When it comes to talking about birth there can be so much divisiveness: home VS hospital, epidural VS natural, etc. Though these polarized debates can cement an opinion for some, they are confusing as hell to many others. The truth is, most women would be very content with the best of all possible worlds.
As a wise friend once asked, Why can't we get the freshly baked bread AND the epidural?
I think it's a great idea to take what you can get from both the hospital and the hippies, and cobble together the kind of birthing support that's just right for you.
On that note, I'd like to throw out some ways home birth practices* can help in a hospital birth setting.
1. Stay home in early labor.
In first births this is especially important. There's no reason to rush off to the hospital at the very first sign of labor. Stay home until you're in active labor (this starts when contractions are 3-5 minutes apart). And do what home birthers do. Dim the lights, keep random people away, get in the bath, get in the shower, moan, groan, get on all fours, rock back and forth, eat and drink lots of water or Gatorade.
2. Think of hospital procedures and medications as "back up" as opposed to essential.
Birth may be difficult or hard or downright painful but most often it works. We are designed to do this. And in the instances where something isn't working out we have fantastic medical technology to back us up. Home births work on the assumption that, in low-risk pregnancies, all will be fine and in the case that something does come up, you can transfer to a hospital. You can get into the mind-set that hospital care is a "back up" even if you do know you'll be going there for the actual birth. This can build your confidence both in normal labor and in medical technology. Both have their place.
3. Learn some other ways to cope with pain than the epidural.
If you're giving birth at home you can't get an epidural, so you're forced to really educate yourself about other options for reliving pain in labor. Even if you know you want to get an epidural in labor, you might benefit from learning these other techniques- massage, changing positions, vocalizing, hypnosis, etc- as you may go through some portion of labor without pain medication for any number of reasons. In general, learning lots ways to cope helps build confidence.
4. Get a midwife.
In the US most babies born at home are delivered by home birth midwives. But midwives deliver in birthing centers and hospitals, too! And they are often covered by insurance. There are lots of myths about midwives circulating, but the fact is certified midwives are trained medical professionals who can prescribe tests, sonograms and medications. The only thing they are not trained to do is surgery. But we have doctors for that.
5. And/or a doula.
A doula provides continuous labor support, something not offered by hospital staff or obstetricians or even (some) midwives. This continuous support has been shown to reduce the chance of medical interventions including c-sections and even shorten the length of labor. Doulas are often used in home births as a primary source of comfort and support.
6. Labor in your tub and/or a hospital shower as much as possible.
Women giving birth at home often rent or buy a birthing tub to help with pain in labor. Being fully immersed in warm water can be as effective for coping with pain in labor as an intramuscular shot of narcotics. Birthing centers and a few hospitals have tubs for laboring, if not there will be a shower which is a good runner up.
7. Read about what normal birth is like.
Pick up one of Ina May Gaskin's books or another book about how normal birth works, and read it. Gaskin's enthusiasm for the female body can be infectious. It can give you just the reassurance you need.
8. Avoid people and websites and books and movies that make you feel overly anxious about birth
*including movies that make you feel anxious about the hospital.
Reality television shows that feature dramatic medical emergencies and terrified pregnant teens get ratings but are they instructive or inspiring when you're expecting? Maybe not. I'd also caution against watching documentaries or TV shows or reading birth books that highlight things that can go wrong in the hospital. It's time to be skeptical, sure. But it's also time to build confidence and minimize fear.
Labor hormones tend to flow when mom feels safe and protected. Birth, it turns out, is kind of an intimate experience. So have people with you in labor who believe in you and who believe in birth (partners can read positive birth stories, too). Play gentle, repetitive music on headphones if you want to. Turn down the lights when you get into your labor and delivery room. Bring your own pillows. Go to the bathroom and just sit on the toilet for a while. Talk to your partner in advance about how he or she can support you and help buffer you from all the logistical hoo-hah of checking into the hospital and getting settled.
Some hospitals still have an outdated policy about not eating and drinking in labor. Some don't. Most hospital staff won't care of you have sips of Gatorade or water in labor. They'll also turn a blind eye to snacking. Home birthers tend to eat and drink through labor to help maintain hydration and much needed energy. And they tend to move around a lot. Just because there's a bed in the middle of the hospital room doesn't mean you have to lie down on your back. If you're not being monitored, get up and move! Or squat. Or lean. Or kneel on the bed. All this helps labor progress and it can take the edge off the pain.
I wish this cobbling together wasn't up to us. Wouldn't it be great if all hospitals had equal amounts of midwives and doulas as doctors and nurses? And wouldn't it be nice if we could all labor in tubs with the option of an epidural if we needed it? Birthing centers attached to hospitals offer this complete package but there are pitifully few in the US. So, until we make big changes to our maternity care system many American women have to be proactive when it comes to getting the best of both worlds…and as you can see, there are lots of ways to do it!
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