things if everything was going smoothly), I still did not completely know what I wanted. I suppose I went into it expecting to be given suggestions on positions to labor/birth in and, when I wasn't given any, I ended up giving birth while laying on my back in the hospital bed. I think that between that and pushing my son out too early (I never felt the urge to push...I simply did because I was told to) is the reason I ended up going to the operating room due to AWFUL tearing.

With my second, I barely made it to the hospital in time. I wasn't there more than 5 minutes before she was born. I didn't exactly plan it that way. I just went from contractions being 7 minutes apart to suddenly 2 minutes apart, with no in-between. I had only made it to the elevator to go up to Labor and Delivery when I REALLY had to push. Between my 2 children the hospital had begun offering water births so I was planning on doing that, but obviously didn't get there in time for them to even fill up the birthing tub :\

If you're lucky enough to have a hospital that "allows" for many of the things a crunchy momma wants, then simply know what your limits are and have a birth plan ready. However, don't assume that they will help guide you through the birth you want. You still need to be an advocate for yourself and know what you want (birthing positions, etc).

If your hospital isn't one that typically does the things you're wanting, I would definitely look into getting a doula, so your precious memories of that experience aren't of arguing with the hospital staff the whole time :\


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## Melany (Aug 9, 2005)

I have had two natural hospital births and both were in full support of a wonderful OB. I interviewed MANY OBs early on in my pregnancy and when I asked questions that resulted in a belittling comment from the DR, I found someone else.

The other thing that helped was my mother worked at the hospital I wanted to use. She walked up to the L&D nurses and asked them who they would use for a natural birth. They all suggested the doctor I ended up using.

When it came time for the birth plan, he never belittled my requests. There were a few things he couldn't consent to, and he explained why, mostly on my "if I have a C/S" list, but he never made me feel like I was a moron for asking.

I think one of the reasons I had such a positive experience birthing naturally in the hospital is my Doctor's ability to talk to me like a human being and his acceptance of an educated patient. All of the decisions were a dialog, he never shut me down, and that allowed me to trust him when it came to labor and let go to do what I needed to do because I trusted that he would honor my wishes.

I am planning a third birth and this time it will be at home, but only because we moved a few hours away from where we used to live.


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## myra1 (Jan 20, 2013)

#1 is educate yourself! YOU need to know the pros cons risks and alternatives of every intervention.
Have an advocate, other than your husband, who knows your wishes and will speak up. You may be in too much pain.
Choose a care provider wisely, a cnm who is experienced in and supportive of natural births worked for me.
Arrive ready to push if possible. I did this with all but my first and every hospital policy got chucked. We didn't even get I.D. bracelets.
Remember that every single intervention is a potential slippery slope. Example I control my GD well with diet so I don't even do the test, that way I don't get the high risk diagnosis. Of course I test my blood sugar regularly and eat great. I have big babies and go to 42 weeks, so i don't have ultrasounds since they tend to put me in a box and can be misleading.
Trust your body and exude that trust to your birth attendants! When you seem helpless they feel you want the "help"!


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## Bocanej (Jun 27, 2012)

I had a natural hospital birth last year, and besides a few minor glitches (the shower only had cold water, the hot tub stopper didn't work so the water had to run continuously, my midwife was late b/c she had delivered three other babies during her shift, the nurses who checked my dilation probably hurt me more than my lo did on his way out, the nurses let my ENTIRE family in immediately after I had my lo...) it went great.

It really did, looking back at the glitches, it makes me laugh that quite a few things really did go wrong... but I guess I was just so excited to have my first baby, and so empowered that I was handling it naturally (probably had lots of endorphins popping) they were just like details that were easily ignored. I did write a birth plan, and the hospital and nurses respected it every aspect. In fact, they followed it exactly. No one ever pressured me to wear a monitor, get an IV, take my lo out of the room, etc. My husband and lo stayed in the same room with me the whole time, and I felt very well cared for.

For my next baby, I have considered birthing at home... though I have to say that the experience of staying somewhere that I didn't have to cook, do dishes, clean or do laundry for three days was pretty nice. Every question I had, there was someone right there to answer it for me. It almost felt like a vacation. I like the idea of having a natural birth at home, I just wonder... would I have to clean up everything afterwards??? I like to think that my husband, family and friends would help out at home, but I don't know. People have a way of disappearing when the time comes and you need them. Would I be able to recover and bond as peacefully?


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## pinklucy (Jul 8, 2005)

I had planned to have my first baby in a birthing centre, but after a pregnancy related liver condition was discovered I ended up being induced in hospital. Despite this I had a very positive, natural experience. The first thing I did was insist on some time alone to rest and come to terms with my new situation, despite my doctor wanting to rush to induce me. I had done birth art during pregnancy to help ease my fears about labour. On a scrap piece of paper with a ballpoint pen I drew some birth art, incorporating the unplanned factors such as the monitor and a possible IV drip. I gave them names to personalise them and drew the monitor as a heart hugging my pregnant tummy and imagined it holding my baby and keeping it safe. I did some relaxation and tried to move positively into the new situation.

I had an amazing student midwife who was very supportive of keeping my birth as natural as possible. I refused to have a canula inserted in my arm which felt like a personal affirmation to only have intervention if entirely necessary. My midwife brought a birthing ball and a mat so that I could move off the bed and change positions even though I was strapped to a monitor. We kept the lights low and my midwife read the monitor readings using a small torch. Later on as I moved more, rather than trying to suppress my movements, my midwife suggested a change in monitor to give me more freedom of movement. After a while I really didn't notice the monitors at all. I was naked and I felt powerful. I gave birth in a squatting position which I naturally got into and when my baby was born I scooped him up and held him to me.

Although my birth wasn't entirely natural it's a story I like to share because most people who are induced believe that they have to be stuck on a bed under bright lights at the mercy of medical intervention. Indeed, my doctor told me this is how it had to be. I gave birth, squatting naked in dim lighting with no pain relief (apart from a TENS machine which we couldn't work properly and abandoned!) It was the most amazing experience I have ever had and has inspired me to choose a home birth for my next baby. I know my experience is rare for women induced in hospital but it shouldn't have to be.


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## malta (Feb 25, 2013)

Although I planned on a homebirth (with my sister as midwife), I ended up going to our local birthing center due to perceived complications from a bicornuate uterus. I happen to live in a very progressive town, where, at the local hospital (just two blocks from my home) nurse midwives essentially run the show.

When I knew that it was a possibility that I might end up at the birth center, my husband and I did a tour of the facility. All the questions I planned on asking -- about their basic procedures, keeping the placenta, declining intervention, etc. -- were voiced first by the nurse we met with. It was fairly clear that this wasn't a typical hospital setting.

I ended up being induced at 39 weeks, after it was clear that the babe wasn't growing anymore in utero. The nurse midwives, knowing that my sister was my primary midwife (who practices in another state), were enormously respectful of her and the role I wanted her to have. My two other sisters ended up joining us because they knew I needed extra support being away from home and the ideal of a home birth.

For the two+ days of gradual induction, my three sisters spoiled me and my husband -- cooking wonderful meals, bringing plants and books from home, providing humor and love and light-heartedness. Although I had already filled out a thorough form of all my wishes, I almost didn't even think it was necessary; the nurse midwives and attending nurses (many of whom were once home birth midwives) were so present and kind -- they too were bummed that I didn't have a home birth.

My sister was given room to guide me through labor (despite having no contacts in that hospital) and she caught my beautiful son, with my two younger sisters there to witness the birth.

In the end, I (and my sister) were sure that I could have done a home birth without complications. Still, the alternative of a natural(ish) -- I don't consider being induced natural -- birth-center birth ended up being sweet in its own way. I feel so grateful to have had the experience I did.


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## mum4vr (Jan 31, 2007)

Thank you for this awesome thread!

DS1 was a hospital birth with many ugly interventions- ugh! (WI 1993)

DS2 & DD were lovely hospital births with a wonderful CNM who helped me write & execute my birth plans (NE 1998 & 2000)

Now we live in very rural OK. Due in sept. NO birth centers within 2 hours (& my 2nd & third came super-fast!). The 2 nearest hospitals have had their birthing privileges pulled! We must either travel 90+ min to the nearest hospital w birth priveleges, or HB w a midwife from 2 1/2 hours away who travels from another state (with 2 terrible hospitals as emergency backups). This is nothing like ideal. (Can I move back to NE & my super MWs for this one, hah?)

DH is not ok with HB dt our local hospitals, which can't even handle a "normal" birth, being our backup w a baby in possible distress; neither am I, really. The OB is iffy-- tells me no one will give me a hard time re refusing eye ointment, etc then spends 15 min trying to talk me into it (at my 6 wk appt!), then tries to reassure me at later appt that no one will try to force anything. This all has me reconsidering that long drive to that birth ctr in TX! But I don't want to spend my labor in a "high speed chase" to the ctr, esp considering the likelihood that we'll arrive too late & I'll get the "side of the highway" birth experience!

At least the MW is willing to be our doula & meet us at the hospital (which is somewhat between us, geographically); she helps set my mind at ease. I'm not sure if it's worse knowing how rough it may be from ds1's birth, or how smooth it could have been, but won't likely be here from the other 2 births!

Hearing from those who've btdt whether supported or no is very reassuring & comforting. Thanks so much; can't wait to read more! (downloading some birth plan ideas just now...)


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## pohaha (Nov 14, 2007)

I had my first at a hospital. We took Bradley classes, read lots of books, and thought we had a great birth plan. Mostly we just said we wanted to avoid routine procedures and to ask my consent before doing anything. Well, we ended up having a terrible L&D nurse. She made me feel bad for wanting to remove my clothes during heavy labor... Even mentioned an obese African American woman who was just "lettin all hang out.". Awkward to have to labor around her after that. To top it off, the midwives on call were equally unsympathetic to my requests. They tried to break my bag of waters after I explicitly told them not to. While checking my dilation on all fours they got out the hook and were holding it on the side of the bed where my husband couldn't see it. I happened to look down and yell at them to stop. The exams were excruciating. The midwife ended up breaking my water with her hand during that exam with the hidden hook. When I was 8 cm and in transition they threatened to get a court order to give me Pitocin, since my contractions were not getting any closer than 5 minutes apart and only lasting about 30 to 45 seconds. I ended up getting an epidural because I could not handle transition and having to fight for a natural birth at the same time. My husband told them my wishes, but they told him his opinion doesn't matter. Thank goodness there was a shift change when it came for me to push....the new midwife said they were going to send me in for a c-section. For no good reason other than time. I had been in active labor for about 15 hours total. It was a horrible experience.

Next baby we switched our insurance during open enrollment so I could birth at a hospital with a birth center. They had tubs to labor, but not birth, in. I still felt very pressured by the clock... My waters sprang a leak and I didn't realize they changed their policy to where they want you to come in right away and be in active labor within 12 hours, rather than wait at home for 24 hours for labor to start. I had some truly wonderful nurses who let me know that they can't control whatever decisions I make. Essentially, they don't have a Lo-Jack on me







Nothing is going to rush this natural process. So my plan at that point was if I got to 12 hours and wasn't in active labor (at which point they would send me to L&D), I would go home until I got into active labor. The midwife woke me up at 4am to let me know I had about 2 hours, So I got up and started doing lunges up and down the hall in front of the nurses station so they knew I was "trying". I started having real contractions at 6 am and moaned extra for the benefit of the midwives







. I labored in the tub a bit and when I felt like I was getting close the midwife checked me again and told me I was still at 4cm. WTF. So I said screw this noise, get me an epidural...narcotics, whatever. That was the Transition talking. My husband wheeled me down from the birth center to L&D...when I got in the room, I stood up and felt my baby coming out. She was born in 3 pushes and 5 minutes, and I delivered her standing up supporting myself on the edge of the bed. Great timing!

I felt so empowered by my natural birth that I felt healed from the trauma from my first birth.

The cost of insurance is so high now we do not have the option of changing it again, so I must give birth to my 3rd (due in June) at the same hospital I had my first. I can not have a home birth I planned on because I suffered a pulmonary embolism at 8 weeks and I'm on blood thinners. But I feel like I learned a lot from the nurses and the experience of my second birth that I can successfully navigate the hospital staff and have a natural birth:

- It's your body. It's your baby. Try not to think in terms of them "letting" you do things, like wear your own clothes or walking around or going to the bathroom. Or eating and drinking. I do not plan on asking if it's okay, because I know it is...and I will have a big Trader Joes bag filled with snacks, squishy bread, honey sticks, water and juice. They are not in charge of you, you make your own decisions and just do them. It takes two to oppress.

- Do your research and know what you want. They don't always know to ask you before doing something routine, because for them it's, well, routine. Be flexible for the health of you and your baby, but don't let them bully you. Of course we want to Make Nice, but not at the expense of your birth for the sake of hospital staff doing whatever is easiest for them.

- I know my body. I know my contractions did not come closer than 5 minutes apart with both of my babies. And I still had a natural birth with my second. My body works.


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## erigeron (Oct 29, 2010)

Quote:


> Originally Posted by *pohaha*
> 
> - It's your body. It's your baby. Try not to think in terms of them "letting" you do things, like wear your own clothes or walking around or going to the bathroom. Or eating and drinking. I do not plan on asking if it's okay, because I know it is...and I will have a big Trader Joes bag filled with snacks, squishy bread, honey sticks, water and juice. They are not in charge of you, you make your own decisions and just do them. It takes two to oppress.


 I agree with this. This is one reason I didn't put a lot of this kind of stuff in my birth plan. I figured, I'm not going to put "I want to wear my own clothes in labor". I'll just wear them. And I'm not going to put "I want to move around in labor", I'm just going to move around. Etc.


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## eabbmom (Oct 22, 2011)

I really like the discussion of terminology. You don't have to enter the hospital like it's a war zone. You can decide before hand how you'll act, wear your own clothes, eat, move around. I think going in w/ that mind set helps the mother stay out of her victim space where things are "done to her" and instead she can be strong and make decisions w/ her care team. Mom's need to remember that just b/c something is standard in a hospital it does not mean they must consent.


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## puddle (Aug 30, 2007)

1. Choose care provider and hospital carefully. Check C-section rates. Don't just check out your provider--check out everyone they share call with.

2. Hire a doula or monitrice.

3. Prioritize what you want, and be flexible.

4. Labor as long as possible at home with your doula/monitrice.

I had a great OB for my second pregnancy, but had an inexperienced and panicky doctor on-call when I delivered. I think the only reason I got a (mostly) natural birth with that doctor is because my son came so quickly. By the time I got to the LDR room I was at 7cm, and by the time they tried to get an IV in me minutes later, I was pushing. I gave birth in my own clothes and without an IV because there just wasn't time for either.


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## Quinalla (May 23, 2005)

1. Do your research, know what interventions you are and are not ok with in what circumstances. A lot of things that hospitals/care providers do routinely are not necessary and are often detrimental, but in certain situations may make sense. Also, sometimes it can make sense to agree to a few unnecessary interventions and really fight for the ones that are important for you. In my case, I was fine with an IV and EFM and occasional cervical checks, but wanted to be able to eat & drink, move around (they set up the IV so I could and were fine with unhooking me from the monitor for times), not be asked/pressured to take pain meds, no episiotomy, etc.

2. Talk to your care provider early and often about everything. Sometimes you have to handle their feelings with delicate care, but it is worth it to get what you want out of labor! Being willing to really listen to your doctor and responding thoughtfully even when you are disagreeing helps a lot, it sets the tone for them to listen thoughtfully to you as well. Also, don't fell silly bringing questions written down or other materials to your appointments, I know for me I have a hard time remembering what I want to say when I get into that familiar Doctor/Patient rut of do what the doctor says.

3. Labor as long as you can at home, I found the Bradley method advice of when to go in the most helpful as it describes very well the feelings you will have in early labor vs. late labor, even for first-timers. I know that some of my success of having my birth go the way I wanted was due to being in the hospital for only 4 hours.

4. Make sure you know your hospital policies well too. If you have an OB, they will likely not be there until the very end so make sure you have a hospital on your side too. Try and get a natural-birth friendly nurse, have things in writing from your OB if they vary from the hospital policy, make sure your support person (husband, doula, friend, etc.) knows what you want so they can help you to explain if you are in labor land and having a hard time communicating.

5. Go in with a plan and positive attitude, but also be open to what will happen. Not everything is going to go 100% perfectly, but if you are well prepared, you will be well equipped to handle what happens!

6. Definitely remember that you do not have to consent to things just because they are policy or "policy"! Go in confident and have little rehearsals in your head about how you will handle things. If in the hospital they want to do X thing, ask them to explain what the risks and benefits are of doing vs. not doing at all vs. wait-and-see. This will often throw them off their normal track of half-suggest/half-order and back into informed-consent mode. For a lot of reasons, birth is one of those times when a lot of care providers forget about informed consent.


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## Caryn Talty (Oct 22, 2012)

I've had two hospital births and two home births. Our 4th was born in a hospital about a 1 1/2 years ago. To prepare, I created a specific birth plan with my husband and we brought it with us when our midwife took us on a tour of the hospital. Our baby was two weeks past her due date, so there was a lot of monitoring going on. We waited until she was ready, and of course I believe that made all the difference. I had prodromal labor on and off for 4 weeks, so I was tired that last month. She was not positioned correctly until right before I went into actual labor. Although it was a very long labor (20 hours) I was able to manage very well without medication because I was able to move around as much as I wanted. (I did not have an IV and was allowed to eat as I pleased). I think it helped that they knew I had given birth naturally three times previously. Natural childbirth is not easy, but as long as you are determined and you have the right support system you can do it. At one point it looked like my labor was stalling and instead of using pitocin my midwife suggested we try a breast pump. She was very supportive and confident.

Afterward she told me I was the first patient that it ever worked on.









I never once doubted it would work while I was in labor, though. She made me feel that confident in myself.


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## sageowl (Nov 16, 2010)

My health insurance pretty much dictates the setting (hospital), and I wanted a natural birth, so I made sure to hire a doula (since I don't do well in hospitals, as a rule). So the #1 tip from me is hire a doula/support person (in addition to your labor partner) if you can afford one because having the continuous support through several shift changes of nurses made a huge difference for me in terms of being comfortable with what was going on around me in a hospital setting.

The hospital I use actually encourages you to write a birth plan, and provides a template (so you know which interventions they actually might use), so I had one, and felt that it was followed (whenever feasible). When deviations were necessary, I felt like I was well-advised, and the staff was willing to try the least invasive approaches before resorting to more "medical" ones.

In my case, labor came on fast and furious, but I labored at home until contractions were 5 mins apart (and had that feeling that if I waited any longer, there was no way I was going to be able to sit in a car!)

To deal with pain in the hospital, I mainly used breathing techniques I had learned, which helped a lot. I had a lot of back labor in the beginning, but I was one of the few women not using an epidural so I spent a good part of my early labor in a birthing tub (yay!). That helped with the back labor. (The doula was able to get the baby to shift, so later on that wasn't as much of an issue.)

We kept the lights dim which helped me with relaxation-I hate bright lights!

I brought a lot of music to listen to which helped cover up a lot of the hospital noise, and gave me something else to focus on.

The nurses generally left us alone except when we needed something. We had intermittent monitoring/checks, so occasionally they'd come in and do that, but otherwise were pretty hands off and just let us do our thing in peace. They had some good suggestions on positions/movements to try when progress started to become an issue, and one even suggested using acupressure when things were slowing down unexpectedly.

After the baby was out, he was put on my bare chest, and breastfed almost immediately. The rooms were set up so that they just do everything in there with you, so there's no taking the baby anywhere under normal circumstances (unless you need neonatal intensive care).

Staying with the baby after birth was not a problem. The baby roomed in 24/7 with me the entire stay, and nobody fussed about the fact I wanted him to sleep in the bed with me.


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## LaotianMama (Sep 5, 2012)

My first birth with my son happened in, where I feel is important too, a mom- and baby-friendly hospital and I made 9 great points on how to increase the chances of achieving a natural birth in a hospital:


*Have a midwife as your care provider*
*Hire a doula*
*Prepare a birth plan*
*Educate yourself!*
*Decline every and any intervention during pregnancy*
*Labor at home as long as possible*
*Labor in water, if possible*
*Don't be afraid to vocalize and visualize*
*Trust*

More on How to Have a Natural Hospital Birth


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## erigeron (Oct 29, 2010)

I think it's as wrong to blindly decline every intervention as to blindly get every intervention. If you have a care provider you trust, talk it over with them, pros and cons. Find out about what interventions might be done in the hospital and why. Then make your decision on a case-by-case basis, and be open to changing your mind if the situation changes and an intervention you previously declined is now more warranted. Interventions are not useless procedures made up by OBs to oppress women. Each one has its proper place. (I realize that is probably not exactly what you *meant*, LaotianMama, but it is what you *said*.)


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## mama2soren (Feb 12, 2009)

I am an L&D nurse, and I have worked for several hospitals, each with their own "culture." I planned a HBAC with my 2nd, but we transferred for non-emergent reasons to a hospital, where I did continue to have a natural birth, aside from an IV for hydration (I was severely dehydrated, unable to keep food or liquids down.)

Here are my suggestions:

-*Research the heck out of your OB or CNM and the hospital. *If you know any nurses on the L&D unit, talk to them. Ask what providers they like working with and why. Talk to other new mothers who value the same style of birth choices as you to see how there experiences were with their OB/CNM. Ask local doulas. At an interview, an OB/CNM can say whatever they want and seem completely open-minded. Yet, is this the way the actually practice?

-*Don't assume a CNM is more natural-friendly than an OB*. Is it often true? Yes. But not always. Where I used to live, the CNM's were very limited in their style by their supervising OB, who was old-school and awful (routine manual uterine exploration after every VBAC??). The hospital the popular CNM group practiced in had a nearly 40% C/S rate. For our shadow care, I saw an OB who was more midwife than most midwives I've met. He stepped aside to let my husband catch our baby. The cord wasn't clamped until long after it stopped pulsating. He stayed with me the whole time I was pushing (2 hours). He encouraged me to go home at 12 hour postpartum. He made sure my placenta was properly bagged and refrigerated so that I could take it home. Had we brought our own Aqua Doula tub into the hospital, I could have birthed there.

-*Have a doula.* Ideally, hire a doula who has worked with your OB/CNM team before with great success. Having a good rapport between doula and provider is a great benefit.

-*Remember that you can fire your nurse!* Your nurse can make or break your experience. Some love working with women who are well-prepared and well-educated about their births. Others like doing things the same way with each laboring mother, and get snippy if you don't want to go along with their plan. You do not have to accept that. Send your partner out to talk to the charge nurse to say something like, "it seems like my partner and Nurse X don't really have that great connection we were hoping for. It is really important to us to have a nurse who will help us work towards our goal for a natural birth. Are there nurses on staff this evening who you think might be a better fit?" Chances are, the nurse will be happier with a different assignment, too.

-*Have a well-rounded education about your birth options.* Yes, read Henci Goer. Ina May. All the MDC favorites. I love them too. Also read the more "mainstream" stuff. Not because you necessarily agree with it, but because it might help you understand the thought processes of your nurses, docs, etc, which will help you have thoughtful, not-defensive discussions about your choices. If you choose your OB/CNM well, discussions like these will be easy. However, if it comes across that you are very mistrustful, or have an us-versus-them attitude, you'll lose some allies.

Hope this helps.


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## Calladona (Feb 23, 2011)

I've had two natural hospital births...

With the first one, I waited at home as long as possible and went in fully dilated (I wouldn't totally recommend waiting THAT long). There wasn't much time for any interventions. I did agree to continuous monitoring and a heplock, as I was a VBAC and it didn't matter much because I wasn't moving from one spot anyway (since I was pushing). I did have a birth plan, but I saw it more as a "discussion piece" ahead of time than anything to present in labor (I'm sure that would've been different if I hadn't arrived so far along). I did make sure to emphasize before the birth that I wanted delayed clamping and to skip the eye goop (I still did Hep B and K with her for a number of reasons) and so forth. I had no issue with those requests. I did have to stop a nurse before she hooked me up to pit after the birth.

With the second one, I actually tried to go to the hospital as soon as I was sure I was in real labor (I had a lot of prodromal labor). Even doing that, I arrived 7 CM and was less than an hour from giving birth. Again, there was no time for intervention. Again, I allowed continuous monitoring (though got up pretty quickly to use the restroom and started feeling "pushy"). Again I allowed a heplock. I can't remember if I presented my birth plan - I think I did. I had no issue with most of my desires, though I did have to give in on the pushing position because baby's heartrate was dropping too much. Midwife was not keen on skipping pit post-birth, but allowed it (but I do think treated me rougher because of it - if I had any advice, it would be to discuss this stuff ahead of birth and try and find as supportive a provider as possible). As for post-birth procedures, the only ones I got trouble on were the vitamin K/eye goop because NY state law says they have to give them. I knew that ahead of time and didn't even ask for it...

Hoping to have at least as decent a birth this time around!


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## philomom (Sep 12, 2004)

Quote:


> Originally Posted by *LaotianMama*
> 
> My first birth with my son happened in, where I feel is important too, a mom- and baby-friendly hospital and I made 9 great points on how to increase the chances of achieving a natural birth in a hospital:
> 
> ...


Eh, I don't need a doula with my Bradley trained hubby. He was all the help I'll ever need. I don't need to pay a stranger to support the intimate birth of my family.

Labor in water is not necessary for everyone. I took a shower early on and then stayed dry. I have no issues with women who want to labor in water, but it's not for me.

The rest of the list is good!


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## bearandotter (Apr 18, 2012)

lots of great suggestions in this thread. One I didn't see:

Don't change into a gown, you CAN wear your own clothes (no matter what the nurses say). I think that wearing my own skirt and tank top during labor reinforced that I was myself, in charge, and not a sick hospital patient. I think the nurses and other staff saw my clothing and it reinforced/made them realize I was not a 'typical' laboring woman. I was able to be discrete and comfortable to walk the hallways and march up stairs to get things going. My MW could still do what needed to be done and I was more than willing to have things 'cut off' if needed in an emergency. I was naked before I delivered (just out of the bath), but through my long labor nothing got overly dirty. I plan to wear the same things this time around (birth 3).


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## Quinalla (May 23, 2005)

Oh and birth plans, I think writing one is a good idea just so you have it all straight in your head. I never gave mine to my OB or hospital, though I may this time with twins as I'm pretty sure everyone is going to be more worried/pushy. I more made it clear that they should ask for consent for everything before doing it (which they should do anyway except in true emergencies, but they don't always) and went over each "typical" intervention with my OB ahead of time too. And also yes, my attitude was I would just do things and expect them to accept them instead of putting myself in the position of asking permission. I wasn't rude about it, but instead of "Is it ok if I get up and go to the bathroom now?" I would say "I'm going to get up and go to the bathroom now." I think that attitude helps a lot of expecting them to respect you, it puts them on the defensive instead of you.


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## LaotianMama (Sep 5, 2012)

Quote:


> Originally Posted by *erigeron*
> 
> I think it's as wrong to blindly decline every intervention as to blindly get every intervention. If you have a care provider you trust, talk it over with them, pros and cons. Find out about what interventions might be done in the hospital and why. . .
> 
> (I realize that is probably not exactly what you *meant*, LaotianMama, but it is what you *said*.)


True, true. I'm coming from a low-risk pregnancy standpoint, of course.







Definitely confer with the provider about what possible scenarios of interventions on the hospital, which I did, but politely included I would like to decline if unnecessary, as in my birth plan.


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## LaotianMama (Sep 5, 2012)

Quote:


> Originally Posted by *philomom*
> 
> Eh, I don't need a doula with my Bradley trained hubby. He was all the help I'll ever need. I don't need to pay a stranger to support the intimate birth of my family.
> 
> ...


Thank you! Glad you liked it. I hired a doula purely because my husband would be a difficult birth support partner! Haha. I love my husband but I really think that it was more of a hassle for him (and in turn, for me) to expect him to do something so completely out of his element. We discussed it beforehand that it would be really difficult for him to see me in pain and that I deserve any and all support I can get, but he can't be the only one to have that burden. If we fidnt have a doula, I think we would have made extra efforts to make him ready though. Again, I feel that birth support comes in many forms and it should be fitting for that type of wanted labor and birth experience-- I wanted to be able to have the knowledge that doulas are trained in because, hell, I'd never done this stuff and there's just so much reading and researching I can do, whereas doula training is a plethora of I-never-thought-of-thats! Plus, there are plenty of doulas-in-training (free of charge to low-cost) that could greatly benefit from attending a birth so that's a win-win!


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## myra1 (Jan 20, 2013)

Quote:


> Originally Posted by *LaotianMama*
> 
> True, true. I'm coming from a low-risk pregnancy standpoint, of course.
> 
> ...


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## myra1 (Jan 20, 2013)

Of course some interventions in pregnancy can be needed, but I have found that for a healthy pregnancy, it *WAS* best for me to decline all interventions. When I asked the midwife for pros and cons, the response was along the lines of "well, more information is always a good thing...." however, the info we got from testing was sometimes wrong or did not take my individual situation into account. However, bc it was a hospital based ob/cnm practice, having the test results in my chart put me in a box.

For example, the ultrasound contradicted dates we knew were right and indicated a large baby, leading to induction and more testing pressure. Cervical checks in late pregnancy are sometimes unrelated to how imminent labor actually is. Instead of doimg the GTT, I tested my blood sugar daily afer meals for a period because I am a gestational diabetic when fed the sugar solution, but this is not reflective of how I really eat during pregnancy. Since I am able to control my sugar thru eating well, a diagnosis of GD would have caused countless unecessary interventions. Even with measuing the fundal height...at one visit, the ob opened the chart to my previous visit by mistake, and magically I measured to the date 4 weeks ago that she thought I was lol. When I inquired, she updated the chart and then I suddenly measured to the correct date!

Testing has its place when a crucial decision has to be made, but the results can be so impersonal and skewed that I really believe it should be limited since providers rarely are capable of taking them with a grain of salt.


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## erigeron (Oct 29, 2010)

You weren't blindly declining testing, though. You made your decision about each test based on the individual test and your situation and what is important to you. Which is pretty much what I'm talking about. There's a big difference between "I don't want any test or intervention at all ever because INTERVENTIONS R EBIL" vs "I understand the case for this procedure but do not feel it is right for me because of ABC. I would prefer if we did XYZ."


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## erigeron (Oct 29, 2010)

In my case, I declined all early ultrasounds because I was sure of my dates, and declined the quad screen because I wasn't too fussed about the 1/1000 chance of down syndrome, but I did get the 20 week ultrasound. While I declined the GD test in favor of a random blood glucose and A1c, I now think that wasn't the best course of action and next pregnancy will probably test my sugars for a few days (I don't like the idea of drinking glucola or eating something and then not being able to eat for an hour, pretty much solely because I was hungry so much in pregnancy). I didn't do any cervical checks late in pregnancy because they're pretty pointless. I did the saline lock and intermittent monitoring in the hospital. But if the situation had changed I was open to the idea that the need for testing/intervention might change. At 28 weeks I had a lot of abdominal pain and went to the hospital to rule out complications, and there was a lot of testing and monitoring that I was okay with because of the circumstance. My overall point being--evaluate each test/procedure/intervention on its merits.


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## LaotianMama (Sep 5, 2012)

IMHO, I don't count testing as interventions. Testing can lead to a cause or need for intervention though. When I mentioned intervention in my post, I simply mentioned how I declined to have my membranes sweeped at just 40 weeks, which was offered just because I was FORTY WEEKS. Things like that-- induction before "full term," multiple ultrasounds for no medical reason, etc. I had a hep lock at my birth, after discussing it with the nurse and my doula and it was okayed by me. I also got 4 ultrasounds, did glucose testing, got repeated cervical checks at my first pregnancy. My second pregnancy was a complete opposite story though (you live and learn, I guess)! :-D Still, I didn't "blindly" decline them, and that was my situation. Every pregnancy is so different.

Testing has its place, of course, and even an uneventful otherwise healthy pregnancy requires peace of mind or to treat it under care of professional advice.


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## mum4vr (Jan 31, 2007)

Mamas, I hope this thread isn't getting to be a less-friendly place to share our ideas-- it is a thread *requesting* our ideas... any and all of them.

Our ideas can differ-- that's ok-- let's get all the ideas listed that we can-- who knows which idea will help another mama?!

If one mama says her idea of a natural hospital birth incudes declining *all* interventions, she shouldn't have to qualify that or justify it, even if she -did- decline all of them blindly (turns out she didn't). By definition, fewer interventions would be more "natural," although not necessarily the best choice for everyone, nor even the safest choice for every birth.

Let's show some love here, please


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## LaotianMama (Sep 5, 2012)

Quote:


> Originally Posted by *mum4vr*
> 
> Our ideas can differ-- that's ok-- let's get all the ideas listed that we can-- who knows which idea will help another mama?!


I agree with this so much. My list is what helped *me* achieve what the thread is about and all I can do is share that for other mamas seeking guidance and a starting point or even what not to do!


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## erigeron (Oct 29, 2010)

Quote:


> Originally Posted by *mum4vr*
> 
> Mamas, I hope this thread isn't getting to be a less-friendly place to share our ideas-- it is a thread *requesting* our ideas... any and all of them.
> 
> ...


Well, I definitely feel like this thread is a less friendly place for me now, since I'm the only person you could have realistically been talking to with this post, and you just basically told me I shouldn't say what I think if I disagree with another poster. I thought this thread was about achieving a natural hospital birth. In my opinion, it's important to be informed and thoughtful. rather than reactionary, about testing and interventions to achieve that. *shrug* I'm also really confused as to what I said that prompted you to say 'let's show some love'--where was I unkind? I don't see it. If you have a problem with something I said, I'd appreciate you coming out and saying so. If you just have a problem with the fact that I disagreed with someone, well, I don't know what to tell you.


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## myra1 (Jan 20, 2013)

I enjoy reading the differing opinions, experiences and decisions since it makes me think about options and alternatives!
Of course we are all free to make our own choices. I don't find anyone else expressing theirs to be offensive! I hope my sharing my choices is helpful and no one feels it is a judgement on theirs! Hope we continue to share freely because it is tough to get this kind of a cross section of options from a single care provider.


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## LaotianMama (Sep 5, 2012)

Quote:


> Originally Posted by *erigeron*
> 
> I thought this thread was about achieving a natural hospital birth. In my opinion, it's important to be informed and thoughtful. rather than reactionary, about testing and interventions to achieve that.


Your thoughts are right. This thread is about ideas/experience on a natural hospital birth; we all provided our input so that's all that matters. I'm not here for anything else.


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## LaotianMama (Sep 5, 2012)

Quote:


> Originally Posted by *myra1*
> 
> Hope we continue to share freely because it is tough to get this kind of a cross section of options from a single care provider.


I wonder what other ideas I seemed to have overlooked since I shared what worked for me so, yes I'm hoping more share their thoughts.


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## mum4vr (Jan 31, 2007)

Just to clarify, I wasn't intending to call anyone out in particular-- just to share my hope that we are all friendly, loving, and supportive of each other sharing ideas on so personal and precious a subject.

I hope no one would feel that their ideas or birth experience are considered wrong by others after being asked to share, publicly. I do enjoy the many differing opinions on what contributes to a natural hospital birth. That's all; nothing more intended.

Thanks much!


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## Oread (Aug 12, 2012)

I tried to have an unmedicated hospital birth, and did end up with an (unwanted) epidural. My number 1 suggestion for other women would be to have a doula. Also, my care providers had told me that they were supportive of unmedicated births and I made the mistake of believing them. Maybe they support it theoretically, but hospital policy sure is not conducive to natural childbirth. It should have been a red flag for me that my care providers (CNMs) really hedged around the question when I asked them about it at my prenatal appointments, with a patronizing "oh that's a nice idea, I guess we'll see" attitude.

So having a trained and experienced advocate who is with you all the time and knows all sorts of comfort and pain relief techniques - a doula, would absolutely be the most helpful thing. Also being prepared to be assertive with the care providers might be helpful. I felt very pressured and bullied by them to be a "good patient", even though they were very nice to me, and I should have just told everyone to screw off and leave me alone (or better yet, just ignored them) instead of trying to argue with them while in labor. Dealing with them all the time and trying to avoid constant monitoring that would leave me confined to bed really ruined my focus, and ultimately I got freaked out and just took the painkillers at 7cm. I am a little bit disappointed in myself, but at the same time it was not a supportive or comforting environment, and I was not prepared for that.


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## EchoSoul (Jan 24, 2011)

Agree whole-heartedly with the above. It sounds exactly like my experience. I think having a doula is crucial. I only have one child, and he was born, as naturally as I could manage(I did wind up getting a Tylenol for "pain relief" during transition because the staff were stressing me out to the point I lost my focus), in a hospital. I was told a doula would be useful.. but I had hoped my fiance would be enough. But the L&D staff pushed and shoved him around until he was clueless. So yeah, agreed with above, have a doula, who is aware, and ready to defend how you want to do things. Trying to defend my methods myself during labor was exhausting, and stressful. Hearing my fiance argue quietly with the L&D staff was exhausting, and stressful.


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## cynthia mosher (Aug 20, 1999)

Just popping in to make sure you all saw our Mothers Day Contest. In addition to three Boba baby carriers we're giving a $300 dinner/spa package for one lucky mom. Contest ends in three days! Get the entry info here: http://www.mothering.com/community/t/1382508/let-mothering-and-boba-pamper-you-this-mothers-day/0_100


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## cynthiamoon (Nov 29, 2009)

Very interesting insights! I will be looking into these suggestions.


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## JenVose (Jun 17, 2013)

So glad that I found this thread, it has been very encouraging to hear perspectives of a number of women who have gotten what they wanted from birth in a hospital, and helpful to hear from those who had issues with their hospital birth.

My first was born in a free-standing birthing center, but as she was will be just under 2 when I am due, and the birthing center was almost two hours away, this seemed like a major set-back in this pregnancy. This time, I am planning on a birth at our local hospital with CNMs (first was with a CPM).

So far, I have confidence that I will be able to achieve most of my goals for a natural birth even in the hospital setting. And from what I've seen from previous posters in the thread and from my own experiences, I just wanted to add that I feel that the No. 1 priority in getting the hospital birth that you want is to be sure to choose the right provider.

The only midwives in our town operate out of a university-based clinic that also handles the WIC program in our area. They accept some insurance plans and state benefits (which our family qualifies for with this pregnancy as well as out-of-pocket patients, but the vast majority of their patients are there because they qualify for state benefits and because this is the same office as WIC they are familiar with this clinic - also, I've heard very mixed reviews on the OB/GYN who practices at the other "clinic" setting in town, although there are also some individual OB/GYNs who also accept state benefits). There are four midwives that practice in this clinic, and I have now met two of them. They both seem to be ecstatic to actually be working with a mother who chose the clinic to use a midwife and try for a natural birth, as it seems to be much more common that mothers come because they are familiar with the clinic then are confused and upset when their primary care comes from a midwife unless they risk out because they are simply not familiar with midwives or just wanted that "let's get that baby out of there as soon as possible and at a convenient time" type care.

Both have been very supportive so far of my desire to birth naturally, and one of the midwives I have seen actually started in a free-standing birthing center but chose to now be a hospital midwife because it gives her more opportunity to be sure that women have the birth they want. As she mentioned, women who are able to go through with a home birth or birth in a birthing center usually get the birth they want with low interventions, but if their circumstances require a transfer to the hospital, they often find themselves blindsided because they are completely unprepared; whereas in the hospital she can help mothers with a higher level of risk because immediate care is available without a transfer. I absolutely LOVED that she seemed to know exactly where I was coming from.

This particular midwife encouraged me to begin developing a detailed birth plan (I did not have one with my first birth because I didn't know how things would go, what I would or wouldn't want, and knew that in the birthing center interventions wouldn't be pushed on me) and said that she and the other midwives will work with me on my birth plan to be sure that we all understand what my desires for labor, delivery and postpartum are. She encouraged me to make an early visit to our hospital, and she said not to schedule a regular L&D tour, but told me that they always have someone available, even on weekends. She said I should call a few minutes before we want to go and make certain that they aren't especially busy or dealing with a high-risk delivery, so that they will have plenty of time to explain all their practices in detail so I can have a clear idea of the hospital's procedures. She made sure to emphasize to me to be sure to ask any questions I might have of them and try to get a feel for how I will feel about working with them, as well, since they will be the first people that I have to deal with when I come in for labor and delivery, until one of the midwife team is able to get to the hospital. And she also encouraged laboring at home for as long as possible, saying if it was possible for me to time it so that I got to the hospital around 30 minutes to an hour before delivery, that would be great. She seemed to think that based on the fact that I only labored at the birthing center for about 5 hours with my first pregnancy, and had a two hour drive to get there, that we had done an excellent job of timing, and that I should have a better idea this time around of how my labor was progressing, and since I had a 24 hour labor with my last, it shouldn't be too quick to adequately judge.

She made it quite clear that there are many practices which are in place at the hospital which are "routine" and that if a mother hasn't made it clear in a birthing plan that she does not wish to have things done in that manner, they may simply be done out of habit using the basic "blanket" consent forms that the hospital has for providing care. While I do somewhat worry about whether or not I will miss something in my birth plan that I really hadn't intended to happen, I was very grateful to her for being forthcoming and basically telling me to be very aware of this beforehand so that I can continue to ask questions of her and the hospital to make sure that I don't get caught by an unexpected "routine" that I didn't wish to have happen. But it is comforting to know that at least the midwives seem so very respectful of a birth plan, she said it will help them to better know what I want and be able to advocate for it, and to have it in writing will help them by making certain that the nurses will know what my wishes are until the midwives are able to arrive.

She also advocated a "give and get" attitude on some things (which I have been approaching this pregnancy with, anyway). If there are procedures that I might not wish, ideally, but wouldn't be adamantly opposed to, she said I may wish to exclude them from the birth plan and try to gently turn them down or be willing to accept them in order to maintain a firm stance on the issues that are more important to me and that I'm not willing to compromise on. In my example, I was GBS positive but chose not to have IV antibiotics for my birthing center birth. Although I still have mixed feelings about the IV antibiotics for a hospital birth (I do feel like hospital birth could be more risky and might call for the antibiotics if I am GBS positive this pregnancy), she said I might wish to accept them this pregnancy while I declined other measures which I am adamantly against (like Pitocin to induce labor). Or more especially, being willing to have a saline lock put in place even if I do not require an IV at the time (which I am completely willing to do, as I already felt that this would help to "sweeten up" the hospital staff by cooperating on some issues, and also being understanding that if an emergency situation were to arise, this would make things so much easier for them and for me!).

That's my advice, so far. I'll be checking in and hope to see more stories, and if I have anything else to add (sorry for the long-windedness when I haven't even BTDT yet!), and will be sure to update after the actual birth.


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## cyclamen (Jul 10, 2005)

So much great advice in this thread. I am planning our second/third hospital birth. (Second birth was planned to be in hospital but ended up at home.) One thing a doula in my DDC brought up is if you have a good relationships with your midwives/OB and know your hospital policies well, sometimes it's a good idea to get to the hospital earlier than later. Traveling in late labor can be hard. It can be nice to have time to nest and get comfortable instead of taking a car ride during transition. I'd have to agree with this wholeheartedly.


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## MommyFirst (Aug 25, 2011)

Love the great advice!

I had an absolutely wonderful natural childbirth experience in a hospital, (a tertiary, academic center no less!), so I know that it is possible. That said, here's my $0.02 on it:

1. The most important decision you will make is your care provider. I think CNMs are wonderful, and if they are an option at your institution and you meet their risk criteria, I say go with the nurse midwives! If you choose or need an OB, it is SO important to try to find one that will not only provide your prenatal care, but will also be the one to deliver you. Ask about their call coverage, and what percentage of their own patients they deliver--so many moms find themselves unhappy with the cross-cover doc, (who often doesn't know them, their preferences, etc.). Remember, your midwife or doc is both the one who calls the shots about interventions, timeline, and escalating care, and is also your go-to person if you are having any frustrations or concerns about nursing, hospital policies, etc. When they have your back, it really doesn't matter if the cranky charge nurse wants an IV placed...

2. Be a little careful about birthplans. In my experience, some nurses find patients with very specific, black and white expectations to be somewhat of a target for disagreement. (And maybe it's just coincidence, but it sure seems like the longer the birth plan, the more likely you are to end up things you don't want!) What I have seen work nicely for families is a simple statement in your chart that indicates your desire for a natural birth, and that you request that any interventions be discussed prior to initiation. Then, it's up to you and your partner to ensure that YOU know what you want, that you are on the same page, and that there will always be someone present, (doula, family member, etc.), who can express your wishes.

The one caveat to this, though (in my opinion), is to be very clear with the nursery about your preferences for your baby. If it's not spelled out, trust me--your infant will get the standard "newborn protocol," (immediate bath, erythromycin ointment to the eyes, Hep B, and Vitamin K). Depending on the institution, you may also have to be very clear about your feeding preferences and use of artificial nipples. Also, if possible, try to make sure that a family member is present with your baby at all times. (True story: even though I'm a pediatrician at the hospital where I delivered, and we had all of our wishes clearly spelled out, had my husband not accompanied my baby to the nursery for the initial assessment, she would have ended up getting the works. (We only wanted Vitamin K and the basic labs.)

3. And, no offense to doctors in training, (I was there once and it's difficult), if you are delivering at a teaching institution, find out if your care will be managed by resident physicians. Here's why: with inexperience comes fear. Fear naturally leads to escalation of care. A resident might become alarmed very early about something that a more experienced and seasoned doc might say is ok to just watch for a little while. I remember as a resident being much more aggressive with interventions and treatment, in large part because you are worried that if you don't do something, bad things will happen. With time, you learn that sometimes observation and the "tincture of time" is really the best course of action. So, if you are at an academic center: 1. Check out the midwife service if they have one. (Usually, residents do not participate in the care of patients being followed by CNMs.) 2. Request that your care be managed by an attending physician. If that's not possible and issues arise with one of the residents, it is NEVER inappropriate to ask them if they have discussed your progress and care with their attending or to simply request to speak to the supervising doc yourself.


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## drouege (Feb 19, 2013)

I had a natural hospital birth and it was everything we expected. The hospital room was in the birthing center part of the hospital. So we had a birthing tub in our very spacious room. We went in with a very clear birth plan. No one was to be there but myself dad and the midwife. It was important that the hospital knew that I planned on breastfeeding (esp since i got dehydrated after birth nd couldnt breast feed right away) so he wasnt givin formula or sugar water. Once I was better nd hydrated Our little one stayed in the room with us also. But back to the birth we were able to decorate the room which made it more calming nd less hospital like. The nurses were extremly helpful and so were the lactation specialist. The nusery ppl were a little pushy, trying to give him vitumen K shots nd bringing him to the nursery but we stood firm with our birth plan. Over all it was quit pleasent. Our midwives are currently building a birthing center so our nxt birth will b there.


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## mum4vr (Jan 31, 2007)

ITA with those who've said have a birth plan, but keep it minimal, short, and simple.

Make nice with your L&D nurse-- she is your new best friend! Really-- I can't tell you how much more difficult things would have been for us if it weren't for my wonderful nurses! (If she -isn't- wonderful for you, then ask the charge nurse to swap her out for someone else-- make the excuse that you know you're moody during pain & it's not the nurse's fault, or w/e).

It's important to know whether your doc/ midwife actually SUPPORTS your plans, or just TOLERATES you as a nuisance to be dealt with later (bc later means *during labor*!)

If you have -any- suspicions that hospital staff will be pushy about your birth plan, or any aspect thereof, DON'T go to the hospital until you're ready to push!

Even after having natural hospital births in the past, we ended up being bullied, degraded, and had many unnecessary interventions this time around. It all started bc we got to the hospital WAY too soon (I naively thought they'd check to see if my water had broken, then let me go home-- nope, my water broke, so they admitted me immediately!) My doctor had -said- he agreed with my birth plan, but later admitted he hadn't fully read it, and did not agree w any mom who wished to refuse pitocin! etc. I felt we were punished for standing our ground-- pick your battles while there, or better yet, choose them ahead of time.

Most importantly, love yourself and your family enough to forgive yourself if you later feel guilty about how things happened-- sometimes there is no planning for or accounting for how things go during L&D.


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## babymommy2 (May 14, 2009)

I had 3 hospital birth, 2 natural (natural as in vaginal birth with no pain medication). The biggest difference with the natural births was not being induced. Also had midwife for the 2 natural births and hired a doula for one of them. This particular hospital had tubs, which helped a lot. Those are the three things that made the difference for me, no induction, having the extra labor support of a midwife or doula and the tub. And also want to add, they were straight forward normal births. Not all births are, and while yes there are some interventions which increase the risk of pain medication, there are also times when things go wrong and pain medication is necessary. I know someone who had 4 completely natural births, and fully expected to have the same with the 5th, but everything went wrong, due to an abnormally short cord and mal presentation, not because of mismanaged labor. I think it is healthy to always have the mindset that it is okay to have a back up plan and it doesn't mean you should feel bad or guilty about it not working the way you hoped.


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## EllieDell (Mar 20, 2014)

This has all been very good to read! I'm "due" in a few days, and while my OB isn't at all interested in helping me have a natural birth, I've heard that the nurses where I may be going (if I decide not to have a UC) are very flexible and accommodating.

I've printed a few copies of my "birth preferences" sheet for the hospital bag; it's large-print and right at a full page, and has short single-sentence requests like "I want to hold baby immediately when he's born", and "I don't want vaginal exams or electronic monitoring". It's divided into sections too - during labor, during/after the birth itself, in case of a C-section, and newborn procedures. Now though, I may just use a simple statement like "I really want an all-natural labor and birth! Please advise us of any procedures before doing them!" and keep the longer plan as a backup, in case they need specifics and to keep my husband on track regarding what I want.

It's sad to see that once women go into that mental "labor land" state they're often overrun by pushy nurses or midwives who totally ignore any prior wishes. I don't think my husband will have problems telling them 'no' - he was a jail guard for years and confrontation was just part of the gig - and if my mom can make it, she'll be good for that too. She's not very big physically, but I've always thought she'd make a great bouncer. =)


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## crystalnjohn (Apr 14, 2014)

Quote:


> Originally Posted by *Lizzysgot5*
> 
> Yes, yes, and yes.
> 
> ...


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## crystalnjohn (Apr 14, 2014)

I am expecting for the first time. Any books you recommend i buy to have a natural birth.????


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## simonsez2u (May 30, 2010)

I had a natural hospital birth with my daughter. It was my first VBAC so I wanted to be in a hospital. I believe having a supportive OBGYN and hospital staff helped tremendously along with a wonderful doula. The entire labor from start to finish was about four hours. It happened so fast. I admit that by the time I got to 8cm dilated I broke down and asked for an epidural. However, with encouragement from my doula and the hospital staff (including my doctor) I was able to deliver without any intervention. It was great and I felt like I had a team of cheer leaders. For me the support was very important.


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