My fears (loooonggg, I'm sorry)

[CarlyDee]

Hi all! I am super interested in having a home birth, and would love that more than anything. However, I'm not too optimistic of that happening. Hubby is in the military, so we have the dreaded Tricare. I've searched around, and the CNMs around here will not do home births (surprise, surprise). There are CPM's here that we could pay out of pocket, but they're so expensive, and while we're not poor or anything, we definitely can't afford ~$4000 for a midwife.

The only way I would feel comfortable giving birth in a hospital, is if I could have as little interference as possible, and I could have the hospital room the way I want it, and make it as "homey" as possible. My fears, however, are that if I labor for a long time, my doctor will force me to have a c-section, and most likely tell me that it's "for the safety of my baby" even if that's not true. I'm also afraid I'll get a forced epidural, forced pitocin, and other forced medication that I REALLY do not want. So, if I DO have to give birth in a hospital (I'm still trying to think of a way to have a home birth, but just in case) my questions are:

1) What are the chances of a doctor allowing you to bring your own birthing pool to the hospital, and laboring/giving birth in it? (The hospital here does not have their own birthing pools.) Has anyone successfully done this?

2) How do I make it perfectly clear that I do NOT want any unnecessary interventions (c-section, medication, etc.) and I don't want him to lie to me and say it's for the safety of my baby, just because it will be easier for him.

3) Am I allowed to bring music, candles, essential oils, etc.? And am I allowed to turn off/dim the lights, and just give birth by candle light?

4) I don't want to give birth on my back, unless this is how I feel the most comfortable. How do I make it known that I WILL be walking, rocking, sitting on a birthing ball, on my hands and kness/side/squatting, NOT strapped to machines with constant fetal monitoring, and there's nothing he can do to stop me? Is he allowed to MAKE me lay on my back?

I'm really really really passive, and I have a hard time sticking up for myself. I'm afraid that if he tries to get me to do something I don't want to do, I'll cave and allow it, because I have a really hard time being strong and coming up with compelling arguments. Doulas here are also extremely expensive, so that's not an option. My hubby is supportive, but he will likely want to do what the doctor says. I don't have any friends here (just moved here) that can be with me to stick up for me. My mom is AWESOME, and I know she would act as a make-shift doula, and I know she would stick up for me, but she lives across the country, so I don't even know if she'll be able to make it to the birth.

Sorry I have so many questions! I have tons of fears about this, and this was the best I could do to get them out of my mind and into writing. I hope all of this makes sense. Thank you all so much for any help or advice you may have!

[mitintraining]

Here are my recommendations, granted neither I nor my husband are military, but years of doula-ing has taught some things. If you are not feeling comfortable with decisions your doc would make, please try to find a better care provider, do the CNM's do hospital births, is one of them better than this care provider. Make your intentions known during the prenatal visit with a birth plan. When scheduling your next appointment ask for more time to go over things with doc, then he won't be rushed. Also get a signed copy of your birth plan in your file-by you, DH, and your doc. Also call the hospital and make sure you can do the things you want, or you can waive, opt out of the things you do not want. No hospital can force you to do a procedure, they can however bully, berate, and make life tough for you or your baby during your stay. I recommend finding out in advance what is 'allowed' and then working to change things that are on that list in order of importance.
Secondly, please do not discount the idea of a doula because of expense, talk to some of them, usually they offer payment plans, or sliding fee scales to accommodate varying financial situations. Same thing with the CPM's most will work with you to some extent. A doula could be the buffer you need, although you still need to have a written and signed birth plan, to get you through. At the least she can buy you some time when needing to make decisions.
Good luck on your journey. Again do not discount the possibility of either a midwife or a doula cutting you a break, I did many times and it was great. Also read, read, read about pregnancy, birth, writing birth plans, and everything else you need to know about.

[47chromosomes]

I think all of those questions are questions for the hospital/doctor. I am not military, but in our hospital people ARE aloud to rent a specific birth pool by a specific supplier, and can give birth in it given they have taken a water birth class and are considered low risk. BUT, I think the hospital in my town is particularly progressive and, well, crunchy. Personally, I have given birth twice on dry land, and it was just fine.

I know at our hospital it would be fine to bring essential oils and music and to wear your own clothes, etc. I have given birth in the hospital once, with a doula, and at home once. Both were amazing experiences.

Here is my advice. Home birth is so wonderful, and even though it is pricey, we've always felt privileged to pay. To be honest, it feels dignifying to have to make up a strict budget and follow it in order to pay for valuable services of home birth midwives who know you by face and name if you ever call with a problem. You may find after some strict budgeting that you can swing it. But if you can't...

If you just can't afford a home birth, my advice is to hire the best doula you possibly can. Hire someone who has experiences helping mothers birth in the exact hospital you will be at. Ask for recommendations for midwives who are covered by your insurance. And then think about laboring at home with your doula as long as possible. Chances are (at least was my own experience) that going to the hospital sometime in active labor you will not give much thought to the fact that the room is not homey. Sure, you can have your own music and labor coping tools with you, but you may not even care. Your doula can help to support you in your decisions like no epidural, pitocin, etc., or at least help you to make informed decisions in the moment. I highly recommend the book Birthing From Within. It has great ideas, tips, thoughts, and does not assume that every woman will choose or can have a home birth, but instead focuses on helping women to have an optimal birth for the circumstances they are given.

[onlyboys]

Originally Posted by CarlyDee

1) What are the chances of a doctor allowing you to bring your own birthing pool to the hospital, and laboring/giving birth in it? (The hospital here does not have their own birthing pools.) Has anyone successfully done this?

I've heard of this happening, though I've never seen it. You didn't mention where in the US you are, which might help others help you determine what the climate is like in your area. I sincerely doubt that an OB in a conservative area is going to be willing to crawl out on the waterbirth limb unless there are waterbirth provisions in place at the hospital.

2) How do I make it perfectly clear that I do NOT want any unnecessary interventions (c-section, medication, etc.) and I don't want him to lie to me and say it's for the safety of my baby, just because it will be easier for him.

You make it clear at every point possible. Mention it to the OB (if you're in a practice, mention it to every OB at every appointment) often, and in a positive, constructive way. Just remind them at every opportunity that you are committed to a vaginal birth, that you are normal and healthy and you don't want any interventions if possible.

3) Am I allowed to bring music, candles, essential oils, etc.? And am I allowed to turn off/dim the lights, and just give birth by candle light?

I would suggest not asking "permission" but for forgiveness. Just bring what you need to the hospital. I've seen births at the hospital where the mom brought in a crock pot, birth ball, candles, oils, massage implements, bath salts, etc. Candles are sometimes problematic because of the oxygen issue, so I'd personally check with the nurse about that one. You can create the light you need by bringing a lamp, or by just turning off the lights. When the baby comes, they often break down the bed and turn on these stage light things, but you can request that they NOT do that if you want to.

4) I don't want to give birth on my back, unless this is how I feel the most comfortable. How do I make it known that I WILL be walking, rocking, sitting on a birthing ball, on my hands and kness/side/squatting, NOT strapped to machines with constant fetal monitoring, and there's nothing he can do to stop me? Is he allowed to MAKE me lay on my back?

This one's easy. Just refuse to get in the bed.

I'm really really really passive, and I have a hard time sticking up for myself. I'm afraid that if he tries to get me to do something I don't want to do, I'll cave and allow it, because I have a really hard time being strong and coming up with compelling arguments. Doulas here are also extremely expensive, so that's not an option. My hubby is supportive, but he will likely want to do what the doctor says. I don't have any friends here (just moved here) that can be with me to stick up for me. My mom is AWESOME, and I know she would act as a make-shift doula, and I know she would stick up for me, but she lives across the country, so I don't even know if she'll be able to make it to the birth.

I'm going to call it like I see it here, and hope that you don't take this the wrong way or see it as overtly negative. This concerns me greatly because women become even more passive when they are in labor. Seriously, I've seen women who are strong, confident women who believe fully in their body cave to intervention and pressures because of the merest suggestion of the midwife or doctor. Starting now, you need to work on your assertiveness and your voice. YOU CAN DO THIS WORK; YOU WERE MADE FOR IT!

There are many doulas who need births to become certified, and women who are total birth junkies who want to be there just to be there. Seek out these people, even if you do not know them, and make friends with them over the course of your pregnancy. Build yourself a community of natural birth experts who you can go to when you need to. La Leche League is good for this.

I'd also check with the local homebirth midwives. See what prices they offer, ask about payment plans and options and see how much it would be a month. Think about ways to make a little money between now and then. Don't automatically discount it without doing the research.

Just FYI, I've had two lovely hospital births--they didn't remotely compare to my homebirth.

[jgale]

I'm a midwife who has worked in both home and hospital settings and I'm a home-birth mama myself. Here are my thoughts.

Obviously homebirth would be the best option for you--given your hopes for how your birth would go. I think in this country we are so unused to paying for healthcare that it seems somehow extravagant and wasteful to pay for a homebirth when you could have a hospital birth for free. But the day that your baby is born is a day that you will literally remember for the rest of your life. It has the potential to be transformative for you as an individual and for you and your husband as a couple. It also represents your baby's first interactions with the world.

Compared to how much most people spend on a wedding, or a car, or on eating out in a year $4000 for a home birth, given what it represents, is cheap! Many midwives will work with you on a payment plan. By paying them a fair price for their work, you are also enabling them to continue to offer this incredibly important option to the community.

Okay, off my soap box now. If you decide to go the hospital route:
1. you will definitely not be allowed to use candles in a hospital
2. you probably will not be allowed to bring your own birth tub in--no hospital that I have ever worked in allowed patients' to bring their own tubs--the nurses would need to know how to fill and empty it (because you will be in labor) and the unit would need to have a waterproof doppler (which they may not have).
3. you should definitely ask about the nurse-patient ratio on L&D as well as the nurses' comfort with intermittent monitoring--many L&D nurses in my community have literally NEVER done intermittent monitoring and do not know how to do it.
4. I would strongly recommend having an advocate of some kind because trying to birth your baby and fight with the hospital staff at the same time would be extremely unpleasant (to say the least)
5. Essential oils, dim lights and music shouldn't be a problem
6. The best thing you could do to try and have a nice, un-interfered-with hospital birth is to arrive at the hospital as late in labor as possible. To that end, you might want to practice checking your cervix in pregnancy so that you will be able to do it when you're in labor (it's easier then).
7. Start this dialogue with your provider early--like now--so you have plenty of time to ask lots of questions and express you concerns.
8. You didn't mention any postpartum issues, but you might also want to consider what concerns you might have with newborn care and your postpartum recovery and see how flexible the hospital is on those issues...

Good luck. I hope you are able to have a homebirth because homebirths are just so freaking awesome.

Best wishes,
Jessi

[allisonrose]

With my first child, I went for a hospital birth due to finances. HMO would not have covered a cent and, yup, looking at $4,000 as well. It didn't go the way I wished but I was glad to manage a vaginal birth.

Just my thoughts:
Military healthcare does make life a bit on the tough side. Talk to some other military wives in your area to find out how things work. My hubby is former military but we waited until he got out to have a child (for various reasons). I worked with a military wife who had a baby under military care but she happily went along with an induction at 38 weeks which ended up as a c-section because she was "done being pregnant".

Even though doulas can be pricey, still ask around. Student doulas often do free births to get experience. You might also find a doula willing to discount since your hubby is military.

If you do go for a hospital birth:
I'd recommend doing all you can to test negative on the GBS test. I tested positive and it made my birth more complicated.
Also stay home as long as you can. I remember the OB guidelines are something like a contraction every 5 minutes whereas here on MDC, mamas talk about waiting till contractions are every 4 or even 3 minutes. (Searching should pull up some info I'm sure since my memory is rusty.)
I would also consider supplementing to strengthen your bag of waters since premature rupture of membranes also complicates issues. (Yup, happened to me.) I believe Vitamin C and E are supposed to help but don't know off hand the amounts.
I did see CNMs for my hospital birth and think that helped a bit since the OB on call came in to talk to us briefly and she was definitely more commanding about what should be done. I told her to leave and send the midwife on call back in (wasn't one of the midwives we saw for prenatal care).

Naptime beckons so I have to cut this short!

[CarlyDee]

Thank you all so much for all your lovely advice! I will definitely remember all of this when talking to my doctor. I will definitely be laboring as long as possible at my home, so hopefully all I have to do when I get to the hospital is push.

[CarlyDee]

Have some exciting news! I just found a CNM in my area that does home births that is covered by Tricare! I'm absolutely thrilled. I can only thank MDC, because I found this information in my Tribe area forum.

[msmiranda]

That's fabulous! I was going to chime in to tell you that while I feel very very strongly about my preferences for no interventions during labor and birth, I know for a fact that there is no way that I would be able to advocate for myself during labor. I get very in my head and very passive and easily led. I can't argue with anyone about anything. I was fortunate that while my first son's birth was in a hospital, I had CNMs who were great and absolutely had my back. With my second I had moved and couldn't go back to them, so I chose to birth at home because, due to my first labor experience, I knew how passive I became in labor and even though I had "done" birth once, I wasn't confident that I would be able to have a natural birth in the hospital even though the OB practice I was seeing at first was not that bad as OB practices go (meaning their c-section rates were still too high for my taste but lower than many). I think what convinced me that OB care was wrong for me was talking to them about natural birth. They just didn't ever see it. As one of the OBs put it, most women who ask them about it are first-time moms and ultimately get the epidural because they "can't handle it." She looked at me like I was superhuman or something because I had gone drug-free.

Saying that to say: Normal birth is not in the skill-set of most OBs. It is not what they do, it is not what they see every day. Thus, if that is what you want, and there is no medical reason you need to seek obstetrical care, you need to see a midwife. There are exceptions of course -- OBs who are more like midwives and "medwives" who are just like most OBs -- but in general I always tell women that choice of care provider is key to achieving a normal birth (in the absence of complications that necessitate something different) and that a midwife is the way to go.