5 Things Your Hospital Birth Class Probably Won’t Tell You (from a Birth Doula & Childbirth Educator)

Eva Monhaut-Jenkins
3 days ago
5 min read

Learn these five tips for better childbirth education from a seasoned childbirth educator.

Hospital birth classes do a great job teaching you how to time contractions, when to call, what to pack, and the basics of what labor can look like.

But they almost always skip the deeper truths — the ones that protect your autonomy, your body, your instincts, and the physiology of your birth.

As a doula serving families across the Michiana area, I’ve supported enough births to tell you this: There is so much more you deserve to know.

So today, I’m breaking down five powerful, evidence-based things your hospital class probably won’t cover…but absolutely should.

Let’s get into it.

1. Cervical Checks Are Not the Only Way to Track Progress

You’ve probably been told that dilation is the main indicator of progress. But here’s the truth:

Your cervix is only one data point — and it’s not even the most reliable.

Birth workers use multiple other signs to understand where someone is in labor, including:

⭐ The Purple Line

A reddish-purple line that can rise between the buttocks during labor. Research suggests it correlates with cervical dilation because of pelvic congestion and pressure. For many people, it’s a non-invasive way to observe progress without an internal exam.

⭐ Sounds and Vocalizations

The deeper, more primal, and more rhythmic the sounds become, the more intense and productive contractions usually are. I can often tell a client’s stage of labor by the tone of their exhale or the pause before a contraction begins.

⭐ Movements and Instincts

Rocking, swaying, curling inward, pressing hips, bracing knees, or needing the shower — these instinctive behaviors show labor deepening far better than a centimeter measurement ever will.

⭐ The Rhombus of Michaelis

A diamond-shaped area in the lower back that literally expands during pushing as the pelvis opens. This is part of the body’s natural biomechanics to create more space for the baby to descend.

No dilation number can tell you any of this. A cervix can jump from 2 to 8 centimeters in an hour — or stay steady for a while even with strong, effective labor.

Progress is complex. And your body gives so many clues that don’t require anyone’s fingers inside you.

2. Hospital Policy ≠ Law (And You Always Have the Right to Say Yes or No)

This one is big.

Many people assume that hospital policies are mandatory. But policies are simply protocols, not laws — and you always hold the final say over:

cervical checks
continuous monitoring
IV fluids
membrane sweeps
movement during labor
eating and drinking
pushing positions
newborn procedures

You have the right to informed consent and informed refusal for every single intervention. No exceptions.

This is where real advocacy comes in — knowing how to speak up without confrontation, understanding your options, and using clear language to communicate your preferences.

This is exactly why I created my👉 Birth Advocacy Toolkit — so you walk in knowing:

your rights,
your options,
the scripts to use,
and how to navigate pushback with confidence and calm.

If you want to feel grounded and heard instead of swept along by hospital routine, the Toolkit is essential. It’s birth-changing.

3. Labor Does Not Happen on a Schedule — And Your Due Date Is Not Exact

The estimated due date (EDD) is just that: an estimate. A guess. A mathematical average.

Evidence-Based Birth and multiple studies over decades consistently show:

Spontaneous labor typically occurs anytime from 37–42 weeks.
First-time parents often birth after their due date.
The “40-week” timeline is based on outdated data from the 1700s.
Ultrasounds and menstrual tracking are helpful, but still not exact.

So if you’re 40 weeks and “nothing is happening,” you are not late.

You are not behind.

You are not failing.

Your baby might simply not be 40 weeks old biologically — you may be 39, 41, or somewhere in between.

Human gestation varies widely, and it’s normal.

This is why induction conversations should be nuanced, evidence-based, and aligned with your preferences — not triggered automatically by a calendar date.

Learn more about support for your birth and expert advice from a childbirth educator in your area.

4. There Are SO Many Natural Pain Management Tools You Can Use in a Hospital Setting

Hospital birth does NOT mean your only options are epidural or suffering. There are many evidence-supported pain coping tools you can use anywhere, including in a hospital, such as:

⭐ TENS Unit

A small device that sends pulses through the skin to reduce pain perception. Research supports TENS for early labor — it gives control, reduces anxiety, and can lessen the intensity of contractions.

⭐ Birth Comb

Using a comb activates acupressure points in the hand, sending competing sensory signals to the brain (a mechanism called “gate control theory”). This reduces how the brain perceives contraction pain.

⭐ Hydrotherapy

Showers and tubs decrease pain, lower cortisol, and increase comfort. Many hospitals allow shower use even if they lack labor tubs.

⭐ Position Changes

Movement increases pelvic space, helps baby descend, and reduces pain. Upright and forward-leaning positions are especially helpful.

⭐ Visualization & Affirmations

These shift the nervous system into parasympathetic (calm) mode — reducing pain perception and increasing coping.

⭐ Breathing Techniques

Slow, low, rhythmic breathing reduces tension and oxygenates both you and baby.

These tools work. They’re available. And a doula helps you use them instinctively and effectively.

5. Pushing on Your Back Isn’t Your Only Option (And Often Not the Most Effective)

Despite what movies show, pushing on your back is rarely the most beneficial position. Research supports more effective pushing and less pelvic floor strain with positions like:

hands and knees
side lying
squatting (supported)
kneeling
semi-sitting
upright forward leaning

Being on your back narrows the pelvic outlet and works against gravity. For some women it feels right — and if it does, that’s perfectly valid. But it should never be the default simply because it’s convenient for staff.

Positions that align with instinct and gravity help: