I get this question very often from moms who I either talk with during our consultation, or by moms who have hired me to support them through this very question.
Yes, you can. But being honest, you have to be very intentional about it.
Birth in the hospital never used to be the norm, and in fact birth with OBs isn't the norm in many other countries across the world. (Great resources to learn more about the history of childbirth in America are the movie The Business of Being Born and books such as Babies Are Not Pizzas, by Evidenced Based Birth). The idea of having most births have some sort of intervention came about because well intentioned men wanted to try to make birth less painful and easier.
Let me say that when you try to mess with nature and how things are created, it doesn't go well. Ever.
Today a majority of women will give birth in a hospital setting, whether by choice, comfort, or because it is the only option in their region. Many doctors and labor and delivery nurses are trained in how to make a mother more comfortable during labor by using medications. This has become the norm and believe it or not most nurses and doctors have never seen a physiological birth (meaning an uninterrupted, no medications, no intervention birth). Whether it's because of an epidural or from the use of Pitocin to either speed things up or start a process in the first place, the truth is most nurses don't know how to support a mom who truly desires an unmedicated, intervention free birth.
So, can this still take place in a hospital then?
Yes, it can, but like I said, it takes lots of intentionality from you and your birth team. So here are some tips on how to make it happen.
Know Truly What to Expect in the Hospital Setting (What You're Up Against)
I don't mean to be a pessimist when I say this but do know that the hospital setting is ultimately set up for a medical experience. To be frank, people only go to the hospital when they are in dire need of medical assistance. So why then should a healthy mom with a healthy, no risk pregnancy needs to give birth there? (Food for thought). With that being said, they ultimately treat birth like it is an emergency waiting to happen, whether that is from policy such as you can't eat just in case you need to go under (outdated information, here is the most recent study in regard to this rule).
Ultimately if you don't like the atmosphere of the hospital, then don't go to it. Look at what other options there could be in your area, birth center, birth cottage, or even a home birth.
Knowledge (Take a good out of hospital birth course)
Know what to expect when it comes to labor, especially natural labor. Take a good course to know what your options truly are (I'm not talking about ones that are set in place by hospital policy, because they aren't all your options believe it or not). Learn various comfort measures you can use during labor, as well as what a healthy pregnancy actually looks like and your options for various tests during pregnancy as well. Know the red flags of when a provider is trying to get you to go in for an induction that isn't for an actual medical reason (hint wanting to induce for a big baby is not a reason to be induced. Here is a great study on that here).
Great options for birth class are
A great book to read is Natural Hospital Birth.
Pick a Provider Who Has Experience with Natural Birth (Great interview Question)
You should be interviewing your provider, whether an OB or midwife to make sure you're a good fit anyway, so throw this into the mix of questions when you're talking with them. Also, just because they are a midwife working in a hospital doesn't guarantee they have a lot of unmedicated births or don't want to have an induction because of a supposed big baby. Never assume, ask!
Know How to Advocate
In addition to knowing what the red flags are when it comes to pushing induction or pain medication, or even wanting to speed up labor with Pitocin, know or practice how to advocate for yourself. Also have your husband practice as well. Again, natural, unmedicated hospital birth is not common, so you will most likely get some form of pushback from either a doctor or nurse along the way. Know how to ask for more time to make decisions and know where to get evidenced based information when you ask for an alternative.
Hire a Doula
We are trained to help support families during labor, especially when it comes to unmedicated. Not only do doulas know various positions and comfort measures for labor, we also know how to remind the husband how and what he is wanting to advocate for. When you hire a doula, you will know for sure one other person in the room (you don't know necessarily which doctor will be on call, and you won't know the nursing staff), and she will be there to support what you want!
Labor at Home as Long as Possible
While many doctors will say that the typical rule is to come into the hospital when you are having contractions 5 minutes apart, lasting for a minute long, going on for an hour, if you are desiring a unmedicated birth, your chances of having low interventions increases when you labor at home for as long as possible. Once labor has been established, changing your location will most likely not slow your labor, nor will meeting so many new people along the way.
What are your tips for having an unmedicated hospital birth? Comment below!