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How to achieve natural birth?

post #1 of 49
Thread Starter 
I'm 31 wks pregnant today, and am late in the game thinking about this. My physician is a mainstream OB and I will be giving birth in a hospital that is highly rate, but has a 30% c-section rate. I would like to avoid interventions as much as possible. I am not opposed to pain relief, such as epidural, but would like to avoid if at all possible to avoid the intervention cascade. I am feeling increasingly depressed (?) that I won't be able to assert myself in the delivery room and will end up just having the barrage of usual interventions. Anyways, my husband is very supportive. This weekend we had our childbirth classes and the midwife instructor was very encouraging for natural birth and had many suggestions. No. 1 being stay at home as long as possible!

What should I do now in the meantime? Is there reading I should do? Videos we should watch? How do we go about preparing? I'm worried that we'll just be overwhelmed and easily led into interventions by the nurses.

I'm sure these seem like silly questions. I'm just more in the mainstream, I suppose, and most (all) of my friends have had epidurals and then also things like inductions, c-sections, etc.

TIA!
post #2 of 49
Quote:
I am feeling increasingly depressed (?) that I won't be able to assert myself in the delivery room and will end up just having the barrage of usual interventions
if you're concerned about that, i'd suggest having an adocate with you in the delivery room who will be your voice when the going gets tough. you can't always count on your 1 support person (who is there to support you during labor + birth) to also be a vocal advocate against unnecessary interventions.

about how to deal with labor + birth in general... recognize that birth is a normal, natural process (no matter how much or what the nurses may say to the contrary ). take each rush as it comes, breathe, and learn to relax your whole body. you can do this right now: close your eyes and be aware of every point of tension in your body ~ then consciously release it.
post #3 of 49
I agree with Klothos....

If you are having a hospital birth, and wish to avoid certain procedures, DO NOT go to the hospital without someone to advocate for you. Someone besides your partner. Take it from me (I wanted totally natural birth and had about 10 interventions, including a cesarean.) it is INCREDIBLY hard to advocate for yourself while in labor and delivery. Ditto for your partner, who will also be very emotionally involved and busy with your labor. I strongly adive you to hire a professional, a doula. It would be well worth the expense to avoid having procedures done to you and your baby that you do not want.

Also, may I just say....if you wish to avoid a cascade of interventions, I would give some serious thought to saying no to an epidural. It will leave you flat in bed in a terrible position for your body to do its work in. You may be required also to have an IV and continuous monitoring while it is in, which means you will be hooked up to 3 things while flat in your hospital bed. Epidurals can also cause labor to stall, which may lead to Pitocin or a cesarean. And that's not even mentioning all the side effects for your newborn. Just some food for thought!
post #4 of 49
You sound alot like I did when pregnant with my 1st (hospital birth). I DID end up w/the epidural, IV and constant EFM, but that's about it, and I consider myself lucky to have made it out of there w/out a c-section (thankfully, I labored at home the majority). But I still lost any semblance of control overy my birth when I accepted the epidural. I could only birth on my back, did the stupid coached to 10 pushing and had my feet in the stirrups. Ugh. My 2nd was born naturally in the water at my midwife's freestanding birthcenter. Wonderful birth!

My first suggestion, is to stay out of the hospital bed at all costs. Once they get you hooked up to the EFM (and they will want you in that bed w/the belts on ASAP and for as long as they can keep you there!), they don't like to let you go. I found labor in bed to be excrutiating. I was doing great laboring when moving, walking, leaning over DH and all the other things I did at home for the many hours of labor before going to the hospital.

Once they got me tied down to the stupid bed, it was all over. And the "shushing" from the nurses when I vocalized (I was not screaming, but moaning thru contractions), didn't help either.

I keep hearing from other new moms "I was doing ok until I had to get in bed with that monitor". Of course, mabye laying down will feel good to you in labor, you never know!

Ask them, no TELL them, to use a doppler on you and refuse to get on the bed at all. I would also seriously consider refusing all internal exams, they really tell you nothing about when babe will be here. You will know when you feel baby coming down and see the head crowning, and so will they!

Think about what relaxes you now. Write down 5 things you want your DH to do/tell you while in labor. Make him memorize them. Read Birthing From Within and Ina May Gaskin. Practice vocalizing through contractions and releasing your tension. And yes, get a doula. So worth it, I would never set foot in a hospital without one after my first experience. It is very hard to fight and birth all at the same time. And you just shouldn't have too!

Good luck
post #5 of 49
everything watermamma said is so true.

especially: My first suggestion, is to stay out of the hospital bed at all costs. Once they get you hooked up to the EFM (and they will want you in that bed w/the belts on ASAP and for as long as they can keep you there!), they don't like to let you go.

disgusting but entirely the truth.

w/ my first, they told me they were going to do a quick check for dilation... which suddenly became, "you're at 8 cm., now you have to stay in bed on your back because it's hospital policy." it hurt so much, slowed down labor, and made the entire experience become horrible.

don't let them pull that crap. remember: you always have a right to pull off the monitors and give birth the way that your body tells you to!
post #6 of 49
My midwife says they can do a monitor strip standing up.

I strongly stongly recomend the doula!!!

What classes are you doing.

I think its great you are asking for suggestions. you may get more than you can handle. I have some thoughts but I am trying to have this baby tomorrow so I will have to post when I can

Take Care
post #7 of 49
Isn't the hospital supposed to be where you go to have a safe birth? Aren't doctors supposed to make birth safer? Then how come women have to go to so much trouble to protect their birth process from hospital workers and the hospital environment? It's just so crazy.

Anyway, I agree that you will want to stay home as long as possible, and have someone there specifically to be your advocate. A doula may or may not be the best person to do that -- some hospitals don't care for doulas, and can make them leave if they are perceived to be causing too much trouble. (i.e., declining interventions on your behalf, or encouraging you not to get interventions that the hospital staff would prefer you have.)

These aren't silly question, either. They're very important questions, and it's to your credit that you are looking for answers. Have you read A Good Birth, A Safe Birth? I seem to remember strategies for avoiding interventions in there.
post #8 of 49
I agree with everyone else who said to have an advocate along with you. Just an FYI: agreeing to an epidural is agreeing to a long string of interventions. You will have continuous monitoring. You will have a continuous IV with fluids. You may need pitocin, as the epi tends to slow things down. If things slow down, you are more likely to have AROM. After AROM, you are more prone to infection and maternal fever, which would then necessitate antibiotics and possible fetal distress. You are more likely to end up with a forceps delivery and/or an episiotomy because you can't feel to push and you will be flat on your back. Etcetera.

That said, I'm not coming from a holier-than-thou position. I had an epidural. Just wanted to give you more info so you can make an informed decision.
post #9 of 49
Its not too late in the game to change care providers. Is there a birth center within a reasonable distance? FWIW, I changed from a family pratice doc to a homebirth midwife at 36 weeks with my 2nd pregnancy. I also changed HB midwives at 37 weeks because of an unexpected move across country. It worked out great both times! Its never too late to switch to a care provider that respects your wants and needs...you won't regret it.

You need someone who is willing to work with you not someone that you have to fight against. Labor is not the time to have to defend yourself...you should be protected.

Good luck!
post #10 of 49
The only thing I have to add to all of this wonderful advise is to write out a Birthing Plan. There are a few websites that give you a format to follow, this way, when you are in pain, you will have all of your requests written down and (in Canada) this is your legal "voice" when you may not be able to answer all of the questions. I also advise that you write down "I do not want an epidural offered to me! I will ask for one when I feel I need it". Or something to that effect. Otherwise you may have a nurse, like one of mine, who decides to offer it EVERY time she saw me. :
BTW I had an epidural with my first, and it caused me to dialate from 1.5 cms to 10 in 2 hours! With my second, the nurse was barely able catch dd before I pushed her out, no one knew I was ready to push but me! No pain meds ot intervention required!
post #11 of 49
When I was in labor my brain went into sort of a hormone-induced fuzz. I wasn't able to stand up for myself even when I KNEW that the hospital staff was telling lies (l"lying flat on your back is no different from other labor positions" "Don't push or you'll damage your cervix" etc...).

Actually, the only reliable way to avoid hospital interventions is don't go to the hospital until you are quite certain that the baby is ready to come. Some of the indicators are what the Bradley Method people call "self-doubt", and feeling like you need to take a shit but you can't. Maybe there are other indicators.

There are all kinds of reasons that they will try to bully you into the hospital too soon, for example, if your water breaks, if you go into labor but it doesn't progress quickly or if they think you are past your due date. Don't fall for any of it .

Anyhow, the best laid plans go awry. I went too soon because there were 3ft of snow on the ground and I was worried we wouldn't be able to get through. As the hospital they basically tortured me until they induced fetal distress and then did a forcepts delivery. No doubt they will do the same to you if you give them a chance.

--AmyB
post #12 of 49
I went into a hospital birth with the same ideas as you have about avoiding interventions. I thought I'd done my research. I had a doula. I didn't go to the hospital til I was 5cm. I thought I was more actually but I think I was in so much pain cause I had back labor. I ended up a c/s In hindsight I wish I'd changed providers.

The problem I had was a posterior baby and my labor wouldn't progress. Now no one pushed me into a c/s - the staff were quite tactful about that. No one pushed me into an epidural. But after about 24 hours of labor, only 1cm progress, I found myself stuck because the OB staff had no experience in helping my labor progress by natural methods. I bet if I was in a birthing center or had a midwife at home even, I could have birthed naturally. I've since heard of lots of things I could have done. Actually I'd heard standing and walking around was good but I didn't want to do that because I was in so much pain. Strangely enough lying down on my side was less painful. If I'd had a strong midwife who'd have given me a push in the right direction at the time, I think it would have helped.

I think it is possible to have a natural birth in a hospital but it's not easy especially if you run into difficulties like malpositioning. You're going to be in an environment where they don't have the expertise to deal with that. Then they'll have nothing to offer you except interventions which might make things worse. I chose an epidural for the wrong reason I think. After no progress for about 16 hours, I thought I'd try the epidural because I had heard from other women that sometimes it can relax women and the labor might progress. But when the baby is malpositioned I don't think this is true, and in fact, it made it worse. And the intervention cascade happened and I ended up with a c/s.

If you plan on having more children, do anything and everything you possibly can to avoid a c/s. Because if you think having a natural childbirth in a hospital is depressing, read up on trying to have a natural VBAC in a hospital. It's even worse.

Sorry to sound so negative. I just regret not changing providers. I'm a pretty assertive person and thought I could handle the hospital staff. I just didn't know what to do about posterior babies and either did they.
post #13 of 49
Wombat -

My L and D sound very similar to yours (except I was induced at 1cm) I had a posterior baby, too....and being on my side felt the best, too. I wish I had had a different care provider, too. Or stayed home. They really encouraged me to lay down at the hospital, when they should have had me up and moving. I ended up with a c/section, too. (I'm planning a home VBAC in 12 weeks!)
post #14 of 49
I had two un-medicated births in a hospital and it was not a problem. I would second some earlier recommendations:

* Write a birth plan in which you express your desire to avoid medications (and other interventions) and request that you not be offered any pain medications, but that you will let them know if you want them.

* "Natural Childbirth the Bradley Way", was, I thought, a pretty good read

* A hot shower was a must for me.

* All that said, with my first I was so out of it from pain and exhaustion, that I couldn't talk much to express my needs or even really formulate coherent thoughts by transition/pushing. With my second I gave my DH instructions on simple things I wanted him to do (such as bring me a glass of water or OJ every hour) and that was helpful.

Good luck!
post #15 of 49
Lots of good information already mentioned.

If you haven't already, read Kitzinger's Complete Book of Pregnancy and Childbirth A ton of excellent information on just about everything regarding natural childbirth and pregnancy. Also, read Ina May's newer book Guide to Childbirth It has the most inspiring birth stories I have ever read, as well as excellent information on childbirth. After reading it you will know how natural childbirth is and can be.

Write a birth plan

Consider hiring a Doula to be an advocate for what you want and to help you labor.

Strongly consider refusing any pain mediations. These will dull your senses and weaken your body's a bility to labor naturaly. Instead, walk around, use a birth ball, different positions, use a shower or tub.

Labor at home as long as possible before going to the hospital.

Consider finding a doctor or midwife who understands what you want.

Good luck
post #16 of 49
about the birth plan ~ while i agree it's a great idea to have one written, be warned that some hospitals and care providers will completely ignore it.

i wrote a birth plan w/ my first and even took it in to the doctor(s), and had them put a copy of it in my medical chart / file so that they'd know my wishes beforehand... and they still completely ignored everything i had written. :
post #17 of 49
Thread Starter 
Thank you so much for all your suggestions! I will read through them all carefully and pick up the recommended books.

I'm going to foward this to my DH so we can further discuss if we should hire a doula or consider an outside advocate. I don't think we will change providers, but we can at least discuss what our plans our.

I agree not taking pain relief will help avoid the intervention cascade, so that is our plan. It is hard to predict since I don't know if the baby will be positioned properly, but I want to go in fully informed.

Thanks again for all the suggestions!
post #18 of 49
Dont have much to add, but wanted to post these 2 links on optimal fetal positioning:

http://www.homebirth.org.uk/ofp.htm
www.spinningbabies.com

Like Lucysmama and Wombat, I also had a cesarean for malposition with my 1st child, although my DS was frank breech. Positioning is SO important and not something that should be ignored (I dont think anyways).

Good luck with your birth! I wish you the best!
post #19 of 49
Lynsey, you beat me to posting those links!

Positioning is very important, and it is such a shame that most care providers don't discuss with you how to maximize your chances of having an optimally positioned baby!
post #20 of 49
Switch providers! We switched twice during our pregnancy including at 28 weeks. It worked out well. We had a midwife at the hospital and it was covered by my sucky insurance yet the midwife was chill and left us alone for the most part.
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