If you’ve asked the question can I have a natural birth in the hospital, the short answer is: of course! But there are some very careful considerations you’ll want to make before banking on this. As you may or may not know, many hospitals have a 30% or greater Cesarean rate. This is not entirely due to high-risk patients. The answer to why the Cesarean rates are so high in the United States is not a simple one. But hopefully as we look at providing some useful tips for those hoping to minimize medical interventions during birth, we can begin to paint a realistic picture of what makes natural birth in the hospital possible … or impossible.

Here are some key steps for increasing your chances of having a satisfying birth in the hospital:

1. Hire a doula to support you and your partner. Discover whether doulas are currently allowed in Labor & Delivery at your hospital due to covid, but consider hiring a doula even if they are not as the doula will be on the line to provide remote support. It is tremendously helpful to have them available to respond quickly via text, video chat, or speaker phone when you are in need of support and encouragement. Make sure to pack a tripod / phone/device mount in your birth bag! This tool will make all the hands-free difference in the world!
2. Discover your hospital’s Cesarean rate if possible. LeapFrog is a good source for this. 2019 data is available. Since 1985, the WHO has recommended this rate be between 10 and 15%. Talk with your providers directly about the type of instances when they would recommend or prefer a Cesarean. Your doula can help you with this by providing suggested questions to ask and helping you create a set of written birth preferences.
3. Find out what you believe about your own definition of a natural birth. If you can, take a childbirth class outside of the hospital to help you determine this. Does natural birth mean a birth without surgery or surgical instruments? Is it a birth without an epidural? Is it a birth with no interventions at all? Do you want the hospital to provide you with supportive tools such as a labor tub or wireless fetal monitoring? Until you follow your own instinct to decide what things you’d like to try for your birth, it can be very difficult to assume that you will get the support you’ll need.
4. Consider midwifery care. If there are midwives available to you under your current insurance and facility, consider making a switch to care that is midwife-led. Midwives are known for “high-touch, low-tech” care which improves safety outcomes. And there is always at least one physician available to collaborate with if necessary.

Let us know if you have any questions! In the DC metro area, we would recommend the following options for having a natural birth in the hospital: GW Midwifery, BirthCare Alexandria, Washington Hospital Center Medstar Midwives, or Reston Women’s Center.