Natural Childbirth in the Hospital: Is It possible?

By Christina Erl-Daniels
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woman in hospital after birthWhen I went into labour three months ago with my firstborn I was ready for a battle.

I had heard the horror stories: women shackled down to foetal heart monitors in the hospital bed, psychologically coerced into having epidurals, abandoned by their obstetricians as an advocate, separated from their partners, and threatened by medical staff and social workers when they attempted to follow through on their intervention-free birth plans.

The only midwife in our town didn’t have space for me – I was devastated. I wanted a natural home birth, intervention free, surrounded by friends and family and all the comforts of home. But, I had to accept the future reality of a hospital birth.

I became determined to know all I could about policies, procedures and legalities. I researched all the baby books and set up interview appointments with six different doctors recommended by the midwife’s office.

In the face of medical arrogance, I grilled every doctor: “Do you routinely perform episiotomies? Do you support natural childbirth? Do you rely heavily on the foetal heart monitor?” A lot of the questions I asked were clearly out of date. Doctors don’t shave or tie you down anymore, but some were clearly more accustomed to routinely performing unnecessary procedures, such as episiotomies.

One doctor hedged when I asked her how comfortable she was with a variety of birthing positions. She cautioned that I could tear terribly in the squatting position, but later I found out that doctors avoid that position because they cannot see everything so they feel out of control. Nevertheless, I wanted an open-minded doctor and by the fourth interview I found her.

She was patient, attentive and understanding throughout our entire interview. Her patience was overall the most impressive feature when other doctors had clearly been irritated because I was not blindly accepting their expertise. She assured me that times have changed and that many of the stories I had heard were of ancient, barbaric days long past. She supported the idea of natural childbirth and encouraged me to labour at home for as long as possible. When I mentioned not wanting the antibiotic eye drops for my newborn baby she said, “no problem, you just have to sign a waiver.”

Throughout my pregnancy I read more. Naomi Wolf’s book, Misconceptions, was released and I devoured it. Though the cases she discussed had taken place in profit-driven, American hospitals, I knew that Canadian hospitals too have an agenda. Here, expedient births are carried out to maintain the hospital’s strict budget. In both countries c-section rates rise considerably on Fridays before a long weekend.

I continuously questioned my doctor. I was most worried about undergoing a c-section. She eventually confided the hospital’s 21% caesarean rate. She went through the different surgeons with me who perform c-sections, assuring me that, if needed, she would try to call one that does not take your entire uterus out and place it on your stomach for closure, which makes women undergoing the c-section feel incredibly noxious. My doctor always reached out to my concerns.

When I went into labour I didn’t realize it for a long time. I awoke with cramping at six a.m., but compared to some of the menstrual cramps I had experienced this was tame. I figured it was another weird pregnancy pain and ignored it for awhile. At ten thirty I happened to have a doctor’s appointment. I was one centimetre dilated. What joy! However, my doctor cautioned me that it could still be a week before I had the baby.

My husband, Shaun, and I went for a stroll and then ran some errands. By now it was well into the afternoon and I occasionally had to stop and scrinch my face during a ‘cramp’ – I was not yet willing to call them contractions. At one point in a hardware store Shaun went to find cement nails and I sat on some boxes of floor tiling to wait for him. People walked past and gave me the ‘oh look, she’s pregnant smile’ and I sat there focusing on the pain wondering, is this labour? Everyone always said, “don’t worry, you’ll know”, but then it happens and you’re not sure. It was all very humorous.

Once home we ate dinner and I spoke on the phone with friends. Everything seemed to coast along until around ten o’clock. I felt woozy and told Shaun I was going to lie down. I asked him to rub my back and I thought I would sleep. Lying on my side it wasn’t long before the cramps were intensifying. Shaun started to time the cramps and we played meditative music and lied on the bed together.

Two hours later (which seemed like twenty minutes) the cramps intensified more and I started to pace around the house while Shaun surfed the net to find more detailed descriptions of labour. My water had not broken, nor did I have any bloody show. My cramps were erratic in length, strength and timing. Everything said they should be getting longer, stronger and closer together.

By two am I was rocking on my hands and knees and, regardless of what any literature said, this could no longer be false labour. I packed my bag and Shaun called the hospital.

The nurse suggested having a warm shower or bath before hurrying in as the contractions were still rather erratic and, therefore, I needn’t rush. I got in the shower. I was shivering and noxious – the hot water helped with this, as well as easing the pain considerably. Finally, we drew a hot bath and I laboured in there until almost eight in the morning.

I was in a safe place and the heat made the contractions completely bearable. My mother came over in the early morning and lit a candle for me to meditate on – this was extremely helpful as it gave me focus. Shaun breathed with me through every contraction. It was he who remembered the hee-hee-whos we had learned in class and thank goodness because they really got me through the tough ones.

The contractions jumped from between three to five minutes apart until around eight in the morning when Shaun ran to the store for juice. All of a sudden they hit harder and every two minutes. I decided it was time to go to the hospital. I wanted to labour at home for as long as possible, but I didn’t want to have a baby in the car.

When Shaun got back from the store I got out of the tub and discovered the onset of my bloody show. The second I was out of the warm water the contractions became many times more painful. I struggled into clothes in between contractions and slowly made my way into the cold car. A hot water bottle rested on my belly and gave some comfort.

In the car I thought about how we had been awake all night and though it seemed like an hour to me, it had probably been a lot longer for Shaun. He was still breathing with me and I cautioned him to stop, as I feared he would pass out behind the wheel!

At the hospital Shaun parked right in front with a sign on the dash: “Wife in Labour” (a really good idea). We passed the check-in as we had pre-registered (another really good idea) and made our way up to labour and delivery.

Many people smiled at me on the way up and I honestly felt like punching them at the time, but when I held my child I would understand. With inquisitive looks, the nurses took us into the assessment room. They need to decide if you’re really in labour and whether or not you can still go home for awhile. I was six centimetres plus and definitely having a baby soon.

When the nurses realized we were the couple that had telephoned over seven hours ago, they were amazed that I had laboured at home for so long – they had expected us within an hour.

When she arrived, my doctor seemed both surprised and pleased. She knew how much I wanted a natural birth and now I was definitely past the possibility of an epidural. She checked me again and offered to break my water, but I declined the intervention. We had left the birth plan in the car, but my doctor was on top of it all. She told the nurse I wanted minimal foetal monitoring, so I got my initial twenty-minute strip done and then I was free to move around. However, the pain was getting to the point of excruciating fast.

Shaun took me into a shower, but the water was cold and made the pain worse. Shivering and breathing hard, we walked around the halls and to the other shower which was warmer but the ledge was hard to sit on with no way to get comfortable. I gave up on hospital water therapy. Ironically, what had been most helpful the entire labour was unavailable in the hospital.

We walked and laboured and breathed and as I made my way around the ward I saw other women in their birthing rooms flipping through magazines or having calm, quiet conversations with their partners. I was moaning, grunting, breathing, hee-hee-whoing like a mad woman. It seemed such a paradox. They stared at me like I was a wild animal and I looked at them thinking they couldn’t possibly be labouring, but they were.

Within two hours of my arrival the pain had become rapidly more intense and I could no longer stand. I was in transition. The final phase before delivery, the last centimetre and I had the powerful, carnal urge to push. Every contraction I felt my uterus tighten and push down on my pelvis and internally every muscle wanted me to push with it, but my nurse didn’t want me to listen to this animal urge. Shaun told her to call my doctor.

My very calm doctor returned and checked me to find I had only a tiny bit left – what they call a lip or a ridge – to dilate and she suggested getting on my hands and knees to encourage this process, but when I did this the urge to push intensified and I couldn’t stop myself. Despite all the warnings from the adolescent intern, with her memorized text book advice, that I would swell if I pushed there is no fighting this urge. My doctor pushed the remaining ridge out of the way, broke my water and had me prepped for delivery.

With my bum at the foot of the bed, one leg held back by Shaun and the other by our mothers, I started pushing with each contraction. It wasn’t the position I had envisioned, but I was too weak in the knees for anything else. This is the final frontier. You are not only delivering a child – you are clearly delivering yourself from every assumption you may have once had about yourself.

I started to fight the pain and immediately my doctor looked me in the eye and said, “You must push through the pain”. I began a psychological game with myself. This pain was not going anywhere and the more I avoided it the longer it would continue. With all my strength and courage I pushed as hard as I could with every contraction.

Between contractions the medical staff would step back, carry on conversation, organize their instruments and calmly watch me. During a contraction all eyes in the room are on your grandly exposed crotch. They tell you to “push, push, push” and try to encourage you with mirrors held to your vagina so you can see your progress. When I was crowning the doctor grabbed my hand so that I could touch the baby’s head, but in all honesty, none of this mattered to me. I was completely focused on pushing as hard as I could.

Like a lioness, I roared as his head came out. Then I was told to stop pushing. It was unbelievable agony with the baby half in and half out, but in an eternal blink I gave one more push and my baby was on my chest.

The shock in this moment is profound. In spite of every human instinct, emotion and sensation that had told me I was going to die during delivery, I was alive and holding a brand new human being. This person had just come out of my body. I did not even think about the sex of the baby until my mother asked Shaun what it was – a boy, a miracle. He looked right up at me. My heart grew ten sizes.

At 12:07pm on his due date, Tuesday, October 16th, Liam was born after forty minutes of pushing and just under three hours after arriving at the hospital. My doctor had followed every one of my requests. She had handed the baby straight to me, delayed the cord clamping even though the intern had rushed to do it, she advised the nurses that eye drops were not to be administered, and she had never done anything without requesting my permission first.

If I had not found a doctor who was going to be an advocate for me, many of the ‘routine’ procedures that are administered to women in labour and their babies after birth would have easily taken place.

After we were cleaned up and made comfortable, Liam ate eagerly from my breast and Shaun and I sat in peace with our tiny new angel.

A few hours later I was moved to the maternity ward. I had already had a quick shower while Shaun held Liam, so by the time we made it to my new bed I was exhausted. Liam and I crawled back into bed together where we stayed until the next day. I could not sleep. I felt complete.

Across from me in the ward was a woman who had delivered her baby girl exactly one hour after me; however, her baby could not stay with her and was brought back and forth from the nursery. She had a very difficult time labouring in the hospital and after many hours had not dilated past one centimetre so her doctor administered an epidural. The epidural caused her to dilate so fast that she tore terribly internally and was now unable to hold her baby without assistance.

When her doctor came in for a visit I heard him speaking with her about what a saviour the epidural was. Despite her immense pain, she did agree with him, but I wonder if she could have experienced the kind of post-birth freedom and bonding experience I was having, would she still feel the same? In fact, she told me how much she envied me during labour, walking the halls and using the shower which she so desperately wanted access to, but couldn’t use since she was attached to her bed by the epidural, IV, and catheter. Her doctor had never presented her with the option of a walking epidural and she had not known about them.

I thought about my experience versus hers. How different would it have if I hadn’t interviewed so many doctors? What if I hadn’t done the research to empower myself in my birthing experience?

I realized how much knowledge really is power, especially in the medical field. I knew what my hospital could and could not fight me on. Though we realize how much good fortune was with us that day, Shaun and I had known what to expect in case of an ill newborn, a c-section or any possible reasons for intervention.

Women who aren’t mentally prepared for the excruciating pain of childbirth will be more likely to accept intervention. I never pretended that natural childbirth wasn’t going to hurt like hell even when women lied to me and said, “oh honey, it’s not that bad”. What they really meant to say was: “it’s really, really tough, but you can do it.”

Though there will always be emergencies that call for life-saving intervention, every woman deserves the chance to experience natural childbirth.

Being prepared is empowering and having a good partner/coach is what will get you through it, but without a doctor who is willing to be your advocate it is all for naught.

Christina Erl-Daniels studied English and Philosophy at the University of Victoria followed by training at the Langara College school of Journalism in Vancouver, B.C.. She is a full-time mom, freelance writer and healthy living advocate. Currently she is living in Kelowna, B.C. with her husband, Shaun and their son, Liam (20mo.). She expecting her second child in July.

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