UC methods for hospital... (probably wrong forum)

[workingmom2011]

I simply was not aware of home births until a few  months ago. This is my 3rd baby and I'm

35 weeks. I've had one CS for breech after spontaneous labor and a medicated induced VBAC.

Now I want all natural and meeting tons of resistance from OB due to my "high risk" status...but I'm defiant and will get it. At least that's what I'm thinking. They can't make me do anything...

Anyway, I barely started talking to midwives and most are 30+min from me which leaves me kind of scared because I have SUPER quick labors... my hosp is 40 min away so same problem there. (there is an inferior hosp 15 min from me so that will be the super backup)...

Anyway, the whole thing is that I accept that birthing is a natural private animal instinct driven event finely tuned by evolution and any coaching, watching, bright lights and invasive things just simply stall and adversely affect the flow...

In learning about midwives it seems they are almost like doctors in that they coach you etc when I really don't want someone to tell me when to push... I would rather be left alone ... and the only upside is that you are a home which sometimes I don't see as an upside...

SO I have been reading a lot of unassisted CB stuff to learn the mechanics and things that happen to a woman if you let it happen by yourselves... and I think it's making all the difference. I feel as if I can take this knowledge and go to the hospital and be persistent about a natural birth...

Home birth just doesn't seem feasible due to the short research time, the exact clarity if the insurance will truly cover it (apparently in MA they do cover CVM's but not DEM's or other types of midwives etc... and paying out of pocket is out of the question)...

I don't know what my point is. I'm writing for some feedback. Has anyone positively used UC methods to successfully navigate a natural hospital birth despite pushy interventionist type of medical personnel?

[Full Heart]

There are good mws and bad mws just like there are good drs and bad drs.  You don't really know what kind you are getting unless you interview them.  I have never had a mw tell me when to push.  I actually hate pushing and prefer to breath the baby down and they sit there and wait.  As far as distance to hospital vs homebirth.  I don't know how fast your labors are but mine are generally 4-5 hours and my mws have lived up to an hour away before and still made it in time.  And if its really that fast for you then getting to the hospital in time for them to push anything on you is slim.  There are plenty of women who desire a natural birth and can get that at the hospital.  Having a supportive dr in your corner is helpful.  Having a doula can be beneficial as well.  Make sure you have a birth plan.  There are tons of horror stories out there but you can find lots of good information about how to obtain a good natural hospital birth.  During my last birth I had to be induced for PIH.  They still let me breath the baby down, kept VEs to a minimum, never broke my water (baby was born in the caul), etc. So I know it can be done.  I did it without even having an OB, at 42+2.  Good luck!

[IdentityCrisisMama]

Yours is a very interesting question and perspective.  My first thought is that, yea, maybe wrong forum because I don't tend to think of homebirth as a middle ground between hospital birth and UC.  OTOH, I can see how some may feel that way.  

As far as taking some of the knowledge you've gained about UC into the hospital... any knowledge is good, yk?  I'm not a UCer  and don't lean that way at all really.  If I were to guess, UC is about way more than knowing the mechanics of unmedicated birth and has a great deal to do with truly being unassisted, which doesn't seem like something that can be duplicated in the hospital.  

I imagine it being akin to homebirth in that there are some interventions at home that you just know are not available (many medications, for instance).  Knowing they are not an option at home changes the dynamic immensely for some (like me!).  In a hospital setting I, personally, could not have just pretended they weren't available, yk?  In a similar way I don't think I could birth "as if I was UCing" if I had a midwife to rely on.  I, personally, don't feel like you can truly pretend that support isn't there.  The intervention of having a birth attendant drastically changes things, imo.  

As far as midwifery being similar to OB - that can be true, for sure.  First there is a distinction between midwives who practice in a hospital and those who practice at home.  I think you would see some differences there.  But even among HB midwives there is bound to be a big range.  I've been to 3 (2 for pregnancy/1 for well woman) and all three were similar in some ways and way different in others.  

I imagine there are a lot of great books and articles about unmedicated birth in a hospital setting.  I would think that starting there would be a good place.  Good luck on your birth!!  

[member234098]

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Edited by member234098 - 6/10/12 at 4:27pm

[onetwoten]

Unfortunately, I don't think it's that uncommon these days to "not know of" homebirths. Many people look at them at something that "used to happen in the olden days" and honestly don't realize that they are still an option.

I consider mysefl fairly well versed in natural childbirth and homebirth, and I will ignorantly admit I have no idea what  cre'che  is.

As for making the hospital most like a UC. You will have to fight for it. Don't take this lightly. That doesn't mean it can't happen. Write a birth plan, not even for the hospital, but for you and your spouse and anyone who might be there to support you.

Do NOT sign a general consent form. This is cruccccial. Be firm with the staff that you have not signed this and will require individual consent for eevry procedure they perform on you or the baby.

After this, I would honestly be as polite as possible, but flat out tell them you want to be left alone. Tell the nurses you will call if you need something, but that otherwise you would prefer to opt out of monitoring/checks etc. They may tell you they "have to" but this is not true. No one can force a medical procedure on you.

The more information and knowledge you have, the better. You may not be having an actual UC, but having all the knowledge will help you back up your requests with evidence, instead of just "I want it that way"  ie things like pushing when you would like, not having an IV, not having pitocin, etc etc. Have the studies to back up your decisions, and then remain firm.

There is one really good hospital birth story on here, where the mama signed a "I do not give general consent" and gave the form back to them, and journals all she had to go through. It was hard, but things happened her way, and she got to make her own decisions. I believe it may have been kidzaplenty, but I'm not entirely sure. I could try to find it later, or someone else may remember it as well.

[sweeetpea]

Well, they can't MAKE you do anything, but they can and will use emotional blackmail and straight out lies to get you to comply with what they want you to do.  You can check out www.myobsaidwhat.com for a ton of comments that OBs, nurses and midwives make to pregnant and birthing moms to scare them into compliance.

However, you are buying a service from the hospital & medical staff,  They are used to providing that service in a certain way, and will likely get flack from their supervisors if they are not doing what their protocols say they must do.  So you will be pressed.  Maybe pressed hard, maybe not.

To get what you want - educate yourself!  Know what your options are in any situation.  Do not get drawn into debates.  Practice saying "No, thank you".  "I do not consent".  "If you touch me/perform that procedure against my will, that is assault and I will prosecute".  

I had a client who simply ignored any instruction given to her by the nurses/OB.  She birthed the way she wanted to, on her terms.  The staff was unhappy, but the outcome was fine because the staff, including the OB was basically respectful and not prone to abusing their patients.  I have seen other providers verbally and physically abuse their patients who were not compliant (physically forcing mom to turn from hands and knees to back, etc)

Also, if they really don't support your choices, there may be retaliation, such as declaring your baby "sick" after birth, and confining him to the NICU, not allowing you to breastfeed on demand, even threatening to call CPS.

[sarahkristy]

Not all midwives coach you or watch you...etc... My first birth in a hospital with midwives...I actually NEEDED them to be there for my labor and they really weren't except to come in to check on the baby's heart beat etc... and then when I got the epi after 30 hrs of labor...they finally came in and were very pushy about pushing and after 3.5 hrs of pushing (posterior baby) I ended up with 3rd degree tears and a lot of resentment towards the hospital group of midwives......

Second birth ... at home with a wonderful team of midwives. I wasn't checked at ALL, they arrived when I asked them to...and didn't do much of anything unless I asked. It was basically unassisted until I started pushing on my own and really needed some psychological support. The only time they touched me was to support me perineum during crowning besides the necessary heart rate checks.

It was wonderful. So it really depends on who you get.

[secondimpression]

Wow, I'm kind of shocked at some of the replies suggesting that you can go into a hospital and think you have any hope at having something remotely close to a UC armed with just education and a willingness to say "no". Of course it can be done, but that's certainly rare and the exception rather than the rule. The moment you walk into a hospital, you become a walking, breathing liability. And unless you show up to deliver with an OB you have an established history with, they will likely assume the worst: that you're some ignorant crazy with these dangerous ideas in your head about how birth works. I know because I've been through it. My first birth was a planned UC that wound up in the hospital. I was educated, I knew all the major studies and could quote them, I knew about not signing the stupid consent form. But you know what? I was 9.5cm and pushing when I showed up and that left NO time to argue with staff over how I wanted the birth to go and when long forms with lots of fine print were shoved in my face, I signed them. I wound up with extensive physical and emotional trauma that even after 2 years, I haven't healed from. It's simply not enough to go in educated. And you say that you have fast labors and a bit of distance to travel, so you're likely to show up pushing like I did. Trust me, you can't read a consent form while pushing or debate the merits of routine episiotomy as the baby is crowning. Even if the attending OB is sympathetic (mine was not, just FTR), there just isn't time for it and you're likely not to be in the right head space to do it.

Now all that said, I chose to have a HB MW (CNM) attend my second birth. When I interviewed her, I made it abundantly clear that I wanted her to sit on her hands and do nothing (not even talk to me) unless I specifically asked her to. She did just that and I essentially had an attended UC. It was peaceful, ecstatic and entirely on my terms. You absolutely CAN have a UC with a MW, you just have to be clear about your plans for the birth in advance.

You also mentioned money, there are MW's out there who will work with you on a pro-rated basis, some will even negotiate a much lower fee for the birth only if that's all you want them for. Many also have sliding fee scales or will work out a payment plan with you. It doesn't hurt to call your local MW's and ask. If your insurance covers a HB MW, it usually doesn't matter if the claim isn't submitted until after the birth either. Don't let the fear of bills be a barrier to calling and finding out!

[mnnice]

Just as disclaimer.  I haven't UC and while I am support of others I am directionally don't think I would UC (it's a moot point as I am all done having babies)

I am with the previous poster.  I do not think that you are going to have anything remotely like a UC if you walk in the hospital.  You can have few interventions that the standard hospital birth, but to me the fact they you are going to have to tell the staff over and over not to intervene makes it a completely different experience than UC even if you end up with no interventions.

You could labor (and ideally birth too) in the parking area/structure and only go in the building if you had a concern about someone's health.  Ideally you would have no concerns and someone could just drive you home.   I do think the security staff could be an issue with this method.  The idea of giving birth either outside in a public space or in the confines of a vehicle don't personally sound that appealing to me.