Wednesday, November 28, 2012

I want to have a natural birth, but am planning to have my baby in a hospital. What should I do?

As new of a doula as I am, I get this question a lot - whether it be from clients or from pregnant friends who for whatever reason have decided to go the natural route. I got this question from a friend in a Facebook message today, and decided to edit my response slightly to offer to anyone who may be in this situation!

First of all, congratulations on the life growing inside of you and your decision to have a natural birth! Birth is freakin' awesome and will change you in more ways than one. And your decision to have a hospital birth is just as valid and special! Contrary to popular belief, it IS possible to have a natural hospital birth, and there are some important things to do in order to increase your chances.

1. Get your hands on The Business of Being Born, if you haven't already. It is a wonderful documentary that will really confirm your desire to go natural. Here's the website and you can get the movie on Netflix or Amazon.

2. Consider getting a doula. A common misconception is that doulas only do home birth, but that couldn't be further from the truth - in fact, most doulas do most of their work in hospitals! Your doula will meet with you and your partner a few times before birth to build a relationship with you, learn how to support you, and help you sort through all the pregnancy, birth, postpartum, breastfeeding, and parenting (and other) worries. Then she'll join you in labor and offer you emotional support and physical comfort. Also, a big part of her job will be to make sure that your wishes for your birth are carried out whenever possible. She will NOT speak for you, offer medical advice, or do anything clinical (and if she says she will or does it that's a big red flag), but will help you to find your voice in pregnancy and birth and will make sure you are making informed decisions on every aspect of your care. I personally think that everyone should have a doula, whether they are planning a natural birth or not, but they are so especially important when planning a natural birth. If you have any questions about doulas or need recommendations for ones in your area, feel free to ask me. :)

4. Develop a birth plan. If you choose to hire a doula, she will help you with this. I recommend it be as short as possible while still making your wishes known - I usually have my clients do a one-pager with a "Yes, please" column and a "No, thanks" column. Each column has bullet points such as "Dimmed lights in my hospital room," "Freedom to move, eat, and drink," or "Skin-to-skin contact immediately after birth." Your "yes, please" column should have a lot more than the "no, thanks" column - whenever possible turn a negative into a positive. For example, your "Continuous monitoring" in the "no, thanks" column can easily be changed to "Intermittent monitoring" in the "yes, please" column, and etc. Give your birth plan to your doula and your care provider as soon as it's finalized, and discuss it with your care provider to get a gauge of his/her thoughts on it.

5. Read these books:
  • Ina May's Guide to Childbirth by Ina May Gaskin is written by the "pioneer of modern midwifery" and is just chock full of awesome stuff. Warning/disclaimer: I don't fully endorse everything in the book, and a lot of it is pretty darn crunchy, so be prepared if that has a possibility of catching you off guard. But it's still REALLY valuable and worthwhile to read.
  • Natural Hospital Birth: The Best of Both Worlds by Cynthia Gabriel will give you lots of tips on how to have the greatest possibility of the natural birth that you want in a hospital setting.
  • Your Best Birth by Ricki Lake and Abby Epstein is written by the creators of The Business of Being Born and will help you think through all the possible considerations of interventions in your labor. Your doula will do this too, but sometimes it's helpful to have it all in one book.
  • The Birth Partner by Penny Simkin will help your partner prepare for the big day by learning about your labor and how to support you in it.
6. Most importantly, remember the sacredness of this journey and that your body was designed to do it. This doesn't mean that you are perfect and won't need intervention, but don't believe for a second that you definitely WILL need intervention either. Whatever the outcome is, you will almost certainly be warmly greeted by a cute, squishy, suckling little baby at the end of it all, so look forward to that as much as you can!