What was continuous monitoring like for you? - Page 2

[kriket]

Originally Posted by briannas auntie 

I honestly wonder if a doctor can force you to have monitoring during labor.  It seems like so many doctors are so used to monitoring that they'd use guilt trips to get you to keep it on.  Has anyone ever had a threat of having authorities called if you didn't comply with having continuous fetal monitoring? 

Jessie

Yeah, I just got massive guilt trips. In transition I started peeling things off me, clothes, blankets,wires, masks everything. The nurses were trying to put things back on as quick as I pulled them off all the while telling me they were "keeping my baby safe" and such. I dunno, but by the point of transition, who cares? Is there anything you can do? By the time they wheel me to the OR for a c-section I would have pushed the baby out in the hallway.

I loathed the monitors. If DH were more willing, and HB MW's weren't "illegal" in Ohio, I wouldn't go to the hospital at all.

[Blanca78]

Thank you all--these replies are very helpful and given me a lot to think about. Comtessa, I'm really interested in what you posted about the IV. The thing is, my doctor used to allow heplocks, which I would be fine with. But apparently the nurses haven't been very consistent about flushing it to keep it open, and my doctor has had a couple of recent situations where she felt she needed emergency IV access and the heplocks weren't working. My doula heard the same thing about this doctor from other doulas--she used to be fine with heplocks. The IV really was a sticking point for me, but at the same time I don't feel like it's a deal breaker. However, that on top of the prospect of continuous monitoring has me worried.

I guess at this point my feeling is more one of overwhelming frustration than a sense that monitoring/IVs will definitely suck or not suck. I mean, I don't know. If they turn out to be more annoyances than anything, I can deal. Next baby I'll be on different insurance and will have access to a great CNM practice that works with a crunchier hospital.

Anyway, that frustration comes from the underlying illogicality of it all. I am low risk! My baby is in the 50th percentile for size! I have had absolutely no health problems or difficulties this pregnancy. My wedding ring is even still loose, for god's sake. WHAT IS THE POINT OF ALL THIS PROTOCOL? I mean, I am not even absolutely ruling out an epidural at this point--I have not had a baby before; I don't know if there will come a point in labor where I really feel the pain relief will help me. BUT, if I were to consent to such a thing, I would only want to do so IF I KNEW I HAD GIVEN MY BODY ITS BEST SHOT. But, all these routine restrictions add up to me having less choice in the moment. Less autonomy. That's where it's difficult and anxiety-producing for me. I want to know that I am able to work with my doula to do what my body wants to do in the moment. I am absolutely open to suggestions or guidance from care providers, but I want them to give natural birth the benefit of the doubt--and turn to interventions ONLY IF NECESSARY--rather than laying obstacles in the way of a peaceful natural birth, when these obstacles have been repeatedly shown to interfere with the labor process.

I know I'm preaching to the choir here but it is just so maddening. All that said, I really do like my doctor on a personal level, and I think she truly is the lesser evil compared to a lot of other people. If I were high risk or in an emergent situation, I would absolutely trust her and want her caring for me. But I wish I didn't feel like I had to fight for a demedicalized birth, even in a hospital setting. Flexibility is all I'm asking for.

[Ldavis24]

Originally Posted by Blanca78 

Thank you all--these replies are very helpful and given me a lot to think about. Comtessa, I'm really interested in what you posted about the IV. The thing is, my doctor used to allow heplocks, which I would be fine with. But apparently the nurses haven't been very consistent about flushing it to keep it open, and my doctor has had a couple of recent situations where she felt she needed emergency IV access and the heplocks weren't working. My doula heard the same thing about this doctor from other doulas--she used to be fine with heplocks. The IV really was a sticking point for me, but at the same time I don't feel like it's a deal breaker. However, that on top of the prospect of continuous monitoring has me worried.

I guess at this point my feeling is more one of overwhelming frustration than a sense that monitoring/IVs will definitely suck or not suck. I mean, I don't know. If they turn out to be more annoyances than anything, I can deal. Next baby I'll be on different insurance and will have access to a great CNM practice that works with a crunchier hospital.

Anyway, that frustration comes from the underlying illogicality of it all. I am low risk! My baby is in the 50th percentile for size! I have had absolutely no health problems or difficulties this pregnancy. My wedding ring is even still loose, for god's sake. WHAT IS THE POINT OF ALL THIS PROTOCOL? I mean, I am not even absolutely ruling out an epidural at this point--I have not had a baby before; I don't know if there will come a point in labor where I really feel the pain relief will help me. BUT, if I were to consent to such a thing, I would only want to do so IF I KNEW I HAD GIVEN MY BODY ITS BEST SHOT. But, all these routine restrictions add up to me having less choice in the moment. Less autonomy. That's where it's difficult and anxiety-producing for me. I want to know that I am able to work with my doula to do what my body wants to do in the moment. I am absolutely open to suggestions or guidance from care providers, but I want them to give natural birth the benefit of the doubt--and turn to interventions ONLY IF NECESSARY--rather than laying obstacles in the way of a peaceful natural birth, when these obstacles have been repeatedly shown to interfere with the labor process.

I know I'm preaching to the choir here but it is just so maddening. All that said, I really do like my doctor on a personal level, and I think she truly is the lesser evil compared to a lot of other people. If I were high risk or in an emergent situation, I would absolutely trust her and want her caring for me. But I wish I didn't feel like I had to fight for a demedicalized birth, even in a hospital setting. Flexibility is all I'm asking for.

Oh mama I have so many thoughts for you spinning in my head right now, I have been following the thread out of curiosity because I didn't have a hep lock or IV or continuous monitoring although I did have a ton of doppler monitoring, I haven't been able to give you my perspective on what you are looking for.

Just please be very VERY aware that most hospitals and most OBs and most (definitely not all) nurses in L&D NEVER give natural child birth the benefit of the doubt. They don't know what natural childbirth is a lot of the time. 

To them, the actions they take are not "interventions" they are every day things that have become deeply ingrained as the norm and the correct thing to do.

I am really not trying to scare you, I just noted you said this is your first baby and I don't want you to be surprised or disappointed if they basically feed you lip service about natural childbirth but when it comes to push and shove they could care less...Maybe this sounds callous toward OBs and the nurses in L&D...There really are some gems out there who work with mamas as best they can and do everything to help them achieve their goals. I just think you need to really really prepare yourself for the possibility that you could be in for a real fight to get the birth you are hoping for!

I wish you the best of luck and I definitely hope you and your LO are happy and healthy when it is all said and done! Please don't be offended by anything I said, I definitely don't want to step on toes :)

[Blanca78]

Not offended, Lauren! A little scared, yes, but I appreciate your perspective. That's a big reason I wanted to hire a doula, to help me navigate everything. It's just all the information I get is so conflicting. I know people who have had natural births at my hospital that they said were just great--left alone, nice rooms, understanding staff--but then I run up against this stuff with the monitoring, etc. I gather that a lot of it has to do with the staff on duty--some nurses are great with natural birth, others are totally freaked out by it. My doula is very experienced and familiar with this hospital and so I hope she can help me know how to request a staff change if who I get is not helpful.

Ideally I'll be at home as long as absolutely possible. We're five min from the hospital so it shouldn't be a big deal to go in late.

[Ldavis24]

Originally Posted by Blanca78 

Not offended, Lauren! A little scared, yes, but I appreciate your perspective. That's a big reason I wanted to hire a doula, to help me navigate everything. It's just all the information I get is so conflicting. I know people who have had natural births at my hospital that they said were just great--left alone, nice rooms, understanding staff--but then I run up against this stuff with the monitoring, etc. I gather that a lot of it has to do with the staff on duty--some nurses are great with natural birth, others are totally freaked out by it. My doula is very experienced and familiar with this hospital and so I hope she can help me know how to request a staff change if who I get is not helpful.

Ideally I'll be at home as long as absolutely possible. We're five min from the hospital so it shouldn't be a big deal to go in late.

I'm so glad you have a doula!! That in itself is going to be a huge huge help to you I hope...Also, awesome that you are so close to the hospital. I had to drive about an hour and DH stopped for a coffee at DDs on the way at 3 in the morning. Not so fun :)

I totally agree with staying as long as possible. Maybe some other mamas can chime here but as DD was my first I thought I was so much further along than I was...My unsolicited advice would be to wait as long as you can and then try and wait some more! I thought I was super far along and then when I got there I was only 3cm...It was hard to know though because when you don't have anything to compare it to you assume (or hope in my case) that what you are feeling when you go to the hospital is about as intense as it gets. I think i was little naive 

[SuzyLee]

With my hospital birth they monitored me for about 5 min right when I arrived and that was all.

I didn't have an issue with that per se,... The issue was that in labor I didn't want anything touching me. Yup I was the crazy naked lady who had flung off all her clothes.

So if they had been trying to get me to wear a belt I probably would have ripped it off too

[thencamehenry]

Blanca I'm sorry you are fighting an uphill battle.  FWIW, I don't really remember when my heplock was hooked up to the IV and when it was disconnected.  I know both of those things happened at some point but the difference between heplock ad IV was not noticeable for me once I was in la la labor land.

I'm sorry the birth is more medicalized than you would like but you are in on the joke here.  As an educated woman I thought "wow, how silly" way more than I thought "the doctor/nurse seems concerned, I'll be lucky if this inherently risky process turns out okay."  Knowing what's likely to happen is huge because a lot of the hospital protocol makes it seem like something is/could be going wrong if you don't know to expect it.  Your knowledge takes away a lot of their power. 

It's great that you have a doula.  Are you taking a good childbirth class (the kind that encourages you to question the status quo)? 

[greencarnation]

The midwives group I am hoping to birth with uses wireless, waterproof ones, so they can be used all throughout with movement.  I plan to try it with, but if it bothers me, or they complain my moving is messing up the readings, I will take it off and tell them tough tooties,  Well, I will probably say something more vulgar. ;)

I think you should try it, and if you don't like it, tell them it is your baby and your body and they can deal!

[briannas auntie]

Originally Posted by SuzyLee 

With my hospital birth they monitored me for about 5 min right when I arrived and that was all.

I didn't have an issue with that per se,... The issue was that in labor I didn't want anything touching me. Yup I was the crazy naked lady who had flung off all her clothes.

So if they had been trying to get me to wear a belt I probably would have ripped it off too

Are you actually allowed to be naked during labor in a hospital?  I always thought it was policy that you had to wear those hospital gowns. Can you get in trouble for not wearing a gown during labor or birth?  If labor makes you very warm, then I wouldn't want to wear a gown at all.

 I can't stand those things. The last 2 surgeries I had, the gowns made me so sweaty and hot that I wanted to take them off so badly.  I was so hot that my skin broke out badly in a heat rash on my back, which was very uncomfrotable.

Man, I can't believe how much I am learning even before I am pregnant.  Thanks to this site, I will totally be prepared for having a baby!

Jessie

[Ldavis24]

I think the minute I walked into my hospital room I literally ripped my clothes off and spent the rest of my labor completely naked.

I didn't care, it is amazing how uninhibited you can become when you are so solely focused on pushing out a baby.

The only time I put anything on was when I was walking the halls and then I put on 2 hospital gowns, one backward and the other forward so I could just rip them off again as soon as I got in the hospital room. If you have people around you who have an issue with you being naked then I think there will more problems than just that.

My nurses and MW saw me naked for about 17 hours, no one batted an eye. It's just a body. If they had tried to put something on me I would just ripped it off again, what are they going to do, duct tape clothes to you!?
 

Originally Posted by briannas auntie 

Are you actually allowed to be naked during labor in a hospital?  I always thought it was policy that you had to wear those hospital gowns. Can you get in trouble for not wearing a gown during labor or birth?  If labor makes you very warm, then I wouldn't want to wear a gown at all.

 I can't stand those things. The last 2 surgeries I had, the gowns made me so sweaty and hot that I wanted to take them off so badly.  I was so hot that my skin broke out badly in a heat rash on my back, which was very uncomfrotable.

Man, I can't believe how much I am learning even before I am pregnant.  Thanks to this site, I will totally be prepared for having a baby!

Jessie

[Comtessa]

Originally Posted by briannas auntie 

Are you actually allowed to be naked during labor in a hospital?  I always thought it was policy that you had to wear those hospital gowns. Can you get in trouble for not wearing a gown during labor or birth? 

It is one of my absolute biggest pet peeves that we all use the language of permission when we talk about hospitals.  They have established their institutional power over us so thoroughly that we are cowed by it, and we find ourselves asking meekly, "am I allowed to do this?  Or that?"  We are the ones who allow them to have access to us.  We are the consumers of their product, and as such, we have authority over which products we will consume and which we will not.  

The truth is, they have very little authority to tell us what we will (or will not) wear in their hospital.   But we don't know that, and they have made us afraid to question their policies, so we all go along with it, even if we hate it.  When I arrived at the hospital with my first labor, they handed me a gown and I simply said, "no, I'm not going to wear that."  And nobody argued with me. 

[Blanca78]

We can bring whatever we want to wear to the hospital! Right? I have no idea what I'll want on me at the time but those gowns are so annoying with their strings and flaps.

Anyway, mamas, I just wanted to update you all: at my 34 week appt yesterday my doctor (not her backup, whom I met with before) said intermittent monitoring up to pushing was fine (according to my doula this is the standard arrangement for practitioners around here). 15 min on the hour. Which still sounds like a pain in the a** but I feel better. At the end of the day this doctor operates within a more medicalized model than I am comfortable with, but my choices are limited due to insurance (I have to go to the med center for the university where I'm a student), and I really do like her on a personal level--she strikes me as pragmatic and respectful of my needs (at 30 weeks she actually encouraged me to seek out a midwifery practice she knew because she thought it would be more in line with what I wanted, but it would have meant driving 1.5 hours instead of 5 min and my doula would have had trouble attending). Feeling like she respects me as a patient is a big thing. What is important to me is that I feel my autonomy and intelligence are respected, and while it's a bit more uphill this pregnancy than I would like, I feel like with the help of my doula I still am on track to have a good birth.

Also, my doctor is totally supportive of me laboring at home as long as possible (like, till 8 centimeters). The trick will be not going in too early, but even without cervical checks my doula is very experienced and says she generally has a decent idea of how dilated someone is. I also want to look into checking my own cervix.

Thanks all for your insights. This is a great thread.

[Ldavis24]

Originally Posted by Blanca78 

We can bring whatever we want to wear to the hospital! Right? I have no idea what I'll want on me at the time but those gowns are so annoying with their strings and flaps.

Anyway, mamas, I just wanted to update you all: at my 34 week appt yesterday my doctor (not her backup, whom I met with before) said intermittent monitoring up to pushing was fine (according to my doula this is the standard arrangement for practitioners around here). 15 min on the hour. Which still sounds like a pain in the a** but I feel better. At the end of the day this doctor operates within a more medicalized model than I am comfortable with, but my choices are limited due to insurance (I have to go to the med center for the university where I'm a student), and I really do like her on a personal level--she strikes me as pragmatic and respectful of my needs (at 30 weeks she actually encouraged me to seek out a midwifery practice she knew because she thought it would be more in line with what I wanted, but it would have meant driving 1.5 hours instead of 5 min and my doula would have had trouble attending). Feeling like she respects me as a patient is a big thing. What is important to me is that I feel my autonomy and intelligence are respected, and while it's a bit more uphill this pregnancy than I would like, I feel like with the help of my doula I still am on track to have a good birth.

Also, my doctor is totally supportive of me laboring at home as long as possible (like, till 8 centimeters). The trick will be not going in too early, but even without cervical checks my doula is very experienced and says she generally has a decent idea of how dilated someone is. I also want to look into checking my own cervix.

Thanks all for your insights. This is a great thread.

I just want to warn you that if you are trying to move around while they to the "15 minutes" it could very well turn into constant monitoring. Often every single time the signal is lost they will restart the time. It happens a lot when a mama is moving around. So just be prepared to end up being monitored for a lot more than 15 minutes every hour. I'm serious. Tell them they can do a doppler periodically but if you consent to being monitored every hour for 15 full minutes the odds are going to end up that you will be stuck being monitored the whole time. I'm cynical I know but what your doctor says doesn't really mean much because the doctor won't be there until the end. it is the nurses at the hospital who call the shots and if they are used to getting what they want and doing it their way you are going to be in for a tough labor.

[bird_verde]

Originally Posted by thencamehenry 

You've already gotten some good feedback, but I'd like to share my experience with you.

My son was born in a hospital with a NCB-friendly OB/CNM practice.  Their policy and my birth plan stated intermittent monitoring - I think 10 minutes every hour.  They put the belts on when I got there and it never came off the whole time I was in labor (7 hours from arrival to birth).  Apparently they required a solid 10 minute strip.  If the baby moves or I move and they lose the heartbeat for even a few seconds it didn't count.  At some point, not sure when because I was in heavy labor by then, they wanted to break my water and do a scalp electrode because they couldn't get a consistent reading. I could hear his heartbeat but the strip had some gaps as he wiggled and turned, much as you would expect a healthy baby to do as he finds his way out.  I said I didn't want to do it unless he was in trouble and asked if they could monitor him with a hand-held doppler.  The nurse basically said no, that's not the point, and eventually admitted that a full 10 minute strip was required for my chart, a CYA thing.  It had nothing to do with my baby's or my health.  I truly feel like breaking my water and forcing me to lay flat on my back in the middle of intense labor would have been the start of a cascade of interventions if I hadn't known enough to refuse.

My experience with dd1 was very similar to the pp above.  I pesosnally hated the monitor.  It was on the whole time from the minute I wnet into active labor until I gave birth.  It was so distracting for me in labor as the nurse's only concern was getting a good strip and asking me to constantly stay still for 10-20 minutes - not really what I wanted to do in active labor.  Funny thing is that my doctor was totally unconcerned with getting the strip as he just used the doppler occassionally and told the nurse the full strip wasn't necessary but for some reason she was insistant.  This was actually part of the reason I decided on a homebirth for the second one - so that I could be left alone and move around!

[Dot-to-Dot]

I think a lot depends on the type of labor you have,

I agree with this.  Can you just try monitoring...if it's annoying, tell them to remove it and offer to sign a waiver of your gross negligence to your baby's safety? (Please note sarcasm)  I wouldn't mind knowing how the baby is doing during all of labor...however, for me, it was terrible and I hated that damn belt every time they put it on!  But it sounds like plenty of other women didn't mind it.  *shrugs*.  It's impossible to say how you'll feel about it when the time comes.

If the nurses aren't reliable with heplocks...then the hospital needs to adjust their service to better suit the paying patient...not the patient adjust her wishes to better serve the doctor.  :\ 

[prone_to_wander]

I was bullied into continuous monitoring and I wish it was the hill I chose to die on. It made my contractions so much more painful. Even though I had the wireless one, I felt my movement was restricted. Everytime I bent over it stopped working and I'd be in the middle of a contraction and they would be tugging on the straps. Next time, it'll be my hill to die on.

[Serenity Now]

Monitoring never bothered me. I actually kind of liked watching the contractions on the monitor, because I thought it was kind of cool. They start out like little hills at first, and then when things get going, get turn more in to plateaus. I guess I'm a geek. :) I think also I'm a huge go with the flow type personality, and not much gets under my skin, so most of their policies just roll off my back. I like the assurance of having an IV because my blood pressure, which is normally low anyway, drops like a rock when I hit transition. I'm talking like 50/20. Like, I am unresponsive. And it's nice having that quick access to adrenaline, and they can pump me full of fluid to try to counteract it as much as possible. We didn't know it was going to do that with my first, so my BP dropped to 42/20, the baby's heartrate plummeted also, but with oxygen for me, and some adrenaline, and squeezing the bag of fluid in to my body, all was well. When it actually happens, I don't know that anything is wrong, which in hindsight is probably the scariest thing. I feel a little sleepy, but my mind is so far gone that it doesn't ring any alarm bells at all. I just slowly drift away, and everyone thinks I have fallen asleep or I'm" in the zone" (that was my midwife with my non-epidural hosp birth), and leaves me alone. and somewhere through this tunnel I can hear them talking, but I can't move or talk to them. It's kind of funky.

I always bring my own clothes. The nurse at my last birth gave me a talking to about it, but it's not her decision what I wear, it's mine. She thought I'd get upset if it got messy. Nah. I can wash it.

I've given birth in 3 different hospitals, and in general I was able to pretty much do whatever I wanted. Honestly, my midwife birth was the worst as far as being bossed goes. The woman just had some idea I was an idiot in her head and she was trying to de-indoctrinate me about the right way to birth. Whatever. It didn't go as she had planned, lol. With my first birth my husband was the one who delivered the baby. The OB didn't even touch her. The midwife wouldn't let dh near me, but I wish she would have let him do it again because she was pretty terrible. And with my third I delivered her myself, and once again, the OB was just nearby. I've never had anyone pull on the cord, or scrape out the placenta, or really do much of anything to me. Nursing care has been spotty. Some of them good, some of them bad.

With my first birth (I'm high risk) I was expecting all these horrible things to happen to me because I had read on here and other boards about the way the hospital brings you down. But it wasn't like that. My first birth was really nice. It was very peaceful, and lovely. My second birth was a bit of a mess, because he was in a weird position and my midwife had ego issues, but it was still fine. And my third birth was very emotional because of some family issues, but incredibly sweet. I'll remember pulling her warm, wet limp little body out and laying her on my tummy, while she didn't cry but just looked at me in the eyes for the longest time, for the rest of my life. Unfortunately because she didn't cry she ended up needing oxygen, but they just kind of sprayed it on her face to make sure she pinked up OK, so we could sit and get to know one another. My biggest problem with birthing in a hospital is the after care. Once again, the nurses are really hit or miss, and I get out of there AMA as soon as I feel comfortable.