Last Minute Tips for a Natural Birth in a Hospital

My good friend is going to be giving birth any day now and is planning a natural birth in a hospital. I've been thinking about her lots and can't wait to hear how everything goes. I thought I'd jot down a quick list of tips she can use as she goes into this transformative experience. In my experience, being in a hospital makes it more difficult to have a natural birth (but by no means impossible - I know many women who have labored with pitocin and have gone on to give birth without pain medication) simply because the option for medication is there...that is why I thought I'd give these tips.

1. Remember everything you've studied and learned. Remember to trust your body and the process. Remember that the pain will not last and that it will be over before you know it. While you're laboring and it is getting intense, tell yourself you can do anything for one minute. Count to 10 as you have a contraction and tell yourself you can get to 10. Remember to breathe...slow down your breathing to give your body oxygen - feel the energy rush back into you as you become grounded again.

2. When you feel like giving up or when you feel like the pain is so intense that you want to die (hah!), it'll be over right after. Everyone told me this and I had no comprehension of what they meant until I experienced it myself...I literally could not bear it any longer and in that moment, it was over. And then the joy was indescribable.

3. Make sure you have support - either your partner, mother, doula, friend, etc. Make sure they will stand by you and help you get through it while reminding you of the type of birth you desire. Make sure they'll stand up for you and be your voice with the nurses and doctor.

4. Enjoy the process. Let go of the fears and savor these moments. Think positive thoughts. I love this quote by Grantly Dick-Read, "Many women have described their experiences of childbirth as being associated with a spiritual uplifting, the power of which they have never previously been aware...To such a woman childbirth is a monument of joy within her memory. She turns to it in thought to seek again an ecstasy which passed too soon." Incredibly, after you give birth, you may feel too that it passed to soon. Savor it.

5. Move around! Change positions. Do not stay flat on your back in the bed. Be upright! It will move your baby down and your pain will be more manageable.

6. Overall, just be present. Embrace the laboring, the pushing, the delivering. Don't let yourself get down by thoughts of "How much longer is this going to take?" Those thoughts will come, but push them away and fill it with a positive thought instead. Tell yourself it's a beautiful day for your baby's birth and practice patience.

Here's all of the warm wishes and luck in the world to my beautiful friend!

The wonder of natural childbirth

Cjane posted this today on her blog:

3. Would you do another non-medicated birth? And if so, WHY???

Here is the deal about that whole deal.

Now that I look back on Ever's birth I see things a little more clearly.

The pain? Hmm. Yes it hurt. It was pounding and brutal. Then there was the part when I felt my body split in two . . .

But.

But it wasn't the physical pain that astounded me about that experience. For me, the pain? Meh. It was shortly lived and gone the second the baby left the (fleshy) building.

But.

The pain coupled with the metaphysical?

Holy.

It was the stretching of my spirit that really shook my core. The psychological impact that comes from going to a place where earth meets heaven and tiptoeing along that blurry line of life and death. It was the part where I felt the weight of something so huge, so much bigger and more fantastic than anything I could have ever imagined. It was closing my eyes and seeing a checkerboard sphere rolling around like I was viewing pure energy at a molecular level. It was completely psychedelic and strange and completely awe-some.

And when I think the physical feeling of my body splitting open I also think my spirit was doing the same. In that process, my spirit made more of me to be able to contain all of that experience. Like a hand inside a latex glove, I was filled with humanity, expanding, extending, magnifying. I was more. And I will never get over the residual memories--they still astound me.

Are you kidding me?

I can't wait to do it again.


I LOVED her description of natural childbirth. It is exactly how I feel about my experience. It was so completely overwhelming and intense, yet I honestly cannot wait to do it again. The feeling of being "more" than you thought you ever were was astounding. I, of course, cannot put it into such beautiful words, like Cjane does, but I completely echo her sentiments. It is something so incredible, something so much more rewarding than I can even explain. 

How to have a natural birth in a hospital

I asked my friend, Rachel, who blogs at The Beginning of Motherhood, to share some thoughts about how to achieve a natural birth in a hospital setting. Rachel has a lot of experience with this, as she has had five children naturally and works as a nurse in Labor and Delivery. Thank you so much for sharing your wonderful tips!

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I have seen all sorts of births and all sorts of birth plans. I have seen women do fabulous going natural on pitocin, laying in bed, and in all sorts of other situations. I have also seen some women who have been doing great soaking in a tub, but ask for an epidural. I have seen some who I would have thought regretted not getting an epidural, but when asked, said they appreciated the experience. Any way it happens, a natural birth(going without pain medication) is something that you need to have a reason for wanting. To me, that has been the key ingredient. Also, your desire may change further down the road through labor, and that's OK. So, I would say the first step in having a natural birth in the hospital, is to decide if you really want to and why. These are not questions that anyone can really give you an answer too, but yourself, but I'll attempt to start you on your path.

First off, you can do a natural birth. Women have been doing them forever. So the real question is do you want to. The main reason for getting an epidural is the obvious: pain relief. Labor is hard work, and can be very painful. But, pain tolerance is not really an indicator of whether or not you will want an epidural. What you need to decide is if your reason for wanting one is greater than your reason for not wanting one. A few case examples. Many women are afraid of the needle in an epidural, or the pain of the epidural itself. I have had one woman tell me that when her contractions are so intense that she no longer is afraid of the needle then she gets the epidural. She always gets them. Therefore, for her, the labor is worse than the epidural. On the other hand, another woman I took care of felt like her fear of the epidural was greater than her fear of labor. Therefore, she always went natural. Some other factors to think about when it comes to reasons for/against getting epidurals: 1)you ability to move is greatly reduced when you have an epidural. Once you have one you are in bed, with a tube to drain your urine, and the nurses have to help with movement of the legs. This may be OK with you, and may be worth it, but again, it's just something to think about. Many people are worried about drugs being introduced. From what I have researched, the drugs given in epidurals will not cross into your babies body, but it does effect immediate breastfeeding(though not long term). It does tend to slow down labor, and there is an increased use of forceps or vacuums with them. For those who are experiencing exhaustion or can not relax, though, it may be useful. These are just some of the factors involved, and I would suggest thoroughly researching them.

So onto how to work through a natural labor in the hospital.

Request a hep-lock(where the iv is in you, but not connected to any tubing), or no iv at all if you feel comfortable with that. If you are not receiving iv fluids, make sure you are eating and drinking. If your hospital only allows ice chips, eat as many ice chips as possible and add sugar:) I would even bring some Gatorade pre frozen just for you to suck on. As long as it's ice, it fits in the policy. Some research I have read suggests that a woman needs at least 125-250 ml of water and hour. That's 1L of fluids every 4-8 hours. If you have to have an iv, you are still capable of moving. Request that you have an iv pole for the fluids to hang on so that you can walk around with it. If you do have any fluids running in, keep in mind that you can also get too much. Especially if you are on pitocin as that tends to increase water retention. One bag of iv fluid equals a liter, so keep that in mind when gaging how much you are drinking. Make sure you are going to the bathroom often, at least every one or two hours. An empty bladder will facilitate labor. Sitting on the toilet is also a comfortable position:) An iv pole can actually be very useful to hold onto during contractions. When you are feeling weaker, but still want to stand, an iv pole makes a good brace to pull down on. It is also useful during pushing. If you are wanting to squat, the pole can be used to hold onto.

Request intermittent monitoring. Keep in mind that this may only be possible if the nurses aren't busy, and your babies heart rate is looking OK. Intermittent monitoring has been shown to be safe and effective in monitoring the heart beat of the baby. ACOG guidelines suggest listening to the babies heart beat every 15-30 m while in active labor. This also needs to be done during a contraction and immediately after. This allows the nurse to check the heart rate while you are in different positions or different places. If you have to be connected to the monitors, you can still sit up and move around. You can stand, squat and walk. The difficulty in this comes from making sure that the heart rate stays on the monitor. It is helpful to have someone hold it on tighter during contractions, while sitting up, or squatting. Anyone can do this, it doesn't have to be a nurse. If you notice that the babies heart rate isn't picking up at different times during your labor, try having someone hand hold it. While I normally, don't like internal monitors, for someone who is going natural and having to be on the monitor, they can be useful. With internal monitors, the babies heart rate is picked up much easier and movement is not restricted as much. This would be something that I personally would like at on a case by case basis, and only if the mothers bag of water is already broken.

Which leads me to the bag of water. I would suggest not getting it broken as a matter of policy. Research shows that it does tend to decrease labor time, but only by about 20m. Once your water is broken, contractions tend to be stronger and harder. If you want to shave off time in labor, I would suggest having your water broken during transition or after(around8-10cm). At this point, your labor is already pretty intense, and shaving off time at this point is usually very welcomed. This really is just my opinion. Also, once the water is broken, it allows for germs to be introduced. So often the water is just broken, without a thought as to the individuals preference. Just make sure you at least think about it.

The bed in the hospital can actually be very useful. There are a lot of different positions that it can help you obtain. If you want to kneel, you can kneel over the top, bring the bottom down and kneel on that, or just be on your hands and knees on something soft. During pushing, you can bring the head all the way up and the feet all the way down to simulate a squat or birthing chair. I would play around with it and see how you might find it the most useful. It is also useful to use to kneel on, or put a birthing ball on and lean on.

Water....this has been shown to be one of the most effective pain relief measures for those who are going natural. If you find yourself getting tired, afraid you can't go on, or just needing to try something different, try a hot bath. Some hospitals do not allow this. If this is the case, bring a heating pad that you can use to sit on on the birthing ball, use with counter pressure, or just relax muscles and tension.

If you need to have pitocin, don't sell your selves short and feel like it's impossible to have a natural birht. I have seen many women do fantastic with pitocin. Some key things to remember...you can do it. You have to have a reason for wanting to do it, but it's OK if you don't want to. Ask your provider if you can do low dose pitocin. This will add the pitocin more gradually. You can also request that your pitocin be turned off once you have reached active labor. At this point, your body will sometimes take over and you will no longer need pitocin.

For some it is useful to try not to think about the contractions in terms of pain, but just intensity. If you prefer this, make sure you ask your nurse not to ask you your what level your pain is at. But let her know whether or not it is getting more intense. This is an important indicator of how your labor is progressing and how well a woman is coping.

One last point, when you first arrive at the hospital there is a whole admittance procedure. If you are not in too much pain, it's not that big of a deal. But if you are having to work hard through contractions, appoint someone else to answer the questions that are needed.

healthy birth practices and spirituality

new data shows that there is a connection between childbirth and spirituality. you can see what i've said about spirituality here.

“'Childbirth and motherhood provide many women with an ideal context in which to recognize the spiritual aspect of their lives,” said Lynn Clark Callister, R.N., Ph.D., FAAN, a professor of nursing at the Brigham Young University College of Nursing and study co-author.  “Our research illustrates that for most women, childbirth is a deeply spiritual experience.  As healthcare providers, we need to recognize and support this evidence, and listen to women’s voices to guide their care.'” 

The themes that emerged in the study included: childbirth as a time to grow closer to God, the use of religious beliefs and rituals as powerful coping mechanisms, childbirth as a time to make religiosity more meaningful, the significance of a Higher Power in influencing birth outcomes and childbirth as a spiritually transforming experience."

read the summary here.

at the end of the article, it lists Lamaze International's "Six Healthy Birth Practices" so i wanted to list them here. i truly believe that following these six practices will almost always lead to a wonderful outcome for mother and baby.

1. let labor begin on its own

2. walk, move around, and change positions during labor

3. bring a loved one, friend, or doula for continuous support

4. avoid interventions that are not medically necessary

5. avoid giving birth on your back and follow your body's urges to push

6. keep mother and baby together; it's best for mother, baby, and breastfeeding

positions for labor

(me during my second labor, dilated to 5 cm, in a hands and knees position with my husband doing counter pressure on my back)

preparing yourself mentally for labor is just as important as preparing yourself physically. knowing what positions to use for pain relief during labor are key to finding comfort or at least, tolerance, during contractions.

i have personal experience from using upright labor positions to help during labor verses not using any techniques at all. with my first labor, i labored on my side in bed (that is what was comfortable and relaxing to me) up until i started active labor (about 5-6 centimeters dilated). at that point, i just couldn't cope with the pain anymore and couldn't find any ways to relieve it. that is because i wasn't educated on what positions to try during labor...or even if i did know about them, i guess i just didn't even think to try them! (that is why having good labor support is key...to help you remember what you do already know!) i ended up getting an epidural about an hour and a half after arriving at the hospital because i simply couldn't handle the pain anymore - however, i believe fully if i would have tried different positions that i would have been able to stick with my goal of giving birth naturally. (sitting in the hospital bed is probably the LEAST comfortable birth position...probably why most women choose to receive an epidural! i know...i've been there!)

with my second labor, i was much more prepared and labored in a variety of different positions, hands and knees being my favorite. my husband put counter pressure on my back, stroked my hair, or lightly rubbed my back. at times i remained standing, and leaned over onto the back of the couch, breathing deeply and slowly through a contraction. these positions helped my labor to be much, much more bearable than my first. there was only about 20-30 minutes at the end where i really felt like the pain was getting hard to cope with, other than that, by using different positions, i found great pain relief during my labor.

research shows that upright positions shorten the first stage of labor. they also reduce pain and speed birth. a study showed that women who labored upright during the early stages were 17% less likely to seek pain relief through epidural anesthesia.

see the articles here and here.

as the laboring woman, you will find the position that is best for you. your body will guide you to what is comfortable and what helps relieve the pain for you - each body, each baby is different, thus every labor will utilize different positions to ease the discomfort.

here are some effective positions for laboring:
(click on the link to read descriptions of each position)

standing
walking
forward leaning
slow dancing
swaying
lunging
sitting
rocking
sitting on a birth ball
sitting on the toilet
all fours and all fours leaning

during my second labor, i used forward leaning, swaying, sitting on a birth ball, and all fours (aka hands and knees). when it came time to deliver my baby, without even thinking, i got into an all fours leaning position which for me, made it extremely easy to push my baby out. she was a big healthy baby that came out in 4 pushes!

there is a great section on the website, giving birth naturally, about labor positions. i highly encourage reading it as it gives a great background on why upright positions are great for labor as well as helping to understand why the positions routinely used in hospitals can be so ineffective (lithotomy and supine positions). find the section here.

what positions did you use during labor to find comfort and pain relief?