Natural Hospital Birth: The Best of Both Worlds

by Cynthia Gabriel

Natural Hospital Birth, Updated Edition shows how to apply the guidelines and tactics of natural birth in a hospital setting, where 99% of births take place.

Many mothers-to-be find themselves torn between the desire for a natural childbirth with minimal medical intervention and the peace of mind offered by instant access to life-saving technology that only a hospital can provide. In Natural Hospital Birth , doula Cynthia Gabriel asserts that there is no good reason that women should not be able to have both. Cynthia shows expectant mothers what they can do to avoid unnecessary medical interventions and how to take initiative and consciously prepare for the kind of birth they want to have. Also included are inspiring stories from other women who know firsthand that natural birth in the hospital is possible. With this book, mothers-to-be will be equipped with the knowledge they need to ensure a satisfying hospital birth that they will look back on with peace and joy.

Genres: Parenting, Nonfiction, Health, Adult, Education, Medicine, Medical

272 pages, Paperback

First published May 15, 2018

About the author

I'm a mother of three, a doula, childbirth educator, and medical anthropologist. I teach about the experiences of pregnancy, labor, birth, and parenting across the world, especially in Russia, Canada, Brazil, and the United States. I think all new parents need our support to do this incredible work of raising our Future. You can find my thoughts here: https://thebirthmuse.wordpress.com and here https://www.facebook.com/Natural-Hosp...

Reviews

[Heather · Rating 5 out of 5]

This is the most valuable book I've read on labor and delivery yet. Although the target audience is for those seeking to have an unmedicated birth at a hospital, I think *all* expecting parents should read it, regardless of whether they are pursuing that route, home birth, or birth with medical intervention at the hospital. This book goes into explicit detail about the different phases of labor and delivery, pain management methods (natural and medical), techniques on how to effectively communicate with your caregivers your preferences, and many other incredibly valuable topics.

The ubiquitous "What to Expect When You're Expecting" and "Your Pregnancy Week by Week" fall embarrassingly short on helpful guidance for labor and delivery, and this book is infinitely more useful…I would love to see this book at every maternity resale shop, garage sale, moms-2-moms sale, and on every bookstore shelf, instead of those other two.

[Sharon Dodge · Rating 4 out of 5]

I read this book almost against my will; the first chapter or so wasn't to my taste at all, full of visualizations and general gooeyness that left me cold. But then it surprised me; a book that actually addressed different cultural experiences surrounding birth, and discussed useful tips on how to handle a staff that is bent on making a decision for you - particularly for folks who, by virtue of rural location, might only have one doctor or staff available to them who might still believe in episiotimies, the lithotomy position, or a hospital with a 40% Caesarean rate. (Yep, they exist.) Lists of what to come prepared with (medical information, etc.), how to best calculate your expected labor time based on the speed of your initial contractions and how quickly you progress, how to gently spread the word of an interest in avoiding interventions without an obnoxious list, etc. are items I have wanted to find for forever and really haven't seen anywhere else.

Almost as importantly, I was thrilled to see this book actually addresses the partner's viewpoint more than most (and partners are not definitively referred to as husbands - another pleasing note). It is the only book thus far I've asked my own partner to read, because I feel it's the only one that might genuinely benefit him.

Even if you aren't considering a natural birth, this is a truly useful book; since it's not unheard of for natural births to occur simply by virtue of getting to the hospital too late, not to mention epidurals are rarely given until you're at least partway into labor, the coping mechanisms it provides if nothing else are thoroughly useful.

[Melissa · Rating 5 out of 5]

This book is a fantastic resource for women wanting a natural experience, but also the peace of mind of birthing in a hospital with all the technology available in the small chance that anything would go wrong. It is empowering, accessible and smart. Gabriel's passion for birth is evident and she knows her stuff - it is a great resource for first time birthing mothers because she references so many of the natural birth schools of thought. It is also one of the first birthing books I've read that gives an extremely detailed account of not only the physical stages of each part of labor, but also the emotional stages women might go through as well.

Gabriel also has an extensive section on birth plans and why they are important. She guides the reader through questions to write a dream birth, a detailed birth plan for themselves & their support (partner, doula) & a medical team birth plan (much shorter & focused). She even recommends how to phrase certain things to ensure a higher level of respect and cooperation in a hospital birth setting.

I will soon be embarking on my second birth - in a hospital going for a natural experience. The first time, after laboring for a LONG time, I ended up with an epidural in the last couple of hours. I am satisfied with the treatment that I received, but I would've liked to make it through completely drug free. Armed with my first experience coupled with all the preparation I've been doing, I'm confident I can make it through!

It is a great contribution to the natural birth literature out there and a must read for birthing women!

[Katie · Rating 5 out of 5]

The more I think about this book (now 10 months out of delivering my daughter), the more I appreciate this book. It's a really practical, non-judgmental/non-fanatical guide to having a natural birth while in a hospital. I think it's geared more for people who are using a more traditional practice of obgyns, so since I used a midwife group I didn't find I needed to "fight" for many of the things she talks about. But, I found all the suggestions for things to do at home while in early labor and when to know it's time to head to the hospital, super helpful. I was referring to it right up until we left. I'm really glad I had this book!

[Delaney Crane · Rating 4 out of 5]

I unfortunately did not get through this entire book before having my baby, but I did at least make it to the part about figuring out if you are in labor haha
I enjoyed this book and did think it had a lot of good information and tips and tricks for having a natural birth in a hospital. It starts with encouraging you that you are able to give birth naturally and then from there it goes through each section of labor, delivery, and postpartum. Even if you are a first time mom just curious about what to expect during each stage, this book is very informative in that aspect. It also goes through many different interventions that you might come across and how to avoid them. The only thing I will say is that this book could actually instill a small bit of fear and anticipation in having to fight to get your way, whereas in my experience, I did not feel any of that pressure from my doctor or any of my nurses. But I know that it can definitely vary from hospital to hospital.

[Hannah Bruxvoort · Rating 5 out of 5]

I am so encouraged after listening to this book.

I’ve trusted my body to know what to do throughout pregnancy—I can also trust it to know what to do in labor. If you are hoping [as I am] for a natural birth in a hospital setting, this is a wonderful resource for preparing for the experience.

[Carmen · Rating 5 out of 5]

I absolutely loved this book. As a first time mommy, I felt completely unprepared to have my baby. I am terrified of hospitals, and my biggest fear was being stuck in a hospital bed and not being able to move, just waiting for my child to be born. After my anxious, jittery self read this book cover to cover three times, I felt more than prepared to have my baby girl. There is great information in here for women who want the most natural birth possible but also want the safety of a hospital setting. It is also a helpful read for your significant other or family members who will be with you during labor and birth. This book is not near as confusing and long-winded as other books I've tried. It's just a very straight-forward, informative read. I highly recommend it.

[Robyn · Rating 4 out of 5]

This is a great resource, whether you want a fully unmedicated birth or just to pick up some strategies and info for avoiding a specific intervention. Obviously it's "biased" but the assumption is if you're reading this book you've already made some decisions about your birth plan. Even if you don't want a "natural" birth (I understand this term is kind of considered offensive these days, for good reason) I think there is a lot of good info here and just some great tips in general for writing a birth plan, how to not go to the hospital too early, dealing with labour, and communicating with hospital staff/advocating for yourself/partner.

Some glaring typos throughout (someone really biffed the find and replace on the "Reeferences" section) but wasn't too bad. After just finishing a book that used the inclusive language "birthing person" instead of "woman" or "mother" dare I say I prefer the gender-neutral language in a birth book? As Brahm and I were discussing when reading The Birth Partner, using such language has the positive effect of removing any connotations associated with gender roles. Having to consider myself as a "woman" in the hospital vs. a "birthing person" is more stressful because it subconsciously reminds me of how poorly women are often treated by the medical establishment (if you don't believe me, go out and find the first woman you see and ask for her stories about not being believed, ignored, etc. when trying to bring up legit medical concerns).

Anyway, good book, would recommend if you are hoping to avoid one or many medical interventions at your birth. Definitely planning to read this author's other book on the fourth trimester.

[Meredith · Rating 4 out of 5]

The idea that a natural birth is possible in a hospital setting is exciting, but what this book demonstrates despite its optimistic title is that it is nearly impossible. Rather than a "natural" childbirth, this book shows you how to demand, bargain, fight, and plead every step of the way for the least invasive and medically managed childbirth possible under 21st century hospital policies. Unless you are giving birth in a hospital rated Baby-Friendly by UNICEF and the World Health Organization, having a “natural hospital birth” will be an uphill battle every step of the way and may still be impossible in the end. Even at a Baby-Friendly Hospital it may still be a challenge.

Because of standard hospital policies and procedures enacted due to the fear of litigation on the part of hospitals and doctors, mothers are not allowed to choose options such as intermittent fetal monitoring, eating and drinking during labor, moving around during labor, no IV or just a saline lock, no vaginal exams until the mother feels the urge to push, giving birth in an upright position, and delayed chord clamping even though these options are permitted according to guidelines from the American Congress of Obstetricians and Gynecologists and the American Medical Association. She and her birth partners must constantly fight to even be allowed non-medical pain management as laboring women are pressured to have epidurals or narcotics for pain relief because medical pain relief is a substitute for one-on-one personal care by a birth attendant. Instead of being given options that facilitate a natural childbirth, laboring women must have a team of advocates with them to protest against unnecessary medical interventions every step of the way and demand natural childbirth options to combat the hospitals' desire for only medically managed births with interventions as standard practice. And this book explains how this can be done.

The key to having as close to a natural birth in a hospital as possible is to demand another hour whenever the hospital staff wants to do something to the laboring mother. This is incredibly sad testament to the horrible state of modern maternity care, but it can be relatively effective. The author did point out that in cases of true emergency, the hospital staff won't ask, or tell, or try to cajole the laboring mother, they will simply jump in and start doing things, and hospital security will escort her birth partner and labor support people out if they attempt to interfere. So, asking/demanding another hour is not truly dangerous; it will just make the hospital staff hate her, which means they will be mean about it if a real medical intervention becomes necessary.

Aside from how to force the hospital staff to respect a woman's wishes for a natural childbirth, included in this book are strageties for finding a care provider susportive of natural childbirth, creating a birth plan, managing labor and recognizing the optiminum time to go to the hospital, distinguishing between emergencies and non-emergencies, and methods for overcoming a stalling labor without medication. For more non-medical pain management techniques, The Birth Partner is an excellent book.

The author never addresses how having to battle the Industrial-Medical Complex every minute wouldn't be a horrible experience rather than "the best of both worlds." Labor is difficult enough without having to fight and beg for minimal disturbances and interventions every minute that a woman is in the hospital. Just the stress of the triage required to admit a laboring woman to labor and delivery is sometimes enough to completely stall her labor.

If you are on the fence about having a homebirth, this book may tip you towards deciding to have a homebirth. It clearly spells out how to beat the hospital at its own game when it comes to rules, restrictions, and mindless obedience to guidelines, but just reading about how hard it will be may make you want to avoid the hospital all together. For those seeking a natural childbirth but wanting the comfort of near instant access to medical interventions in the case of emergencies, then a birth center would be a great option. Sadly, because of the lack of birth centers and effort that Big Medicine puts into closing the few that do exist, women seeking natural childbirth must often choose between a homebirth and a hospital birth.

This book unintentionally provides every good argument for the need of birth centers in the United States. Some women want a natural childbirth but are not comfortable with the idea of a homebirth. Hospitals offer a sense of security even if it may sometimes be a false sense. There needs to be a middle ground between homebirth and hospital birth where mothers can attempt a natural birth while knowing that there is a structure in place to transfer them for every medical intervention possible in case of a true emergency.

Since birth centers are affiliated with hospitals and work with at least one ob-gyn in their communities, a woman will not feel so powerless if a hospital transfer is necessary because she will be familiar with the hospital, the ob-gyn, and possibly the labor and delivery staff unlike with a homebirth where a woman simply gets what she gets at the closest facility if a hospital transfer is necessary. There are procedures in place for hospital transfers from a birth center, making them quicker, more routine, and less chaotic than transfers from a homebirth. And a mother runs less of a risk in running into negative reactions from hospital staff when transferring from a birth center. Some birth centers can also offer some of the same minimal medical interventions found in hospitals. Truly natural birth in a birth center would come closer to offering “the best of both worlds” than “natural” birth in a hospital.

[Rachel · Rating 5 out of 5]

Great and empowering resource for expecting mothers who desire a natural birth, but still want the safety net of being in a hospital, where physiological birth is not always well supported.

[Laura · Rating 2 out of 5]

This book immediately assumes you’ve already decided you want a natural birth in a hospital. Which, I guess, fair play - it’s all in the title. But it immediately dives into language like “you want this, you want that” before it offers any pros/cons on why someone would want this or that. It feels much more like a book for someone that already knows a whole lot about their labor and delivery options but less about how to advocate for themselves. I was really hoping for more education to be able to decide what I would or wouldn’t want.

In the most generous sense, I started by thinking I didn’t really vibe with everything the book preached. But to be honest, there were some parts that were downright fear mongering. Some passages felt very manipulative or unnecessarily pushy. When talking about commonly used medical interventions, the author starts with the risk of death or paralysis — and yes, we should be informed! But if you can’t avoid some of these interventions, you don’t need the fear on top of everything else.

The strongest message was about standing your ground to advocate for a natural birth, with lots of advice on how to argue with medical professionals. If you need that advice, you might love this; but it wasn’t really the advice or perspective I was looking for.

What I was looking for — and was indeed sprinkled throughout — was pain management techniques without drugs. I did learn a whole lot about labor, which was very helpful, but I’m sure this content is available elsewhere without the biases. Overall, I wouldn’t recommend this unless you 100% identify with the title.

[Vicki · Rating 3 out of 5]

Nothing against the book, more against my overpreparing, but it was repeating stuff I'd read in other books at this point. If you are looking for one book to read that's not too woo and not too "there's nothing you can do birth plans are for suckers," this might be it.

[Atefeh Eghbali · Rating 5 out of 5]

Lot of good information

[Debbie · Rating 4 out of 5]

Not only does this book cover what makes natural hospital birth “The Best of Both Worlds,” it in and of itself is the best of both worlds—the perfect blend of an informative overview of what happens to you physically and emotionally during labor, as well as an empowering look at how to deal with giving birth naturally in a hospital (without going too far down the “good vibes” pathway, which can be deterring for some women such as myself).

A comment on the audiobook: while overall the narrator was easy to listen to, the author would have greatly benefitted from using a link shortener for all the resource links that were included in this book. It must’ve been annoying having to sit through reading a giant YouTube link in the physical or ebook version of this, but it was next to impossible to deal with on audio.

[Katy · Rating 4 out of 5]

This is a GREAT resource for women preparing to have an unmedicated birth in a hospital, especially for first time moms like myself. I loved how the author didn’t completely slam the entire medical industry. She does a great job at explaining interventions and possible pushback you may receive, but I never got the feeling of “every single person in a hospital is out to ruin your life” that is common in other resources for unmedicated birthing. Great book!

[Debby Kuruvilla Nelson · Rating 5 out of 5]

This was a long and extensive read, but I appreciated its thoroughness and the steps the author took to ensure that readers feel adequately prepared with realistic expectations when seeking to achieve natural birth in a hospital setting.

It walked through mental and physical preparations during pregnancy, informed readers of common hospital procedures, and then gave a detailed dive into each stage of labor along with the authors recommendations for it. It also had a short postpartum section, and was full of encouragement for moms seeking the most natural start possible to their baby’s life in the world!

[Gabby Sequeira Lucero · Rating 5 out of 5]

Part one of this book almost had me giving up— felt a bit like a sales pitch and was very gushy. However, part two and onward had the most helpful info I’ve ever read!! Very detailed explanations of the stages of labor, the range of things that could happen, the range of choices you have, and scripts to use when talking to hospital staff about your choices! I’ll probably re-listen to all of that and take notes this time!

[Heidi Westendorp · Rating 4 out of 5]

Very informative read!

[KayLee Parson · Rating 5 out of 5]

This is my favorite birth book I’ve read. It was super informative and I ended up highlighting a ton to look back at! It explains all the different procedures and interventions you’ll hear about and be offered in a hospital setting. It helps you find a voice and learn how to advocate for yourself. I feel super ready for labor with my first now!

[Kylie Moffat · Rating 5 out of 5]

I think this book had some good information and tips for laboring naturally while in the hospital. I liked the way that the content was laid out. It makes it easy to read and refer to later.

[Jami · Rating 5 out of 5]

I love natural birth. I firmly believe that women's bodies are MADE to birth babies and there are far too many interventions in hospitals, especially American hospitals (this coming from an American-born woman who has had two, soon-to-be-three hospital births).

These interventions often cascade, resulting in a disaster. Ruptured membranes without immediate contractions? Pitocin to the "rescue" (nevermind that it often takes time for contractions to begin and this is totally fine in typical, healthy pregnancies). This results in constant fetal monitoring, impacting the woman's comfort and mobility. This also often results in an epidural, which can cause fetal heart rate issues. Epidurals can cause fevers (among a host of other issues, but I won't go into my own journey after my personal epidural nightmare...). This fever cannot be disentangled from a uterine infection, so c-section it is. It's heartbreaking that far too many women don't realize how contra-indicated, non-evidence-based, and antiquated these practices are! I want to scream from the mountains and beg for maternal hospital reform in the wonderful, developed country in which I live.

But I digress...

I have been feeling out of place regarding my birthing desires. I don't belong to the at-home anti-vaccination camp and I don't belong to the accept-all-hospital-interventions camp either. Before now, I hadn't seen any books like this one. A pro-natural, pro-hospital birth resource?! Can it be true?

Huge thanks to the author for her invaluable research and plethora of experience which contributed to this helpful resource. I appreciated that she quoted Evidence-Based Birth often as well, for I find myself devouring these articles as I navigate my own birthing journey once again.

I also appreciated her birth plan generator questions. Though I have already created my birth plan, her insights will help me revise it to be even better.

Another key takeaway will be the powerful strategy to say "I'd like to wait an hour," when interventions are suggested. It's the perfect non-committal answer. With how busy hospitals are, one hour is often extended and the stalled labor issue or whatever else is resolved on its own...because we got out of momma's way and trusted her body to do what it's made to do. What a novel idea!

Speaking of novels, this review has gone on long enough. I hope that moms everywhere will read this, despite their choices of natural vs medicated. It's empowering, educational, and important!

[Stephanie · Rating 5 out of 5]

I got so much from this book. It's not a big book; it's pretty quick to get through, which is a great bonus.

Some background: I would, indeed, like to give birth without drugs or other medical interventions. I'm pregnant with my first. I had actually pictured myself giving birth at home, but my husband was uncomfortable with that idea, and understandably so. We are in uncharted water here. I've been told that I shouldn't get attached to a birth plan or even the idea of a drug-free birth because if it doesn't go the way I've pictured it, I "don't want to be disappointed". Being disappointed doesn't scare me. I can go into Starbucks and be disappointed when they are out of chai lattes. I'll get over it pretty easily. What frightens me is regret. Regret that I'll cave and give in to some bullying nurse or doctor, or let something happen when I can feel in my heart that it's wrong. Even if the Starbucks is out of my latte, I don't regret going in there for one.

While the advice on writing a birth plan is very valuable and something I plan to reference when I write my own, this book helped me to realize that what will truly make me feel comfortable giving birth in the hospital is to hire a doula. That probably won't be true for everyone who reads this book, but I'm grateful for that moment of personal clarity. It also made me feel calmer about birthing in a hospital in general. It seems at first like a book that helps you "cheat" the modern obstetric system, but Gabriel reminds you gently along the way, and particularly in closing, that just because you want to have a drug-and-intervention-free birth experience for you and your baby doesn't mean that the hospital or its staff are your enemy. If you and your birthing coach(s) go into the hospital confident and self-assured about what you want, the hospital staff will likely respond in kind by leaving you alone and being open to helping you achieve your preferred birth experience. And I really, really needed to be reminded of that. Highly recommend this book.

[Tracy · Rating 5 out of 5]

My first birth ended in a c-section, which was quite traumatic for me and left me in pain for many months. When I found out a few months ago that I am pregnant with twins, I figured I would have to throw my plans for a normal delivery out the window. Reading this book gave me back the confidence I needed to find a care provider who would support an attempt at a natural, VBAC twin delivery. I appreciate the special attention the book gives to birthing multiples and dealing with a VBAC. I used Gabriel's suggestions to find a doula that I think will help me and my partner have the best delivery available to us. The book helped me ask the right questions of my doctor and helped me communicate my desire for a natural delivery. I now feel that I have all the necessary people on my team. The suggestions for labor positions and relaxation exercises are infinitely more useful than the suggestions given to us at the useless labor and delivery class we took through the hospital. I am excited to use the book to write a birth plan with my husband and doula. No matter what the outcome of my next delivery, I feel that this book gave me many of the tools I will need to make it a positive experience

[Tiffany · Rating 4 out of 5]

I should start with a note that I am not opposed to using interventions such as pitocin or epidurals. I read this book while expecting my fifth child and had the previous four with epidurals. 3 of the 4 worked out great, the last did not so I started doing research on pain coping techniques should the same ever happen again.

This book is written toward first time mothers who want a completely natural birth but are delivering in the hospital for whatever reason. I like the open mindedness of this author, that's sometime hard to find in the natural birth community. I skimmed through much of the description of what labor feels like (been there done that) but what I read did sound accurate and helpful to first timers.

I really enjoyed the parts about coping with pain. It was helpful and could actually be done whether in a hospital or at home. The best part was that the author did not try to pigeon hole all women into one technique for managing labor. Many different approaches were described all with the idea of do what works best for you coming through loud and clear.

I would recomend this to any woman considering a natural birth or a woman just looking to have some labor coping strategies at the ready.

[Antara Basu-Zych · Rating 5 out of 5]

what a great resource! I'll have to report back based on how the tips worked in practice in a few months, but I definitely saw great, helpful discussion about situations that happened in my first birth. I can see that if I had read this book back then, and put some of the advice to work, I might have felt more satisfied and in control of the experience. This time I expect I am better prepared. I liked that there was a good balance of stories and real-life experiences with scientific research and her cultural perspective based on Russian hospital births. I didn't think she was preachy given that the attitudes towards natural birth can often take an all or nothing approach. I also appreciated that the structure of the book makes it flow,while also allowing each chapter to stand alone for quick reference. For example I will definitely reread the birth plan chapter and the tips for active labor, plateaus, etc. I already employed the suggestions for interviewing my OB and I think it helped open up important conversations that might otherwise been delayed or missed... Anyway, I think anyone set on a hospital birth, yet wishing to be empowered and knowledgeable about their options should read this book carefully.

[Kris Dersch · Rating 4 out of 5]

I read this cover to cover when pregnant with my first child in 2014 and just picked up the new edition at the library to review for my second birth coming up this summer. A helpful resource. Doesn't drown itself in negativity and controversy like many on this topic can with some super helpful easy tips. I had a pretty traumatic birth last time at 33 weeks and was surprised by how helpful I found the information in this book even in that situation. Whether you have a doula, have a preemie, have complications, or none of the above, this is a helpful one to go over in pregnancy if minimal drugs in labor is your goal.

[Shannon · Rating 4 out of 5]

I think this is a great book for any mama who is looking for a natural birth, but would like to do so in a hospital. The book walks through a lot of information from the stages of labor to postpartum. I found the chapter on the stages of labor to be very interesting as well as all of graphic throughout the book. The author also talks about a variety of birthing position and natural ways of dealing with the pain of labor. Most of the information I have read or heard before, but it was still a very informative book. I definitely recommend reading this one if you are planning to have a natural birth at a hospital.

[Michelle · Rating 5 out of 5]

I loved this book. I initially wanted a home birth but it just wasn't an option where I live. Particularly helpful sections included how to differentiate between what the nurses/hospital "wants" you to do for their comfort and convenience and what is actually medically necessary. I feel like I am well informed for the things I will have to say "no" to and have appropriate phrases (like, "can we wait an hour before doing xyz?") to help achieve the type of birth I want. Highly readable with loads of tips for partners, too.

[Kami · Rating 5 out of 5]

My doula recommended this book to me and I am so grateful that she did. I relied on it heavily in preparing for my VBAC - and believe the book contributed to my success. It contains a lengthy discussion of things you can do to improve your hospital birth experience, including very practical and effective methods for dealing with hospital staff. I suggest it to all my pregnant friends, even if they want an epidural, as it’s so informative.

[Bridget O'Connor · Rating 3 out of 5]

With part of the title saying "The Best of Both Worlds," I expected there to be a more balanced perspective of what a natural birth and one with some medical interventions could be like. This book however felt like a tool to teach you how to fight against suggested interventions. I did not find as much support for the ideas of when/why/how you'd should consider a medical intervention. Nonetheless, there are positive and helpful tips in this book.