Whether you plan to give birth at home or in the hospital, a little due diligence goes a long way. Ensuring that your expectations for your birth are met means delving deep into your own personal vision of what giving birth means for you. If you decide the best place to have your baby is the hospital, that doesn’t mean you have to forfeit your right to a spiritual, transformative childbirthing experience, something akin to a homebirth.
Homebirth in the hospital? Isn’t that an oxymoron? Well of course you can’t be in two places at once, but what if a hospital birth could be as much yours, as personal and satisfyingly unique, as a birth that happens in your own home?
Home is a wonderful place to give brith and to create a family. For many, it’s the best and the safest place to birth. But if you are not able to birth in your own home—either because of personal preference, insurance restrictions, or medical reasons—you should not be denied the empowering and transformative experience every physiologic birth can be.
Why would you want to go through childbirth without medical intervention? Isn’t that archaic? On the contrary, a recent look at the evidence shows that the majority of common medical childbirth practices currently used in US hospitals actually create more complications than they prevent.
On a more personal level, medical management of birth denies your body one of the most powerful experiences available in life. Giving birth as nature intended is Mother Nature’s course in Parenting 101. Guiding a child to maturity takes patience, perseverance, bravery, wisdom, acceptance of loss of control, humor, respect for your partner, and a lot of faith. And these exact qualities are what sustain and guide you through physiologic childbirth.
The vast majority of pregnant women are healthy. Birth does not usually require technical intervention that rivals that seen in intensive care units. However, giving birth does require a great deal of support. Every woman should have the skilled care of an experienced provider who knows what to do when Mother Nature needs assistance. The provider can be a midwife, a family physician, or an obstetrician. And this can happen anywhere. Yes, even in a hospital.
The planning for a safe, empowering, spiritual birth experience in the hospital needs to come long before labor. Birth plans (contracts that outline your wishes during labor) are fine, but all too often births don’t go according to anyone’s plan and the well crafted written document can become irrelevant. Or worse, a source of conflict. Most important are good solid agreements with your birth team—agreements made long before your due date. You need to trust that however the birth goes, you will be cared for and supported according to your wishes.
Here are the five best things you can do—and one you never should—to create an empowered birth:
- First, take responsibility for your choices. Each pregnant woman has a choice about where she gives birth, who she chooses to provide her care, and who she invites to support her during her birth. These choices make all the difference when the big day comes. Do your research. Check out your options regarding different facilities in your community, interview childbirth providers, and make your choices carefully.
- Expect communication to be open and flowing both ways—between your provider, your birth team, and yourself. Expectations, fears, and preferences should be shared long before the first contraction. If you can’t communicate well while you’re pregnant, don’t expect to be able to communicate effectively during labor!
- Pay attention to continuity of care, because it can support a safe birth environment. If your primary provider may not be there when you go into labor, find out who will be. Make sure you meet the other possible doctors or midwives before the big day, and make certain your needs will be met as surely as if your primary provider was there. Be certain that the other possible providers will agree to honor your expectations.
- The confidence you have in your provider and in your birth team is essential. When you give birth you should have no questions about the competency or the trustworthiness of your companions. Spend your months of pregnancy developing relationships built on trust so you can let your team care for you completely during labor and birth.
- In any hospital, there must be control of protocols. Every woman is different, every labor is different, and forcing all women to give birth according to set protocols is unrealistic. As long as the baby and the mom are doing well, women should be allowed to go into labor and give birth at their own pace, in their own style. And if non-emergent interventions seem to be needed, they should be discussed and agreed upon, rather than used according to impersonal rules. I can not stress this point strongly enough: Protocols are the most disempowering aspect of modern maternity care, giving the message that our bodies don’t really know how to have babies without someone else managing the process for us.
- Finally, the sixth C to consider, the one that should never be allowed into a birth: conflict. Conflict releases stress hormones that work against the powerful hormones that facilitate birth. Humans are mammals, and no mammal gives birth easily when fearful or in an unsafe situation. If you resolve most issues long before your first contraction, you shouldn’t have to fight for your choices while you are in labor.
A ‘homebirth in the hospital’ is probably not going to be handed to you as a ready-made package. Most hospital births are managed with excessive amounts of intervention, and these interventions are considered good medicine, despite growing evidence to the contrary.
By asking for support but not intervention, by trusting your body to know how to give birth, and by preparing yourself to handle the stress of labor without denying yourself the full experience, you can be part of transforming maternity care in this country. Each birth is a once in a lifetime experience. Take the time to plan and prepare, to make yours the very best birth it can be.
Stacey Marie Kerr, MD, is author of Homebirth in the Hospital
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