Thanks to The Human Pacifier for an intriguing post about how achieving a "natural" birth in a hospital is an incredible feat. She raises a very important point that having an unmedicated birth at home or in a freestanding birth center is worlds apart (and arguably much, much easier) from a "natural"* hospital birth. Women who achieve this in a hospital really DO deserve a medal! It's so much more challenging than doing it out of hospital. I think women sometimes assume that it would have been/felt the same no matter the location. Perhaps when we're holding conversations about this, we need to emphasize that a lot of the things that cause pain, discomfort, and stress aren't present when you birth outside a hospital, so things are usually much less painful in the first place.
Now, I don't want to turn this into a simplistic home vs hospital kind of post. But that is one of the fantastic advantages of laboring outside of a medical institution! No IVs or heplocks.** No Pitocin augmentation. No fetal monitor straps. No internal monitors. No restrictions to bed. No one asking you to "rate your pain 1 to 10" or "would you like something to take the edge off/help you relax/help you sleep." Generally vaginal exams are limited-to-none or only on the mother's request. No mandatory birthing in the stranded beetle position. No Valsalva pushing ("hold your breath and count to ten and push Push PUSH!!").***
In some ways, I feel like I got off easy. All I had to do was labor and give birth! No fuss, no fighting, no declining this or that. Just birth.
* I really dislike the term "natural birth." It's too vague to be useful and carries a "holier-than-thou" connotation. You know, "natural" is better than "artificial" kind of thing. So I generally use a more specific word depending on what I am trying to convey: unmedicated, physiological, undisturbed, etc.
** Occasionally you will see IVs/heplocks used outside a hospital setting, usually to administer abx if the woman is GBS positive and requests that treatment, or to correct severe dehydration due to vomiting. But these are really exceptional circumstances.
***Okay, okay, I betcha some out-of-hospital birth attendants have done this...and I know that not every hospital does either. But it's true generally.