A Natural Hospital Birth? Please share ideas! - Page 2

[mum4vr]

Thank you for this awesome thread!

DS1 was a hospital birth with many ugly interventions- ugh! (WI 1993)

DS2 & DD were lovely hospital births with a wonderful CNM who helped me write & execute my birth plans (NE 1998 & 2000)

Now we live in very rural OK. Due in sept. NO birth centers within 2 hours (& my 2nd & third came super-fast!). The 2 nearest hospitals have had their birthing privileges pulled! We must either travel 90+ min to the nearest hospital w birth priveleges, or HB w a midwife from 2 1/2 hours away who travels from another state (with 2 terrible hospitals as emergency backups). This is nothing like ideal. (Can I move back to NE & my super MWs for this one, hah?)

DH is not ok with HB dt our local hospitals, which can't even handle a "normal" birth, being our backup w a baby in possible distress; neither am I, really. The OB is iffy-- tells me no one will give me a hard time re refusing eye ointment, etc then spends 15 min trying to talk me into it (at my 6 wk appt!), then tries to reassure me at later appt that no one will try to force anything. This all has me reconsidering that long drive to that birth ctr in TX! But I don't want to spend my labor in a "high speed chase" to the ctr, esp considering the likelihood that we'll arrive too late & I'll get the "side of the highway" birth experience!

At least the MW is willing to be our doula & meet us at the hospital (which is somewhat between us, geographically); she helps set my mind at ease. I'm not sure if it's worse knowing how rough it may be from ds1's birth, or how smooth it could have been, but won't likely be here from the other 2 births!

Hearing from those who've btdt whether supported or no is very reassuring & comforting. Thanks so much; can't wait to read more! (downloading some birth plan ideas just now...)

[pohaha]

I had my first at a hospital. We took Bradley classes, read lots of books, and thought we had a great birth plan. Mostly we just said we wanted to avoid routine procedures and to ask my consent before doing anything. Well, we ended up having a terrible L&D nurse. She made me feel bad for wanting to remove my clothes during heavy labor... Even mentioned an obese African American woman who was just "lettin all hang out.". Awkward to have to labor around her after that. To top it off, the midwives on call were equally unsympathetic to my requests. They tried to break my bag of waters after I explicitly told them not to. While checking my dilation on all fours they got out the hook and were holding it on the side of the bed where my husband couldn't see it. I happened to look down and yell at them to stop. The exams were excruciating. The midwife ended up breaking my water with her hand during that exam with the hidden hook. When I was 8 cm and in transition they threatened to get a court order to give me Pitocin, since my contractions were not getting any closer than 5 minutes apart and only lasting about 30 to 45 seconds. I ended up getting an epidural because I could not handle transition and having to fight for a natural birth at the same time. My husband told them my wishes, but they told him his opinion doesn't matter. Thank goodness there was a shift change when it came for me to push....the new midwife said they were going to send me in for a c-section. For no good reason other than time. I had been in active labor for about 15 hours total. It was a horrible experience.

Next baby we switched our insurance during open enrollment so I could birth at a hospital with a birth center. They had tubs to labor, but not birth, in. I still felt very pressured by the clock... My waters sprang a leak and I didn't realize they changed their policy to where they want you to come in right away and be in active labor within 12 hours, rather than wait at home for 24 hours for labor to start. I had some truly wonderful nurses who let me know that they can't control whatever decisions I make. Essentially, they don't have a Lo-Jack on me Nothing is going to rush this natural process. So my plan at that point was if I got to 12 hours and wasn't in active labor (at which point they would send me to L&D), I would go home until I got into active labor. The midwife woke me up at 4am to let me know I had about 2 hours, So I got up and started doing lunges up and down the hall in front of the nurses station so they knew I was "trying". I started having real contractions at 6 am and moaned extra for the benefit of the midwives . I labored in the tub a bit and when I felt like I was getting close the midwife checked me again and told me I was still at 4cm. WTF. So I said screw this noise, get me an epidural...narcotics, whatever. That was the Transition talking. My husband wheeled me down from the birth center to L&D...when I got in the room, I stood up and felt my baby coming out. She was born in 3 pushes and 5 minutes, and I delivered her standing up supporting myself on the edge of the bed. Great timing!

I felt so empowered by my natural birth that I felt healed from the trauma from my first birth.

The cost of insurance is so high now we do not have the option of changing it again, so I must give birth to my 3rd (due in June) at the same hospital I had my first. I can not have a home birth I planned on because I suffered a pulmonary embolism at 8 weeks and I'm on blood thinners. But I feel like I learned a lot from the nurses and the experience of my second birth that I can successfully navigate the hospital staff and have a natural birth:

- It's your body. It's your baby. Try not to think in terms of them "letting" you do things, like wear your own clothes or walking around or going to the bathroom. Or eating and drinking. I do not plan on asking if it's okay, because I know it is...and I will have a big Trader Joes bag filled with snacks, squishy bread, honey sticks, water and juice. They are not in charge of you, you make your own decisions and just do them. It takes two to oppress.

- Do your research and know what you want. They don't always know to ask you before doing something routine, because for them it's, well, routine. Be flexible for the health of you and your baby, but don't let them bully you. Of course we want to Make Nice, but not at the expense of your birth for the sake of hospital staff doing whatever is easiest for them.

- I know my body. I know my contractions did not come closer than 5 minutes apart with both of my babies. And I still had a natural birth with my second. My body works.

[erigeron]

Originally Posted by pohaha 


- It's your body. It's your baby. Try not to think in terms of them "letting" you do things, like wear your own clothes or walking around or going to the bathroom. Or eating and drinking. I do not plan on asking if it's okay, because I know it is...and I will have a big Trader Joes bag filled with snacks, squishy bread, honey sticks, water and juice. They are not in charge of you, you make your own decisions and just do them. It takes two to oppress.
 

 I agree with this. This is one reason I didn't put a lot of this kind of stuff in my birth plan. I figured, I'm not going to put "I want to wear my own clothes in labor". I'll just wear them. And I'm not going to put "I want to move around in labor", I'm just going to move around. Etc. 

[eabbmom]

I really like the discussion of terminology. You don't have to enter the hospital like it's a war zone. You can decide before hand how you'll act, wear your own clothes, eat, move around. I think going in w/ that mind set helps the mother stay out of her victim space where things are "done to her" and instead she can be strong and make decisions w/ her care team. Mom's need to remember that just b/c something is standard in a hospital it does not mean they must consent.

[puddle]

1.  Choose care provider and hospital carefully.  Check C-section rates.  Don't just check out your provider--check out everyone they share call with. 

2.  Hire a doula or monitrice.

3.  Prioritize what you want, and be flexible.

4.  Labor as long as possible at home with your doula/monitrice.

I had a great OB for my second pregnancy, but had an inexperienced and panicky doctor on-call when I delivered.  I think the only reason I got a (mostly) natural birth with that doctor is because my son came so quickly.  By the time I got to the LDR room I was at 7cm, and by the time they tried to get an IV in me minutes later, I was pushing.  I gave birth in my own clothes and without an IV because there just wasn't time for either. 

[Quinalla]

1. Do your research, know what interventions you are and are not ok with in what circumstances. A lot of things that hospitals/care providers do routinely are not necessary and are often detrimental, but in certain situations may make sense. Also, sometimes it can make sense to agree to a few unnecessary interventions and really fight for the ones that are important for you. In my case, I was fine with an IV and EFM and occasional cervical checks, but wanted to be able to eat & drink, move around (they set up the IV so I could and were fine with unhooking me from the monitor for times), not be asked/pressured to take pain meds, no episiotomy, etc.

2. Talk to your care provider early and often about everything. Sometimes you have to handle their feelings with delicate care, but it is worth it to get what you want out of labor! Being willing to really listen to your doctor and responding thoughtfully even when you are disagreeing helps a lot, it sets the tone for them to listen thoughtfully to you as well. Also, don't fell silly bringing questions written down or other materials to your appointments, I know for me I have a hard time remembering what I want to say when I get into that familiar Doctor/Patient rut of do what the doctor says.

3. Labor as long as you can at home, I found the Bradley method advice of when to go in the most helpful as it describes very well the feelings you will have in early labor vs. late labor, even for first-timers. I know that some of my success of having my birth go the way I wanted was due to being in the hospital for only 4 hours.

4. Make sure you know your hospital policies well too. If you have an OB, they will likely not be there until the very end so make sure you have a hospital on your side too. Try and get a natural-birth friendly nurse, have things in writing from your OB if they vary from the hospital policy, make sure your support person (husband, doula, friend, etc.) knows what you want so they can help you to explain if you are in labor land and having a hard time communicating.

5. Go in with a plan and positive attitude, but also be open to what will happen. Not everything is going to go 100% perfectly, but if you are well prepared, you will be well equipped to handle what happens!

6. Definitely remember that you do not have to consent to things just because they are policy or "policy"! Go in confident and have little rehearsals in your head about how you will handle things. If in the hospital they want to do X thing, ask them to explain what the risks and benefits are of doing vs. not doing at all vs. wait-and-see. This will often throw them off their normal track of half-suggest/half-order and back into informed-consent mode. For a lot of reasons, birth is one of those times when a lot of care providers forget about informed consent.
Edited by Quinalla - 2/28/13 at 7:09am

[Caryn Talty]

I've had two hospital births and two home births. Our 4th was born in a hospital about a 1 1/2 years ago. To prepare, I created a specific birth plan with my husband and we brought it with us when our midwife took us on a tour of the hospital. Our baby was two weeks past her due date, so there was a lot of monitoring going on. We waited until she was ready, and of course I believe that made all the difference. I had prodromal labor on and off for 4 weeks, so I was tired that last month. She was not positioned correctly until right before I went into actual labor. Although it was a very long labor (20 hours) I was able to manage very well without medication because I was able to move around as much as I wanted. (I did not have an IV and was allowed to eat as I pleased). I think it helped that they knew I had given birth naturally three times previously. Natural childbirth is not easy, but as long as you are determined and you have the right support system you can do it. At one point it looked like my labor was stalling and instead of using pitocin my midwife suggested we try a breast pump. She was very supportive and confident.

Afterward she told me I was the first patient that it ever worked on. 

I never once doubted it would work while I was in labor, though. She made me feel that confident in myself.

[sageowl]

My health insurance pretty much dictates the setting (hospital), and I wanted a natural birth, so I made sure to hire a doula (since I don’t do well in hospitals, as a rule).  So the #1 tip from me is hire a doula/support person (in addition to your labor partner) if you can afford one because having the continuous support through several shift changes of nurses made a huge difference for me in terms of being comfortable with what was going on around me in a hospital setting.

The hospital I use actually encourages you to write a birth plan, and provides a template (so you know which interventions they actually might use), so I had one, and felt that it was followed (whenever feasible).  When deviations were necessary, I felt like I was well-advised, and the staff was willing to try the least invasive approaches before resorting to more “medical” ones.

In my case, labor came on fast and furious, but I labored at home until contractions were 5 mins apart (and had that feeling that if I waited any longer, there was no way I was going to be able to sit in a car!)

To deal with pain in the hospital, I mainly used breathing techniques I had learned, which helped a lot.  I had a lot of back labor in the beginning, but I was one of the few women not using an epidural so I spent a good part of my early labor in a birthing tub (yay!).  That helped with the back labor.  (The doula was able to get the baby to shift, so later on that wasn’t as much of an issue.)

We kept the lights dim which helped me with relaxation—I hate bright lights!

I brought a lot of music to listen to which helped cover up a lot of the hospital noise, and gave me something else to focus on.

The nurses generally left us alone except when we needed something.  We had intermittent monitoring/checks, so occasionally they’d come in and do that, but otherwise were pretty hands off and just let us do our thing in peace.  They had some good suggestions on positions/movements to try when progress started to become an issue, and one even suggested using acupressure when things were slowing down unexpectedly.

After the baby was out, he was put on my bare chest, and breastfed almost immediately.  The rooms were set up so that they just do everything in there with you, so there’s no taking the baby anywhere under normal circumstances (unless you need neonatal intensive care).   

Staying with the baby after birth was not a problem. The baby roomed in 24/7 with me the entire stay, and nobody fussed about the fact I wanted him to sleep in the bed with me.

[LaotianMama]

My first birth with my son happened in, where I feel is important too, a mom- and baby-friendly hospital and I made 9 great points on how to increase the chances of achieving a natural birth in a hospital:

1. Have a midwife as your care provider
2. Hire a doula
3. Prepare a birth plan
4. Educate yourself!
5. Decline every and any intervention during pregnancy
6. Labor at home as long as possible
7. Labor in water, if possible
8. Don’t be afraid to vocalize and visualize
9. Trust

More on How to Have a Natural Hospital Birth

[erigeron]

I think it's as wrong to blindly decline every intervention as to blindly get every intervention. If you have a care provider you trust, talk it over with them, pros and cons. Find out about what interventions might be done in the hospital and why. Then make your decision on a case-by-case basis, and be open to changing your mind if the situation changes and an intervention you previously declined is now more warranted. Interventions are not useless procedures made up by OBs to oppress women. Each one has its proper place. (I realize that is probably not exactly what you *meant*, LaotianMama, but it is what you *said*.)

[mama2soren]

I am an L&D nurse, and I have worked for several hospitals, each with their own "culture."  I planned a HBAC with my 2nd, but we transferred for non-emergent reasons to a hospital, where I did continue to have a natural birth, aside from an IV for hydration (I was severely dehydrated, unable to keep food or liquids down.)  

Here are my suggestions:

-Research the heck out of your OB or CNM and the hospital. If you know any nurses on the L&D unit, talk to them.  Ask what providers they like working with and why.  Talk to other new mothers who value the same style of birth choices as you to see how there experiences were with their OB/CNM.  Ask local doulas.  At an interview, an OB/CNM can say whatever they want and seem completely open-minded.  Yet, is this the way the actually practice?

-Don't assume a CNM is more natural-friendly than an OB.  Is it often true?  Yes.  But not always.  Where I used to live, the CNM's were very limited in their style by their supervising OB, who was old-school and awful (routine manual uterine exploration after every VBAC??).  The hospital the popular CNM group practiced in had a nearly 40% C/S rate.  For our shadow care, I saw an OB who was more midwife than most midwives I've met.  He stepped aside to let my husband catch our baby.  The cord wasn't clamped until long after it stopped pulsating.  He stayed with me the whole time I was pushing (2 hours).  He encouraged me to go home at 12 hour postpartum.  He made sure my placenta was properly bagged and refrigerated so that I could take it home.  Had we brought our own Aqua Doula tub into the hospital, I could have birthed there.

-Have a doula.  Ideally, hire a doula who has worked with your OB/CNM team before with great success.  Having a good rapport between doula and provider is a great benefit.  

-Remember that you can fire your nurse!  Your nurse can make or break your experience.  Some love working with women who are well-prepared and well-educated about their births.  Others like doing things the same way with each laboring mother, and get snippy if you don't want to go along with their plan.  You do not have to accept that.  Send your partner out to talk to the charge nurse to say something like, "it seems like my partner and Nurse X don't really have that great connection we were hoping for.  It is really important to us to have a nurse who will help us work towards our goal for a natural birth.  Are there nurses on staff this evening who you think might be a better fit?" Chances are, the nurse will be happier with a different assignment, too.

-Have a well-rounded education about your birth options.  Yes, read Henci Goer.  Ina May.  All the MDC favorites.  I love them too.  Also read the more "mainstream" stuff.  Not because you necessarily agree with it, but because it might help you understand the thought processes of your nurses, docs, etc, which will help you have thoughtful, not-defensive discussions about your choices.  If you choose your OB/CNM well, discussions like these will be easy.  However, if it comes across that you are very mistrustful, or have an us-versus-them attitude, you'll lose some allies.

Hope this helps.  

[Calladona]

I've had two natural hospital births...

With the first one, I waited at home as long as possible and went in fully dilated (I wouldn't totally recommend waiting THAT long).  There wasn't much time for any interventions.  I did agree to continuous monitoring and a heplock, as I was a VBAC and it didn't matter much because I wasn't moving from one spot anyway (since I was pushing).  I did have a birth plan, but I saw it more as a "discussion piece" ahead of time than anything to present in labor (I'm sure that would've been different if I hadn't arrived so far along).  I did make sure to emphasize before the birth that I wanted delayed clamping and to skip the eye goop (I still did Hep B and K with her for a number of reasons) and so forth.  I had no issue with those requests.  I did have to stop a nurse before she hooked me up to pit after the birth.

With the second one, I actually tried to go to the hospital as soon as I was sure I was in real labor (I had a lot of prodromal labor).  Even doing that, I arrived 7 CM and was less than an hour from giving birth.  Again, there was no time for intervention.  Again, I allowed continuous monitoring (though got up pretty quickly to use the restroom and started feeling "pushy").  Again I allowed a heplock.  I can't remember if I presented my birth plan - I think I did.  I had no issue with most of my desires, though I did have to give in on the pushing position because baby's heartrate was dropping too much.  Midwife was not keen on skipping pit post-birth, but allowed it (but I do think treated me rougher because of it - if I had any advice, it would be to discuss this stuff ahead of birth and try and find as supportive a provider as possible).  As for post-birth procedures, the only ones I got trouble on were the vitamin K/eye goop because NY state law says they have to give them.  I knew that ahead of time and didn't even ask for it...

Hoping to have at least as decent a birth this time around!

[philomom]

Originally Posted by LaotianMama 

My first birth with my son happened in, where I feel is important too, a mom- and baby-friendly hospital and I made 9 great points on how to increase the chances of achieving a natural birth in a hospital:

1. Have a midwife as your care provider
2. Hire a doula
3. Prepare a birth plan
4. Educate yourself!
5. Decline every and any intervention during pregnancy
6. Labor at home as long as possible
7. Labor in water, if possible
8. Don’t be afraid to vocalize and visualize
9. Trust

More on How to Have a Natural Hospital Birth

Eh, I don't need a doula with my Bradley trained hubby. He was all the help I'll ever need. I don't need to pay a stranger to support the intimate birth of my family.

Labor in water is not necessary for everyone. I took a shower early on and then stayed dry. I have no issues with women who want to labor in water, but it's not for me.

The rest of the list is good!

[bearandotter]

lots of great suggestions in this thread. One I didn't see:

Don't change into a gown, you CAN wear your own clothes (no matter what the nurses say). I think that wearing my own skirt and tank top during labor reinforced that I was myself, in charge, and not a sick hospital patient. I think the nurses and other staff saw my clothing and it reinforced/made them realize I was not a 'typical' laboring woman. I was able to be discrete and comfortable to walk the hallways and march up stairs to get things going. My MW could still do what needed to be done and I was more than willing to have things 'cut off' if needed in an emergency. I was naked before I delivered (just out of the bath), but through my long labor nothing got overly dirty. I plan to wear the same things this time around (birth 3). 

[Quinalla]

Oh and birth plans, I think writing one is a good idea just so you have it all straight in your head. I never gave mine to my OB or hospital, though I may this time with twins as I'm pretty sure everyone is going to be more worried/pushy. I more made it clear that they should ask for consent for everything before doing it (which they should do anyway except in true emergencies, but they don't always) and went over each "typical" intervention with my OB ahead of time too. And also yes, my attitude was I would just do things and expect them to accept them instead of putting myself in the position of asking permission. I wasn't rude about it, but instead of "Is it ok if I get up and go to the bathroom now?" I would say "I'm going to get up and go to the bathroom now." I think that attitude helps a lot of expecting them to respect you, it puts them on the defensive instead of you.

[LaotianMama]

Originally Posted by erigeron 

I think it's as wrong to blindly decline every intervention as to blindly get every intervention. If you have a care provider you trust, talk it over with them, pros and cons. Find out about what interventions might be done in the hospital and why. . .

(I realize that is probably not exactly what you *meant*, LaotianMama, but it is what you *said*.)

True, true. I'm coming from a low-risk pregnancy standpoint, of course. Definitely confer with the provider about what possible scenarios of interventions on the hospital, which I did, but politely included I would like to decline if unnecessary, as in my birth plan.

[LaotianMama]

Originally Posted by philomom 

Eh, I don't need a doula with my Bradley trained hubby. He was all the help I'll ever need. I don't need to pay a stranger to support the intimate birth of my family.

Labor in water is not necessary for everyone. I took a shower early on and then stayed dry. I have no issues with women who want to labor in water, but it's not for me.

The rest of the list is good!

Thank you! Glad you liked it. I hired a doula purely because my husband would be a difficult birth support partner! Haha. I love my husband but I really think that it was more of a hassle for him (and in turn, for me) to expect him to do something so completely out of his element. We discussed it beforehand that it would be really difficult for him to see me in pain and that I deserve any and all support I can get, but he can't be the only one to have that burden. If we fidnt have a doula, I think we would have made extra efforts to make him ready though. Again, I feel that birth support comes in many forms and it should be fitting for that type of wanted labor and birth experience-- I wanted to be able to have the knowledge that doulas are trained in because, hell, I'd never done this stuff and there's just so much reading and researching I can do, whereas doula training is a plethora of I-never-thought-of-thats! Plus, there are plenty of doulas-in-training (free of charge to low-cost) that could greatly benefit from attending a birth so that's a win-win!

[myra1]

Originally Posted by LaotianMama 

True, true. I'm coming from a low-risk pregnancy standpoint, of course. Definitely confer with the provider about what possible scenarios of interventions on the hospital, which I did, but politely included I would like to decline if unnecessary, as in my birth plan.

[myra1]

Of course some interventions in pregnancy can be needed, but I have found that for a healthy pregnancy, it *WAS* best for me to decline all interventions. When I asked the midwife for pros and cons, the response was along the lines of "well, more information is always a good thing...." however, the info we got from testing was sometimes wrong or did not take my individual situation into account. However, bc it was a hospital based ob/cnm practice, having the test results in my chart put me in a box.

For example, the ultrasound contradicted dates we knew were right and indicated a large baby, leading to induction and more testing pressure. Cervical checks in late pregnancy are sometimes unrelated to how imminent labor actually is. Instead of doimg the GTT, I tested my blood sugar daily afer meals for a period because I am a gestational diabetic when fed the sugar solution, but this is not reflective of how I really eat during pregnancy. Since I am able to control my sugar thru eating well, a diagnosis of GD would have caused countless unecessary interventions. Even with measuing the fundal height...at one visit, the ob opened the chart to my previous visit by mistake, and magically I measured to the date 4 weeks ago that she thought I was lol. When I inquired, she updated the chart and then I suddenly measured to the correct date!

Testing has its place when a crucial decision has to be made, but the results can be so impersonal and skewed that I really believe it should be limited since providers rarely are capable of taking them with a grain of salt.

[erigeron]

You weren't blindly declining testing, though. You made your decision about each test based on the individual test and your situation and what is important to you. Which is pretty much what I'm talking about. There's a big difference between "I don't want any test or intervention at all ever because INTERVENTIONS R EBIL" vs "I understand the case for this procedure but do not feel it is right for me because of ABC. I would prefer if we did XYZ."