Before you read this informative post by Katie, a labor and delivery nurse, I need you to understand two things:
- I’ve had three natural, beautiful births in one hospital (well, a birth care center – filled with doctors and nurses – attached to and run by a large hospital) and plan to birth our next baby in another hospital. I can’t speak personally about negative hospital birthing experiences because I haven’t had any!
- All of my births have been attended by compassionate, helpful nurses. I’ve never had a midwife or a doula, and we’ve done just fine. After reading this post, I’m feeling very blessed and wondering if we’re in the minority?!
I’m a labor and delivery nurse.
If you’ve never had a baby, you probably haven’t given me much thought. If you’ve ever given birth in a hospital, though, you’ve probably spent far, far longer with me or my coworkers than you did with your carefully chosen OB or midwife—maybe in the whole nine months. For your sake, I hope I’m wrong—but if I’m not, read on for some of my tips on maximizing your chances at a healthy birth.
Since Amy already spelled out the risks that come with intervention, I’m not going to reiterate. Suffice it to say that as a nurse, an almost-midwife, a mother, and a person of faith, I believe that the process of birth generally works in the way it was created to. Yes, there are exceptions. Yes, we can give birth painlessly in this day and age, much in the way that we can coax the farmers’ fields to yield hundreds of times the crops that they naturally would, by using pesticides and fertilizers. However, it’s becoming apparent that none of these “advances” come without a price—and I believe this is because humans were meant to work hard, both to both to bring forth life and to sustain it.
But what about those who say “the only thing that matters at the end of the day is a healthy mom and baby”? I’ll agree that those things matter most—but they’re by no means the only things that matter. I’ve seen moms so demoralized by how they were treated in labor that they struggled to bond with their babies. So traumatized by the processes used to “get them a healthy baby” that they chose not to have any more children. Hearing the above statement forces them to bury their pain underground and makes them feel guilty, shamed, and alone.
The good news is, practices that support natural birth are those most likely to result in a healthy mom and healthy baby. Letting labor begin on its own; an unmedicated mother; immediate skin-to-skin contact; vaginal birth; and breastfeeding. Does that mean if one of these factors is missing, that a healthy mom and baby (and bond) can’t be achieved? Absolutely not—but it does represent a challenge.
Here are my top five tips for achieving a healthy, safe, and natural birth:
- Give birth out of the hospital. If you do give birth in a hospital, please investigate their policies (nothing but ice chips? No VBACs? Separation of mom and baby?) and Cesarean rates first.
- Use a midwife. You’re less likely to have a Cesarean, an episiotomy, an early pregnancy loss (!) need pain medication, or have a forceps or vacuum-assisted birth.
- Hire a doula. Your labor is likely to be shorter, less painful, and less likely to end in Cesarean, and your likelihood of succeeding at breastfeeding is higher. Furthermore, having someone to advocate for you means you can focus your energy on giving birth—not worrying that you’ll be abrupt and hurt somebody’s feelings.
- Take a Bradley, Lamaze, or Hypnobirthing class. While I fully believe that women’s bodies are created to know how to birth, our instincts are suppressed in this society, and there is also much surrounding birth (especially in the hospital) that is not instinctual. Navigating hospital routines and common pressures successfully requires education about how to surmount obstacles that have nothing to do with actually birthing a baby.
- If you’re in the hospital, request a nurse who supports natural birth as soon as you check into L&D. Some of us will fight over the chance to do labor support—back rubs, reflexology, frequent position changes, and being your advocate—and then there are those whose comfort zone is to get their patients epiduralized ASAP. There’s no promising that a doula-in-disguise will be on duty when you check in, but it only makes sense to ask.
There’s more than I can possibly say here that you should know about the underpinnings of maternity care in the United States, and the forces at work that can shape your birth for better or for worse. Instead, I’ll direct you to my top five resources for educating yourself about birth:
- Nursing Birth. This is a blog written by, yup, another L&D nurse who feels the same way I do about using her position to help educate the public so that you can have your own “best birth.” Her tone is light but informational, and her “Injustice in maternity care” series is a can’t-miss.
- The Thinking Woman’s Guide to a Better Birth. This is a classic that helps you understand the risks and benefits of various birth settings and interventions.
- Lamaze International’s Care Practices for Normal Birth. These provide succinct and very evidence-based rationale for best practices in birth.
- Pushed
by Jennifer Block. More recent than #2, this is a staggering compendium of the latest research, quotations from experts, recent newspaper headlines and court cases. If I could recommend JUST ONE resource to give a comprehensive picture of what birthing women and their families should know about today, this would be it.
- Childbirth Connection. Packed with evidence about the healthiest practices for pregnancy and birth.
Here’s hoping each one of you is able to give birth peacefully, in health and faith!
Katie is a labor and delivery nurse who will finish her studies in midwifery at the end of this year. She has been married for four wonderful years, and has an energetic one-year-old daughter who was born at home last summer. She and her husband are currently working toward their dream of operating a homebirth midwifery practice and growing their own food on a small-scale organic farm, and they strive to live their lives in a way that honors the nature of God, humans, and creation.
Great post, Katie! Good luck to you as you start catching babies all on your own!
What wonderful informative information! Thanks Katie!
Dear Katie,
}
Will you come to Louisville, Ky? So I can check into my hospital, and NOT have a nurse in L&D triage say, “Oh, you have twins? Are you here for a C-Section?” ARGH! I completely agree with everything in your post — which is why I show up at the hospital crowning {after a false start, in which I get sent home, of course
Amy …
As far as my experiences have been, I think you may be in the minority. Of course, it may also depend on what kind of support system you have — meaning, in this area, we have a ‘natural birth group’ — a strong VBAC awareness group, as well as doulas, midwives, homebirth advocates, and the like. However, there is only one hospital in the metro area that ‘allows’ women to labor the way they want.
For myself, I’ve had 4 births — the first one, 15 years ago, I totally signed up for the induction of labor, epidural, etc. My second daughter (now 4), I had a drug free birth by accident — I went to the hospital with contractions, which were not fruitful. I was sent home, told to return when I couldn’t talk through the contractions. As a result, I came back about 20 hours later, crowning. Had Rachel with the L& nurses, no doctor. LOVED it!
When I was PG with my twins, I had to FIGHT tooth and nail for the birth that I wanted. I was strongly encouraged the day we found out (not my reg OB)about the twins (14 weeks) to schedule a C Section. My OB was comfortable with a breech extraction of Baby B (he refused to turn!), but strongly encouraged an epidural, “just in case”. Came in with contractions, just like with Rachel … close and regular, but no dilation. Wanted to go home, but ended up with another u/s, monitoring overnight, and multiple requests by the staff for induction. Went home the next morning, came back 2 days later crowning. Told the anesthesiologist, “Thanks, but I won’t be needing you today.” Boys were born healthy, no NICU time, and went home with me in 3 days.
Homebirth is not for me, but I encourage and support my mother friends who choose that route. I just want to labor the way that I want, in a supportive hospital. I want to be able to EAT, DRINK, walk, squat, be on all fours, shower, etc …. without feeling like I’m on a timer, or being hooked to multiple machines.
Sorry I got off on my soapbox, but this is a topic that gets my dander up. Katie did a fantastic job, and I thank you for having her here!
@Dianna, I’m thrilled that you got on your soapbox.
I’ve heard very few “natural birth” stories with twins. So glad you had a happy one!
Great resources!!! And it’s so wonderful to know that there are L&D nurses who care to help a momma through natural childbirth! Unfortunately I didn’t have that (out of the 8 or so that were assigned to me throughout my labor) with my first. The only answer I got when asked how to help labor along, or how to position to deal with contractions was “when do you want your epi?”. I felt like I missed out on so much of the early bonding because I finally got one.
Things were MUCH different w/ my 2nd and I couldn’t be happier with our natural birth.
I think I’ve done all of those things wrong, every time! I wouldn’t say my experiences have been great. The most challenging aspect has been the l and d nurses. In my 4 births, I’ve had one l and d nurse who encouraged me to do something the “natural” way. All the others tried to persuade me to take pain pills, stool softeners, or other meds or to have an epidural. The hardest part is that they influence my husband and then he starts thinking we’re going about this the wrong way. But… I’m not easily swayed and do not have a problem just saying no. And the hospital where we’ve given birth the last few times has changed its policy on separating baby and mom and pretty much allow rooming in now. I’ve never had a doula, but I do have my mom there with me and my husband. I’ve been induced at 38 weeks every time and am hoping to not be induced this time, but fear having a c-section due to large baby even more. I just keep reminding myself while I’m in labor that God’s grace is sufficient for me- and it is. If it’s sufficient to get me through labor then I can survive the iv pole, the blood pressure cuff, and the pressure to take meds. But I would like a different birth story. I would love to give birth at home, but am afraid to risk it. I would love to give birth in a birthing center where I could get into a tub, but we don’t have one where I live. I would love to give birth without an iv pole or blood pressure cuff or fetal monitor, but am willing to put up with these inconveniences for a few hours. I would love to have a better labor and delivery experience, but am content to survive it with a healthy baby.
Celee
@Celee, I salute you for suffering through what you have in order to labor and birth these babies! Just want to be sure you caught the stats above (buried in the links), which reflect that for most women, homebirth is not “risking it” at all, but in fact represents a LOWER risk of complications than birthing in a hospital. I will also tell you confidently that your odds of having a C/S due to potential size of your fifth (?) baby if you are not induced is INCREDIBLY unlikely. Additionally, one of the differences between induced and spontaneous labor is that in the latter, the hormones of labor soften and mold the pelvis in a way that may not occur when “only” contractions (versus the entire “hormonal cascade of labor,” as initiated by the baby) are stimulated. Just some food for thought, and best of luck to you as you do what you need to do in order to navigate the challenges presented to you!
Fantastic piece! Wish we could clone you. You’re going to make a great CNM. Much good luck. We need you in those dirty trenches!
The L & D nurse I had during transition with my first baby was amazing. She was responsible for me and a lady across the hall. Well, I don’t know the whole story, but apparently the woman across the hall was convinced she was in labor, but the doctor and nurses said she was not. She was screaming and carrying on and cursing, etc. Our nurse was constantly getting called in there by her. Finally, she (the nurse) told her supervisor that she had a mother in transition who was laboring naturally but whose breathing was not going well- my O2 levels were dropping as my contractions built one on top of the other. She insisted she needed to be able to work one-on-one with me to get me through since I had made it so far. The supervisor assigned someone else to deal with Ms. Swears-a-Lot and my L & D nurse helped coach me through some intensive breathing. She was a huge part of why my natural birth was a success! She actually went off shift right as I started pushing, but she hung around to see the baby (and find out the gender!).
@JessieLeigh, How awesome that she took such good care of you! Perhaps Ms. Swears-a-Lot should have visited your room for a few minutes…
Great tips. I highly recommend “Pushed” and “The Thinking Woman’s Guide.” Both are amazing resources.
One thing I never considered was asking for a nurse with a specific preference. I just assumed you were stuck with whoever was assigned to you. What a great tip.
I will have to link to this article on my site http://www.Unexpectant.com that explores the realities in journey to modern motherhood.
this is a pretty awesome post! love this part especially: …”I believe that the process of birth generally works in the way it was created to. Yes, there are exceptions. Yes, we can give birth painlessly in this day and age, much in the way that we can coax the farmers’ fields to yield hundreds of times the crops that they naturally would, by using pesticides and fertilizers. However, it’s becoming apparent that none of these “advances” come without a price—and I believe this is because humans were meant to work hard, both to both to bring forth life and to sustain it.”
Wonderful article!
I’d like to share my website as another resource for women interested in learning about their post-cesarean birth options.
Here are some quick statistics about VBAC vs. repeat cesarean:
http://vbacfacts.com/quick-facts-vbac-vs-repeat-cesarean/
@Jen Kamel, VBAC Facts, Thanks for the link! I personally hope to never “need” the information, but I know many who do.
I had my two babies by c/s one was emergency c/s by OB in a small town with no real knowledge given to birthing modeles,therefore I was very naive about what to expect and frightned about the whole process. I did not bond with my baby for a long time after the birth nor was it a pleasent experience. My second baby was born by c/s because the OB said it was a given because I had already had one therefore I could not have a natural birth, knowing now what I do this could of been avoided on both counts. I am very dissappointed in the medical profession and irresposiablility to my me as a birthing mother. Only wish I had this information when I was having my two children.
@Gabby Webster, So sorry that you had two rotten experiences. It’s my hope that this series will prevent other women from having to endure the same.
Thank you for this series. I’m really enjoying it. I’m not sure I’m ready to come over to your side, however. I’ve had two births at a hospital with a midwife. Both were all natural, drug free. I was well prepared and handled the pain well. Now that I’m expecting #3, I just don’t think I can do it again! I’m thinking of trying the epidural route. We’ll see through. I’ll keep reading.
@Kelly A, You can do it, you can do it!
I feel like for we also must be in the minority with our hospital birth. We chose a local hospital recommended by our OB to give birth. We took the courses offered by a doula/nurse at the hospital without giving it much thought. The experience was great. We were not pressured to use medication or anesthesia. We were encouraged to use whatever positions seemed natural. The methods we were tought in birthing class were not exclusively the Bradley method, but were oriented from a husband coach perspective and included lots of relaxation, meditation, breathing, use of walking, birthing balls, etc to encourage the birthing process. We were also taught about exercise to do before to prepare for the birth. Our nurses were very supportive during the birthing process- perhaps we just happened to get lucky- but it was truely a great experience. They helped with comfort, and provided my husband with the information he needed to be a great coach. We went into labor on our own, five days after our due date. I was in labor for about 8 hours, and out our little boy came!
These are great tips, but I wonder…what do you recommend for a woman who may not have these options? I live in rural Mississippi. There are NO midwives to be found within 100+ miles. There are no birthing centers or doulas in the phone book here. I tried to find someone to do a home birth and they just don’t exist here.
I’m pregnant with our 6th child. I’ve always thought a birthing center would be AWESOME, but it’s simply not an option for me. In fact, if I don’t agree to be induced, I’m not even guaranteed to have my OB deliver my baby. I could end up with one of three other doctors (2 of which would be a nightmare for me).
My doctor is an awesome Christian man with 8 children of his own. He’s very compassionate and wonderful but he shares a clinic with some other doctors who I just plain do not like. In their clinic, whoever is on call is who you get. I want him to deliver my baby – therefore I’m probably going to be induced. Is this ideal? No. But in a tiny town in the middle of nowhere MS, I feel like it’s my best option.
I guess I’m just wondering if you have any advice for those of us who don’t have all the options that you seem to have.
Dear @Rose, I’m truly sorry you’re in an area with such limited options, and I’m also sorry that much of what I had to say above does not apply to you. I think your situation is unfortunately very common.
That being said, you have to prayerfully decide what is best for yourself and your family. That may be choosing induction so that you can have the best birth possible with the doctor who supports you. It may be praying and trusting that the “right” doctor will be on call when you do go into labor. It may mean enlisting a supportive nurse (as above) in helping you achieve your goals in spite of the doctor who is on call. And the last idea I’m going to mention is probably going to seem incredibly radical, but it may mean considering “unassisted” or “husband-wife” childbirth (most frequently called UC). A growing number of couples, and in particular Christian couples, are choosing to birth their babies in the privacy of their own home and without the intrusion of even a midwife. (A quick Google search can connect you with many of them.) There is no mention of a midwife when Mary gave birth in the stable to Jesus–if women so “needed” outside intervention to give birth to their babies, would God have entrusted the birth of his son to a teenage mom with “no prenatal care” and no trained birth attendant? Once again, I’m sure this seems crazy to a lot of people, but for many centuries, attendance by only family and/or close female friends in labor and birth was the norm. Contrary to what the medical establishment would have us believe, this was NOT the cause of rampant maternal and infant death. That came later, with the advent of doctors who didn’t wash their hands between dissecting cadavers and “delivering” babies… As an L&D nurse who has “caught” a large number of babies before the doctors got there, and someone who’s a couple months away from finishing midwifery school, I can attest that there is little magic performed by those attending a birth. Ideally, we just support what’s happening naturally. At worst, we interfere with it!
Anyway, what I’m trying to say is that it’s my sincere belief that many women don’t truly “need” midwives anymore than they “need” hospitals and obstetricians–what they need is a safe and private place to give birth to their babies undisturbed, in faith and peace.
Best of luck to you and please let me know if you’d like to correspond any further. I hope you come to a place of serenity with how you are called to give birth to your baby.
Sincerely,
Katie
Updating to add: I know there are many who will be quick to point out that serious complications may arise and that UC is far from an ideal option for most women. I will also provide the necessary caveat that I’m not trying to give medical advice to any specific person on how to handle their pregnancy and birth. However, I will maintain that submitting to “care” providers whose practice ranges from non-evidence-based to purely sadistic (which is a type of provider I’ve worked with often, and the type I fear that Rose is referring to) is an even LESS ideal situation, and I also believe that faith can protect the faithful.
In addition to this: ” our instincts are suppressed in this society, and there is also much surrounding birth (especially in the hospital) that is not instinctual” I think that the way birth is SHOWN in our society…on TV specials that show 34 weeks to 2 weeks post birth in a 30 minute snippet…it gives women a skewed view of what birth is REALLY like. “Oh, I’ll just labor for 20 minutes then a doctor tells me when to push!” …Not even a LITTLE BIT.
@Maegan, The media definitely does NOT help an expectant mother’s education of what is to happen.
I should share my birth stories one day on my site. I’ve been blessed to have had both my sweet babies at home with the help of the most awesome midwife ever.
What helped me decide to have homebirths was the Lamaze Guide to Childbirth and hearing other stories of other women. Though there are exceptions, I also believe that our bodies were beautifully designed by Him to do the work of labor.