Hospital birth after 3 UCs

[lia_joy]

I've only ever given birth unassisted. Deep inside I knew it was what was best for me& my babies.  My first was solo so I was actually a little anxious with #2 having my husband present.

But this time I've felt this nagging from very early on and I finally concluded that my intuition is telling me I *need* to birth in the hospital.  I feel kind of sad about changing my plans, but also feel relief & a lot less anxious about it now that I've recognized that this is the best course of action... Even though I have no clue why yet.

Detailed explanation:

http://liajoy83.blogspot.com/2011/12/changing-plan-from-unassisted-to.html

I'm very interested in hearing experiences of others who intuitively knew they needed to birth in the hospital (especially after having beautiful UC experiences that you'd gladly repeat!)

[ursusarctos]

!!! What a great blog post, and good for you for trusting your intuition wherever it leads you! I was in a similar position several months ago with my first birth. I had been hanging out on the UC forum for years and seriously considered one, wanted one. At the very least, I had assumed all my life that I would birth at home with midwives (my mom had all homebirths). But, very much like you describe, I couldn't get the idea of birthing in the hospital out of my head. It wasn't a feeling like something bad was going to happen, just that I should go to the hospital. I still wasn't completely sure until I went into labor, and I did prepare for a UC in case it felt right. But in labor, and it was a long, mild one of 36 hours, I felt that I couldn't completely let go until I got to the hospital. Finally in transition I realized how far along I was and felt no doubt whatsoever that I wanted to get to the hospital - wasn't afraid, just very much wanted to be there. I ended up having an easy, normal birth standing by the side of the bed, 20 minutes after getting to the hospital, but then had a massive hemorrhage. I think that part of the hemorrhage may have been caused by certain things the midwives did in the third stage (let's just say it wasn't conducive to me producing oxytocin to contract my uterus), but at least half of it came from a small tear to my cervix, which happened to be right on an artery. Once they got my uterus contracting, I was still bleeding heavily, and they actually put me under so they could quickly stitch my cervix. I got a transfusion too. I was in the right place, and I felt a huge sense of peace and gratitude through it all, and everything worked out so well, and everyone was very respectful and really did their best. The only thing I have an issue with was the immediate handling of the third stage, and even then, I felt at the time so very peaceful and good that I am being able to accept it and let it go.

Honestly the biggest factor for me was prayer. I am not religious but I do believe in God and I do pray, and I specifically prayed for guidance in the issue of where to give birth, and I feel that my prayer was answered so sweetly (I even got to labor at home almost the whole time - when we called the hospital, twice, they told us to stay home - and I felt such peace and gratitude through it all - everything just worked out so well, I don't know how to describe it). If and when I am pregnant again I will go the same route (prayer). I would really love to have a homebirth in the future, with a midwife I think due to the previous PPH, but in the end will yield to what I think the universe/God is telling me.

Ok sorry this is a bit disjointed but baby woke, must go.

ETA: I know my PPH could have many causes, or have been random. I just feel like some things the MWs did may have contributed to it (can't believe I feel like I have to explain this on the UC forum, but anyway just to clarify). Anyway I had the good feeling that comes with being where you are supposed to be, and that matters more to me than the details. I think that if I feel like hospital birth is for me again, I would probably put more effort into "planning" more - have a birth plan and try to get a place in the birth center within the hospital I went to, which is more natural birth oriented. I guess I was so steeped in natural birth that I just didn't consider how very aggressive/not peaceful the 3rd stage routinely is in hospital. So that might be something to consider, as you are used to unhindered, peaceful births.

Edited by ursusarctos - 12/22/11 at 1:37pm

[lia_joy]

Thank you for sharing!! Although I feel more at peace with this decision each day, the *why* is still hanging over my head -- I expect it will til the whole birth has unfolded -- so I appreciate hearing stories where there was confirmation...

I am actually *Hoping* for a hemorrhage as strange as that sounds, because it is so clear to me that there is a Reason I need to be there and *just* a hemorrhage would mean it's not a complication directly effecting the baby (my biggest concern) or the birth.

My last labor was only about 3hrs and I went from 4cm to pushing in right around 10 min. Even though I've learned better than to think I know what to expect based on previous births, I'll probably go in as soon as things feel intense to avoid possibly birthing in the car.  The hospital is 30min away.

I've seen these midwives for prenatals before, and all my annual exams since so at least there has been a relationship established over the years. I doula'd at this hospital (with these MWs) so I have a pretty good idea of what to expect there...

Management of the 3rd stage is one thing I'm going to have to negotiate and possibly fight.  When my sister birthed there, I was so excited that they told her they automatically do "delayed cord cutting"  But when the time came they only waited 1-3 min!! I was horrified. That was the first birth I'd witnessed in person besides my own UCs and I always waited til the placenta was delivered, so i was shocked that they considered just a couple minutes "delayed." 

Anyway, I plan to spend all my prenatals going over this stuff with the midwives so I can have as much of it worked out ahead of time as possible.  Thankfully, I have gained a lot of confidence and experience over the years and I don't feel that I'll be easily intimidated as I was at 19, 21 or even 25. I'm a lot more comfortable standing up for myself/my baby and saying "No." or "this is how I'm going to do this" or whatever :)

[newsolarmomma2]

I didn't get my last UC for this reason. I knew something was off, and I was right. I transferred to the hospital and got a very much needed CS And I don't regret it one bit. It was the very last thing I wanted to do, but if you believe in listening to your body, sometimes it can lead you places you didn't want to go.

Don't worry about the hospital. If you find a good MW/OB practice (instead of just showing up and hoping for a good doc) you can go over this stuff beforehand. Even if you just show up, try to research the hospital. Some are much friendlier than others. I passed 5 to get to one that was friendly and didn't push me into things I didn't want. Totally worth the effort, it's one thing you can control (where you go).

And DCC is Ok after 1-3 min because thats when the blood flow stops. They usually cut it when it stops pulsing, which is 1-3min, as weird as it may sound to a UCer. :-)

Best wishes for you new baby!

[Almi]

Another lovely post by you, Lia.

I actually find this very interesting.  I have tossed around the idea of hospital birth this time, too.  But my dreams have told me that I shouldn't go, and after some more soul searching, I think UC is right for this baby again - at least at this point in time.

Some things to think about with hospital birthing (and of course every hospital is different but I can't imagine their policies can differ too heavily on certain things):

- Some places might not let you deliver your baby in any way or place except laying on the hospital bed.  I was told I could PUSH in any position I wanted, but I would not be able to deliver however I wanted - not even delivering the baby onto the bed (no catching).

- They absolutely will not let you or your husband catch the baby.

- They will not leave you completely alone, even if that is what you wish.

- They will probably not let you deliver the placenta before you cut the cord (they wouldn't have had a choice with my twins...).  My OB stated this reason: "I would not recommend waiting until the placenta actually delivered before clamping the cord since there can be bleeding from the baby through the placenta at that point."  However it sounds to me like that is only with clamping...I suppose you could delay cutting, but it would be pretty redundant once the cord is clamped.

- You might not be able to legally forego every single newborn procedure.  Be careful what you sign at any time - even when you are being admitted to the hospital.  Read everything before you sign it (or have someone read it for you).

The first three things are very important to me...that was another big reason why I decided to definitely UC again this time.

[lia_joy]

As soon as I decided to go this route, I started a list in my notebook that will be coming to my prenatal appointments so I don't forget to go over all of this stuff far in advance. 

I think the whole "delayed cord cutting" is a perfect example of how these midwives practice is pretty awsome compared to the average mainstream hospital birth, but still out of my comfort zone & far from my ideal... When i watched my neice's cord being cut, it was very emotional for me, not because I thought she was being damaged but just because she was being innitiated into a culture of rushing and protocals and she & my sister were not honored in their first few moments the way I wanted them to be...

     Another woman I doula'd for at this hospital began pushing on the toilet and they hurried her to the bed to deliver. even though she protested, she went along. They didn't force her onto her back, though. she delivered on all fours on the bed and they didn't try to move her anymore.

They did tell my sister, at one of her prenatals, "We don't do waterbirths here, but you can labor in the tub and if you refuse to get out, we can't make you."  Even if they try to insist on it when the time comes, I respect the fact that they brought that to her attention. That was almost 3 years ago and they've remodeled since then. I was told at my first prenatal that they DO waterbirths now but I didn't ask a lot about it since I was still planing to UC then...

I'm going to be very careful about signing anything and I'm actually going to request to see the paperwork ahead of time so I can go over it thuroughly & address any big issues -- maybe see if I can sign a waiver refusing certain things... having this stuff discussed in advance will hopefully at least give me an idea of which things are going to be a major PITA to refuse, so it'll be easier to prioritize/pick my battles.

I know some of the things -- probably management of the third stage, cord cutting and newborn stuff -- that I'll have to really insist on but I'm feeling pretty good about setting as much up in advance as I can, and having the confidence to put my foot down and say "I do not consent" if it comes down to it...

I've actually come to terms with not being left alone and am even thinking I might have a doula and my sister there (mostly for taking photographs, but if a complication arises, I think I will want the support, too.) which is wierd for me to feel okay with, but I think i'm leaning towards that...

Catching the baby is going to be a big one for me and if they say they won't "allow" it, I'm going to try to find a creative way around that...If it comes down to having to *force* me to move so they can catch, I don't think they will.  based on what I know of them, they'll try to follow protocal but won't force me if I refuse. The one I know the best actually said she'd rather do homebirths but took the job there for the hours/benefits since she has a family (she's the one I'll be hoping for the day I go into labor ;)

 All the crap they do to the newborn is another one that really concerns me. 

But of course, while I'm going to put effort into planning a birth as similar to my others as possible given the environment, I'm also quite aware that my *reason* for choosing the hospital for this birth might present itsself clearly and immediately (preterm labor or something) so the whole thing just becomes about surviving rather than getting it done the way I'd prefer -- Not to be dark or anything... It's just that I'm very aware that I'm going there for some reason & having that reason delt with might just take priority over EVERYTHING else... I'm taking the approach of planning for the best but bracing myself for the worst.

  I know I read a birth story at one time in which they had a lotus C-section birth, so I'm going to be covering A LOT of scenerios (probably many that have never been addressed at this hospital) over the next few months...

[Just1More]

I just wanted to encourage you in listening to your instincts.  It is the exact right thing to do, and really what UC embodies.  The idea, to me, of UC, is to do what we *really* need/feel/want...not what the establishment says.  You are still a uc-er.  You are in control, and doing what YOU feel is best, and not just following the pattern.  That's what is important.  Not where or how we birth.

That said, my last pg felt a little off.  I had a hard time bonding with the baby, was I was obsessed with cord issues, and with cleft palate or other mouth problems.  I did still go with my really laid back mw at home, but the whole time I was a little nervous.  It turned out that the cord was wrapped multiple times around her, and her placenta came immediately after she was born.  There was old meconium in the water.  If she had not been born so rapidly, a whole lot could have gone really, really wrong at the last minute.

Her mouth seemed to be fine.  I thought my intution must be off.  I have, however, since her birth, complained that she doesn't nurse quite right.  Her latch looks great, and she grew fine.  She was always fussier than normal, though, and a horrible sleeper.  Now that she is eating solids, she's happy and sleeping well.  I was looking for a new tooth the other day, and discovered that her upper lip is held down on either side by bands of tissue that extend well into her gumline.  She can't lift her upper lip like the majority of us can.  I *knew* something was wrong with her mouth, and it turned out I was right. 

But, my even though I knew something was off, and it was even with the two things I thought were wrong, neither of them truly turned out to be serious.  Sure, if I had been under the standard model of care and had a BPP or NST, who knows what they would have found.  If I had had more regular heartbeat checks towards the end of labor, the decels would have probably landed me a c/s.  And, with the cord issues, I would have been thankful.  It was wrapped so tightly around her, she has marks on her back still.  Deep reddish purple lines where we unwrapped the cord.  She was unable to move down normally, which is why the placenta came, too.  But, it worked out at home, and I was thankful for that, too.

I'm not encouraging you to stay home, and assume it will be the best.  I just wanted to share that intuition really is a powerful thing, but also that our fears are sometimes not as awful as they seem.  And, that because it is your choice, you can be confident in the outcome.

[Almi]

Lia, this is why I love you.  You have everything so planned out - and it sounds like your hospital is willing to work with you.  I think I'm going to do the same as you and see the paperwork they have you sign in advance and perhaps sign some waivers.  If I can get my way in the hospital...I have no problem with a hospital birth.  And I'm sure I could, but there's also the whole thing of having to FIGHT them for it.  That would bother me and stress me out a lot.  I have VERY little patience when it comes to things like that (things that I feel I shouldn't have to argue about), particularly when I am in pain or otherwise.

I think I'll make my decision after I get my anatomy scan on Tuesday.  I have felt something -might- be "different" about this baby from sometime in the first trimester, and I want to make sure everything is fine.