I'm a mother to a teenage stepson, two daughters and an angel baby. I am taking one step at a time.
Both of my daughters were delivered without an epidural in a hospital. During my first pregnancy, I read all about natural birth, doulas and birthing centre. In the end, we went with delivering in a hospital as in-house doulas or birthing centres were expensive and for my first birth, we wanted to have medical intervention if there were complications.
What to Expect When Giving Birth in a Hospital
I didn’t go to the best ward and I did not have a fixed attending doctor, so I am recounting based on my experience on both deliveries in a rather average hospital standard.
- You are just another patient: To the doctors and nurse, you are just another preggie giving birth. As long as you don’t have a complicated pregnancy record, it’s just another day for them. I asked a nurse how many deliveries she does in a day and she casually mentioned about 10 in a shift.
- You will most likely be plugged into a Cardiotocography (CTG) machine: I had gestational diabetes and in both my pregnancies, I tested Group Strep B positive so I had no choice but to be monitored by a machine which measured the baby’s heart rate, my heart rate and the contractions. I tried requesting NOT to have a machine but was politely denied, citing my pregnancy conditions.
- Don’t bother about the birth plan, instead emphasize the essential wants: I prepared my birth plan for my first pregnancy. My birth plan covered a few items (1) allow me to be in my preferred birthing position (2) No epidural unless I specifically requested it (3) Delayed cord clamping (4) My husband to decide if I am not conscious during delivery
I presented the birth plan to the nurses and attending doctor and the plan was given a quick glance. As I did not have a fixed gynaecologist, the attending doctor and nurses were always changing so the birth plan was not read by everyone. The medical team did respect my decision of having no epidural and delayed cord clamping which I had to specifically state during labor and delivery.
To have an Epidural or No Epidural?
Books advocating for a natural birth will go against the epidural with many cited medical reasons. I won’t bore you with the same details since they can be found all over the internet.
My experience is, it depends on your pain threshold and how long you are in labor. If this is something you would like to experience, go for it and know that eventually, it will pass. I have a friend who wanted to not go for an epidural but ended up opting for it as her labor lasted almost 48 hours. She lasted almost 12 hours without but gave in thereafter. Now she tells me it was a decision she never regretted and should have asked for it earlier! Fortunately, my labor, while it was 10 hours, was not as long as what my friend experienced so I was able to deliver without an epidural.
Birth Experience for my Firstborn
My firstborn birth experience is still vivid as it was my first time delivering and without an epidural.
How My Labor Came About
My firstborn came 5 weeks early and it was even before I experienced any Braxton Hicks contraction (false contraction). I was reading a lot about labor beforehand so I had an idea that I was going into labor. It was 3AM and I started having regular contractions. Shortly, I felt a swoosh of liquid swooshing out. It was not a lot, just trickles. For first-time mums, the initial contraction felt like a period cramp and it came and went off regularly. My hospital bag was already packed (thank goodness) and my husband was still sleeping. I was somewhat surprisingly calm. I still recalled I went to have a warm shower and sterilised my breast pumps so that I could bring them over to the hospital. An hour later, I woke my husband who jumped up in surprise.
We survived the car trip (I was so afraid of giving birth in the car while travelling to the hospital). Headed straight to the A&E as instructed so that arrangements could be done for the delivery ward and I was wheelchaired over to the delivery ward. The nurses asked me to pee and change into the hospital gown. I brought my own blanket which the hospital was okay with.
Strapped to a CTG machine and Checked for Dilation
I was strapped to the CTG machine and bedridden thereafter. I showed the attending nurse my birth plan and she just glanced at it and said noted. Nurses came in and out to check periodically. My husband started taking some photos which I could still handle. Contractions were getting stronger and stronger. Doctors came over too, sometimes in pairs and started checking my dilation. My goodness, the dilation checking was unpleasant and I squirmed badly. It was only 3cm dilation. I was thinking to myself - on my goodness, 3cm and the contraction pain was already pretty intense. I was pretty adamant to go without an epidural so when the doctor came and asked me my pain rating of 0-10, I gave a 6. She went away after that without asking or recommending an epidural.
Left Mostly on Our Own
I was left there with my husband for some time as the hospital had to run some tests - to find that I was Covid negative and had Strep B. I had to have an IV drip to include antibiotics to manage my Group Strep B. Nurses and doctors came in to check once in a while and were rather unconcerned as my dilation was still 3cm. My husband and I were mostly left alone, I was attempting to sleep and had to lie sideways as my baby’s heartbeat was faster than what the hospital wanted so the medical team coaxed me to lie sideways. I wanted to unstrap but was advised to keep the wires on due to the fast heartbeat. I kept my bed inclined to at least allow some degree of gravity to work.
Contractions at Full Blast
After some time, I cannot describe how painful the contractions were but there was a point when I started scratching the plastic sides of the bed. My husband was giving me laughing gas, which I consented to but it was not at all helpful. All the while, I did not ask for an epidural and no one mentioned it too. Contractions came in waves. I had a short moment to relax when the contraction faded. I did my best to control my breathing when a contraction came. Soon, the contraction pain reached its peak and changed from pain to an urge to push, I rang up the nurse to tell her that I was pushing and she (finally) got concerned. A doctor came in again to check and this time, I was 9cm dilated. They rolled me to the delivery room.
The funny thing was that once pushing happened, there was not much contraction pain. A nurse placed her hand on my tummy to feel for contractions. As I did not have an epidural, I could inform the nurse or correct her when there was a contraction. If you were on an epidural, you would not be able to feel it and had to rely on the nurse to tell you to push. All I felt was the urge to bear down. I wanted to be in a squatting position but everyone was somewhat strapping me to a bed to deliver which I just accepted. To be fair, I did not voice out this request and went with what the hospital will typically did.
Ring of Fire and Episiotomy
Many birthing books will talk about the ring of fire at the point when the head was showing to the point the baby was delivered, I was unable to feel much difference because everything is kind of burning and numbed down there. While I didn't want to have an episiotomy, I had to since the doctor was very firm that it is better to have one as I was already having second-degree tears. Perhaps because of the episiotomy, localised anaesthesia was given so I didn’t feel as much during my final push for the baby to be out. Finally, I gave birth at 1 PM in the afternoon.
Super Fast Recovery
The best thing about delivering without an epidural was recovery. My recovery was almost instant. Right after delivery and spending the golden hour skin-on-skin with the baby, I was conscious, awake and brimming with joy to experience everything. It felt like completing a marathon. Hell yes, painful but once delivery is completed, my body instantly bounced back.
My Second Birth
My second delivery was almost a copycat of my first one except that it was faster and contractions were much more bearable. Not too sure why 3 AM was always the start of my contraction. We were more prepared this time round and my girl came out crying at 10 AM. Previous experience did help and my mummy's body was more prepared for the delivery. Once again, I had gestational diabetes and Group Strep B but because it was my second delivery, the nurses and doctors are less concerned about me (not sure if that’s a good thing but I was happy). I was able to negotiate to move more and get unplugged for the initial contractions.
This time round, I didn't even bring up a birth plan to the medical team. Almost all of my essentials were honored. I was able to walk around more, able to skip episiotomy this time and had delayed cord clamping. I did not request for a different delivery position since my delivery for my second one was really fast (30 minutes compared to 2 hours for my first one).
Useful Resources for Natural Vaginal Birth
Spinning Babies: My mother-in-law had a caesarean as my husband was a breached position baby so I was extremely concerned since it was part of our medical history that such an occurrence might happen. Spinning Babies is an organization that helps preggies to maximize the chance of a natural vaginal birth. This was my go-to for every week. Subscribe to their newsletter to get weekly updates.
Bradley method of childbirth: I had the chance to read a book about it and Bradley method is to control the pain (book link below). Frankly, I don't know how different the various delivery methods are but I subscribe to this since it makes sense. My husband and I did not take the course. Neither was he a coach but he was overall very supportive during delivery and he held on to some guidelines I told him to gatekeep for me. For example, he reminded me again and again that I told him not to have an epidural which helped me to hold on this resolution.
Delivery in a hospital might have restrictions but it is possible to still have a positive delivery experience. If you truly wish for a natural birth, it is best to have a supportive gynaecologist, doula or birthing centre for which you are willing to budget.
Be clear on what you want for your delivery. It might not need a birth plan but you have to be clear on your delivery essentials. In my case, it was no epidural unless I asked for it and delayed cord clamping.
Don’t get too upset if the delivery did not go your way. I definitely did not ask for gestational diabetes or Group Strep B infection but I got them in both of my pregnancies so work with what you have. If you need to be strapped and bedridden, do what you can, like make the bed inclined instead of flat to help with the delivery. If it is an emergency c-section, it is always done as the best decision to deliver your baby healthily. A traumatic birth experience is often when expectations of delivery did not match to the actual delivery. Do realize that it is not your fault that some things did not go your way and the faster you accept it, the easier it will be to enjoy your postpartum and caretaking. This is what I learnt after feeling guilty for delivering my firstborn five weeks earlier. I blamed myself for the premature delivery and had a mild level of postpartum depression back then.
Mama's recovery is more important. I ran a fever after delivering my firstborn and there was truly no milk for day 1. I requested my newborn to be supplemented with formula and sent to the nursery while I recover from my fever. That rest was much needed so that I could feel better and attend to her for the other days in the hospital. She did eventually get breastfed for a year in the end.
It is not all horror stories to deliver in a hospital. Some natural birth advocates criticised the excessive medical intervention, which I do agree with to some extent. Nevertheless, it is still possible to have a positive birth experience in the hospital when you (the mama or father) are clear on the key items and at the same time, flexible to adapt to create the best experience possible. Good luck and safe delivery of your little one!
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2022 Muriel B Tewes