the absurdity of attempting a "natural birth" in a hospital setting

[wednesday]

This post is not meant to knock down anyone who is happy about their natural hospital birth, or planning one...just want to share my thought process on this. DS was born in a freestanding birth center and while I think it was a reasonably good experience, I felt afterward that home would have been so much better. It turned out to be more interventionist than I'd anticipated, and a lot of things that happened were not things I'd been prepared to need to decline, if that makes sense.

ANYWAY...DH is sort of on board with that, but other times he says maybe I should have a more open mind about the hospital. His main reasons are "what if something goes horribly wrong" and, basically, money. We have good health insurance so a hospital birth would undoubtedly be far cheaper out of pocket than a lay midwife. (FTR I'm not pregnant yet anyway, this is all hypothetical. And we no longer live anywhere near a birth center so the only options are home vs. hospital.)

I think about all the things I don't want do deal with having to do with a typical hospital birth -- from the standard hep lock/IV, vaginal exams, continuous fetal monitoring, to nursing staff who think women birthing without pain meds are inconveniencing them (I'm sure many if not most of them feel this way), to wanting to catch my own baby and bond sts right away without any rough suctioning or unnecessary bathing, weighing etc. And we live in an area that is FAR from progressive, I have no hopes that I could expect anything BUT the typical NON-evidence based birthing management practices.

I try to explain all this to DH and he turns around and says I've made this out to be a bigger deal in my head than it is and he knows how I obsess about stuff and I just need to tour the hospital so it's not this big source of "fear" and so on :

Today I said to him, "You know, I think going to a hospital for a birth but wanting it to be natural and wanting my practitioners to be knowledgeable and experienced in dealing with natural birth...would be like going to McDonald's to order a Big Mac, but asking them to make it with organic, antibiotic-free pastured-raised beef, and have it be prepared by people highly educated in nutrition. What I'd be asking for just isn't on the menu."

DH is a MAJOR foodie, like really into locally-grown, organic food that he prepares amazing meals from...eating at McDonald's is literally his very worst nightmare. So it was really a perfect analogy for him to see just how "wrong" a hospital birth feels to me.

[pamamidwife]

I really love that analogy! It's so true.

I don't understand why women hire OBs for their low-risk normal births, either. Why hire someone that specializes in surgery if you don't want surgery??

[rmzbm]

Great analogy! And pamamidwife makes an excellent point! Where-oh-where was MDC 9-ish yrs. ago? Or, where was I?

[LoveChild421]

I love that analogy!

[MichelleAnnette]

I love your analogy! I might have to borrow that one.

Maybe agree to tour the hospital if he will agree to go to several midwife interviews with you?

[saratchka]

I agree that in many hospitals your analogy is sadly accurate. I had an OB attended hospital delivery with DD, and found much of what you describe to be true. I was lucky enough to have the most natural minded of the six OB's in the practice at my delivery, and I still wasn't happy with the level of intervention. You're simply asking the hospital staff to do things that they are not well versed in or comfortable with, so you're not going to get the level of service you deserve in those circumstances.

That said, a lot can be done to mitigate the negative aspects of hospital birth if you're able to select an OB who is truly respectful of your choices and have a doula attend your birth. It still won't be anything like the homebirth experience (which I'm very much looking forward to this summer!) but if circumstances require you to deliver in a hospital, those two things can really help.

I'd say you should go ahead and tour the hospital (after all, what harm can it do?) but only on the condition that your DH agree to interview homebirth midwives with you. A sit-down with our midwife was all it took to make my DH comfortable with the idea of a homebirth. He needed to hear some stories directly from her and ask her questions about the things that frightened him. Once he'd heard her answers, he really felt better!

[mama_at_home]

Wonderful points! No matter how "natural" a woman's birth is in the hospital, it is still not going to be the same as at home. I attended my friend's hospital waterbirth. The labor and birth were really nice and not very "hospital-ish." I was actually starting to think to myself "hmm, maybe I have been exaggerating when I talk about how bad hospitals are for birth." But as soon as the baby was born, I watched as the nurses came and took her and placed her under a warming lamp. Then her heel was pricked to test her blood sugar. Then she got the vitamin K shot. Then she was hooked up to all kinds of wires for her hearing test. A nurse tried to take her away for her bath and the mom had to insist that she stay. What started out as a peaceful birth for mom and baby soon turned into a bustling room full of interventions. I am so glad I attended her birth because it gave me the extra boost of what I needed for my homebirth. (I have birth 7 weeks after her to my twins).

[wednesday]

Oh gemelos, you really described what I DON'T want! It's funny, I've had friends who had "natural" hospital births and were happy with how it went, but if I ask, "So how did it go with declining the hep lock, and the continuous fetal monitoring," etc., and they're like, "Well, I didn't MIND those things...". Okay. Well. I would mind.

I don't think I need to go on the tour. DS was on the same wing as the maternity unit when he was hospitalized with RSV last year. DH and I actually peeked into a labor/birthing room while we were there. However --the lack of attention by some medical personnel to the droplet precautions they were supposed to be observing during his care gave me the willies. Our room was literally 30 yards from newborn babies. I am so NOT a germaphobe but that experience really freaked me out even more on the idea of birthing there. You hear it so much it becomes a cliche, but hospitals really ARE full of VERY SICK people...a newborn has no business being around that.

[Momma Aimee]

not to start a fight

but

keep in mind there are good hosptial births, and that birth plans are often respected.

We ended up with a medical birth -- well medical delievery -- and very glad to have been at the hosptial.

however

every wish we had WAS respected; I didn't have a hep lock or IV as a matter of course, and didn't get it till I had to have it for example. I didn't have continual monitors as a matter of course, it was when it was needed. Nothing that was done was done "jsut because" or "because that is how we do it". I was educated, knw why i didn't want thoses things, and voiced my opinion early and in definate terms.

I had a natural birth, untill I had to have medical intervention, and had he been better positoned, then i would have had a totally natural birht with no drugs, no interventions, no tools no anything.... I was on that track and know a number of women who have accomplished it -- a really natrual birth in a hospital room.

Mayeb if we'd been at home it would have gone diffently -- but I aslo might have ended up in an amblance with an emergecy c-section in ER too.

we didn't have a heat lamp, I held the baby till DH took him to be weighed and measured, then DH held him then returned him to me. NO one ever took him from the room, no one touched him unless DH or I was physically holding him. he was never woken for vitals, or any other reason (save me waking him to eat). he wore clothig i broght......He was in my arms, or being held by DH or my mom or dad the whole time we were in teh hsoptial, never in the cradle, never alone.

A lot of the bad stuff is lack of parental education, self-advocay, or lack of parental backbone. I was always polite, but i was the momma.

HB is a great option; and I support it 100%. ...............but it should not be chose out of fear of the hosptial not respecting you. it should be chose on its own merits, not simple to avoid something else.

We had a CNM and we went 33 hours past the water breaking, and pushed 3 hours. things an OB might not have been happy with. so we had the best of both -- IMHO.

Maybe tour the hsoptial? Maybe meet with a CNM with hosptial privilages. maybe one who does both home and hos (like ours) so that you are not pressed to choose Home vs Hos at the very start just to find a care giver...and so you are not in a postion where you can't cahnge your birth location without changing your provider.............and also so you have a MW who is felxible and can go either way with you. ------------ I feel more confident in a CNM that COULD go to the hosptial, even at home, so you know she isn't keeping you home jsut cuz she can't go to the hosptial.-------------------- that way you can do whatevr is right at the time of birth -- based on your wants and needs and health and so on??

yes you have to be your own advacte, do your reseach and have a back bone and a smile .. but not all hospitals are awful (yes I know some are)

Aimee

[momof4peppers]

I totally agree with what Aimee said. I had a good hospital birth. I think a LOT of the problems come from the litigous era we live in, sadly. Hospitals HAVE to think about protecting themselves. Lest someone sue them and put them out of business. And many many moms are willing to just go in and follow the procedures - they're not willing to take the risk that to "rock the boat" might result in any harm to their baby, either.

I always think about this family that had a homebirth in which - very tragically - their baby died. They NEVER ONCE blamed the midwife, even when the video showed that the midwife really should have done things differently. The local prosecutor used the video against the midwife, the parents testified FOR her. I think it's important to be open to the fact that things can and do go just as wrong during a homebirth, that might have been done differently with more experienced people in a medical setting.

I hear your fears (I share many of them!) and wish I could tell you how to overcome them. For me, it was talking to my OB, and seeking out other patients who had used him AFTER doing some research here. I am totally on board with whatever happens with my birth, happens.

[DreamsInDigital]

Awesome analogy wednesday. Too cool!

[Queen of my Castle]

I live in Canada and birthed at a small hospital for my first, and had a pretty great experience. I didn't realize what all the fuss was about until my sister, who lives in the states, had a baby, 2 days ago. Hearing about her 'natural' birth (drug-free, laboured most at home) but typical delivery at a hospital made my head spin- my mom was with her and I couldn't believe half of the procedures, security measures etc that were considered normal. My poor mom felt pretty wacko- pretty out of place. Now I know what you're talking about a bit more, it wouldn't seem that our systems would be so different, and probably if I had been in a big hosp in Toronto it would be similar to my sis' experience. Even still- just hearing about her (great, healthy, drug-free) birth makes me want to homebirth JUST to advocate it!!
A

[miriam]

...would be like going to McDonald's to order a Big Mac, but asking them to make it with organic, antibiotic-free pastured-raised beef, and have it be prepared by people highly educated in nutrition. What I'd be asking for just isn't on the menu."

OffTopic, but my DH used to ask for a piece of cardboard fried in grease when we were dating when he took me to McD's.

Then he would ask the cashier if he could have a seat closest to the orchestra.

Back to the topic:

My midwife tried to deliver a multip at home, but then transferred her for lack of progress (at the insistance of the woman's husband). My midwife decided later that the woman simply wanted to be able to deliver in a hospital naturally. She, in some twisted way, needed this experience. The woman had a caesarean in a hospital before, then a home birth, and with this, her third birth, she decided on some level, to deliver in the hospital, naturally.

She got her wish, but she used her husband, her midwife, her unborn child, and her own body for the experiment.

I simply like the home court advantage, every single time.

[saratchka]

Aimee, it's absolutely wonderful that you were able to have a hospital birth experience that you were happy with. Truly, I applaud you for it. You talk about advocating for yourself and having backbone, both of which are wonderful things. I just don't know how you managed it during labor and immediately after the birth.

I labored at home into transition and arrived at the hospital at 8.5-9cm. My birth experience, while very uncomplicated and smooth, was far too intense for me to be able to formulate coherent sentences, much less to argue with the nurses as they positioned me on my back to push. And I hardly comprehended the words coming out of the neonatologist's mouth as she informed me that they were taking my daughter, whom I had not yet had the opportunity to hold, away to the NICU to observe her breathing. I could not possibly have evaluated the situation well enough to realize that my daughter's breathing was fine, just a touch raspy, and insisted that she be given to me to hold while she reached some level of equilibrium. All the basics were in my written birthplan, but those that the hospital staff disagreed with were pushed aside.

And even had I been able to advocate sufficiently for myself, I still would have been in an unfamiliar environment, delivering my baby in a room full of strangers. And after the birth, I had to remain in that environment for days while well-meaning nurses instructed me in what they felt to be the correct methods of newborn care. By this time I was able to advocate for myself, but I couldn't help feeling that I shouldn't have to. They weren't trying to make my life difficult, but it was hardly the peaceful bonding time I would have liked to experience with my child and husband.

So while I fully agree that it is possible to have an unmedicated birth in a hospital setting. And I'm sure that many women are able to insist on continued nonintervention throughout the hospital stay, I just don't think that necessarily equals a positive birth experience to everyone. Last time when I said I wanted a "natural birth" what I meant was an "unmedicated birth". This time I also mean that I want to be in an environment where I feel comfortable and don't have to contend with interruptions from strangers and unsolicited parenting advice.

[laohaire]

Originally Posted by Aimee21972

A lot of the bad stuff is lack of parental education, self-advocay, or lack of parental backbone. I was always polite, but i was the momma.

I was agreeing with you up until here. It seemed like you were objecting to the common human practice of generalizing, and I too try to avoid that. And here you went and generalized, in a way that was a lot more harmful than any other generalizations I've seen in this thread.

I also completely disagree with your statement. Besides doubting its veracity, I also object on the grounds that a laboring/delivering mamas SHOULD NOT have to be worrying about her "parental backbone." This is one of the major reasons I did not wish to birth in a hospital - I knew I'd have to be ready to FIGHT the entire time, instead of drifting off to laborland and having a safe and protected birth.

And here you say that it's entirely possible to have a safe birth at a hospital - but if a woman doesn't, "a lot" of the time it's because SHE didn't fight enough ("lack of parental backbone").

All my sociology books call that "Blame the Victim."

[Emilie]

[
Today I said to him, "You know, I think going to a hospital for a birth but wanting it to be natural and wanting my practitioners to be knowledgeable and experienced in dealing with natural birth...would be like going to McDonald's to order a Big Mac, but asking them to make it with organic, antibiotic-free pastured-raised beef, and have it be prepared by people highly educated in nutrition. What I'd be asking for just isn't on the menu."

You hit the nail on the head. I hope it is okay if I reuse this analogy!!!

WOW!
Smart mama.

I hope your dh gets on board. He undoubtely will- with a smart persuasive wife like you to convince him.
My homebirth was as I feel in my heart birth was intended to be. It makes me want to do it again.

Emilie

[Momma Aimee]

Well it was NOT the birth I wanted -- but what happened was physcial and not the fault of the hospital -- and would have happend at home as well. soooooo

However

I just don't know how you managed it during labor and immediately after the birth.

I had a great and detailed birth plan -- and I posted a sign on the outside of our door for EVEYONE to read it, and I would tell people to read it.

very supportive -- aka well-trained -- DH and doula. DH knew the things i drilled into him as importnat --- no one touches baby without ne of us touching baby at same time; baby does not get put down alone, if anyone asks if i want or need mediaction, tell them to wait for ME to ask and so on....... Doula kept me n track, and kept DH on track. My mom was there an knew what I wanted. Everyone basically knew to refer to the birth plan if I was not in a state to answer (and I was not alwasy in a good state).

I went in proactive -- this is how is is going to be -- I didn't wait for the staff to try something else, then tell them how i wanted it. .

I posted cute -- but strict -- signs all over the room. no medication, we'll ask. no circ, no shots, no bibki, i breastfeed only.......

and for the 48 hours we were there no nurse offered advice....I think since i was confidnet in myself no one felt they had an opening.

I am not blameing the victim........

I am sayig a lot of wemon don't get educated, don't do the research, and go iwht the flow (well the doc said this and he must know, be right) -- then afterwards don't like the outcome and say "I didn't know" it is our responiblity as women and moms to KNOW -- to seek it out before hand..................just like woman who claim the want to BF, then stop at sore nipples cuz they didn't know. they are paying lip service to something (desire to bf, desire for a nb) without doing the lag work and the prep work, they are setting themselves up to fail and it is their fault.

I truely believe most of the problems in birthing and breastfeeding today are at least in part lack of education, pepoeration and yes, back-bone on part of the mom. MDs and hosptials are nt going to flip over and what we wnat them to be untill and unless they are forced to change.

And I spent NONE of my labor time fighting -- I did my work before hand, had my support people there, and had no conflicts. (we also worked hard to find a provider who was like minded).

Homebirth is a great option, but what i am saying is to choose it for itself, not out of fear of the hosptial. My point is a hosptial birth can be great too -- if you do your homework and are prepared (not if you just walk in and don't know what to expect, or think that it will be one way without taking measures to make it that way)

[Momma Aimee]

one other thing to think about -- and i am not dis-counting a HB --

if DH is not 100% ok with it, and behind the idea.....

you may be setting yourslef up for a more stressful and anxiety birth AT HOME than in the hsoptial.

This is DH's baby too, and you are his wife, he deserves to be confortable with the event too. he should have his fears, thoughts, wants and concerns respected too.

if he is worries, stressed, upset, anxious, or just not 100% with it -- that will effect both of you at teh birth ... and may trunt he hb into something you don't want either.

[miriam]

The fact is that there is a homebirth movement gives the hospital maternity wards some competition, and therefore incentive, to improve their care and reputation.

They make lots of $ off of the techno baby delivery show.

Imagine what the care would be like if there were no competition or choice to the hospital birth.

[wednesday]

He's not really that anxious about HB for the safety aspect...it's really more about the money, to be honest. He was more anxious about HB when we were expecting our first, and so the birth center was a really good compromise. The funny thing is, the house we now live in is closer to a hospital than the birth center was. (A couple blocks away as opposed to a couple miles.)

Aimee, I hear what you are saying about advocating for oneself, and all that...I just don't want to go into a situation knowing what I want is so at odds with the typical practice. No offense to you, and I'm glad things worked out the way you wanted, but the whole concept of a birth plan is just bizarre to me. In fact...I don't want anyone at my next child's birth to be such a stranger to me that it takes signs, notes, plans, and multiple human advocates to adequately inform those strangers of my preferences and protect me from what they might otherwise do to me.

Also, I forgot to mention this in my earlier post, but I know a woman who used to be a L&D nurse at the local hospital for several years. And when she got pregnant and began researching the kind of birth she wanted for herself--she ended up choosing a homebirth with a lay midwife. She went back to work briefly after her baby was born but within a few months left the field of nursing for a different career altogether. This was not like a long time ago either, her child is only 3. That to me speaks volumes.