I think that one of the major reasons birthing in the hospital is difficult for women is because most of us have difficulty being uninhibited around others, especially people we don't know (this includes doctors, nurses, midwives, etc.) Some of us are even somewhat uptight around our own spouses!
When I was pregnant with Lucy, I read over and over again that one of the keys to natural, as-pain-free-as-possible birth is being completely uninhibited. To not worry about what you look like, how you sound, *gasp* if you poop, etc. So I really practiced focusing on what my body would be experiencing, and sort of separating the mental from the physical. I strove to push aside any insecurities and fears I had and embrace the waves (I hate the word "contraction," by the way).
When it came time to go to the hospital, I put my plan into action. I rocked, I moaned, I got in the tub. When I decided to get out, I *politely* declined a gown. No clue why. I just didn't want it. I must have been a sight- laboring, naked, preggo woman walking around the room, squatting periodically and circling my hips, making crazy, low, moaning sounds . (This is cracking ME up just writing this!)
Then, transition hit. All the information I read prior had indicated that most mamas having unmedicated birth don't throw up. Well, I guess I an am exception, because I puked my guts out. Granted, it only lasted a few minutes, but it was crazy how violently sick I was. Since I had declined the iv and was, as a result, drinking tons of water, dehydration wasn't an issue. And because I was busy pushing my baby out a few minutes later, I didn't have time to think about it.
Later, though, I wondered why I had been so sick. It's silly, but I almost felt like it was a sign of weakness.
Then, I came across a quote by Ina May. In her chapter on "sphincter clause," Ina May describes how certain parts of our bodies are connected. Loosening one end of the sphincter subsequently loosens the other. This is one reason doulas encourage laboring mamas to loosen their mouths- to not hold tension there. Relaxing the mouth "above" relaxes the mouth "below."
Here's the connection. What's going on during transition? The cervix is working to dilate those last few centimeters, and pushing is imminent. Ina May writes that "Vomiting normally helps the dilation of the cervix, a la Sphincter Law" (221). I think that if we (as birthing mamas) can let go of our inhibitions, our bodies will find their own way to birth. For me, it was throwing up. That's what my body needed to dilate those last few centimeters.
Getting sick wasn't a sign of weakness at all. Instead, it was a sign that my body knew what to do, and I was able to let it happen.