If you have your heart set on a low-intervention, drug-free natural birth at the hospital, follow these 4 steps while still at home to give yourself the best shot.
Aiming for an un-medicated or low-intervention labor and birth? You might want to stay home from the hospital as long as possible, especially if this is your first baby. That's because the best strategies for achieving a "natural" labor—movement, hot water, deep relaxation and patience—are often easier to put into action at home than in the hospital.
Most low-risk women are perfectly safe spending early labor at home. During early labor, which can take, on average, 8 hours or more for a first time mom, the cervix softens, thins and eventually dilates. We used to say that women should head to the hospital when they were in active labor, which was defined as starting at 4 centimeters. But recent studies indicate that this leads to too many unnecessary cesarean sections. Revised definitions take into account the fact that early labor often takes a whole lot longer than many providers have previously been willing to wait. In fact, the American College of Obstetricians and Gynecologists now says that for first-time moms, active labor begins when the cervix is dilated to about 6 centimeters.
When women head to the hospital during early labor, they may spend too many hours in bed with doctors, midwives and nurses clocking their progress. They can expect long hours of fetal heart and contraction monitoring, lots of staff interruptions, and limited access to a tub or ability to move around. Many women are admitted early because that's what their doctors recommend, but many simply don't have enough at-home strategies. For your best shot at a low-intervention birth, try these 4 strategies in any order both at home and once you get to the hospital.
Walking, rocking, squatting, sitting, swaying and switching sides while resting can help your body work with your contractions as gravity and mobility help baby move into the birth canal. Plus, movement eases tension and gives your mind something to focus on other than pain. It's much easier to stay mobile and use movement at home without the restrictions and confines of hospitalization.
Give your midwife, doctor or hospital a call when your contractions are at least 5 minutes apart for an hour or more and are getting progressively stronger and closer together no matter how you move. If they're 5 minutes apart while you're lying in bed but spaced further apart when you move to the tub or go for a walk, it's probably not time to go to the hospital yet.
hot compresses, showers and baths are a laboring woman's best friend. Hot water eases pain and allows muscles in the back, belly, legs and perineum to relax while the uterus does its job. If you don't have a deep tub, a shower will do and hot compresses on a sore back and belly are miracle workers. Spending early labor in a tub is perfectly fine, but it may lengthen the time between contractions for a while. Don't worry, your contractions will pick up steam soon enough. Many maternity units have birthing tubs or Jacuzzis on site, so don't hesitate to ask about spending active labor in hot water, too.
Call your provider when your contractions are getting stronger and closer (see above) even when you're in the tub or shower or when hot water is no longer enough to ease your pain. If your water has broken, check in with your provider before you dip into the tub. Many doctors consider it perfectly safe to bathe after your amniotic membranes have ruptured but others worry about the slim chance of infection.
Rhythmic breathing, meditation, self-hypnosis and other relaxation techniques are excellent tools for all stages of labor, but they're easier to manage when you're not being interrupted. Once you're in the hospital, your nurse will frequently check your vital signs, hook up monitors, draw blood, start IVs and do other interventions that may clash with your Zen. At home, you can light candles, close your eyes, follow your breath, meditate and create an ambiance that promotes relaxation.
If your contractions are so strong that your relaxation techniques aren't cutting it, try moving to the tub or shower, change positions, or check in with your doctor or midwife about whether it's time to come to the hospital.
Some labors start with days of off-and-on contractions that wear moms out long before "real labor" even starts. Even after contractions get organized into a regular pattern, early labor takes, on average, 8 hours for a first-time mother and 5 or more for experienced moms. As much as you'd like labor to be over, there's usually no need to rush things. Keep yourself entertained, relaxed, hydrated and nourished and plan on labor being a marathon, not a sprint. Be sure to let your midwife or doctor know if you're becoming exhausted. They'll help you decide on next steps whether that's at home or in the hospital.
If you're bleeding heavily, your baby's not moving, you feel ill or have any other concerns that your labor isn't progressing normally, then forget about staying home and go to the hospital where your provider can evaluate you and your baby. And, if you arrive at the hospital only to discover that everything's normal but you're still in early labor, think about heading back home. There's no shame in that and you may increase your chances for having the vaginal birth you hoped for.