For many women, giving birth naturally—without unnecessary medical interventions—is a deeply desired goal. Yet, despite growing awareness of the benefits of natural birth, many hospital protocols make achieving it more complicated than it needs to be. These protocols, often driven by liability concerns, efficiency, and outdated medical traditions, can create an environment where interventions cascade, making it harder for women to labor and birth on their own terms.
If you’re hoping for a natural birth in a hospital, here are some common challenges you might face—and what you can do about them.
1. Mandatory Continuous Fetal Monitoring (CFM)
Many hospitals require continuous fetal monitoring for all laboring women, even if they are low-risk. This means being strapped to monitors that track the baby’s heart rate and contractions, often restricting movement. While intermittent monitoring (listening to the baby at regular intervals) is just as effective for low-risk pregnancies, hospitals lean toward CFM because it helps with documentation and reduces legal risk.
How it impacts natural birth: Limited mobility makes it harder to change positions, use gravity, or find comfort during contractions—all of which can help labor progress naturally.
What you can do: Ask your provider if intermittent monitoring is an option and advocate for wireless or telemetry monitors that allow movement.
2. Routine IV Fluids and Restriction of Oral Intake
Many hospitals automatically place an IV in a laboring woman’s arm to ensure quick access to fluids or medication if needed. Additionally, policies often restrict eating and drinking during labor, based on outdated concerns about aspiration (inhaling food or liquid into the lungs under anesthesia).
How it impacts natural birth: Hydration and nutrition are essential for energy and stamina. An IV tether can also limit mobility and give a sense of being a “patient” rather than an active participant in birth.
What you can do: If you are low-risk, request to drink clear fluids or consume light snacks. Some hospitals allow saline locks instead of continuous IVs, keeping the line open without restricting movement.
3. Time Limits on Labor Progress
Hospitals often impose strict timelines for how long labor should take, using guidelines like Friedman’s curve (which is outdated but still influences practice). If a laboring woman doesn’t dilate at a specific rate, interventions like Pitocin (to speed up contractions) or even a C-section may be recommended.
How it impacts natural birth: Every labor unfolds at its own pace. Forcing progress can lead to unnecessary interventions and increase stress, slowing labor further.
What you can do: Discuss with your provider how they approach labor progress. Ask about evidence-based guidelines, and if intervention is suggested, inquire about alternatives and whether waiting is a safe option.
4. Encouragement (or Pressure) to Get an Epidural Early
Many hospitals operate under the assumption that most women will want an epidural. Nurses may ask repeatedly if you want pain medication, or anesthesiologists may come in to “offer” it early, framing it as a way to “stay ahead of the pain.”
How it impacts natural birth: Constant pain relief offers can undermine confidence. Epidurals, while beneficial for many, can slow labor, require additional interventions (like Pitocin), and make it harder to move freely.
What you can do: Make it clear to your care team that you will request pain relief if needed, but don’t want to be asked repeatedly. Consider hiring a doula for support.
5. Restricted Birthing Positions
Many hospitals still encourage women to birth on their backs, mainly for provider convenience. Squatting, hands-and-knees, and side-lying positions are often discouraged, even though they can make pushing more effective and less painful.
How it impacts natural birth: Lying on your back narrows the pelvis and makes pushing harder, increasing the chances of forceps, vacuum extraction, or episiotomy.
What you can do: Practice different positions during pregnancy, discuss options with your provider, and stand firm in your desire to push in whatever position feels right.
6. Immediate Cord Clamping and Separation from Baby
Some hospitals still routinely clamp and cut the umbilical cord within seconds of birth, despite evidence that delayed clamping (waiting at least 1-3 minutes) has significant benefits for the baby. Standard procedures like weighing and bathing the newborn may take precedence over immediate skin-to-skin contact.
How it impacts natural birth: Early cord clamping can deprive the baby of vital blood and iron stores, while immediate separation disrupts bonding and breastfeeding initiation.
What you can do: Request delayed cord clamping and uninterrupted skin-to-skin time immediately after birth, unless there is a medical emergency.
7. Hospital Culture and Staff Attitudes
Even if policies technically allow for natural birth choices, hospital culture plays a huge role. Some nurses and doctors are highly supportive, while others may dismiss patient preferences, especially if they deviate from the norm.
How it impacts natural birth: A dismissive or unsupportive care team can erode confidence, make it harder to advocate for yourself, and increase stress, negatively affecting labor.
What you can do: Choose your provider carefully, tour the hospital, and bring a birth plan that outlines your preferences. Consider hiring a doula for additional support.
Advocating for Your Birth Experience
Hospitals can be challenging environments for natural birth, but being informed and proactive makes a difference. Ask questions, know your rights, and surround yourself with supportive people who respect your choices. While flexibility is important—because birth is unpredictable—having a strong foundation of knowledge and advocacy will help you navigate the system and achieve the birth experience you desire.
If you’ve had a natural birth in a hospital, what challenges did you face? Share your experience in the comments!
