Worried about hospital birth....

[organicmom3]

I just saw my midwife yesterday....note she is a midwife who works in a doctor's office so she can't practice midwifery exactly the way she would want to.......
I found out she'll be out of town for a full week prior to my due date......yikes....
I found out that though she is in agreeance with everything on my birthing plan, the doctor and staff may not be.....PANIC!
Things like waiting at least 3 minutes to cut the cord (or until it stops pulsating which seems to be way out of the question here) and only having clear liquids for hydration rather than an iv, and , she says they won't do it but they will not be supportive of our decision to not do the vitamin k shot..... My biggest worry is the cord thing...IT is REALLY important to me that they wait....I'd feel better if I knew I'd have the baby with the midwife there and not the doc...but if I get stuck with him? How do I stop stressing over this?

[*MamaJen*]

Do you have the option of transferring to a different midwife, maybe one who does homebirths or birth center births?
The state of Pennsylvania cannot force you to give your child a vitamin K shot -- you are fully within your legal rights to refuse. http://www.vaclib.org/exempt/pennsylvania.htm.
While the hospital can throw up numerous roadblocks, it is your body and you have a great deal of power of what you do and do not consent to. Do you have a doula? A good doula can help advocate for you and avoid interventions. Also, you and your doula could sit down with the OB and go over you birth plan.
There's a good thread going right now about having a better hospital birth. But Ideally, you might want to look into a homebirth if you can possibly swing it.

[cheeqz]

Does your practice birth at a local hospital? I found that interviewing the nurses that work the maternity ward is a good way to find out if you need to have backup with you

I was going to birth at a hospital and found that most nurses there would support your decision, but it was important that they understood your plan, since births with lots of intervention were common (including the after birth procedures). If the the nursing staff looks at you funny when you ask about their practices, then it might be wise to have a labor partner/doula who can be there to support your decisions.

[kltroy]

Why not request a meeting between you, the MW, and the doctor, to go through your birth plan and address some of your concerns? FWIW, my family doctor ended up being out of town during my VBAC birth 19 months ago and I, too, panicked. But the on-call doctor ended up being excellent, and since my doc had taken such good notes about my birth plan, EVERYTHING was honored.

Anyway, as far as small things like eating/drinking during labor, who is going to police that anyway? If it's a doctor, he/she won't be there for most of the labor anyway, so it's really the L&D nurse whose job it will be, and all you have to do is say "my doctor/midwife gave me permission to eat and drink". Done. Also, remember there's only about a 25% chance your baby will come during that time period anyway

[autumnday]

Try to get your baby immediately placed on your chest, if he/she is lying on the cord, they can't cut it

[organicmom3]

Thank you to all... I just really need the encouragement at this point. We are in a small small small (have I emphasized small?) hospital in very rural Pennsylvania..I have the ONLY midwife in town...in the area....the next closest is over two hours away...and while I haven't had a baby in 11 years, it is my 3rd and the 2nd labor/birth didn't last long...so I don't want to depend on a midwife that is two hours away....

My husband (he works at the hospital) already had one of the l/d nurses roll her eyes at him when he mentioned not cutting the cord right away....and it is the practice of the doctor who the midwife works with to cut it right away.....

Anyway, our midwife was supposed to talk the plan over with the doctor....I'm just stressing wondering how much he'll agree with. We are going to try to get our tour of the maternity wing (though small and not much to offer) next week and see if we can get a feel for what any other nurses might be like...unfortunately the one that rolled her eyes is the one that teaches the birthing classes! Thank goodness we have been through this before and didn't need a class!

So if I make sure the baby is lying on the cord, they can't cut it? Won't lying on it decrease the flow?

[*MamaJen*]

Are there any doulas at all that serve your area? It really could be a huge help.
Also, it really sounds like you and your midwife need to have a serious sit-down with the OB and go over your birth plan. You're going to have to strongly advocate for yourself.

[autumnday]

since they cut close to baby's belly button, if he/she is lying on his/her belly there will be no access point for them. Cords are very thick, tough material (sort of like the tendony, ligamenty stuff when you cut up chicken) so the small weight of the baby lying on it doesn't compress it enough to restrict the flow, and certainly not more than having it cut early!

This is often naturally done by mothers when there is no one to interrupt the process, instinctually, we often bring them toward the breast.

[organicmom3]

no, doulas are just something to read about here....

My husband felt better when I told him about putting the baby on my chest...we're pretty sure we can at least get that....and with me and my husband there we can fight them away from taking the baby too soon i think....I just wish I didn't have to feel it would be a struggle. The midwife is to talk the plan over with the ob...that's the way they do things and until I at least hear what she says at the next appt. I guess I shouldn't do more..I don't want to make her job more difficult...I do know she is doing the best she can in her circumstances..I'm sure being the first midwife in such a close minded hospital has to be very difficult for her to pave the way!

maybe taking a tour next week with someone from labor and delivery will help too? OR, make me feel worse...time will tell.....I just pray God has it in mind for me to deliver while the midwife is here!

[Friday13th]

I really hope you get the birth you want. I do think sitting down yourself and talking to the doctor will help (hopefully) or at least give you a good idea what you're up against.

As far as the baby on your chest goes, I've seen OBs clamp and cut the cord much farther down while baby is on mom's chest and the later they cut it closer to the belly button so I don't think the baby laying on you is going to guarantee that the cord won't be cut.

Good luck!

[*MamaJen*]

Are you concerned about things like avoiding an epesiotemy, pitocin, AROM, and so on? While you're in labor, can you get your husband to advocate for you and be your doula? Would he support you in that way?
Remember, you are in control of what happens to your body. It's YOUR body, you own it. If you refuse to consent to an epesiotemy, they can't do it.

[organicmom3]

An episiotomy is not my main concern...I'd like to avoid it and I doubt it would be an issue..but yes, of course my husband will advocate...I just want his focus to be me and not as Watchdog to doctor and nurses....

I haven't even had a chance to research pictocin and what is AROM?

My main concern is the baby...and that cord. It's really important to me they at least wait a full 3 minutes..I'd prefer it longer but feel that's really pushing it in a hospital that is sooooo into doing it immediately. We'll see when the time comes...I'm not giving up on longer but I'll be satisfied if I at least get them to hold off for a few. It's certainly a lot more than my other kids had.

I did find out that my husband talked to an ER nurse last night that used to do OB in another town. She was apparently trained by a doc who did all natural.... she volunteered to come and be 'doula' if I go into labor when the midwife isn't there....and of course if she's not working at the time. That is so sweet .... I don't even know her which would be weird but I'll take all the help I can!

I'm still praying labor will happen either BEFORE or after the midwife is on vacation ...but I need to depend on God that all will work according to His plan.

[organicmom3]

Oh...I just looked up AROM...no the midwife didn't seem to think there would be any kind of problem with that...only if there was a true medical reason would they do that.

[elanorh]

Can you have your midwife (and the OB, hopefully, having reviewed your plan) sign your birth plan and have it 'on file' at the L&D Department? At ours, we fill out paperwork for most everything ahead of time (circ/no circ paperwork etc.) so we don't have to go through insurance information or etc. with the staff at all - just focus on giving birth. Our hospital is relatively rural too.

Is your FP or Pediatrician supportive of the delayed cord clamping? When we decided we wanted to delay with dd2, we talked to our Ped and OB ahead of time, and they were both supportive (no concerns). If OB had not wanted to support it, I would have asked Ped for a letter stating that she was comfortable with our decision, as the physician for our child. If the OB won't bend on it, then a note from another doctor saying that they have no concern, might help.

Who knows, you might go late and get your midwife when she gets back from her trip, too.

I talked to our OB about making sure we delayed cord clamping, and how we wanted to do it, and also "babe immediately to breast" beforehand. He was awesome with our delivery. Delayed cord clamping is not hospital policy here - when a nurse came bustling over with pitocin to do active management of 3rd stage of labor (also something I'd told him I didn't want) - he told her to get it out of the room; it wasn't in my birth plan, I didn't want it, and he hadn't requested it. He told her to throw it away in a different room and that it better not show up on my bill, either. And he did this calmly and firmly - I didn't even notice, I was so wrapped up with dd2. Dh was the one who told me about it afterwards, very impressed with OB's tone/approach with the nurses. This was despite the fact that my OB has no opinion on delayed cord clamping and it's obviously hospital policy to clamp immediately so he's not used to delaying.

You may be asking the OB to do things differently than s/he is used to - but s/he does have a midwife in his/her practice, which seems to me to be a sign that hopefully s/he is more open to natural birth and supportive of some of what s/he might consider the "wackier" requests of an NCB mom.

I have heard of people writing on their inner thighs with marker to say, "I refuse episiotomy," so I'd think that you could also write on your inner thighs that you refuse to allow them to cut/clamp the cord.

It might be helpful to tell the OB that you want your dh to be the one who clamps and cuts the cord as well -- don't say just 'cut' because I've heard of OBs who then clamp the cord, and wait for dh to cut it, which defeats the whole delayed cutting purpose.

It's a good idea to do the research and tell the OB how to manage a delayed cord clamping (IIRC, no pitocin for the third stage of labor, whereas pit then is very common in most hospitals). My OB told me that he could respect that unless I started to hemorrhage, then he'd need to immediately clamp the cord and give me pit.

The other thing I did was bring articles about delayed cord clamping - there was one in a Pediatric Nursing magazine that referred to a study with preemies, for instance. OB was fine with it and didn't need those to convince him, but possibly your OB would. Make sure it's peer-reviewed, scientific or medical articles that you are referring to.

[mauinokaoi]

I can't believe that a doctor who's paid big bucks to take care of you and your baby doesn't have 3 minutes to let the cord go uncut. I would simply say if you cut the cord too soon you will be hearing from my lawyer.