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Natural Hospital Birth...Advice?

post #1 of 15
Thread Starter 
I had planned a homebirth but am now having a hospital birth. This transition is happening due to high blood pressure... and I am switching practitioners too. I am 38 weeks. I feel like this hospital scene is foreign territory to me. I have a meeting with my new OB today to go over my birth plan and hospital policies. I wrote up a birth plan (below) of all the things I could think of but I don't want to (a) seem too confrontational or (b) forget something very important. I know the OB will not have a lot of time to meet with me so I want to focus on the important stuff... Is any of this ridiculous to ask for? Is any of it redundant (i.e. it's already standard)? Am I missing a big intervention?
Any feedback from Mamas and HCPs would be so greatly appreciated!


This birth plan outlines our desires for the labor, birth, and postpartum period. These plans can be revised for medical reasons, after informed consent has been established.

Labor:
Mother will be free to move about during labor and birth to any position, using any props she finds helpful (including shower, birth ball, walking, squatting, etc.)
Mother would like to eat and drink for strength throughout labor.
Mother is open to labor interventions such as cervical ripening and membrane stripping. Mother would like to avoid Pitocin unless absolutely necessary. Mother does not wish to have her bag of waters broken artificially.
Mother's preference regarding pain medication is led by a very strong desire for a natural childbirth. Mother would like to avoid pain medication for the benefit of the baby and the labor process. Please do not offer pain meds to mother-- if long or difficult labor warrants it, mother will request what she feels she needs.
Mother prefers that fetal monitoring occur only when necessary and not continuously.
Any changes in care, procedures, or concerns should be discussed with mother and father so that they may be a part of the decision making process.
Delivery:
Mother prefers a darkened and quiet environment for the delivery of the baby.
Mother prefers no episiotomy; a tear is acceptable if unavoidable.
Please do not use forceps or suction delivery.
The baby will be placed directly on the mother for immediate skin-to-skin contact after delivery and will remain with one of his/her parents for the duration of the hospital stay.
Postpartum:
The cord will not be cut or clamped until it has stopped pulsing.
Breastfeeding will be attempted immediately. Measuring/cleaning of the baby will take place in mother's arms or will wait until first breastfeeding has taken place.
Please avoid suctioning the baby's nose and mouth.
No eye antibiotics will be administered to baby. Mother has has recent screening for STDs and was negative.
Informed consent must be well established for any tests, vaccines, or procedures for baby.
We would like to thank everyone involved for their respect and support for our desires during the birth of our child.
post #2 of 15
How natural birth friendly is this hospital and how is the OB????That'll make the difference. I had a very detailed birth plan for my hospital birth but it was not followed at all. (ie I asked them not to rupture the water...but it was done anyway. The doctor said that he was going to check my cervix and before I knew it GUSH and he broke my water)....It's like my birth plan was totally ignored!!!

I think the birth plan sounds great to me. But your going to probably have to really stick up for yourself and make sure you questions EVERYTHING BEFORE they do it.

Oh and my hospital required continual fetal monitoring for 15 minutes each hour. Had I known I could have rejected that I would have!!!!!! But I felt so out of control.

I know you can't help giving birth in a hospital. I just want you to make sure that you really review the hospitals birth policies so you understand how tough a fight your going to have to put up before you go into labor.
post #3 of 15
I would advise quickly finding a doula. You want to be focused on the birthing process and then your new baby, not fighting hospital staff. A doula can run interference for you and might be well worth the investment.
post #4 of 15
I had a doula in the hospital and hoped to go natural, but didn't make my goal. My doula said that written birth plans often don't get read or remembered, and she just made sure that I communicated things verbally with my doctors and nurses (I had several as my labor went over a couple of days). The first doctor I saw said something about pitocin and I said "We were wanting to avoid that". The next doctor came in and said something about the pitocin and the first doctor spoke right up for us and said "That's not in their birth plan". It was SO awesome to have a doctor stand up for my birth plan. Here's my advice:

1) Avoid induction if at all possible. Stay at home for as much of your early labor as you feel comfortable (and your doctor allows). If you're at home for early labor and come into the hospital already progressing nicely, they'll have less time to try interventions.
2) Communicate your wishes clearly, but don't be pushy and aggressive until someone starts to go against the wishes. Being pushy and aggressive from the start can create a hostile environment.
3) Know your stuff and make the best decisions you can- if a doctor comes in and suggests and intervention ask "How long do we have to decide this?" and then ask if he can come back when you've had time to think about it.
4) Get a great nurse on your side. If possible you could ask for a nurse that is supportive of a natural birth. Having a nurse back you up could make all the difference.

Good luck- a natural birth in a hospital is definitely possible!
post #5 of 15
Quote:
Originally Posted by sunfish21 View Post
I would advise quickly finding a doula. You want to be focused on the birthing process and then your new baby, not fighting hospital staff. A doula can run interference for you and might be well worth the investment.
Yes--I agree! I made a birthplan for my son's birth, and the response I got from everyone was "Most people make them but no one sticks with them; it all goes out the window" (i.e. NOT a supportive staff). BUT I think if I'd had a doula to a) support me and b) take the pressure of "fighting" off DH & I the birthplan could've been implemented.

Good luck!!
post #6 of 15
Thread Starter 
Thank you all so much. I am waiting to hear back from my previous midwife about one of the staff members from the birth center acting as a doula for me. I had 37 weeks of prenatal care with them and they know my wishes really well so I am hoping they will be able to do that for me. My hubby thinks he can run interference but I don't want him to have to.
The head nurse at the hospital seemed pretty comfortable with natural birth but I am following up with OB to see if I get the same impression. I was less than impressed with him at our first meeting when he told me not to be surprised if I end up with a c-section since I have a small pelvis. Pfft. Butthead.

I think I may use the birth plan as a guide for conversation but make sure that I verbalize my wishes and that I have an advocate present. I have heard so many horror stories about AROM without Moms knowing about them... and Pitocin drips started while Moms are sleeping... Ugh.
post #7 of 15
I had a hospital birth without pain meds or pitocin. Your birth plan sounds reasonable. But you need to have an OB who will be on board. At my hospital every nurse who treated me read my plan before coming into the room, so how it is received definitely depends on the hospital.

I think a doula is a great suggestion!!! Really ours was so helpful to us.

One thing that was helpful in my plan was stating my goal up top, to avoid unnecessary interventions. I was clear that I was open to necessary interventions after brief discussion but that in the course of a normal birth a lot of the usual stuff would not be necessary for me.

I think stating that goal helped remove some of the scoffing that some L&D nurses may have when they get birth plans. I got the impression that some of my nurses thought my goal of natural child birth was stupid (I was in the hospital for 2 days before labor started so I had a bunch of nurses), but noone ever pushed anything on me or suggested stuff my birth plan said I didn't want because my birth plan was clear and my midwife was on board.
post #8 of 15
One tip that makes sense to me: ask for a nurse familiar and supportive of natural birth. It can make a big difference.

And get your doc to sign your birth plan. Then you or your doula can use it as a shield.

Try to limit internal exams.
post #9 of 15
I had a natural hospital water-birth. Doula definitely helped, she helped me stay at home when I would have otherwise headed into the hospital, and so I spent 12 hours at home and 5 in the hospital, instead of the other way around.

Just a thought... reading your birth plan, you've written it very nicely and with wonderfully kind wording but: I'd cut to the chase on a lot of stuff. Try to keep each item to one line if possible. If someone needs to scan it quickly (nurses, etc.) then it's better to be brief.

Instead of:
Mother's preference regarding pain medication is led by a very strong desire for a natural childbirth. Mother would like to avoid pain medication for the benefit of the baby and the labor process. Please do not offer pain meds to mother-- if long or difficult labor warrants it, mother will request what she feels she needs.
what about:
Please do not offer pain meds. I will ask if I need them.

Just some thoughts. And remember, for you & your support group, everything they say they "need" to do is optional. It's hard to remember in the moment, but you can waive nearly anything! Stall and ask them for a moment to discuss it with your doula; better yet, have your doula say that every decision needs to be discussed privately before you make a decision.

Best wishes for a wonderful birth!
post #10 of 15
You can avoid a lot of things down the road by refusing a few things initially...like an IV. An IV is not necessary and if it becomes necessary later, should an emergency arise, it is easy enough to put in then. They will try to tell you to have one in case of emergency. If there is no IV, they can't sneak anything into it, YKWIM.

I would also let them know that you don't want internal exams. This will prevent them from being able to break your water without your permission. And IMHO, they hurt worse than having a contraction.
post #11 of 15
Yep, for sure get a doula. Also, see if you can get the OB to sign multiple copies of the birth plan.
You might also want to see what the rules regarding IVS are, and see if you can get a heplock. It's hard to be mobile if you're tethered to an IV. Also along the lines of mobility, see what kind of ability they have to do intermittent fetal monitoring.
Good luck with the hospital birth. You're going into it well educated and well-prepared, so that will help.
post #12 of 15
If your water breaks at home before contractions start, I recommend not going to the hospital until you are having regular contractions. Or even telling them your water broke They get all nervous if you're walking around with a broken water bag and no contractions.
post #13 of 15
A few suggestions I would make regarding your birth plan (if this is exactly how it reads)...

1. Use bullet points for each issue-it makes them easier to read, and less likely to be overlooked.

2. Use words like "I do/do not consent to ______", instead of just saying no to anything.

3. Keep it at clear and concise as possible-you don't have to elaborate on why you do or do not want anything-the fewer words the better.


I would take multiple copies to the hospital with you. Have one placed on your door, so everyone who enters your room has the opportunity to see it. Also have a copy placed in your chart. If possible, have your OB and nurses sign a copy and date it (I put lines at the bottom of mine for this), and keep a copy in your possession.

I know you're getting down to the wire, but don't be afraid to walk away from this OB if they're completely against your birth wishes-you won't regret it.
post #14 of 15
Everyone's had good suggestions...my additions are small.

Refuse a heplock. There's no need for one routinely. They can start an IV fast if they need to.

Bring your own clothes. Being in a hospital gown makes you feel like a "patient". I wore a t-shirt for my 2nd hospital birth (well, I ended up stripping down to nothing near the end ) and it made a big psychological difference from the 1st.
post #15 of 15
I've had two unmedicated hospital births and the big key for me was having a doula and a very supportive husband. Not to mention, my OB was 100% supportive of a natural birth. Both my husband and my doula spoke up when stuff came up and the experience was very positive. I remember one of the nurses said to me that she always enjoyed the natural ones, which was such a nice thing to hear and calmed my fears.

When we had someone try to force something, we would ask why it was medically necessary and when there wasn't a good reason they would back down and respect our wishes. For example, they wanted to take my son from the room instead of letting him room in. My husband stepped up and asked what was medically wrong with him (he was little, full term, but only 5 lbs 7 oz). The nurse said he was small, and my husband asked her if that was a medical problem. She finally backed down and he stayed with us.
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