Questions to ask your provider when planning an unmedicated, hospital birth
As someone who has had two unmedicated, hospital births, and has supported many more as a birth doula; I can attest to the importance of the right provider when trying to achieve this goal. Something that continues to astonish me as a doula is how different providers procedures and hospital policies can be, even when they work right down the street from each other. Picking a medical care provider for your unmedicated, hospital birth, is arguably one of the easiest ways to make your goal easier to achieve. It’s important that you feel relaxed and supported during the experience, and aren’t feeling like you’re having to fight at each turn for the low-intervention experience you are desiring.
Don’t fall into this myth that if you want, or need, a hospital birth, you are bound to fight intervention at every turn.
I have worked at plenty of hospitals within Kansas City that are encouraging and supportive of my client’s low-intervention goals. And if you live in an area where there are multiple hospitals to choose from, chances are they differ in how often they see and support unmedicated birth.
Step one: Interview your medical care provider
DO NOT just go with whatever doctor you have been seeing for gynecological care pre-pregnancy. There is a chance they fit into your birth needs, but there is also a high chance that another provider might be a better fit for your goals.
So how do you find a care provider who best fits your birth plan? Here are the questions I would ask a medical care provider (OBGYN or Midwife), if I was trying to find one to support an unmedicated, hospital birth.
Do you have any midwives on your medical care team? Are you supportive of me hiring a doula for my birth and do you have any ones you have liked to work with in the past you can refer me to?
Even if you don’t plan on using a midwife or a doula, this question can help you know how accepting an obstetrician is of working collaboratively with people who generally offer more holistic care options. If they have contacts within the doula community, that could be a good sign that they are willing to look outside of their expertise to help their patients get the wrap-around care they might need when seeking a more natural birth experience.
How often do you see unmedicated births? Are you comfortable with accommodating or observing my discomfort during the phases of physiological labor?
You might be shocked to know how rarely most doctors, or even labor and delivery nurses, support unmedicated births. While giving birth in a hospital is going to deflate the amount of births most care providers see unmedicated births, some hospitals I have been to are shocked to see a women go without an epidural. Others are used to it and therefore much more accommodating of the laboring persons discomfort. According to this article, about 70-75% of women get an epidural, so if your doctors estimates are closer to 90%, that might mean the environment they work in is not as accommodating of unmedicated births as others may be.
What amenities/policies does the hospital you deliver at have to help facilitate a naturally progressing labor and aid in comfort?
From what I’ve seen in the hospitals that are more comfortable with unmedicated birth, you should expect amenities like… a peanut ball, birth ball, a cub, squat bar, beds that move into various angles for different pushing positions, birthing stool, large tubs or walk-in showers, etc.
If you are planning on using water, policies around usage can vary greatly depending on if you have an induction, if your water has broken, or if you’re needing fetal monitoring. Also ask about policies around drinking and eating, as that can be an important piece of keeping your energy up during what will be one of the hardest workouts of your life. I am seeing many more hospitals allowing (and even encouraging!) light snacking during labor, while others are still stuck in an “only ice chips” policy.
Ask about their policies on monitoring and IV hookups.
A quick way to make a low-intervention birth difficult to achieve is to prohibit movement. While I’ve seen clients give birth without pain medication hooked up to ALL the things during an induction or high-risk pregnancy, it definitely doesn’t help the cause. So if you are planning a spontaneous, unmedicated labor, it’s important to know what you can expect to be hooked up to once you arrive to the hospital and how that might affect your abilities to cope.
Different options with monitoring are (ranging from highest intervention to lowest): continuous monitoring on the fetal monitors that are hooked to the main station; wireless, continuous monitoring; intermittent monitoring (typically set up as 20 minutes on the main monitors, and then 40 minutes off); and then intermittent auscultation (intermittent checking of fetal heart tones using a doppler).
Options for IV access are (ranging from highest intervention to lowest): IV hooked up to continuous IV fluids, IV with saline lock, No IV placed.
There are potentially many more questions specific to your requests you can ask your provider; but these are the top ones I would suggest, as they are the ones where I see the most differences between care facilities. The most important thing you can do when picking a care provider for a low-intervention birth, is to trust your gut! When you are talking with them, pay more attention to how they are making you feel about your wishes, then their exact answers.
And remember, it is possible to have an unmedicated or low-intervention birth in a hospital, it just can take a little more work picking the right team and facility, and knowing how to advocate for yourself. A doula can be a great addition to your team to simplify the process and help you navigate your birth plans effectively. If you’re interested in checking out our services (including out virtual prenatal birth coaching option), click here.
Happy Birthing!
