In hospital settings, women who choose unmedicated births are often misunderstood, under supported, and greeted with disbelief, and “hidden” sarcasm. Hospital nurses are often ill equipped to provide the support needed to help a woman having a normal, unmedicated, non-interventionist birth. They often don’t understand birth, have a fear of birth and have been indoctrinated into the medical model of care.
Hospitals hinder normal labor and birth with many of its routines like IV fluids, electronic fetal monitoring, and restrictions on movement, eating and drinking. Aggressive protocols that include Pitocin and artificially breaking a woman’s water bag abound creating a VERY difficult environment for a natural, normal birth. In spite of all of this, an unmedicated birth in a hospital setting IS possible. Yes it can be a mountain to climb but you CAN do it with the right preparation and the right support.
As you prepare for your labor and birth experience, there are a number of things you can do to make your chances of an unmedicated birth in a hospital more likely. Among them are choosing the right birth team. It is IMPERATIVE, if you are planning an unmedicated birth in the hospital that you bring along with you a friend, family member, or doula. More than anyone else, for a woman who desires an unmedicated birth in a hospital, I believe the presence of a labor doula can have the most profound impact on her birthing experience. (NOTE: All women should have loved ones with them during labor and any one can benefit from having a doula on her birth team. I am just focusing on hospital birth here.)
Although DONA International, the largest association of Doula’s worldwide, has a membership of 6,000 individuals here in the United States alone, many women still have never heard of doulas. Even when a woman does know what a doula is, somehow the benefits of hiring a doula are not realized. I am frequently surprised when I ask a pregnant woman, especially first time mothers, if they have hired a doula and they answer: “No, I don’t think I will need one, my mother, (sister, girlfriend, husband) … will be there.” Or “No I really didn’t want any strangers in my birth room.”
That one always makes me chuckle… Believe ME!!!….. There will be PLENTY of strangers in and out of your room during your hospital birth experience: various nurses, secretaries, lab technicians, OB technicians, students of various specialties, and more. The one person who can remain constant during this time would be your doula!
While it is GREAT to have your mother,(sister, girlfriend) present for your labor and birth; and while it is fantastic if you have a partner/husband who is interested in playing an active role in your labor and delivery experience, I cannot begin to express how important and irreplaceable a doula is, ESPECIALLY if you are planning an unmedicated birth in a hospital. A doula, who has been hired by YOU, who is NOT an employee of the hospital, and who is committed to YOU, YOUR birth, and YOUR experience is invaluable!
I am not just talking about any doula. I am talking about a GREAT doula! One that you have met with, spoken to, and made a decision to hire based on her experience, and the energy you have between the two of you. While a doula can be effective even if your first encounter is at the hospital in labor, she will be more effective if you have met during your prenatal period. Just as it’s important to do your research when choosing a prenatal provider/birth attendant, it is equally important that you do your research when choosing a doula. You want to make sure that the philosophy and style of your doula match YOU and your needs.
The great thing about a doula (and this is not always the case with friends and family members) she is specially TRAINED to help you AND your spouse with the work of labor and birth. She can be your advocate and a liaison between you and your care providers. A great doula knows how to be vocal and strong on your behalf while being gentle and mindful of your needs.
After the birth of your baby you may be amazed at how EVERYONE’s attention (including that well meaning friend and your mother) goes to your newborn. Your needs quickly fade into the background. Even in some of the most “baby-friendly” hospitals, your baby may be quickly brought away to the nursery and often your husband/partner will leave you to go with the baby. Your mother/sister/friend is exhausted and often all they can think about is getting home.
In the midst of all of this, it is your doula who will stay there with you steadfast during your immediate post partum transition. It is your doula who will visit the next day not just to “see the baby ” or to “say hello” but to help you process your birth experiences helping you have a more peaceful transition to motherhood. A great doula knows when to stay and what to say.
Now you may still be thinking… “Nicole, I hear what you are saying HOWEVER, I still don’t want to hire a doula. My sister, girlfriend, mother etc will be there to support me.” That is definitely YOUR choice. However, before you make THAT your final answer, I want to encourage you to ask yourself a few questions.
Has she had an unmedicated birth? Has she ever witnessed a normal unmedicated birth? Is she supportive of unmedicated birth? Will she be able to support you physically, mentally, and emotionally? Will she be able to help you make sense of the medical jargon thrown at you during labor? Will she be FULLY supportive of your choices? Will she do things to undermine you?
I have witnessed it multiple times: Supportive friends/family members either knowingly or unknowingly talk you into pain meds, or an epidural. It often happens because THEY are uncomfortable with you being uncomfortable. They don’t understand the work of labor and as a result want to move in to “help you” or “fix you” and all they know is… “When I (my sister, friend …) had my baby I got an epidural and everything was great after that… are you SURE you don’t want an epidural?”
I have had family members pull me aside to quietly say to me… “I know she doesn’t want an epidural but can’t she get SOMETHING … I remember getting something in my IV for pain.” Mothers in particular, often struggle watching their daughters experience the pain of birth. Even a mother who has experienced an unmedicated birth herself feels trepidation and fear when her daughter, cries out in labor pain. Family members and friends quite honestly don’t usually know HOW to support a woman in labor. A great doula, knows how.
And what about your husband/partner: Will he be equipped to support you, or will he need support of his own? I have seen men be both remarkably supportive as well as irritatingly disruptive during a labor and birth. What is the relationship like between you and your husband during a normal day? Where do the two of you struggle? How will this affect your labor? What does he think about normal birth? Will he truly be able to “let go and let birth?” While being present is one thing, being your primary support is another. A great doula knows how to be supportive to you, your partner, and the two of you as a dyad.
How COMMITTED are you to having an unmedicated birth? If the answer is VERY committed; if you can’t envision your birth any other way; then quite frankly in my opinion you HAVE to have a doula.
Now there is an exception to every rule… If you are a part of a community of friends and women who support, understand, and have experienced normal birth…. Be happy and know that one of them can likely be the support you need. If this is NOT your normal sister circle, you should SERIOUSLY consider hiring a doula.
In the moment when you are working well with your contractions, in a good rhythm, and your provider wants to “speed things up with a little Pitocin” you need someone there who can help you understand your options, your choices and what is normal. A great doula can.
In your moment of wavering faith, when your body is working hard and your mind questions if you can go forward; You want to cry out that you can’t go on and your nurse is repeatedly asking “Are you sure you don’t want an epidural?”
You don’t need someone whispering in the corner… “why doesn’t she just get an epidural?” You need someone to tell you it is going to be fine, you are strong, and you can go on. You need someone who will encourage you and help you refocus while simultaneously communicating your wishes to the staff. A great doula will.
A great doula can do all these things and more. If you desire an unmedicated hospital birth, hire a doula!! Make the investment. Wondering about the actual cost/investment to hire a doula… here are a few words from Lisa… a reader:
“I often seen women say that doulas are “too expensive.” A couple of points about that:
1) I see it as a one-time cost for a once-in-a-lifetime event. To put it in perspective, my doula cost about as much as my wedding dress — in both cases, the memories I got in return were MORE than worth the cost.
2) There is a huge range of prices for doulas. For my current pregnancy, we interviewed doulas ranging from $200 to $750, and you can even find doulas-in-training who will work for free! And more expensive does NOT necessarily mean better; the one we ended up picking was right in the middle of the price range.
3) If the cost of a doula really is a hardship for you, most doulas I’ve seen are willing to work with you on price. So ask about it! Don’t let money be the ONLY reason you choose not to use a doula”
Thanks Lisa for that great insight… I definitely say Hire a Doula… You will be glad you did.
In Birth and Love
Nicole ~ Follow me on Twitter @SistaMidwife