As a doula, I am occasionally asked, “So, do you only attend home births?” Far from it. Though I am a strong advocate of home birth, I believe that labor support is absolutely necessary wherever a woman chooses to birth, and that a woman has the right to choose to birth wherever she feels safest. For approximately 98% of birthing women in the US, this means choosing a hospital birth.
What is also true is that, nationwide, our hospital cesarean birth rate is 36%, with my home state of New Jersey ranking the highest, and our maternal mortality rate in the US ranks 50th in the world. 95% of birthing women are choosing to have epidural anesthesia for labor. These numbers don’t reflect a very high incidence of warm-fuzzy natural births. So, if this hospital setting is where the majority of women, including those who want a low-intervention natural birth, feel safest, then the question must be asked, how do we as mamas and papas and partners and practitioners create a sacred experience in the birthplace where we feel safest?
There may always be circumstances beyond our control. That’s a given, and making the best informed choice in that moment is a necessity. There is much, though, that can be done to create a natural, gentle birth while still being in a hospital setting. You’ve no doubt been told to take a good childbirth class, and that’s a great place to begin. The following suggestions are the “beyond the birth class” pointers that I have taught to expectant families and birth professionals for the past 14 years.
10 Tips to Create a Positive Birth in a Hospital
1. Hire a doula! If you desire a natural birth in a hospital then having a doula for support is essential. Doulas are the “Walking Wikipedias” for all things natural birth. Experienced doulas know the doctors and midwives in their area. They may also know your hospital staff, and have built harmonious bridges there. They can refer you to good childbirth classes, lactation consultants, pediatricians, chiropractors, and are a wonderful resource for many other prenatal and postpartum services. They often have connections with support groups and other parents in your area. Your doula will support you with every step along the way as you prepare for your birth, and will remember what is important to you when your birthing time comes. A good doula has immeasurable value!
2. Imagine your positive birth. The part of the brain responsible for memory does not know the difference between something that actually happened, or something that is vividly imagined. This means that spending time with imaginative visioning provides you with stored memories of positive birth experiences. Take time to picture clearly the details of yourself feeling peaceful and safe, your body opening, your baby emerging with ease. Take in positive birth stories through books, film, and other women who feel satisfied with their births. These positive stories will provide you with confidence and comfort. With good experiences now stored in your brain as a resource when you are in labor, it’s as if your brain says, “Oh, remember that time I had a baby and everything went easily and was just fine? If I’ve done that before, I can do that again right now.” Oh, and stop watching the Birth Story shows. Normal, uncomplicated birth doesn’t make for good high-drama TV, and takes much longer than half an hour. Your memory is taking those in, too, and they won’t serve you well.
3. Figure out your fears. Name them, and if you can, take time to examine and re-write the core beliefs behind them. Our “core beliefs” are what we hold to be true about ourselves. They are the deciding factors behind most of the choices we make in our lives. A person with the core belief of “I am worthy, loved, and safe” is going to have a more positive experience than a person who carries the core belief of “I have to struggle to get what I need”, regardless of their birth outcomes. Preparing to give birth is an opportunity to not only understand the physical process of growing and birthing a baby, but also to explore the mental, emotional and spiritual aspects of preparing yourself for parenthood. Now is the time when working with a childbirth educator, doula, counselor or therapist to heal the negative core beliefs that may undermine your ideal birth is an excellent way to support yourself.
4. Know the policies and procedures in your hospital. Understanding your options in a hospital is critical in order for you to feel empowered and to create a safe space. Ask your doctor and your doula about their experiences with natural birth in your chosen birthplace. Call your birthplace and find out who can answer your questions about their policies. If the birthplace of your choice does not offer options that you find acceptable, find another one that does. They do exist!
5. Write a birth plan. Notice I did not say “Write a five page list of demands and make fifty copies and hand one to everyone you encounter”. People don’t typically like being told what to do in black and white before they’ve had a chance to show you their best. The process of writing a birth plan is a shared exercise between expectant mama, her partner and other support people who will be present for her birth. Thoroughly considering all of your birth options via a mental “dress rehearsal” can help you understand your options and clarify your wishes and intentions for your birth. This exercise then becomes a tool that will help you communicate clearly with your doctor or midwife. If you do choose to put a birth plan into writing, keep it short and simple – a single page, with your top ten utmost priorities bullet-pointed, phrased in the positive (“Thank you for…” and “I would prefer…”, rather than “DO NOT EVER…”). Review it with members of your birth team prior to your birth, so that everyone is on the same page.
6. Thank the hospital staff upon arrival with a gift. Perhaps you bring the banana bread that you baked while passing the time in early labor, or maybe you have a basket of cookies ready to go. Stop for doughnuts on the way to the hospital, if that’s what works for you. Attach a thank you note with your name on it, and a copy of your birth plan. Most hospital nurses work really hard. It’s long hours, a lot of demands on their time and energy, and not a lot of thank-you’s to go around. People are nicer when you begin your interactions with showing kindness and gratitude. (They’re also nicer when you feed them.) This may not inspire anyone to bend the rules on your behalf, but it will certainly start things off on a positive note between the hospital staff and the laboring family in room 16. They will notice right away that this is a different experience for them, and that opens the door for your entire birth experience to be different than “the usual”.
7. Find subtle ways to make your hospital space your own. Consider making a sign to hang on the hospital door that asks that people knock and enter quietly, or even just make one with your names – “Jane and Tom and BabyQ say thanks for your support”. Choose your own clothes to wear, rather than the hospital gown that looks like every other patient. Bring positive birth images to tape to the wall. Bring an aromatherapy spray that you like the scent of. Anything that may lead someone who is entering the space to pause for a brief moment and notice that “Oh, this is different” helps create the space for your birth to be recognized as unique, and treated as such with respect.
8. Bring music into the labor and delivery room. This not only helps with making the space more comfortable, but serves a myriad of other purposes, as well. Rhythmic music can be calming to your mind. Rocking and swaying, often helped along by music, helps move the baby down more comfortably and with greater ease. Singing along can help you use your voice in a powerful way to cope with strong surges (no matter how well you think you can carry a tune). Music creates a sound barrier between your room and the room next door, if the hospital walls are thin. This helps you have a greater sense of privacy, making it easier for you to let your own guard down so that you can surrender deeply to your birth process.
9. LOVE, LOVE, LOVE! Ina May Gaskin says that the energy that created the baby is the energy that will get the baby out. Oxytocin, the hormone produced during lovemaking, is the same hormone responsible for labor. So, anything that would be conducive to good lovin’ is also going to make for an easier birth. Sweet music, hugs and kisses, loving words, soft lights – these are all helpful. Likewise, anything that would be a mood zapper can have the same effect on labor. Keep the hospital room door closed. Keep people in the room to a minimum. Turn the phones off. Let love lead the way.
10. Practice meditation to invite calmness and well-being into your daily life. Meditation isn’t about learning to sit like your legs don’t have any bones. Meditation isn’t about seeking and finding peace and stillness. Rather, it’s about making room for the stillness that is already within you, under all of the layers of busy-ness. In that place of stillness dwells the part of you that already knows how to have a baby. Just like your baby knew how to grow the right number of toes without taking a class to learn how, your body knows how to birth, and your baby knows how to get born. In being able to tap into your own stillness, you will find your strength. Start now. It’s ok to start with a minute – just one minute – of sitting and smiling. Your thoughts may wander, and that’s normal. Just recognize this, and bring yourself back. Take a breath, in and out, and then another breath. Take one minute to take a deep breath and name three things that you are grateful for today. Take one minute before sleep to replay a happy memory from this day. A minute here, a minute there – it adds up. Find your stillness. Trust your body. Trust your baby. You can do this.
It is my hope that you benefit from these pointers and share them with others. If you have any of your own suggestions on what made your hospital birth positive, empowered, and sacred, please share them here in the comments.
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