N is for Natural Birth
How To Have A Natural Birth
Congratulations! You’re pregnant and considering going natural!
But how can you make that a reality?
After all, you’re going against the grain with this decision. The system isn’t exactly set up for natural birth. You may not have a lot of supportive people around you. In fact, you may not know anyone who’s chosen a natural birth at all.
Is there even a midwife practice in your town? And, to that end, do you needa midwife? Or is it possible to go natural in a hospital?
Don’t worry, we’ve got your back. If you’re pregnant, or hoping to become pregnant, and want a natural birth, here are things you can do to help make that happen.
Step 1: Commit
Most women don’t just stumble into a natural birth. It takes determination and commitment.
Birth never happens exactly how you plan, so it’s good to be open to changing plans when need be. However, going into labor without fully committing to an unmedicated birth will make it hard to resist when the going gets tough and nurses are offering medication.
Knowing exactly why you want to avoid medication will be your driving force when labor gets tough.
Step 2: Prepare your mind and body
Labor and birth are their own kind of marathon, and just like you wouldn’t show up to run a marathon without training, you don’t want to show up to birth unprepared.
Labor is a very physical journey, and exercise will help keep you strong. Walking, swimming, and yoga are great ways to prepare for birth by keeping your body strong and pelvis open.
Sitting for many hours a day, as many of us do at work, is not the best thing for getting baby in an optimal birth position. If your pelvis is tight, baby may settle into your pelvis in a posterior position which can cause long labor and painful back labor.
There are some things you can do to help avoid a posterior baby including belly mapping, daily stretching and exercise, prenatal yoga, and just getting up and walking around every so often when you’re at work. It’s also important to avoid sitting in reclined positions like in big comfy chairs and sofas. Sitting on a birth ball is a great alternative.
What you eat while pregnant is what is creating your baby, so it’s vital to eat a high nutrient, real food diet. Be sure to eat enough quality protein, salt, and vegetables. Choose foods from different color groups (called eating the rainbow) so you can be sure you are getting what you and baby need.
Labor is also a mental, emotional, and spiritual journey. Many mamas have found that practicing mindfulness, prayer, or daily affirmations help them connect to their baby and prepare mentally for the birth they are going to experience together.
Step 3: Get a Doula
A doula is a professionally trained birth attendant who will meet with you throughout your pregnancy to establish a relationship, she’ll be with you and coach you throughout your entire labor, and will follow up with breastfeeding and newborn care. Doulas are seriously birth angels.
Women who have doulas are more likely to have spontaneous vaginal births and less likely to have:
Forcep or vacuum assisted births
Negative feelings about childbirth
Other benefits of hiring a doula include:
Higher breastfeeding success
Higher maternal self esteem
Lower blood pressure during labor
Lower pain experienced overall
Oftentimes it’s just a gut feeling about someone. She will see you at your most vulnerable during an incredibly intimate experience, so you will want to be sure you feel comfortable with her. Consider your own style during stress. Do you prefer to be left alone? Do you want someone to continuously encourage you? Would you like a doula who has massage or acupressure training? Choose someone who’s strengths match your needs.
Even if you have an amazing partner, a doula is still a great asset. Your doula knows birth and your partner knows you. Together they are a great team. Your doula will help your partner to help you, and will help your partner to take care of himself as well. Some men feel a little uncertain about how a doula fits into the mix but, believe me, it’s a win-win.
The cost of a Doula becomes negligible when you consider how much more expensive an epidural or a c-section is. Not to mention the emotional toll those things would take when you are hoping and planning for a natural birth.
Step 4: Pick your provider
When choosing your provider you have 4 options:
OB/GYN – Traditional route. These providers are the least likely to be low intervention.
Family physician – Tend to be more holistic. Will be able to care for you and your baby after birth.
Certified Professional Midwives (CPM) – Are midwives, not nurses; they’re only licensed in some states.
Certified Nurse Midwives (CNM) – Nurses who have additional midwifery training.
When choosing a provider, interview a few candidates. When you ask them questions, you want numbers and percentages. If they don’t know or can’t tell you, that’s a good sign to look somewhere else.
Some important questions are:
What is your c-section rate?
How many women have unmedicated births (don’t say natural because providers have different definitions)?
What if my water breaks and I haven’t gone into labor yet?
What happens if I go overdue?
Here’s an expanded list of midwife interview questions, and here is an explanation of types of midwives.
Who is the safest provider?
Evidence shows that midwives are the safest providers for low risk women, because they result in fewer interventions and better health outcomes for mom and baby (source). For example, midwives in the U.S. have an average 5-20% c-section rate (depending largely on location of the delivery), while U.S. OB’s have closer to a 33% c-section rate.
However, some people have a hard time leaving a doctor they like. Some women really like their doctor because he or she is nice and has a good bedside manner. But unless she is also natural birth literate, she may not be the best choice. Keep in mind, you can always return to this trusted provider for your well woman care after you deliver your baby.
If you are choosing a doctor, be sure that the other doctors in their practice are aligned. When women only meet with one doctor, they sometimes assume all the doctors in the practice are on the same page, which is seldom the case. Some women just hope they’ll get the doctor they like when the big day comes, which is taking a huge risk.
Another reason it’s important to be sure that all of the doctors are natural birth literate is because if they aren’t, some women are tempted to accept an induction when their preferred doctor is on call. This isn’t the best option when you’re seeking a natural childbirth because one intervention, like induction, usually leads to more. Not to mention, induction can be a lengthy process for a first time mother, so even guaranteeing your doctor would be there for the induction is its entirety is unlikely. Here is more info on labor interventions during childbirth.
Some doctors are lower intervention but work in hospitals with high c-section rates or that aren’t baby friendly. Interview a few providers, but also look at where they practice and compare those locations too.
Call the hospital that your doctor practices at and ask the same questions as above. If they don’t know, it’s not a good sign. Consider looking elsewhere.
And remember that it’s never too late to switch providers! This is one of the most important experiences of your life, and you should choose someone who will help you achieve the natural birth you desire.
Step 5: Pick your birth place
Choosing a birth place is just as important as choosing your provider. You have 3 choices.
A great place for a woman who anticipates needing more interventions. There’s a hospital bed, monitors, oxygen, etc. on the walls, fluorescent lights, baby warmer, so, not so cozy. The hospital is the only place you can have a cesarean or get pain medication. If you’re having multiples, have significant health problems, or otherwise have a high risk pregnancy, this is exactly where you want to be for you and your baby’s health and safety. And keep in mind, just because interventions are available doesn’t mean they have to be a routine part of your care.
A birth center is like giving birth at someone else’s home. Birth centers are comfy environments, usually with a large bed, and a warm homey feel. They contain medical equipment, but it’s usually hidden away out of sight. Birth centers can provide some interventions but not many, and their safety rests on the premise that if a mother deviates significantly from what is normal and healthy during the course of her pregnancy or labor, she will be transferred to the hospital to give birth there. However, low risk women tend not to need many interventions, and the vast majority of complications during pregnancy and birth come with some forewarning, so emergent transfers are extremely rare.
Many hospitals have caught on that birth centers are popular so they are calling their labor and delivery units “birth centers.” Check to make sure your birth center is run by midwives and is accredited by the Commission for Accreditation of Birth Centers.
At a home birth, midwives bring the same equipment that is at the birth center. They have a plan for transfer of care in case something comes up during pregnancy or labor. However, transfers are rare. Birth usually happens smoothly on it’s own when it’s left to just happen. Home birth midwives are skilled at categorizing women as low risk or high risk, so they only take women into their care who are good candidates for home birth.
Which is the safest?
The safest place for low-risk women to give birth is at a birth center (source). Birth centers are run by midwives who are the safest providers for pregnant women and have the lowest intervention rate and best outcomes for mom and baby. They have the environment of home, but also have some of the equipment of a hospital. They are usually located close to a hospital for practical reasons, so a transfer will be quick if needed.
That being said, if you need to or want to give birth at a hospital, that doesn’t mean you can’t have a natural birth. It’s possible to have a natural hospital birth, it just takes some extra preparation on your part.
Step 6: Know the benefit and risk of each intervention
You already know that the cascade of interventions is something you want to avoid if possible, but how do you know when an intervention is necessary?
Well, first, you need to ask, “Is this an emergency, or do we have time to talk about it.” Usually it is not an emergency and there is time to talk.
Then you can talk to your partner and doula and run the intervention through your B.R.A.I.N.
B.R.A.I.N. is an acronym for:
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Let’s run an example: Pitocin.
Benefits: Can help increase the chances of a vaginal birth when your uterus becomes exhausted.
Risks: Pitocin can cause contractions that are longer stronger and closer together than your body would normally do. This can cause fetal distress which can lead to a c-section.
Pitocin also automatically comes with other interventions like continuous fetal monitoring, which can keep you from moving around and getting more comfortable. Sometimes women who otherwise didn’t plan on getting an epidural end up getting one because they can’t handle the stronger, closer contractions, especially when they aren’t able to move around fully.
Alternatives: Wait it out. Labor is not linear and can ebb and flow. As long as you and baby are doing ok, you can wait. Breaking the bag of water and nipple stimulation are other ways to get labor going without Pitocin.
Intuition: After thinking through the benefits, risks and alternatives check in with your gut. What is it telling you? Sometimes women have a strong reaction and just know.
No/not now: Declining an intervention. If you choose to decline an intervention start by validation your providers concerns and give them your plan for how to proceed. for example: “I know you’re concerned that my cervix hasn’t dilated more. Since baby and I are doing fine we would like to wait a while before starting Pitocin. Can you come back in an hour and we can talk about it again?”
Step 7: Attend a natural birth class
A natural childbirth education class is key in helping you and your partner prepare your mind, body, and spirit for a natural childbirth. A good class will demystify the process, teach you how to prepare, and equip you and your partner with information on what to do during various stages of labor. It’s a great way to reduce stress about birth and become empowered to give birth naturally.
Be sure to choose an out-of-hospital birth class!
This is important because many hospital birth classes are geared more toward how to be a good patient as opposed to really understanding your birth options.
A natural birth class will arm you with the information you need to make the best decisions for you and your family. It will help you prepare for natural birth and make informed choices if at some point in your labor you are confronted with a need for interventions