Wonderful. Empowering. Overwhelming. It is difficult to find a word to describe the experience of a vaginal birth. As a mother -who went through this experience- and obstetrician, even after having delivered thousands of babies, I can’t help but admire every single time the beauty of a vaginal birth, it always feels to me like a perfectly designed choreography…
My Natural Hospital Birth: Overcoming obstacles to get to the birth I had
“I gave birth without pain relief and I consider my fifteen hours of labour as some of my best. My husband turned ace birth partner – a nice surprise, and a lucky one considering we opted not to hire a midwife or doula. We swayed to Don Carlos’s Rivers of Babylon and Simon and Garfunkel’s I am a Rock, among other soothing tunes in our Labour Chill Mix; moo-ed like cows; and got tennis balls rolling on my back. The first ten hours at home and en route to the hospital felt like a date: laughter, teamwork, watermelon juice (it was August, we live in Greece)… and some manageable pain thrown in to rally against together.
What I found least pleasant about my birth experience wasn’t the pain. It was the hospital admittance process keeping my husband and me apart and waiting. The hospitals I know prioritise hospital practicalities and legal self-protection over emotional wellbeing. Routine procedures like the IV are designed to allow quick and easy access to medical intervention, not for soothing pregnant women to “open up and let the baby out”. We didn’t expect the hospital setting to encourage natural birth, so we worked with my obstetrician ahead of time to overcome the obstacles we could predict.
Having read Birthing from Within and Ina May’s Guide to Childbirth (one of these suggests moo-ing like a cow to relax and open the cervix), attended birthing classes at Eutokia and Babycenter’s online birthing course, we were convinced that the less unnecessary medical intervention the better for both mom and baby. Avoiding unnecessary intervention seems like common sense, but as my obstetrician reminded us: common sense is not so common. We prepared for birth in the country with the highest rate (at 70%) of caesarean births in the world, a Human Rights in Childbirth case study.
Here is what was at stake at the hospital and how we managed each concern:
A. My rights over my body – My obstetrician kept me informed of my choices throughout. Her track record in vaginal births, willingness to explain our options, welcoming attitude to our attempts to be informed all set the stage for mutual respect. When she suggested interventions, we agreed. I had a membrane sweep a day before my due date and had my waters broken when I was about 8cm dilated.
B. My responsibility towards my baby – Protecting my birth experience felt like a first success at parenting. The memory still provides a deep well of confidence that we draw from in the endurance sport of parenting.
C. Recovery time – I was able to walk to the toilet by myself after the birth, and to walk to the nurse’s desk to ask for my baby back.
D. Breastfeeding success – I chose to room in with my baby and I enforced this choice by asking for my baby back. Even though we were “rooming-in”, our baby spent a lot of time out of our sight. My obstetrician informed the hospital staff that I was interested in exclusive breastfeeding and asked that they not to offer formula or water. Leaving the hospital after 24 hours ensured that any accidental feeds during the baby’s long absences from rooming in didn’t sabotage my breastfeeding goals.
E. The opportunity to bond with baby – My obstetrician did her best to remove unnecessary separations between us and our new baby. She arranged some alone time for the three of us before the hospital’s priorities took over again after the birth. She also signed off on our “early” release at 24 hours.
Eight tips to having a natural birth in hospital:
- Learn about what you can expect. We had read about the “I don’t think I can do this” moment getting through the last couple of centimetres. Knowing about this ahead of time kept us calm and later we laughed in recognition of the predictability of it. Just because childbirth (and breastfeeding, for that matter) is natural, it doesn’t mean that it comes easily or without need for knowledge.
- Be vigilant about what you want and get your birthing team on the same page. My husband and I wrote our birth wishes down (see below) and talked them over with each other, our obstetrician and the hospital staff until we reached a version that was more realistic. The process of writing this one pager was invaluable – it helped us become more informed and helped us mentally prepare for what success could look like.
- Arrive at the hospital late. On our obstetrician’s advice, we didn’t leave our home until after my contractions were about three minutes apart, ten hours into labour. I credit my obstetrician with sharing this advice, but I imagine that the advice she is able to give varies based on how informed a couple is.
- Make yourself at home in the hospital. We dimmed the lights, brought music and admittedly a small suitcase full of other personal touches we didn’t end up using. It turned out that I was focused inward much of the time in the later stages of labour at the hospital and my husband and music were all I needed to feel relaxed. I still claim that having the little suitcase of other supplies was comforting.
- Have at least one champion who will be vocal about what you want. There came a time when I was in another zone and talking was difficult. I was lucky to have both my husband and obstetrician fend off well-meaning nurses offering an epidural too late into my labour, when it was tempting but would have been counter productive. I later roomed with a mom who was given such a late epidural, essentially sabotaging her natural birth efforts after having done most of the hard work.
- Rooming in – ask for your baby back! In my experience “rooming in” babies seem to spend a surprising amount of time in some auditorium that parents aren’t allowed even to look into. They are not returned after their individual checks are done but when they are all done, unless you ask.
- Ask for the advice you need to care for your baby yourself – how to change a nappy, how to hold the baby to wash away poop, how to help baby latch onto nipple, how to breastfeed lying down. Many of these are much easier to learn with guided practice rather than through books. I noticed that hospital staff are used to parents who are content to let them handle the baby, but who miss out on learning while in the hospital.
- Get out as soon as possible, unless you find the hospital setting a rest from home (my obstetrician suggested I keep an open mind about this since the hospital can be a nice break when there are other children waiting at home). I gave birth at the only Greek hospital at the time that allowed exit after 24 hours, assuming all is well. We fought for our exit and the two couples we roomed with decided to do the same. We were much more relaxed at home and I could stop demanding for my baby back.
The husband adds:
Preparation was key to having an excellent birth experience. To support my wife, it was important to be involved, not just by being present for the labour but at an early stage. Reading the books Katerina mentions, Birthing from Within and Ina May’s Guide to Childbirth, were critical to understanding exactly what was going on – and what to expect — at all of the stages of labour, and how panic can cause the process to go into reverse. Doing my homework beforehand allowed me to remain calm and focused. Being involved also created a sense of shared endeavour with Katerina, an important bond necessary for fostering the feelings of trust and safety between us during the labour.
One more thing: if you’re a birth partner, and you have any feelings of self-consciousness about not behaving “seriously” during the labour, get over them. The books were full of useful tips about what to do in specific situations to help Katerina overcome fears and relieve tensions that commonly crop up. If she was going to open up her whole body to let a human out, mooing like a cow was a small ask for me.
BIRTH WISHES
KM & MB
Due date: Sunday, 11 August 2013
Baby details: Our first, a girl, we intend to name her CLLB
Obstetrician: Dr. Liliana Colombero
We are open to any intervention that Dr. Colombero judges is necessary for the safety of mom and baby. We ask that, outside of an emergency, we are informed before any procedures and be allowed to ask questions about the pros and cons. We are aware that things can change suddenly. Below is our best case scenario, as we imagine it today, 9 August 2013. Thank you for taking the time to read our birth wishes.
HOSPITAL ADMISSION & PROCEDURES
Once I’m admitted, I’d like to:
Prep
- Opt out of being shaved, assuming I’ve shaved myself already.
- Opt out of the enema, assuming my system has emptied out ahead of time on its own.
- Have a heparin lock instead of routine IV, assuming I’m not going for an epidural or c-section.
Environment
- Listen to music and limit outside noise.
- Dim the lights when visibility isn’t important.
- Drink water, or other clear fluids.
LABORING AND BIRTH
As long as the baby and I are doing fine, I’d like to:
- Avoid a cesarean.
- Avoid being induced with pitocin.
- Try a membrane sweep before induction by pitocin.
- Progress in labor without time limits.
- Not be offered an epidural, unless I request it.
When it’s time to push, I’d like to:
- Try different positions.
- Try perineal massage or compress.
- Push instinctively when I have the urge.
- Get guidance about how to push during crowning to reduce the chances of perineal tearing.
- Avoid an episiotomy, unless Dr. Colombero feels that tearing will be very extensive.
After birth, I’d like to:
- Have the baby placed on my stomach immediately for skin-to-skin contact.
- Hold off on the cutting of the umbilical cord until it stops throbbing.
- Try to nurse immediately.
- Wait for the placenta to be delivered in its own time, as much as possible.
- Hold off on procedures (labelling, shots, tests) for an hour to allow for nursing and bonding.
- Stay together during recovery with my husband and baby as long as possible.
IF CESAREAN IS REQUIRED
- I would like to be conscious and have skin-to-skin contact with the baby as soon as possible.
- Please use double-layer sutures to raise my chances of a VBAC in future.
- I would like to stay together with my baby during recovery, and to breastfeed as soon as possible.
POSTPARTUM
While recovering, I’d like to:
- Choose 24-hour rooming-in with our baby.
- Have procedures on our baby done in our presence, as much as possible.
- Breastfeed exclusively.
- Speak to a lactation consultant as soon as possible.
- Avoid baby formula, sugar water, or a pacifier being offered to my baby without my consent.
- Go home as soon as possible, if all is well.”
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