5 Keys to a Physiological Hospital Birth

When it comes to a physiological birth in a hospital setting, here’s what you’ll likely be up against:

– Restricted eating or drinking in labor
– Continuous Fetal Monitoring
– Restricted Movement
– Different providers on call
– Being put on the clock
– ”Required” vaginal checks
– Bright lights
– Interruptions
– Coached pushing
– Staff Changes
– Limited visitors
… and the list goes on 

Whew, I’m exhausted just reading that! 

Ladies, you should not have to fight for a gentle physiological birth. I’m not saying a natural physiological birth in a hospital is impossible, but you will likely have to deal with some restrictions. Planning to have a beautiful pain-free and physiological birth in a hospital takes a LOT of preparation, but here’s the deal, you CAN have a beautiful birth in a hospital!

After supporting women as a doula in settings ranging from a quiet home birth in a dimly lit bedroom to staying with women for over 20+hrs in the hospital, I know what it takes to have the birth of your dreams. That’s why I’m going to share with you my 5 Keys to having a physiological birth in a hospital! 


  1. Set the environment.

Hospitals are notoriously noisy and bright places, it just comes with the territory. With monitors beeping, nurses running in and out, fluorescent lights, and other women in labor on the maternity floor, you can imagine how this environment wouldn’t naturally evoke peace and quietude. However, there are plenty of tweaks you can make to your hospital room to change this! 

  • Dim the lights (or turn them off completely) You can even bring battery operated fairy lights and tealight candles to set the mood. 
  • Bring a portable speaker or play soft music on your phone
  • Ask people to use quiet voices
  • Place a “Do not Disturb” sign on the door or write into your birth plan that you would like little to no interruptions. 
  • Labor in the bathroom, where it’s cavelike and dark 


2️. Choose your care provider wisely.

How do you know if your provider is in alignment with your birth philosophy? The truth is, just because you’ve seen your OB-GYN since 19, doesn’t mean she is the best person to support you in labor. And seeing a midwife doesn’t necessarily mean she practices holistically. If you want an unmedicated, physiological birth, you need a provider who sees it a LOT and knows how to support that kind of birth. Their statistics will determine your risks, so why wouldn’t you want to know them?

Here are some key questions to ask your provider if you are seeking to have an unmedicated birth:

  • What is your primary cesarean rate? (Rules out repeat cesareans)
  • How many unmedicated births have you attended in the past month? 
  • What is your policy on going past due?
  • Do you work with doulas? Do you have any recommendations? (If they rarely work with doulas or can’t name one, chances are they don’t support physiological birth!)
  • What is your favorite pushing position? (If they answer, “on your back”, run the other way!)

A good provider is PROUD of their statistics! If you get the feeling they are annoyed by your questions, that’s a red flag too! Pay attention to your spirit, it will guide you in pregnancy and birth.


3️. Birth in an upright position.

Birthing in an upright position increases the vaginal opening by up to 33% and helps the baby navigate the pelvis without getting “stuck”. Your body and baby have to work against gravity when you labor and push on your back, essentially the baby is going uphill. 

Some great upright positions are:

  • Squatting
    You can hold onto a metal bar over the hospital bed, hang onto your partner or lean over the side of the bed or a birth ball while squatting
  • Walking or slow dancing 
  • Standing it the shower
  • Hands and Knees position (knees in and feet out REALLY helps open the pelvis)
  • Runners Pose (one leg forward like a sprinter on the starting line)
    This opens the pelvis by up to 30%, great for pushing, especially if the baby’s position is not optimal. 


4️. Prepare your heart. 

The internal environment is even more important than the external environment. What fears or doubts are you carrying into birth? Make sure you release those and address them well before you enter the hospital. Check fear at the door! 


5️. Hire a doula! 

If doula’s were a drug it would be illegal not to use them! 

The Cochrane Review did a study on the use of continuous support for women during childbirth. They combined the results of 26 trials that included more than 15,000 women and had these findings:
– 31% decrease in the use of Pitocin
– 28% decrease in the risk of Cesarean
– 15% increase in the likelihood of a vaginal birth
– 10% decrease in the use of any medications for pain relief
– 14% decrease in the risk of newborns being admitted to a special care nursery
– 38% decrease in the baby’s risk of a low five-minute Apgar score
– 31% decrease in the risk of being dissatisfied with the birth experience
– Shortened labor by 41 minutes on average

The evidence for a doula speaks for itself with these statistics, especially for first time moms. Check out local pregnancy and mom groups in your area or ask your provider if they have any recommendations. You will not regret hiring one!  

Have your doula help you create a solid birth plan to support your physiological hospital birth!

Here’s the bottom line…It’s not easy to have a pain-free and physiological hospital birth and it’s certainly not the norm, but it can be done. Set your intention. Visualize it. Prepare for it and keep movin’, baby, even if that means busting out some dance moves! 

If you’d like to read encouraging and empowering “PFB in a Hospital” stories, check out my Instagram @painfreebirth

You can learn how to protect your physiology in ANY setting in my Pain Free Birth E-Course!

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3 Keys to a Pain-Free Birth

Karen gives away her top 3 secrets to a pain free birth, you will not believe it’s free! Come ready to take notes, and don’t forget the tissues. You do not want to miss this!