When I first got pregnant I selected an OBGYN based on my primary care physician's (and also a family friends) recommendation.  My original goals were to have a safe birth that was as pain free as possible and a healthy child.  After researching and changing my views to a more natural birth stance, I find myself wondering, is it too late to find the resources to have a natural birth?  I am currently 24 weeks pregnant. 

I would like to have as natural a birth as possible - with the goal to avoid an epidural and C-section (AND have a healthy child and safe delivery.  So often it seems when you go into a hospital that you don't have much choice about the medical intervention your doctor deems necessary.  I'm not sure how supportive the OBGYN I choose will be - but I haven't been able to find a natural birth center in my area and I'm sure a provider who would help me with a home birth is out of the question here.  I have half heartedly looked for a new OBGYN and they all seem to have the same non natural birth friendly outlook. 

I'm taking lamaze classes, looking into hiring a doula, and trying to be informed.  My real question is, how can you have a natural birth without having a supportive OBGYN as there don't seem to be any in my area. 

I would think that switching to a midwife might be the way to go. Some hospitals have midwifery programs. If yours doesn't, you might try googling to see what you can find. Some states have midwifery associations. I just googled & found the Midwives Alliance of North America. http://www.mana.org/index.html Apparently, if you email them they will send you a list of their midwives in your state. (Click on Resources on the left on their website.) My OB delivers at the hospital with the highest C-section rate in my state. I am in the process of switching to a midwife who delivers at a birth center that is affiliated with but physically separate from a hospital with a much lower C-section rate. Even if the birth center didn't exist or if I get transferred to the hospital because of complications, I am hopeful that there will be a minimum of medical interventions. Had I stayed at the original hospital, I think having a midwife as opposed to an OB would have helped a lot. For instance, the hospital with the largest maternity unit in my state has a 24% C-section rate, but their midwifery program has a <10% rate.

You can certainly change providers, and you are on the money that an approach that minimizes use of potentially harmful interventions best promotes safe, satisfying childbirth. Nonetheless, while it is true that midwives are more likely to have a practice style more supportive of normal birth, you get no guarantee of that. Likewise, obs are more likely to have a medical-model practice style, but not necessarily. One good winnowing technique is to tap into any local grassroots organizations such as a birth network or an International Cesarean Awareness Network chapter, a pregnancy resource center (not a commercial one!), or the local doulas. They are likely to know who offers care supportive of normal birth. However you gather names, you will also want to interview prospective providers. I have a section with suggrested questions and considerations in my book, The Thinking Woman's Guide to a Better Birth, which includes red flag responses, but you can also find a section on interview questions for care providers  on the Childbirth Connection website at http://childbirthconnection.org/article.asp?ClickedLink=247&ck=10158&area=27. While I'm at it, they have  questions for potential birth sites as well at http://childbirthconnection.org/article.asp?ClickedLink=252&ck=10145&area=27.

-- Henci

In my area there are only hospitals. I found my greatest ally to be a doula whose day job was in the labor and delivery ward. She knew all the docotrs and nurses and personalities and the hospital's typical procedures, but she also knew exactly what I wanted and was totally supportive of natural birth, and since the staff knew and trusted her they let us do mostly what we wanted.

Thanks for the suggestion! Even if doulas don't work for the hospital, they usually network with each other and know which care providers and hospitals support normal birth and which don't.

-- Henci

Another great resource from the Childbirth Connection is their 'Pregnant Patients Bill of Rights'. You can order or download it. I always advise bringing it with you to the hospital. That way, if you encounter any adversity, you can pull it out and say, "I know my rights." Being informed is crucial to obtaining a normal birth experience in a hospital.

I agree that being informed on the issues and your rights is crucial. I also think that things will go smoother if any exceptions to usual hospital policy or practice are, if possible, worked out ahead of time with care providers and hospital staff, that couples pick their battles, and that being polite and diplomatic as well as firm are most likely to get couples where they want to go.

-- Henci  

laboring at home for as long as possible, until you start to feel pushy if you're not too far away

once you get there

avoiding a flat on your back position, you can get up to pee if thats the only way, after all its important to try to pee every hour or so anyway

eating and drinking as you feel the need....labor and birth are hard work (although you may have to sneak your food, it's usually not "allowed" )

go over your birth plan before hand w/ your hcp and have several copies on hand, include it when you turn in your pre-registratio n papaers and bring several copies for the all the health care providers you might encounter . when you go over the plan with the dr/midwife/etc be sure to find out any objections they have and if you encounter real opposition to anything ask for evidence to back up their objections

if, while at the hospital anyone trys to coerce you into anything the phrase "i do not consent" can be helpful....shows that you are well versed as to your rights

hth

All 4 of my children were born in a hospital, and all were natural births.  My first (almost 20 years ago) was not "exactly" like I wanted, yet I still achieved a non-medicated, vaginal birth.  I did have to endure an IV, episiotomy, seperation from my baby, etc.  I learned much from the experience; mainly what I didn't want to happen next time! 

The next time was only 15 months later, with the same OB and at the same hospital.  The difference?  ME.....  I knew that I wanted it to be different, and through planning and communication - it was awesome.

By the births of my 3rd and 4th children, I was a practicing childbirth educator and Doula.

I do agree that having a Doula who is knowledgable of hospital "norms" is very beneficial.  Most first mothers "don't know what they don't know".  It helps to have an advocate.

Have a wonderful birth!