As birth doula's we've supported so many different types of birth. Majority have been in the hospital AND most of them did have a goal to remain unmedicated. Here's some of our best tips and observations to help you have the birth you desire:
Know what's on the menu. You can't go to a vegan restaurant and ask for steak. If you have an OB and are birthing in the hospital, physiologic birth is NOT on their menu. It is a rare occurrence, and they are NOT the authority on how to get you there. If you are in this scenario because you couldn't get a midwife, it's important for you to understand birth in an even DEEPER way because you will be the driver in achieving your goal.
Take a GREAT prenatal education class; like ours. In our Confident Birth Education class we teach you how to understand your body, work with it, and have a birth that leaves you empowered and confident. You will be full of all the education needed to have the birth you truly want to have. We're offering 35% off our class right now, use the code "CONFIDENT" at checkout.
Be CLEAR on your goals: if you are a maybe on the epidural, unless your birth goes fast you are likely going to get one. When you're in the hospital they are eagerly waiting to hear you say the words 'I can't do this anymore' and they will quickly offer the epidural to help you out. When being unmedicated is your goal, at that point you need to hear "yes, this is the hardest part, but you are DOING it, I know you can do it! You've planned for this moment, and you are STRONG"
Get your partner on board with the WHY behind your goals. You need your birth support to really understand why this is important to you, and HOW to support you through your hardest moments. They need to be the banks of the river you are carving through labour. They need to be practiced, and prepared for some very hard, intense moments, and not to fix the situation at hand, but to support you through it.
You need to TRAIN for it. You don't wake up one day and decide you will run a marathon with no research, experience, or training. This is similar. A birth is a multi layered event. There is SO Much learning to be done that will improve your experience. Many people experience birth trauma in their first birth especially, and this can be helped with education about what blocks you may come up against, and how to advocate for yourself.
You are most similar to the 5 people you spend the most time with. Make sure these are people who make you feel supported in your goals, and capable! If they don't see and support your vision, use boundaries to keep them at a distance for your pregnancy. You don't need those negative vibes!
Hire a doula. Hiring a doula is like having a guide to get you up Mount Everest. You probably wouldn't consider it without one! You doula can help you prepare your physical body, and your mental state for your birth goals. They also become a very important person in your birth goals because they will fight for them, and remind you of them. They know the books to read, the podcasts to listen to, and the way to keep your nervous system relaxed and ready for birth.
Understand your nervous system: Flight, Fight, Freeze or Fawn. In labour many women resort to fawning due to higher levels of estrogen. This means you will be more likely to say yes to things to appease your nurses, doctors, etc. When you, your partner, and doula are on the same page, you can have conversations about decisions as a team and make sure you are staying the course for your birth goals.