Having the best possible hospital birth - Page 2

[Addie]

Originally Posted by gcgirl

I didn't have to do this myself because all the staff on duty were supportive of natural birth, but I would NOT HESITATE to tell someone to get the hell out if necessary.

Also, if you think you might be uncomfortable doing this, it could be a great role for a doula to take on... a doula with experience attending hospital births should know how to handle this situation, and be able to do it in a way that causes no stress for you or your birth partner.

[Belle]

My standard response to routine interventions was "I'd rather not..." When the nurse tried to get an IV upon admission I said this. She perked up right away and suggested I get in the tub. I could tell she was natural birth friendly. She brought my dh some fresh fruit and juice because he said he hadn't eaten anything and was feeling faint.

I wish that I had had a CNM instead of hiring an OB to start. When I went over my birth plan with him at 32ish weeks was the only time I had ever seen him frown. He insisted on an IV and NPO. He also tried setting up an induction for me at 39+6 to coincide with his vacation. (My baby was born while he was on vacation at 38+4.)

I also wasn't comfortable birthing at home for my first. I don't regret the hospital birth at all. It was where I was at the time. It was a total learning experience and an eye-opener. You have to find a way to work around their stupid rules. I did have my second child at home though. I had a mostly positive hospital birth, but I lucked out with my supportive nurses. I knew I might not be so lucky next time. The on call OB was not the most natural friendly, but thankfully she didn't show up until the very end so she didn't have a lot of time to interfere. The experience fully converted me to a home-birther.

[*MamaJen*]

--If at all possible, find a hospital based midwifery practice or even consider a free-standing birth center. Barring that, find an OB who is enthusiastic about natural birth. A good litmus test is asking how they feel about doulas. If they think doulas are terrific, there's a good chance they'll be at least open to a natural birth. If they don't like doulas, you're probably up for a fight. Also, ask them how often they cut epesiotemies. If the answer is more than "almost never" dump him and get a new OB stat. If your OB is not natural birth friendly, replace him/her. It doesn't matter if you've been seeing them for the last four months.
--Get a doula. Can't stress this enough. If you only take one bit of advice from this entire thread, get a doula.
--Educate yourself. I mean really, really really educate yourself on everything you can that has to do with birth. The standard model of obstetric care in the U.S. pushes a ton of interventions that are not evidence-based medicine -- early induction of labor for non-medical reasons, overuse of pitocin, artificially rupture of membranes, being tethered to fetal monitors, not allowing food/drink during labor, not allowing waterbirth, epesiotemies, directed pushing, a 33 percent c-section rate, immediately cutting the cord, etc. Unless your doctor is an OB in midwives' clothing, you're going to have to 1. know what these interventions are and 2. know how to refuse them. It's work. It takes force of will. A good doula will help you avoid things like this, but she can't circumvent hospital policy, so that's where picking a good hospital helps.
--Learn about the "cascade of interventions."
--Be aware that even if you write a birth plan, you also have to enforce it. Again, a doula will help with this.
--Refuse all induction methods (including membrane sweeps and breaking your water) unless there is a clear medical indication.
--Watch the Business of Being Born. It's a good introduction.

It's possible to have a good hospital birth, but often it's a case of swimming upstream. Hospitals, by default, tend to produce highly medicalized, high-intervention births with a 33 percent C-section rate. If you want a natural birth in a hospital, it will take energy and effort and a sympathetic care provider.

[TanyaS]

1. Hire a doula
2. Take a comprehensive birth class (like Bradley). The hospital class is typically ok for the average woman, but they do not usually teach you how to be a good consumer of health care options.
3. When you have a doula, ask her about your OB and the hospital you've chosen. She will be able to tell you what they are like.
4. Do not be afraid to switch providers if yours is known for high interventions and a high c/s rate.
5. Do not be afraid to shop around for a doula, either. You don't have to accept the first one.
6. I second The Business of Being Born. You need to know that no matter how nice your medical care providers are, they may not be acting in your best interests.

It is possible to have good hospital experience, but you have to be prepared to be confident in your decisions. It can be very emotional at the end and you may not be able to voice what you want. Your husband may not be able to do this for you. Get a doula!

[Hannah32]

Originally Posted by Anna Phor

Hannah, your goals are very similar to mine--my son was born 12 weeks ago. I don't know what your feelings on pain meds are, but mine were very open before the birth; I didn't know how much pain I would experience or how I would react to it, so my attitude was very much "they are there if I need them and if I don't, that's fine."

I was much more worried about pit & other interventions that lead to unnecessary c/s; the hospital that I gave birth at has a high (40%) rate of c-sections.

What worked for me:
educating myself about the normal process of labor; the various stages, what I could expect in terms of contractions, frequency etc, and what would happen with my body.
talking to my doctor about *when* it made sense to come to the hospital given my preference (and I had to be forward about this. She didn't ever ask me about what sorts of preferences I had, and she wasn't the doctor who delivered me.)
Waiting until my contractions were 5 min apart before going to the hospital. My water had broken about 7 or 8 hours before that and I was positive for group B strep so the doc wasn't pleased (but given that she didn't have a time machine, what was she going to do?)
This meant that I spent early labor at home, we took a walk, I bounced on the ball, I ate & drank what I wanted.

I labored for about 4 hours at the hospital before I decided that I wanted pain relief, and gave birth about 3 hours later. In retrospect, I might not have needed it if they were not so insistent on the fetal monitor--I refused the internal monitor, and I also refused a catheter (I forget why they wanted to do either of those). But I was also not committed to giving birth without pain meds, so if that's your goal, ymmv.

I think we have very similar opinions. I'm open to trying the birth without pain medications, but I'm not going to make a decision either way. Like you, my top priority is avoiding surgery.

Thanks for all the advice. While changing doctors right now isn't really an option, I will look into hiring a doula and will make my preferences known. I was reading the list of "Patients Rights" in the booklet the hospital sent and it seemed promising. Also, they room-in with babies and encourage breast feeding. Also, how I have the right to refuse a procedure and still receive proper care and such. I will also do a birth plan and delay going to the hospital at first. No need to hurry.

BTW, I've seen "The Business of Being Born," and while I enjoyed it, I don't think it impressed me the way it did some women on this forum. I agreed with some things argued in the movie, but found other arguments pretty specious and unsupported.

[*MamaJen*]

Originally Posted by Hannah32

I think we have very similar opinions. I'm open to trying the birth without pain medications, but I'm not going to make a decision either way. Like you, my top priority is avoiding surgery.

I think a good way to look at epidurals is that it's one tool that you have in your toolkit for getting through labor, along with things like showering, laboring in different positions, counter-pressure, and emotional support. It's kind of the big guns and it shouldn't be the first tool that you reach for, but it's there if you need it. Going in and getting the epidural as soon as possible can lead to a snowball of interventions, but for some women having long or hard labors, the epidural is a blessing, and sometimes it's actually what allows them to relax and hang in there for a vaginal birth. Like most other interventions, its use should be thoughtful and justified, with full informed consent and understanding of the risks and benefits, rather than routine.

[Xavismom]

I had a fantastic natural birth in a hospital.

I think the #1 thing in my case, was that we went to a Baby-Friendly hospital. If you are near one, I would HIGHLY recommend it. Here is a link to the list

http://www.babyfriendlyusa.org/eng/03.html

I made the worst mistake possible trying for a natural hospital birth... I went in WAY too early. I had a posterior labor, and it was my first one, so I was in intense pain, and therefore thought I was much farther along than I actually was. I think I was just barely over 4 when we got there and they checked me in instead of sending me home. I was so nervous that it would ruin everything and I would be rushed and bombarded with pressure for intervention, but I was not, and I had a very long labor!

MW & Nurse did keep an eye on me, but DH & I were left to ourselves mainly (as we wanted per birth plan) to labor for as long as it took. No rush, no pressure, no one ever mentioned any kind of intervention of any kind to hurry it along. It was wonderfull, and my even my nurse was amazingly kind and supportive. During transisiton, I did start doubting myself, but instead of trying to push things on me, my nurse reasured me verbaly instead telling me how strong I was and how I had already labored so beautifully for so long and that she knew I could do it.

After the birth, no one even batted an eye at anything we wanted do do, like no eye goop, no Hep B shot, not washing the vernix off, etc. BF immediately after birth, and not disturbing the mother/baby bond is important at a Baby-Friendly hospital, as is rooming in, they dont even have a nursery, the baby stays with you the whole time, and so can DH.

[Mandynee22]

I have had two wonderful hospital births...WITH AN OB, and I'm planning a third! It just depends on your hospital and the staff and your Dr/midwife. Just having the name of "midwife" doesn't make one wonderful either.
Make sure you're on the same page with your HCP. Know what you want and how you want it. It would probably help to have a good support person, too LOL
I really think that the best way to get the kind of birth you want isn't that complaicated (obviously I am talking about if there isn't some kind of real emergency). As long as you trust your HCP and you are both on the same page, I'm sure you'll have what you want. Good luck!

[momongeon]

Originally Posted by kltroy

If 10 people come running into the room and say, "We need to get your baby out NOW!" - well, I would believe them!!

Even if your nurse and one or 2 others race in with a doc and make you jump through hoops to get in a new position and give you O2, when they say they have to deliver the baby NOW chances are they will.

Originally Posted by Hannah32

I think we have very similar opinions. I'm open to trying the birth without pain medications, but I'm not going to make a decision either way. Like you, my top priority is avoiding surgery.

Thanks for all the advice. While changing doctors right now isn't really an option, I will look into hiring a doula and will make my preferences known. I was reading the list of "Patients Rights" in the booklet the hospital sent and it seemed promising. Also, they room-in with babies and encourage breast feeding. Also, how I have the right to refuse a procedure and still receive proper care and such. I will also do a birth plan and delay going to the hospital at first. No need to hurry.

BTW, I've seen "The Business of Being Born," and while I enjoyed it, I don't think it impressed me the way it did some women on this forum. I agreed with some things argued in the movie, but found other arguments pretty specious and unsupported.

Ask your provider what is routine at that facility and what ever is not appealing to you ask if they could modify that in any way. Things that may be modifiable: continuous monitoring if everything is stable, Small snacks and drinks as you are able, we do not modify the eating part if a pt is on Pit, had a previous c/s or have an epidural as this increases the chances of c/s. All of our drug free moms are able to eat as they want but most don't want to.

So for those of you who are still in the choosing a provider phase, try calling the hospital you plan to deliver at and speak with the charge nurse or any nurse available in the birthing center. They will know which group of OB/CNM's are the best for what you are looking for as they deliver with them all the time. It is somewhat unfair to say OB's are not good at labor support b/c all of the MD's at the practice I go to spend a lot of time with their pts and offer lots of support. They run a very different OB/GYN practice. They are all very MWy and caring. So they are out there. When I have a pt from another practice that ends up in a c/s for "failure to progress/decend" I say it is "failure to be Maitri"

[philomom]

Have a Bradley trained partner.

Have a CNM be your caregiver.

Go in as late as possible to the hospital.

Don't get into the dead roach position.

Be firm with your requests.

Have a great birth!

[Mandynee22]

Originally Posted by philomom

Have a Bradley trained partner.

Have a CNM be your caregiver.

Go in as late as possible to the hospital.

Don't get into the dead roach position.

Be firm with your requests.

Have a great birth!

Is "dead roach position" (LMAO, BTW) on your back? Am I the only one who feels like that's how I need to be? With both kids, I came out of the bathroom feeling "OMG I GOTTA PUSH NOW LEMME LAY DOWN!!!!" I think if anyone had suggested something else, they woulda been admitted to the hospital soon after

[philomom]

Originally Posted by Mandynee22

Is "dead roach position" (LMAO, BTW) on your back? Am I the only one who feels like that's how I need to be? With both kids, I came out of the bathroom feeling "OMG I GOTTA PUSH NOW LEMME LAY DOWN!!!!" I think if anyone had suggested something else, they woulda been admitted to the hospital soon after

The real word is lithotomy I think... for mom on her back. And yeah, you are the only person I would know who actually wants to be that way. Most of my girlfriends wanted to roll up on one side. I wanted to be standing up.

[umsami]

Ask for things that you want.

Take a tour of your potential hospitals and ask questions. I'm always the person that everybody looks at asking about c-section rates, eating/drinking during labor, rooming in, etc.

For example, one hospital that I gave birth had birthing chair and birth balls available... you just had to ask.

All hospitals that I've used that have required monitoring at least have one or two rooms where you can be mobile while monitoring (telemetry? I think it was called).

Choose a hospital with a lactation consultant on staff. In general, they will be much more support of breast feeding. All of my babies had a "Breast Only" sign on their bassinets...just in case.

PACK SNACKS!!!! I finally was on the ball enough with #3 to pack a cooler "for my husband' with Propel, juice, granola bars, fruit, etc. Made such a difference for me.

Wait as long as possible to go to the hospital. With #2, I spent time in the shower until DH got home. By the time we got to the hospital, I was 7 or 8 cms. DS2 came less than 3 hours later.

[*MamaJen*]

Here's one more: spend more time researching your birth plan than your stroller purchase.

[jecombs]

Great comments so far! I just wanted to add myself to the list of people who have had a natural birth in the hospital. With my DD, we simply felt more comfortable in the hospital because I had never experienced labor and birth before and didn't know how things would go. I also wanted plenty of hands-on BF support after the birth. This time around I would have preferred a HB, but it's just not financially possible. So we're planning the best hospital birth possible!

I think everyone else has covered much of what you need to know. I would just add a couple of things. First, take a tour of the hospital and have a list of all your questions about "hospital policy/procedures". Then figure out what you do or don't want to comply with and put it all in your birth plan/preferences. Have your HCP sign-off on it and pack the signed copy in your birth bag. Then when the nurses are pushing the IV, heplock or whatever, you can present them with the signed birth plan as evidence that your HCP approved for you to have or not have it. The tour will also give you a good idea of what equipment will be available for you during labor (birth ball, tubs, shower, etc). Second, understand that if/when you decide to go with an intervention like an epi, you are signing up for the whole "cascade of interventions" which often leads to c/s. The epi can slow down labor, which will cause them to augment with pit, which will increase the intensity of the ctx on the baby, which could cause him to go into distress, leading to a c/s. This is what ultimately made me decide to forgo the epi. Now, there are plenty of people out there who have a fine and dandy vaginal birth with an epi, but it just wasn't something I was willing to risk. So, the bottom line is be an informed consumer and educate yourself about the consequences of various interventions. Then make an informed choice about what to do.

[mediumcrunch]

A lot has already been decided by your choice of provider and choice of hospital to birth in. After that comes your labor nurse, almost moreso than your doc/midwife they can really make or break a birth experience. Flat out ask for the nurse who enjoys working with unmedicated/natural-minded moms. More often than not you will get what you ask for. My last nurse had a homebirth and two unmedicated hospital births herself. Usually if I communicated with my nurse what I was about, what I wanted I had no trouble getting the care I needed/wanted/deserved. You can always ask for another nurse if you feel the one you have isn't meeting your needs.
Hiring a doula experienced working in the hospital you are birthing in and if possible has worked with your provider before is also a huge plus.

[MiaMama]

Oh, I just remembered one more thing...

After the birth, they wanted me to write down when she nursed, for how long, on each side.... they said that if I was alseep when they came in to check on me, and it was written down, they wouldn't wake me up to ask... seemed reasonable enough (we roomed-in).

For some bizarre reason, this stressed me out. If she latched on for 30 sec, unlatched and looked at me for a min, latched again, fell asleep on the boob, woke up and nursed for a few min..... what should I write? How long did she nurse?

In hind sight, it was totally irrelevent. I have no idea WHY it bothered me. I should have breathed deep, nursed how and when I felt like it, and done a rough estimate on the paper. There are other ways to tell if the baby is getting enough, and I think the nurses just needed to make sure we were not going 5 hours between nursing or something.