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A Natural Hospital Birth? Please share ideas! - Page 3

post #41 of 63

In my case, I declined all early ultrasounds because I was sure of my dates, and declined the quad screen because I wasn't too fussed about the 1/1000 chance of down syndrome, but I did get the 20 week ultrasound. While I declined the GD test in favor of a random blood glucose and A1c, I now think that wasn't the best course of action and next pregnancy will probably test my sugars for a few days (I don't like the idea of drinking glucola or eating something and then not being able to eat for an hour, pretty much solely because I was hungry so much in pregnancy). I didn't do any cervical checks late in pregnancy because they're pretty pointless. I did the saline lock and intermittent monitoring in the hospital. But if the situation had changed I was open to the idea that the need for testing/intervention might change. At 28 weeks I had a lot of abdominal pain and went to the hospital to rule out complications, and there was a lot of testing and monitoring that I was okay with because of the circumstance. My overall point being--evaluate each test/procedure/intervention on its merits. 

post #42 of 63
IMHO, I don't count testing as interventions. Testing can lead to a cause or need for intervention though. When I mentioned intervention in my post, I simply mentioned how I declined to have my membranes sweeped at just 40 weeks, which was offered just because I was FORTY WEEKS. Things like that-- induction before "full term," multiple ultrasounds for no medical reason, etc. I had a hep lock at my birth, after discussing it with the nurse and my doula and it was okayed by me. I also got 4 ultrasounds, did glucose testing, got repeated cervical checks at my first pregnancy. My second pregnancy was a complete opposite story though (you live and learn, I guess)! :-D Still, I didn't "blindly" decline them, and that was my situation. Every pregnancy is so different.

Testing has its place, of course, and even an uneventful otherwise healthy pregnancy requires peace of mind or to treat it under care of professional advice.
post #43 of 63

Mamas, I hope this thread isn't getting to be a less-friendly place to share our ideas-- it is a thread *requesting* our ideas... any and all of them.

 

Our ideas can differ-- that's ok-- let's get all the ideas listed that we can-- who knows which idea will help another mama?!

 

If one mama says her idea of a natural hospital birth incudes declining *all* interventions, she shouldn't have to qualify that or justify it, even if she -did- decline all of them blindly (turns out she didn't). By definition, fewer interventions would be more "natural," although not necessarily the best choice for everyone, nor even the safest choice for every birth.

 

Let's show some love here, please  hug.gif

post #44 of 63
Quote:
Originally Posted by mum4vr View Post

Our ideas can differ-- that's ok-- let's get all the ideas listed that we can-- who knows which idea will help another mama?!

I agree with this so much. My list is what helped *me* achieve what the thread is about and all I can do is share that for other mamas seeking guidance and a starting point or even what not to do! smile.gif
post #45 of 63
Quote:
Originally Posted by mum4vr View Post

Mamas, I hope this thread isn't getting to be a less-friendly place to share our ideas-- it is a thread *requesting* our ideas... any and all of them.

 

Our ideas can differ-- that's ok-- let's get all the ideas listed that we can-- who knows which idea will help another mama?!

 

If one mama says her idea of a natural hospital birth incudes declining *all* interventions, she shouldn't have to qualify that or justify it, even if she -did- decline all of them blindly (turns out she didn't). By definition, fewer interventions would be more "natural," although not necessarily the best choice for everyone, nor even the safest choice for every birth.

 

Let's show some love here, please  hug.gif

Well, I definitely feel like this thread is a less friendly place for me now, since I'm the only person you could have realistically been talking to with this post, and you just basically told me I shouldn't say what I think if I disagree with another poster. I thought this thread was about achieving a natural hospital birth. In my opinion, it's important to be informed and thoughtful. rather than reactionary, about testing and interventions to achieve that. *shrug* I'm also really confused as to what I said that prompted you to say 'let's show some love'--where was I unkind? I don't see it. If you have a problem with something I said, I'd appreciate you coming out and saying so. If you just have a problem with the fact that I disagreed with someone, well, I don't know what to tell you. 

post #46 of 63
I enjoy reading the differing opinions, experiences and decisions since it makes me think about options and alternatives!
Of course we are all free to make our own choices. I don't find anyone else expressing theirs to be offensive! I hope my sharing my choices is helpful and no one feels it is a judgement on theirs! Hope we continue to share freely because it is tough to get this kind of a cross section of options from a single care provider.
post #47 of 63
Quote:
Originally Posted by erigeron View Post

I thought this thread was about achieving a natural hospital birth. In my opinion, it's important to be informed and thoughtful. rather than reactionary, about testing and interventions to achieve that.

Your thoughts are right. This thread is about ideas/experience on a natural hospital birth; we all provided our input so that's all that matters. I'm not here for anything else.
post #48 of 63
Quote:
Originally Posted by myra1 View Post

Hope we continue to share freely because it is tough to get this kind of a cross section of options from a single care provider.

I wonder what other ideas I seemed to have overlooked since I shared what worked for me so, yes I'm hoping more share their thoughts.
post #49 of 63

Just to clarify, I wasn't intending to call anyone out in particular-- just to share my hope that we are all friendly, loving, and supportive of each other sharing ideas on so personal and precious a subject.

 

I hope no one would feel that their ideas or birth experience are considered wrong by others after being asked to share, publicly. I do enjoy the many differing opinions on what contributes to a natural hospital birth. That's all; nothing more intended.

 

Thanks much!

post #50 of 63

I tried to have an unmedicated hospital birth, and did end up with an (unwanted) epidural. My number 1 suggestion for other women would be to have a doula. Also, my care providers had told me that they were supportive of unmedicated births and I made the mistake of believing them. Maybe they support it theoretically, but hospital policy sure is not conducive to natural childbirth. It should have been a red flag for me that my care providers (CNMs) really hedged around the question when I asked them about it at my prenatal appointments, with a patronizing "oh that's a nice idea, I guess we'll see" attitude. 

So having a trained and experienced advocate who is with you all the time and knows all sorts of comfort and pain relief techniques - a doula, would absolutely be the most helpful thing. Also being prepared to be assertive with the care providers might be helpful. I felt very pressured and bullied by them to be a "good patient", even though they were very nice to me, and I should have just told everyone to screw off and leave me alone (or better yet, just ignored them) instead of trying to argue with them while in labor. Dealing with them all the time and trying to avoid constant monitoring that would leave me confined to bed really ruined my focus, and ultimately I got freaked out and just took the painkillers at 7cm. I am a little bit disappointed in myself, but at the same time it was not a supportive or comforting environment, and I was not prepared for that. 

post #51 of 63

Agree whole-heartedly with the above. It sounds exactly like my experience. I think having a doula is crucial. I only have one child, and he was born, as naturally as I could manage(I did wind up getting a Tylenol for "pain relief" during transition because the staff were stressing me out to the point I lost my focus), in a hospital. I was told a doula would be useful.. but I had hoped my fiance would be enough. But the L&D staff pushed and shoved him around until he was clueless. So yeah, agreed with above, have a doula, who is aware, and ready to defend how you want to do things. Trying to defend my methods myself during labor was exhausting, and stressful. Hearing my fiance argue quietly with the L&D staff was exhausting, and stressful.

post #52 of 63

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post #53 of 63
Very interesting insights! I will be looking into these suggestions.
post #54 of 63

So glad that I found this thread, it has been very encouraging to hear perspectives of a number of women who have gotten what they wanted from birth in a hospital, and helpful to hear from those who had issues with their hospital birth.

 

My first was born in a free-standing birthing center, but as she was will be just under 2 when I am due, and the birthing center was almost two hours away, this seemed like a major set-back in this pregnancy. This time, I am planning on a birth at our local hospital with CNMs (first was with a CPM).

 

So far, I have confidence that I will be able to achieve most of my goals for a natural birth even in the hospital setting. And from what I’ve seen from previous posters in the thread and from my own experiences, I just wanted to add that I feel that the No. 1 priority in getting the hospital birth that you want is to be sure to choose the right provider.

 

The only midwives in our town operate out of a university-based clinic that also handles the WIC program in our area. They accept some insurance plans and state benefits (which our family qualifies for with this pregnancy as well as out-of-pocket patients, but the vast majority of their patients are there because they qualify for state benefits and because this is the same office as WIC they are familiar with this clinic – also, I’ve heard very mixed reviews on the OB/GYN who practices at the other “clinic” setting in town, although there are also some individual OB/GYNs who also accept state benefits). There are four midwives that practice in this clinic, and I have now met two of them. They both seem to be ecstatic to actually be working with a mother who chose the clinic to use a midwife and try for a natural birth, as it seems to be much more common that mothers come because they are familiar with the clinic then are confused and upset when their primary care comes from a midwife unless they risk out because they are simply not familiar with midwives or just wanted that “let’s get that baby out of there as soon as possible and at a convenient time” type care.

 

Both have been very supportive so far of my desire to birth naturally, and one of the midwives I have seen actually started in a free-standing birthing center but chose to now be a hospital midwife because it gives her more opportunity to be sure that women have the birth they want. As she mentioned, women who are able to go through with a home birth or birth in a birthing center usually get the birth they want with low interventions, but if their circumstances require a transfer to the hospital, they often find themselves blindsided because they are completely unprepared; whereas in the hospital she can help mothers with a higher level of risk because immediate care is available without a transfer. I absolutely LOVED that she seemed to know exactly where I was coming from.

 

This particular midwife encouraged me to begin developing a detailed birth plan (I did not have one with my first birth because I didn’t know how things would go, what I would or wouldn’t want, and knew that in the birthing center interventions wouldn’t be pushed on me) and said that she and the other midwives will work with me on my birth plan to be sure that we all understand what my desires for labor, delivery and postpartum are. She encouraged me to make an early visit to our hospital, and she said not to schedule a regular L&D tour, but told me that they always have someone available, even on weekends. She said I should call a few minutes before we want to go and make certain that they aren’t especially busy or dealing with a high-risk delivery, so that they will have plenty of time to explain all their practices in detail so I can have a clear idea of the hospital’s procedures. She made sure to emphasize to me to be sure to ask any questions I might have of them and try to get a feel for how I will feel about working with them, as well, since they will be the first people that I have to deal with when I come in for labor and delivery, until one of the midwife team is able to get to the hospital. And she also encouraged laboring at home for as long as possible, saying if it was possible for me to time it so that I got to the hospital around 30 minutes to an hour before delivery, that would be great. She seemed to think that based on the fact that I only labored at the birthing center for about 5 hours with my first pregnancy, and had a two hour drive to get there, that we had done an excellent job of timing, and that I should have a better idea this time around of how my labor was progressing, and since I had a 24 hour labor with my last, it shouldn’t be too quick to adequately judge.

 

She made it quite clear that there are many practices which are in place at the hospital which are “routine” and that if a mother hasn’t made it clear in a birthing plan that she does not wish to have things done in that manner, they may simply be done out of habit using the basic “blanket” consent forms that the hospital has for providing care. While I do somewhat worry about whether or not I will miss something in my birth plan that I really hadn’t intended to happen, I was very grateful to her for being forthcoming and basically telling me to be very aware of this beforehand so that I can continue to ask questions of her and the hospital to make sure that I don’t get caught by an unexpected “routine” that I didn’t wish to have happen. But it is comforting to know that at least the midwives seem so very respectful of a birth plan, she said it will help them to better know what I want and be able to advocate for it, and to have it in writing will help them by making certain that the nurses will know what my wishes are until the midwives are able to arrive.

 

She also advocated a “give and get” attitude on some things (which I have been approaching this pregnancy with, anyway). If there are procedures that I might not wish, ideally, but wouldn’t be adamantly opposed to, she said I may wish to exclude them from the birth plan and try to gently turn them down or be willing to accept them in order to maintain a firm stance on the issues that are more important to me and that I’m not willing to compromise on. In my example, I was GBS positive but chose not to have IV antibiotics for my birthing center birth. Although I still have mixed feelings about the IV antibiotics for a hospital birth (I do feel like hospital birth could be more risky and might call for the antibiotics if I am GBS positive this pregnancy), she said I might wish to accept them this pregnancy while I declined other measures which I am adamantly against (like Pitocin to induce labor). Or more especially, being willing to have a saline lock put in place even if I do not require an IV at the time (which I am completely willing to do, as I already felt that this would help to “sweeten up” the hospital staff by cooperating on some issues, and also being understanding that if an emergency situation were to arise, this would make things so much easier for them and for me!).

 

That’s my advice, so far. I’ll be checking in and hope to see more stories, and if I have anything else to add (sorry for the long-windedness when I haven’t even BTDT yet!), and will be sure to update after the actual birth.

post #55 of 63

So much great advice in this thread.  I am planning our second/third hospital birth.  (Second birth was planned to be in hospital but ended up at home.)  One thing a doula in my DDC brought up is if you have a good relationships with your midwives/OB and know your hospital policies well, sometimes it's a good idea to get to the hospital earlier than later.  Traveling in late labor can be hard.  It can be nice to have time to nest and get comfortable instead of taking a car ride during transition.  I'd have to agree with this wholeheartedly.

post #56 of 63

Love the great advice!

 

I had an absolutely wonderful natural childbirth experience in a hospital, (a tertiary, academic center no less!), so I know that it is possible.  That said, here's my $0.02 on it:

 

1.  The most important decision you will make is your care provider.  I think CNMs are wonderful, and if they are an option at your institution and you meet their risk criteria, I say go with the nurse midwives!  If you choose or need an OB, it is SO important to try to find one that will not only provide your prenatal care, but will also be the one to deliver you.  Ask about their call coverage, and what percentage of their own patients they deliver--so many moms find themselves unhappy with the cross-cover doc, (who often doesn't know them, their preferences, etc.).  Remember, your midwife or doc is both the one who calls the shots about interventions, timeline, and escalating care, and is also your go-to person if you are having any frustrations or concerns about nursing, hospital policies, etc.  When they have your back, it really doesn't matter if the cranky charge nurse wants an IV placed...

 

2.  Be a little careful about birthplans.  In my experience, some nurses find patients with very specific, black and white expectations to be somewhat of a target for disagreement.  (And maybe it's just coincidence, but it sure seems like the longer the birth plan, the more likely you are to end up things you don't want!)  What I have seen work nicely for families is a simple statement in your chart that indicates your desire for a natural birth, and that you request that any interventions be discussed prior to initiation.  Then, it's up to you and your partner to ensure that YOU know what you want, that you are on the same page, and that there will always be someone present, (doula, family member, etc.), who can express your wishes.

 

The one caveat to this, though (in my opinion), is to be very clear with the nursery about your preferences for your baby.  If it's not spelled out, trust me--your infant will get the standard "newborn protocol," (immediate bath, erythromycin ointment to the eyes, Hep B, and Vitamin K).  Depending on the institution, you may also have to be very clear about your feeding preferences and use of artificial nipples.  Also, if possible, try to make sure that a family member is present with your baby at all times.  (True story:  even though I'm a pediatrician at the hospital where I delivered, and we had all of our wishes clearly spelled out, had my husband not accompanied my baby to the nursery for the initial assessment, she would have ended up getting the works.  (We only wanted Vitamin K and the basic labs.)

 

3.  And, no offense to doctors in training, (I was there once and it's difficult), if you are delivering at a teaching institution, find out if your care will be managed by resident physicians.  Here's why:  with inexperience comes fear.  Fear naturally leads to escalation of care.  A resident might become alarmed very early about something that a more experienced and seasoned doc might say is ok to just watch for a little while.  I remember as a resident being much more aggressive with interventions and treatment, in large part because you are worried that if you don't do something, bad things will happen.  With time, you learn that sometimes observation and the "tincture of time" is really the best course of action.  So, if you are at an academic center:  1.  Check out the midwife service if they have one.  (Usually, residents do not participate in the care of patients being followed by CNMs.)  2.  Request that your care be managed by an attending physician.  If that's not possible and issues arise with one of the residents, it is NEVER inappropriate to ask them if they have discussed your progress and care with their attending or to simply request to speak to the supervising doc yourself.

post #57 of 63
I had a natural hospital birth and it was everything we expected. The hospital room was in the birthing center part of the hospital. So we had a birthing tub in our very spacious room. We went in with a very clear birth plan. No one was to be there but myself dad and the midwife. It was important that the hospital knew that I planned on breastfeeding (esp since i got dehydrated after birth nd couldnt breast feed right away) so he wasnt givin formula or sugar water. Once I was better nd hydrated Our little one stayed in the room with us also. But back to the birth we were able to decorate the room which made it more calming nd less hospital like. The nurses were extremly helpful and so were the lactation specialist. The nusery ppl were a little pushy, trying to give him vitumen K shots nd bringing him to the nursery but we stood firm with our birth plan. Over all it was quit pleasent. Our midwives are currently building a birthing center so our nxt birth will b there.
post #58 of 63

ITA with those who've said have a birth plan, but keep it minimal, short, and simple.

 

Make nice with your L&D nurse-- she is your new best friend! Really-- I can't tell you how much more difficult things would have been for us if it weren't for my wonderful nurses! (If she -isn't- wonderful for you, then ask the charge nurse to swap her out for someone else-- make the excuse that you know you're moody during pain & it's not the nurse's fault, or w/e).

 

It's important to know whether your doc/ midwife actually SUPPORTS your plans, or just TOLERATES you as a nuisance to be dealt with later (bc later means *during labor*!)

 

If you have -any- suspicions that hospital staff will be pushy about your birth plan, or any  aspect thereof, DON'T go to the hospital until you're ready to push!

 

Even after having natural hospital births in the past, we ended up being bullied, degraded, and had many unnecessary interventions this time around. It all started bc we got to the hospital WAY too soon (I naively thought they'd check to see if my water had broken, then let me go home-- nope, my water broke, so they admitted me immediately!) My doctor had -said- he agreed with my birth plan, but later admitted he hadn't fully read it, and did not agree w any mom who wished to refuse pitocin! etc. I felt we were punished for standing our ground-- pick your battles while there, or better yet, choose them ahead of time.

 

Most importantly, love yourself and your family enough to forgive yourself if you later feel guilty about how things happened-- sometimes there is no planning for or accounting for how things go during L&D.

post #59 of 63

I had 3 hospital birth, 2 natural (natural as in vaginal birth with no pain medication). The biggest difference with the natural births was not being induced. Also had midwife for the 2 natural births and hired a doula for one of them. This particular hospital had tubs, which helped  a lot. Those are the three things that made the difference for me, no induction, having the extra labor support of a midwife or doula and the tub. And also want to add, they were straight forward normal births. Not all births are, and while yes there are some interventions which increase the risk of pain medication, there are also times when things go wrong and pain medication is necessary. I know someone who had 4 completely natural births, and fully expected to have the same with the 5th, but everything went wrong, due to an abnormally short cord and mal presentation, not because of mismanaged labor. I think it is healthy to always have the mindset that it is okay to have a back up plan and it doesn't mean you should feel bad or guilty about it not working the way you hoped.

post #60 of 63

This has all been very good to read! I'm "due" in a few days, and while my OB isn't at all interested in helping me have a natural birth, I've heard that the nurses where I may be going (if I decide not to have a UC) are very flexible and accommodating.

 

I've printed a few copies of my "birth preferences" sheet for the hospital bag; it's large-print and right at a full page, and has short single-sentence requests like "I want to hold baby immediately when he's born", and "I don't want vaginal exams or electronic monitoring". It's divided into sections too - during labor, during/after the birth itself, in case of a C-section, and newborn procedures. Now though, I may just use a simple statement like "I really want an all-natural labor and birth! Please advise us of any procedures before doing them!" and keep the longer plan as a backup, in case they need specifics and to keep my husband on track regarding what I want.

 

It's sad to see that once women go into that mental "labor land" state they're often overrun by pushy nurses or midwives who totally ignore any prior wishes. I don't think my husband will have problems telling them 'no' - he was a jail guard for years and confrontation was just part of the gig - and if my mom can make it, she'll be good for that too. She's not very big physically, but I've always thought she'd make a great bouncer.  =)

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