Is it possible to have a "Homebirth" in the hospital?

[vetgirl00us]

I live with my family, am single and currently have not found a doula or midwife in the Rome, Ga area. I would like to have a homebirth but I'm not sure how that will work out since I live with my mother (who I don't want attending the birth) and my stepdad. That means, I will have to find a birth partner, somebody who knows what they are doing to help me and ask the rest of the people who live in the home to leave. So if worse comes to worse, my plan is to labor at home as long as possible then go to the hospital and birth naturally there. How hard is it to birth naturally without IV's, laying flat on my back and with monitors stuck all over me while there in the hospital? Homebirth is my best choice but I can't do it here alone so I'm thinking worst case scenario in the hospital. Any advice?

[mamagranola28]

One idea you might think about is hiring a midwife and birthing in a hotel.  I know there are women on this board who have done this and it's worked out great.  You might try posting on the find my tribe threads to see if someone there can point you to a good midwife.  I've attended births (as a doula) in both hospitals and at home.  By design hospitals are set up to move birthing women through THERE system as quickly and efficiently as possible.  Natural childbirth is always unpredictable.  Even if you have a great provider and fabulous doula there is always sacrifice and conformity on the part of the birthing mother.  You can't get a five coarse meal at McDonald's.

Good Luck!

[elisheva]

Is there a birth center near you? I'm assuming you've checked out this route. Ask your midwife - I've heard of other people offering their homes or an unoccupied rental etc. It sounds like it would be really awkward for you to birth at home. 

To quote Navelgazing Midwife: "If you buy the hospital ticket, you go for the hospital ride." There are hospitals out there where the experience is better than at others, but it's still not a homebirth.

[stik]

I have had two, lovely, perfect, intervention-free births in two different hospitals.  One with care from a CNM, and one with care from an OB.  I have never been taken on the hospital ride to get a crappy meal at McDonald's. 

I think a lot depends on the hospital, and a lot depends on the patient.  In my experience, hospital staff have always treated me with respect, provided me with all the information I requested, and respected my informed consent (or denial of consent).  There are many, many stories on MDC of women who have not been treated so well.  I think that I carry some privileges in to health care situations.  I am very well-educated, and I am comfortable using medical terminology, just for example.  I'm very healthy.  I know what interventions I will accept and under what circumstances, and I am capable of explaining these things even in labor.  I have the ability to choose my care providers carefully.  I have short labors.  I know when to pick a fight, and what things I can ignore and sign an AMA letter on in the hospital, but I've never had to sign an AMA letter.  When I'm anxious about an issue, I memorize my citations - I always do, not just for birth, but I've never needed to use my obstetric research citations.  I don't know if that explains my lovely natural births, but I know that my academic preparation was complete to the point of fetishism.

Maybe it also helps that I yell at people a lot in transition.  My husband tells me that at the end of labor with my second dd, I alternated peacefully chanting "baby, baby, baby" with snarling "Don't touch me!"  And no one did.  When my dd was born, the doctor was standing four feet away from me with her hands above her shoulders where I could see them.  I was lying on my left side.  No one turned on the spotlights.  No one broke down the bed.  No IV, no hep lock.  No one did anything I did not give them my express and explicit permission to do.  They were lovely. 

I think the earlier in your pregnancy you establish a relationship with a HCP, the more time you will have to get to know that person, to explain your goals and desires to them, and to switch providers if things aren't working out.  I think fear and mistrust of OBs can undermine natural birth, and it doesn't need to. 

Anyway, while I wouldn't call it home birth, I know that it's possible to have an empowering natural birth experience in a hospital. 

To specifically address the issues you raised:

IVs - are placed as a precaution so that no one has to work to access a vein if you need an emergency transfusion.  EMTs can place an IV in under three minutes in the dark.  But, docs are typically most comfortable forgoing this if they know your iron and platelet levels are good, and if they know you've had consistent prenatal care.  This is an issue where you can make up your mind and skip arguments - if your doc says that you *must* have an IV or hep lock in labor and you don't agree with his or her logic, nod, smile, and plan to ask for an AMA letter if hospital staff get pushy about your refusal.  My OB with my second dd said that hep locks in labor were absolutely mandatory for women delivering with docs from her practice.  However, when I got to the hospital, the nurse gave me the choice.  I declined.  My OB was on vacation.  Because of shift changes, I saw three doctors from her practice and the hospitalist.  None of them complained that I was lacking a hep lock. 

Monitors - continuous fetal monitoring has never been shown to be more effective at preventing complications than intermittent auscultation.  If you get an epidural, monitors will be placed, as will a catheter, and you will be immobile.  If you don't get an epidural, most hospitals like to get a 20 minute strip of contractions/the baby's heart rate every hour.  Nurses will typically strap the monitors on and then leave the room.  They're held on with velcro, not padlocked in place.  If they're uncomfortable for you, take them off.  This will typically bring the nurse back to the room.  Offer to hold the monitor in place for a few contractions, but tell them the strap hurts like hell and you need to walk.  Or tell them you need to use the toilet - that works too.  And then go do your thing, don't wait for permission.

Flat on your back - it works for a small number of women, but if that's not you, don't do it.  Both hospitals I was at encouraged women to walk in the early stages of labor.  Just because the bed is the centerpiece of the room doesn't mean you have to get in it.  Use it when you want to rest or lie down.  Let your body guide you to a comfortable position in a comfortable spot.  My plan, in the event that anyone suggested that the doctor couldn't deliver the baby if I was in a certain position, was to say, "That's fine, I'm delivering the baby myself."  But I never needed to say it.   

Comfort measures in the hospital - I found a warm shower very helpful.  Walking felt good.  Rocking felt good.  Laboring at home for as long as you can is a good idea - at home you can snack, nap, shower, bathe, and not be bothered by hospital staff and procedures. 

[RoseRedHoofbeats]

It is possible to have a natural birth in a hospital- but it's not a homebirth by any stretch. And for most women, in most hospitals, with most providers, it's an uphill battle the whole way.

A LOT depends on the caregiver, and you DON'T always have a choice in who that is. Even if you birth with a CNM or a natural birth friendly OB, they have a boss and policies who can decide pretty much arbitrarily if you're "high risk" and they have to transfer care. Yes, you can spout off citations and yell at people and sign forms, but that doesn't sound like a great way to spend your labor to me. And it's certainly not the same as a homebirth.

There are some really nice hospitals, with wireless monitors and policies that "allow" you to eat or drink, and have VBAC-positive providers... but it's still a hospital. It's still not your house, your bed.

I second the hotel recommendation, or going to your midwife's house!

~Rose

[mdnaturalmama]

I agree with pp suggesting hotel or MW's home. If it were me I'd ask a close friend who was pro-HBing. I know not everyone has those ppl in their lives tho. If you haven't yet found a MW I''d suggest starting there and discuss this with her. I'm sure if she's done years and years of HBs that she's encountered this before and has some advice/suggestions for you. Good luck mama! =)

[stik]

A hotel or your midwife's house won't be your house or your bed either. 

My post was really long, and I made things sound intense and complicated.  I remember the anxious feeling I had during pregnancy that came with the fear that my understanding of what would work for my body would be over-ridden by fascist HCPs.  Despite my fears, having a natural birth in the hospital wasn't an uphill battle.  It wasn't a battle at all. 

Looking over my post, it sounds like I studied for hours and then got hostile with the nursing staff.  Research is what I do to deal with fear about anything, and I didn't spend hours on it.  In birth, as in anything else, I did what made me feel most comfortable (research, walking, showering, snarling).  The hospital staff I encountered were very respectful of that. 

You might get different answers if you ask this question in the larger Birth and Beyond forum instead of Homebirth. 

[RoseRedHoofbeats]

True, but in a hotel or your midwife's house- you can labor in that bed, breastfeed in the bed, sleep with your baby in that bed, and not get woken up every four hours for a vitals check. That's not a guarantee by any stretch of the imagination in a hospital, even a Baby Friendly one. You don't have any control over who attends your birth, who walks into the room, who makes decisions about your care. I'm not saying that a hospital birth can't be positive- it IS possible. My hospital birth definitely had its shining moments, like when I caught my daughter and pulled her to my chest. It's just different from a homebirth.

~Rose

[stik]

I labored, breastfed, and slept with my baby in a hospital bed.  The thing about being woken up every four hours is totally true, and kind of a bummer. 

While I didn't get to choose the doc at my birth (mine was on vacation) I did have power over who else was in the room.  I booted a nurse from my first birth.  It wasn't difficult.  I asked her to leave.  She never came back.  You also control who makes decisions about your care.  Barring a court order ruling you incompetent, it's you.  Hospitals are big institutions, but their power to control an individual is very limited. 

[lovebeingamomma]

The biggest thing (for me) that prevents hospital birth from being like a homebirth, is I will not know the people who are caring for me, I will not know if they support me, and that's so unnerving, and why I'm choosing homebirth this time.  You can't just "pick the right provider" and you'll be gauranteed a wonderful hospital birth , a lot, A LOT depends on the nursing staff, which you can't pick, they will be with you 90% of the birth, all OB's, and most midwives, will not be with you the whole time, they just come in to catch the baby, or if there's a problem.  I have seen nursing staff speak on behalf of the doctor, giving false information.  All that being said, I had two, good, natural, intervention-free births in a hospital.  But they weren't fantastic.  That's because I'm picky, I want what I want and if a nurse says I NEED this or that, I don't comply.  And it's not fun to have to fight like that.  Others comply with the little things, don't care, and have great births, but it depends on how deeply you care about all the little details.  If hospital birth is your only option, it can still be wonderful, but it will most likely take a lot of planning, and strong advocacy on your part.  That's just reality.  By the way, I was told I can't sleep with my baby in my bed, it depends on the hospital.  So there's one example, where they were controlling me, and it wasn't up to me, they would have harrassed me until I complied. 

[vetgirl00us]

Thank you all for the wonderful, informative replies. I am currently in search for a midwife or at least a doula and I will keep in mind the "knowledge is power" mantra. I too, am in the medical field and know what I may REALLY need or REALLY NOT need if I happen to be at the hospital. My hospital is in a small town and they do it the fast, medical way. IV's, epidurals, flat on the back, legs up, etc. I don't want that if at all possible. Again, thank you for all the wonderful info!