Monday, February 4, 2013

Natural Hospital Birth

Natural childbirth is not easy to achieve in hospitals, which may come as a surprise to pregnant women and couples who assume this option will be readily available, if they so choose.  Doula and medical anthropologist Cynthia Gabriel, PhD, has a lot to say on the topic, and offers parents her guidance for how to maximize their chances in her book, Natural Hospital Birth.  One of her tips that I love best is this strategy for active labor:  when the hospital staff has questions for the laboring woman, her spouse or support person can be the one to answer, so the mother can maintain her concentration and momentum in strong labor.  I have noticed how this technique can work beautifully in a hospital setting, where frequent interruptions are common and appear to slow down labor for many women.  Below, Cynthia Gabriel sheds light on the paradox of "natural hospital birth," and offers an inspirational viewpoint on what it can mean for families and those who care for them.

Because my book, Natural Hospital Birth: The Best of Both Worlds, clearly focuses on achieving natural birth inside hospitals, homebirth midwives often ask me why this book has anything to do with them. Midwives can feel annoyed and antagonized by the phrase, “The Best of Both Worlds.” One midwife said, “I just can’t support that. For a healthy woman, all evidence shows that the best place to give birth is at home.”

I get it. And I believe that the evidence of homebirth’s safety is unequivocal. Study after study proves that women give birth well outside of hospitals, often achieving the same or even better outcomes than their hospital counterparts…especially if we factor in the avoidance of medical interventions and the sense of empowerment that natural birth gives to women.

Yet, women in North America are clearly not choosing their place of birth based on scientific studies. They are basing their choice on something else entirely: a complex mix of cultural norms, a belief that hospitals are “modern” and therefore “better” than ancient ways, and a sense of “safety” that cannot be measured in any scientific study. This last one is important. Because I believe that a woman’s labor is significantly impacted by her feeling of safety — her perception of safety, not her actual safety — I have come to the conclusion that I must support women giving birth wherever they feel safest.

There is no reason that those of us who know the power and beauty of natural birth should throw up our hands and give up on hospital birth just because it takes place in a location that cannot be called “home.” Helping women give birth with their own power wherever they happen to be is more important to me than the name of the place. Yes, hospitals have lots of equipment. Yes, the doctors and nurses and hospital staff exert power and authority in hospitals that they do not exert in our own homes. But I am not willing to bow down to those realities as if they are more important than a birthing woman’s instinctive power. In Russia, I watched midwives and doctors honor birthing women’s ability to give birth naturally, without pharmaceutical drugs, over and over and over and over again.  They did not allow the medicalization of the birth place to medicalize the entire experience. Just because they could do a C-section down the hallway didn’t mean that they overused that option. Just because there was an anethesiologist on call did not mean he should be called. It is not a done deal that hospital birth, by definition, MUST be full of interventions and must take a woman’s power away.

Quite the opposite. By refusing to allow this to be true, by insisting that women’s natural ability to give birth is the central truth of every birth (even a birth surrounded by medical professionals), by focusing on the beauty and magic and power of birth rather than our fears that something might go wrong, by accepting the real place of obstetrical care with gratitude (aware that modern obstetrical care is a wonderful invention in a small percentage of cases that would not turn out well without it), we can do something huge for the world. We can reclaim birth everywhere.

For birthing women. For babies. For fathers. For grandparents.

And also, as an amazing side effect, for obstetricians. For nurses. For hospital-based midwives. For anesthesiologists. For all hospital staff. They, too, will be positively impacted. If we bring natural birth to hospitals, we will expose everyone in the hospital to the miracle and power of women giving birth, rather than being delivered. Far more than homebirth midwives (who serve a generally healthy, low-risk population), obstetricians, nurses, and hospital staff support the rare women who experience difficulties, obstructions, deaths, morbidity, and tragedy in birth. Sometimes their skills save lives; sometimes there is nothing that can be done.

Statistically, we know that there will always be a small percentage of tragedies that occur at a birth. But what a gift if we could grace the lives of medical experts with more of the magic of empowered natural birth. There is just nothing like being in the room when a powerful woman reaches to the deepest places of herself to bring forth new life. I cry with a humble joy and feeling of triumph every time.

I believe that the experience is transformative. And worth pursuing in any location where a birthing woman might happen to be.

If doctors, midwives, and nurses who work in hospitals get to experience natural birth more often, I have to believe that it will become easier for them to relax about birth in general. Slowly, more of them will come to understand why some women prefer homebirth. And slowly some of them will ease up on the fear-driven practices that tie everyone’s hands. Birthing women who insist on natural birth can give this gift to hospital staff.


  1. Thank you for this information.It is really informative and helpful for the people.
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  2. I had a wonderful completely intervention free birth at a hospital after being in labor for 42 hours.I think it is totally possible to do and can be just as magical as a homebirth.I think people just need to know their rights and be edcuated and have the team surrounding them all on the same level. I dont feel like you need to be home to do a "home birth" . as long as you are in a comfortable supportive environment you can have the birth you want

  3. I agree that we should work on all fronts to promote less unnecessary intervention. That being said, I'm so glad I had a planned homebirth!

    I had a long period of stall at 7 cm dilated (12+ hours). Though my baby's vitals (and mine) were always fine, I am *sure* that any hospital would have pushed to intervene. And had the interventions not worked and I had a Csection, I'm sure the answer would have been because my baby was 9lbs. He was born at home, however, so I had a drug free birth with no tearing and no episiotomy. And a depression-free postpartum experience, which was as important to me as the actual birth experience.

    I wish medical providers had the ability to be patient like my midwives were. I'm all for natural birth in the hospital, but I feel sure in my heart that that wouldn't have happened for me, and I would have always wondered if it was possible. Now, I know it wasn't.

  4. I was fortunate to have a natural birth experience (first baby) in a hospital with the help of my midwife, my husband and a written birth plan which was given to the nurses in attendance on arrival. So we were all on the same page. Less than 8 hours later I gave birth to a beautiful baby girl 7 lbs. 11 oz March 24th 1991. No medical intervention at all.(drugs) No tearing and no episiotomy . It is definitely possible by planning ahead and speaking to all of your support people before labor begins. I unfortunately did not have the depression free postpartum experience I would have hoped for. I had no idea those first weeks/months would be so physically demanding. We will celebrate her birthday here in a few weeks she will be 22.

  5. Wonderful post, I will be sharing on my blog. Thank you! Achieving natural birth in a hospital setting is always the goal my clients begin with, and fighting the fear machine is really hard. So glad we are doing it though!