How pushy were your doctors?

[zuzunel09]

I do NOT want drugs, pitocin, or a C/S foisted on me unless absolutely necessary...but I keep hearing horror stories about how on the day of delivery, some women's docs just didn't listen to them or bullied them into accepting whatever it was they wanted. I have a tendency to get angry easily, and I'm shy and no good at standing up for myself to doctors...how much did your doctors respect your wishes and besides a birth plan what did you do to make sure things went smoothly?

[laohaire]

The main thing I did - and no, I'm not being snarky to you at all - was to fire my OB and hire a homebirth midwife.

To me, even the stress of wondering how much I would have to fight while laboring was just not worth it.

[MeepyCat]

Really, I think hospital policies and procedures have a lot to do with what you end up with. I went in wanting what you want, and then wound up strapped to monitors in triage for three hours, which sucked, and then had to talk to an anesthesiologist (who wanted me to sit still - more suck), and then, whaddayaknow, I wanted the epidural. (And it sucked, and I am not doing it again.)

To protect yourself, I would take a look at some things:
- What are the rates of epidural, anesthesia, augmentation and c-section for the hospital you plan to deliver at? What are the rates for the practice handling your obstetrical care? Pick a hospital and a caregiver with low rates of these things - high rates may indicate institutional practices that "justify" unnecessary interventions.
- Take a tour and ask questions. What are the l&d rooms like? Are there bath tubs, birth balls, birthing stools? What monitoring procedures are standard for laboring women? How do they feel about you walking the halls while in labor? How do they feel about you laboring in water? What about food and drink?
- Take childbirth preparation classes that focus on natural childbirth.
- Research. Under what circumstances do you think anesthesia, augmentation and surgical delivery are justified? Under what circumstances would you refuse them?
- More research. If you *had* an epidural, augmented labor or c-section, how would you want it to be handled? Why would it happen, what techniques would you want to use to assure the best possible outcome?


By all means, write a birth plan, but stack the deck in your favor by choosing care providers that want to give you what you want to get from them.

[MegBoz]

Yes, there are a lot of horror stories here!
So it's important to find out a docs TRUE views! I personally think it's important to find out how a doc feels on the issues and how he typically practices! He may agree in advance to something out of the ordinary, but if it is "out of the ordinary" for him, you know it will be harder to be sure he sticks to it.

So to find that out, I suggest asking really open ended Qs. Heres my list. Although other posters have said asking a doc, "What do you think of doulas?" is an ideal litmus test to gauge their attitude towards natural birth, mama-centered birth with women advocating for themselves, etc. I think that's a great Q!!!

You want a doc who prefers to practice the way you want him to- not one who says he's willing to do things your way - THAT is when you can end up with fights in the room.

As for me, I didn't have docs, I had midwives! CNMs - and I didn't labor in the hospital at all, went much faster than I expected, so I had the urge to push before even leaving the house! So just arrived & pushed him out. One of my 2 fav CNMs was on call. She was awesome. Didn't fight me or deviate on things like DH catching DS, no premature cord clamping, no cord traction, no eye goop, BFing ASAP, no one tried to take DS from me, etc. It's a very mama & baby-friendly hospital.

Even still... I"m going to plan an HB for next time.

[zuzunel09]

Homebirth and all that is not an option. My husband's HMO covers the delivery and we can't afford to go another way. Please no comments about how I'm a horrible mother for delivering in a hospital that I couldn't choose; life happens and we're at the lower end of the economic spectrum.

I know for a fact that my hospital has a high rate of scheduled deliveries and c-sections. My doctor is condescending and hustles me in and out of my appointments, so finding out his views on things has been difficult. I guess he's ok, but then, I've heard of doctors who were annoyed with laboring mothers because things weren't going according to their schedule.

Anyway, I guess what you're all saying is, get a spine.

[Beccadoula]

The hospital births I've attended have been great on the doctor end and a little rough on the nurse end. I stongly urge my clients to find the right doc. first, next is to have a simple and reasonable birth plan that you've had your doctor sign off on...if they won't sign then maybe they aren't right for the job. The other major thing is having a doula. Having a doula will help you stay focused and relaxed and will give you the needed self-assurance to say no to things you don't want. You need to understand that you are legally able to refuse any intervention - it is called "informed consent". The assumption is that once you're informed you'll consent to the intervention, but you don't have to...and most moms do not know that. If you can, it is best to have your husband or other birth team members briefed about helping you refuse unwanted interventions. Many dads have really taken a stand and been the hero that way. In the mix of all this, you need to remember that these are people who want to help and who often just don't know that there is another way...oddly enough. They have women coming in and getting them in trouble for not getting an epidural in time when the baby is aldready crowning...and us natural people are just such an acception to the rule that they don't know what to do with us. BUT, respectful questioning gets you a lot further than demands and suspicion.

[msmiranda]

I don't think having a spine is necessarily the issue. Before my birth, I was very adamant about what I didn't want. When I was in labor, there was no way that I could have argued with anyone or advocated for myself -- I was way too in my head. (Fortunately, I had CNMs who I trusted and who had my back to ensure I got the natural birth I planned even though I was in a hospital). What a lot of women do is hire a doula to play that role for them. I don't know where you live, but it sounds like your doctor is not a good fit for what you want, so you might consider researching other options in your area depending upon what your HMO covers.

The other absolutely key thing when birthing in a hospital is not to get there too soon. The less time you have there, the less time they have to do stuff to you that you don't want. A doula can help in this way too, helping you labor at home until you are well into active labor and discerning how far along you are so you won't be at the hospital for too long before pushing begins.

I'm so sorry that you are in this position -- it is criminal that women who want a physiological birth have to fight with anyone to get that.

[cileag]

I think growing a spine is excellent. Also, just stay home as long as possible. Unless there is a true need for you to go in--your water breaks and has lots of meconium (baby poop) in it for example--don't go in until you want the docs to do something. Either pain medicine if you change your mind, or you feel as if you're entering transition or pushing stage. I'd say first time moms usually end up coming in too early anyway.

As to other advice, I always recommend being kind and considerate--even if things are not going as planned. If they want to start pitocin, ask if you can wait an additional hour. Same with a c/s for failura to progress. If baby's heart rate continues to be reassuring and it's just time based, ask if you can just wait a little longer.

While you're in triage, ask for a nurse particularly supportive of unmedicated birth--it's often the nurses far more than the docs that guide your labor pattern etc.

Good luck! Unmedicated birth can happen beautifully in hospitals---it just takes a little bit of negotiating, compromise, pluck and luck.

[msmiranda]

Oh, one more thing. When you do go to the hospital, when you check in you should tell them that you are planning a natural birth and request a nurse who is okay with that if there is one there at that time. This is something that they told me to do at the hospital I would be giving birth at (if I hadn't decided to go the homebirth route this time); as the tour guide put it, some nurses enjoy working with those patients and for others it's not their thing. During my hospital birth, I know that there was definitely some self-selection going on, the L&D nurse I had clearly enjoyed working with the midwives and approved of natural birth, and it was great to have someone who was supportive instead of belligerent. They may do that (self-select their patients) without you having to ask but it couldn't hurt to let them know up front.

[MeepyCat]

Originally Posted by zuzunel09

I know for a fact that my hospital has a high rate of scheduled deliveries and c-sections. My doctor is condescending and hustles me in and out of my appointments, so finding out his views on things has been difficult. I guess he's ok, but then, I've heard of doctors who were annoyed with laboring mothers because things weren't going according to their schedule.

Anyway, I guess what you're all saying is, get a spine.

You have a spine. A lovely, prickly one. We're saying: love your spine. Adore your spine. Encourage it. Pregnancy is a wonderful time to practice - you're likely to feel so annoyed anyway. Write righteous letters to the paper, blast your justified wrath at the FedEx delivery gone wrong, carry your belly proudly and wither anyone who touches it without your permission with the force of your ire! After nine months, you should have plenty of practice.

And if anyone tells you that you're a bad mama for delivering at the hospital your HMO will pay for (a problem you have to be quite high up on the economic scale to avoid in this country), use them for target practice too. They're dumb.

Okay: the best way to deal with a crummy hospital is to stay out of it for as long as you can. Take the natural childbirth prep and the hypnobirthing and whatever else you can find, and stay home with it for as long as possible. Read Spiritual Midwifery and Birthing from Within (Ina May Gaskin), and get someone to teach your husband how to provide counterpressure to help you through contractions. No one at home cares how long you're in labor for. No one at home is going to want to get off shift and go home - they are home! So that's taken care of.

When labor starts, go for a walk. When contractions get so you can't walk through them, take a shower (have a support person handy to help hold you up if necessary). Use all the coping tactics that you got from those classes. Learn to check your own cervix (and have your husband check it), and don't go to the hospital until you're almost in transition. If you get there at 9 cm, they won't hardly have time to do anything. (Also, if you're at 9 cm and coping, hospital staff are more likely to let you do your thing than they are if you're at 4 cm and wigging out.)

Take that l&d tour, and figure out how to cope with what's there. No birthing balls? Bring your own (they're yoga balls, you can get them cheap). Can you dim the lights? They may so no snacks, but are they gonna search your bag? Probably not. Monitors can be removed, you can simply refuse to get on the bed. When you're deep in labor it is okay - even encouraged - to let your inner animal take over.

If you can afford a doula, get one. If not, recruit some support people (besides your husband) to read what you're reading, study what you're studying and help you out when the day comes. Your husband should be one of those people, but he may need a sandwich or a potty break sometime, so he should not be the only one.

[cristeen]

Honestly, it also in part depends on how your HMO works. My HMO, I get minimal say in my care provider for prenatals and NO say in it at birth - whoever is on shift is who I get. BUT, I can choose to deliver at the hospital a mile from my house with OBs or drive 20 minutes to the next hospital and deliver with CNMs.

I also suggest doing the research on your HMO. And have some real heart to heart talks with your support team (and I highly suggest having more than just your partner as that team - I had my DH and my BFF and I can't imagine how much worse it would have been with just one of them). Make certain things very clear to them... for me, having an epidural was NOT an option. Period. End of sentence. I know the risks *to me*, and am not willing to take them. Yet I had every single doctor on the floor come into my room and try to convince me that I needed an epidural. And they were not nice about it. Because my DH knew how I felt about it he finally had to threaten the doctors with violence to get them to stop haranguing me about it (I was non-verbal with contractions at 3 minutes at that point). I didn't have to say a word to him.

If the baby has to be removed from the room - do you want a support person to stay with the baby at all times? Make sure you've designated who stays with you and who goes with the baby - and make sure the person who goes with baby (usually dad) knows what is and is not allowed.

If you can swing it, or can find a student, I highly suggest hiring a doula who is familiar with that particular hospital. And stay home until you're ready to push - that can really minimize the interventions (they just don't have time).

[Girlprof]

Oh mama, you want to have a baby, not a political battle. That is fair enough! You should not HAVE to get a spine for this (though you do already have a lovely prickly one). In a better world in a better medical system, you would get support for the kind of birth you want, being whatever kind of person you are.

Now, the thing is, you're going to have your baby in this world in this medical system. You've received some really good advice about how to maximize your chances of the birth you want in the circumstances you have. That is all any of us can do. By all means, ask your OB and your hospital those open ended questions. Find out the exact rules for your HMO and what is covered.

A doula is a super idea. Some hospitals offer them, even for free. You might also be able to find a doula in training in your area who would attend your birth as part of her certification.

Not all hospitals are horrible all the time. I had two lovely hospital births and was never offered an epidural. I was induced with pitocin the second time but that was medically indicated and after a great deal of discussion with my midwives.

Good luck!

[purplepaperclip]

Originally Posted by Girlprof

Oh mama, you want to have a baby, not a political battle. That is fair enough! You should not HAVE to get a spine for this (though you do already have a lovely prickly one). In a better world in a better medical system, you would get support for the kind of birth you want, being whatever kind of person you are.

Now, the thing is, you're going to have your baby in this world in this medical system. You've received some really good advice about how to maximize your chances of the birth you want in the circumstances you have. That is all any of us can do. By all means, ask your OB and your hospital those open ended questions. Find out the exact rules for your HMO and what is covered.

A doula is a super idea. Some hospitals offer them, even for free. You might also be able to find a doula in training in your area who would attend your birth as part of her certification.

Not all hospitals are horrible all the time. I had two lovely hospital births and was never offered an epidural. I was induced with pitocin the second time but that was medically indicated and after a great deal of discussion with my midwives.

Good luck!

This! My daughter's birth was a wonderful, hands-off hospital birth. The doc was there to catch my baby and the only other contact I had with him was when he sewed up my tears. The doc and nurses all pretty much left me alone to do my thing. I was able to push on my own instinct and no one was trying to "coach" me or anything. You can have an empowering, gentle, natural birth in a hospital!
Good luck mama!

[monkaha]

Find a provider that you trust and that will listen to you. I feel like I spent most of the pregnancy fighting the OB re:all the testing and such that she was doing, but made my wishes known thruout. Ultimately, I ended up being induced, but because she explained everything, heard and respected my input for everything, I felt (and still feel) good about it. Some docs are intervention-happy. But I trusted that the interventions that she was presenting to me were for good reason and were because she really believed that they needed to be done-not out of convienience or to fit her schedule. (I do still feel like there was too much testing while pregnant..... )

That and a doula. My doula was wonderful! I reccomend doulas (especially this specific one) to every pregnant woman I know.

[shellnurse]

Hire a doula, hire a doula, hire a doula! Also try to stay at home a long as you safely can. The biggest mistake seems to be getting excited and showing up way to early. Once you are there it's demoralizing to head home, and the staff has you on the clock, in a surrounding that is not very conducive to relaxing and opening your body. Best of luck!!!

[murphysaangel]

I would also recommend hiring a doula - some will offer reduced rate fees, you could contact a student doula, or even a student midwife (who'll be able to check you while at home so that you don't have to go into the hospital as soon!).

[Turquesa]

Originally Posted by MeepyCat

Really, I think hospital policies and procedures have a lot to do with what you end up with.

: And know that under many laws, including EMTALA, you have every right to say the magic words, "I do not consent to that."

Also, are you with a group practice? How likely is it that your physician will be the one attending your birth? Unless it's a planned induction or cesarean (and IMHO there needs to be a darn good medical reason for those), many women end up with whomever is "on call." So it can be kind of a crapshoot what doctor you end up with for the actual birth. One more reason to hire that doula...

[Storm Bride]

Hire a doula, if at all possible (I know you said money is an issue, and that sucks).

I don't think it's about growing a spine, although I've said the same thing about myself. Fighting for birth is hard - and it's really, really hard on top of labour. Labour is exhausting and standing up for yourself when you're running on empty is extremely difficult.

I honestly don't know what to tell you. I've had a c-section performed on me after I said "no". I caved in to the next one, because the OB just wasn't listening to me, and the situation had hit some major triggers from my first birth. My third was done after my OB threatened to leave me without care at 41w, 4d.

So...yeah - they can put on a lot of pressure...a whole lot. It can wear you down in a big way.

Best of luck.

[mjg013]

I think you really just need to know your doctor. I would also hire a doula as a pp mentioned. With my obstetrician, he knew what I wanted and why I wanted it. When I went into labor I had instructions to make them call him specifically even if he wasn't on call. He would then give them explicit instructions to "give her whatever she wants". Those were pretty much his orders. That was all they needed to hear. With my 5th child I switched to a midwife because she was closer to me at the time and we only had one vehicle so it was just more convenient. I had a miserable experience because it was a big practice, the midwife I got stuck with when I went in labor wouldn't listen to me, accused me of not knowing what I was talking about, threatened me with a c-section and then I gave birth in the hospital bed with just my dh while she yelled down the hall to get her a warmer in there.

I think a doula is essential to giving you the information and the support you need to get what you want. If money is an issue then check on a doula in training. And really check out the hospital because the hospital really is responsible for a lot of the birth attitudes you encounter.

[mrsfrazier]

wait as looong as possible until you are close to transition to go to the hospital. when you hand in your pre-registration forms, hand in your birth plan with them. if you don't like your nurses, request a different one (over and over until you get one you like/mesh with). you still could end up pushing on your back if you're not careful tho...