the absurdity of attempting a "natural birth" in a hospital setting - Page 2

[member234098]

... 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...

This is extremely common.

There are legions of L&D nurses who not only would not and do not deliver their own children in the hospital they work in, but they often have home births with a midwife, sometimes a lay midwife, which are considered by many of their colleagues, lesser qualified than the overeducated, over-trained, techno physicians in the maternity wards.

[NYCVeg]

Here's your evidence. I took Bradley classes pre-childbirth. My instructor had taught around 120 students over the years. About half had OBs and planned natural hospital births, the other half were working with mws. So, let's assume about 60 people planning natural childbirth in a hospital--people who took a 12-week intensive course in preparing them for natural childbirth, did all their research, ate well and exercised, did their Kegels and squats and pelvic tilts, shopped around for natural-birth-friendly OBs, wrote and discussed detailed birth plans with their doctors, etc. The instructor revealed that, during all her years as a Bradley instructor only ONE of the students who planned a hospital birth ended up birthing without any interventions. ONE! Out of this large and incredibly motivated and well-prepared group!

I birthed at a birth center (next one, if there is a next one, will be at home--the only part of my birth that was horrendous was the car ride!). The mws do about 70% homebirths and 30% birth center births. They take 25 clients a month and have been practicing for around 20 years. Do you know how many emergency transports they've had, in all that time? Three. Three times they had to call an ambulance, although everything ended up okay--they just didn't, in those cases, feel comfortable driving more to the hospital themselves. The point is: it is rare almost to the point of absurdity that something goes "horribly wrong" to the extent that you can't get to a hospital in time if you need to. An experienced midwife doesn't wait until things have reached that point before telling you you need to transport.

[member234098]

Again, would the hospitals be catering to anyone's desires if there were no other choice? I had my first baby 29 years ago. There were very few birth centers and midwives, but I found one and was successful.

Why would I or any one else in that situation go to the hospital unless I really needed the extra care that was not available at home?

BTW, I also have certified as a Bradley teacher and none of the clients I had were surgically delivered. However, since the local hospitals at the time give/gave everyone an epidural (even in the alternative birthing centers in the hospital), all of my hospital bound clients did receive an epidural "because that is the way we do it".

I live in a huge metropolitan area (6 milliion +); there is lots of collusion, not competition, among the hospitals for maternity care. The only competition now are the free standing birth centers or home midwives.

[sedalbj]

I didn't read all posts, but I can understand where you are coming from. However, maybe not 'absurdity'. it isn't absurd, but it is an' extremely intimidating challenge'.

another very important reason for me not to go to the hospital except in emergency is because of the prevalence of infection in the environment. i got a staph infection in 2nd grade visiting my dad in the hospital and didn't even leave the main waiting area (no kids allowed back then), and there are many infections out there now that are antibiotic resistant. that is a life or death situation for a newborn... and god forbid you end up getting pressured into a c/s and an infection finds your newly opened wound! makes me shiver...

[huggerwocky]

Originally Posted by Aimee21972

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.

I'm sorry to say,. I'd still have may baby at home if DH was not ok with it. In that case he'd be free to leave the room and I'd have a doula instead. I was scarred for life by a traumatic hospital birth and a man will never have to experience this so I just tend to think mom's wish is a little bit more important.

[~*~MamaJava~*~]

I've had 2 close-to-natural births in a low-intervention country hospital...pretty much done with that.
Even if I had no stitches (either time), even if I had very little (#1) to no (#2) drugs, even if I wasn't separated from my baby (except to be weighed)...still not natural, still arguing for my rights, still not what I wanted.
I'm sick of trying to get what I want out of it, and discussing labor interventions while in labor, and requiring my husband to not only advocate for what I said I wanted, but to read my laborland mind and translate for the staff. I also don't like letting my dr do 'what she thinks is necessary' - and I have a fabulous doctor, believe me. I'm just getting too weird for those people I don't want to be "the crazy noisy laboring lady who pushes her babies out sitting up", again. I don't want to be judged, or prodded, or have eyes rolled at me. I want to be respected, which is natural, I think

And I'm over the "hospital for safety" bit as well. For a healthy woman with a normal pregnancy...it's safer at home.

The McDonald's analogy is perfect. They ain't selling what I'm looking for. No hospital is.

My DH is finally coming around, and I'll be talking to him using that analogy too!
If he was really, really freaked out - I mean panicked - about me delivering at home, I'd consider hospital birthing again...but he's not. I don't want to labor with a head case beside me but he's my dh, he gets me, and he knows that I want and need to birth this baby at home. He knows it's about me, and not him. It is about all of us, of course, but I'm birthing. Not him.

[Momma Aimee]

Bradley classes pre-childbirth. My instructor had taught around 120 students over the years. About half had OBs and planned natural hospital births, the other half were working with mws. So, let's assume about 60 people planning natural childbirth in a hospital--people who took a 12-week intensive course in preparing them for natural childbirth, did all their research, ate well and exercised, did their Kegels and squats and pelvic tilts, shopped around for natural-birth-friendly OBs, wrote and discussed detailed birth plans with their doctors, etc. The instructor revealed that, during all her years as a Bradley instructor only ONE of the students who planned a hospital birth ended up birthing without any interventions. ONE! Out of this large and incredibly motivated and well-prepared group!

Out of the 8 couples in our Bradley class 6 of then had a totally natural -- no drug, no intervention, -- birthi a hosptial setting. 1 had a sechduled C for vairous medical rason in teh momma and then we ended up with forcepts at the end.

[Pandora114]

Originally Posted by huggerwocky

I'm sorry to say,. I'd still have may baby at home if DH was not ok with it. In that case he'd be free to leave the room and I'd have a doula instead.

I told my DH that if he wasn't down with the idea of a homebirth he knew where the Jr. Ranks Mess was and he was free to go get blitzed out of his mind while I did my job and I'd page him after.

[Arwyn]

I hear what you're saying Aimee, and I think it does happen - I saw it happen to my friend when we were 19. She wanted "natural", but did nothing to prepare for it, so nothing like natural is what she got.

BUT, I have heard far, far too many women who WERE prepared, who did have extremely detailed birthplans and really supportive, educated husbands and really great doulas, who still were run over by "hospital policies" (even when they had signed OKs from their OB/CNM, even when they had talked to the hospital beforehand) and "this is for your own/your baby's health" (even when they knew that wasn't true, and protested, and had a written and signed birthplan to the contrary). I hear those stories much, much more often than I hear one like yours.

Honestly, I think you got lucky. I think you influenced your own luck tremendously with the work you did, made your odds much better, but nothing you did guaranteed that you would have the wonderful experiences you had. You played the odds, just like we all do to a certain extent in childbirth, and you came out with a good outcome. My problem with seeking a "natural" hospital birth is that the odds are so, so poor for most women, even if they're willing to put in a lot of work. The system is just set up contrary to what natural birthers, people who trust birth and their own bodies, are looking for. It's not quite as impossible as the McDonald's scenario implies, but it's not nearly so easy (or possible for all) as you imply, either.

And as rabid a homebirth supporter as I am, I don't even think this means that women who want natural childbirth should all stay home (although that would probably be a good start ). Hospitals do have to change, not just for women who haven't heard of or aren't comfortable with homebirth, but for those who have a medical reason to be in the hospital, for those who need surgical birth, for those who have to transfer. After watching the history of the past 20+ years (mostly in retrospect!), I'm not convinced that working within the system is entirely the way to do it (I think moving birth largely out of the hospital, so they realize that they are there to support and serve us, as backups, is a better way to go), but I fully respect and admire the women who, like you, do work within it, do work to expand the range of what's possible in hospital, and I thank you. I just don't buy the "I did it, so anyone can if they just work hard enough" argument.

[Mama Poot]

I didn't have a natural birth at all with my first child. I had thought about homebirth in the beginning, but my OB talked me out of it and I didn't have anyone else to help me or teach me, and I didn't know about MDC Even when I DID have a natural birth at home with my second, I know that there were times during his birth where if someone would have offered me drugs I probably wouldn't have refused. Women can be so vulnerable during labor, I know I am, and sadly nurses and doctors take advantage of this. I did tour my local hospital and they are very supportive of drug-free birth up there, they allow laboring in water but not delivery, and I had spoken with my CNM about the fact that if we went there, I did not want IV's or pelvic exams, and they had no problem with that. They never once gave me an exam during my pregnancy and never tried to talk me out of my homebirth. In fact, one of the OB's in the practice asked me lots of honest questions and seemed curious and excited that I was taking my birth into my own hands and trusting my body. It really depends on your location and the doctors in your area. I think a natural hospital birth IS possible, but you would really have to stick to your guns and definitely have backup support like a doula.

[stacyann21]

I'm planning on a natural birth at a birth center with a MW. I always felt that if I ended up in the hospital for whatever reason I would try to go as low-intervention as possible. But after visiting area hospitals and hearing about all their "standard procedures" I literally feel that it would be impossible. I would have to be constantly on top of what was being done and who was coming into the room which is soemthing I can't really imagine doing during transition or pushing, for example. One of the hospitals has a "mandatory" IV policy, a no camera policy and the nurse gave me a funny look when I asked about birth plans. Also, most of the rooms were small enough to completely prevent a woman from moving around during labor, thereby increasing her pain and increasing the chance of her asking for an epi.

[3_opihi]

I've had a HB transfer that was awful, a great homebirth and a fairly great hospital birth. Of all, by far I think home is the best place to deliver. It's unequalled. The only reason I had a great hospital birth, in my mind, is because it was my third child, I was armed and ready, I had researched and well, I didn't let anyone push me around. Of course, it also helped that I got to the hospital right before I started pushing.

I think that good hospital births are a rarity, sadly. It pisses me off that women do have to be so "on guard" just to basically be non traumatized. It's awful.

[Momma Aimee]

I just don't buy the "I did it, so anyone can if they just work hard enough" argument.

You may be correct,

and I DO strongly support hb as an option -- however it is not always the best option (in our case DH was too scared for teh first time as L/D were such an unknown, and since we did end up needing medical care it is not even on the table for next time). Even if you are just thinkin g"insurence will pay for the hos but not home" which, espically when it isn't your first, has to ba a real consideration.

and SOP at the hsoptial CAN BE avoided -- if you think ahead and stand up for yourself. but if you walk in, uneducated, you are going to be lost. BUT the same is true of a home birth -- it doesn't releave you of the need to prepare and educate your self -- it jsut changes what you have to learn.

I jsut do not want anyone to choose HB out of fear of the Hos. CHoose HB on its own merits... not because it is NOT something else.

And -- yes -- i do think we have to work within the system for the sake of our daughters -- leaving the system behind helps only the one leaveing, not the system or the girls who follow us.

I totally respect home birth, and am no way advocating the hos as better -- but it is a real option and hb sould not be seen as perfect in comparrison with teh hell of a hospital birth.

[PGNPORTLAND]

Originally Posted by Aimee21972

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

Originally Posted by Aimee21972

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 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)

I agree with Aimee in everything she has to say here. This was mostly my experience as well. Also I don't think she "got lucky". I know you didn't mean to say it this way, Arwyn, but I would never say that someone who had a successful homebirth "got lucky". That would be considered really offensive. I didn't "get lucky" either. I worked hard bringing my baby out into the world - luck had nothing to do with it.

But, I 've participated in this kind of discussion on these boards over and over again. Yeah, bad hospital births happen but so do bad homebirths - just no one ever talks about it - I think people who want homebirth should have them, by all means, and enjoy them - But I often feel like when someone has a homebirth they feel it's then their right/responsibility to scare people who are having/have had hospital births. It's a very personal decision. What's right for one is not always right for all. I support every woman's birth choice. You really don't know what it's like until you're there in the moment. And then you only know what's right for you, not the rest of womankind. Anyway, flame away, I guess.

pauline

[Cigilteach]

have a back bone and a smile?!?!?!

I posted in great length in a thread misogyny and birth (and later felt like I blathered on way too much but...) about what happened to me when I attempted to approach the hospital with extensive education and "backbone."

The result the first time was a dismayed staff who wished to be home for Thanksgiving and didn't give so much as a fleeting thought to my birth plan, supportive DH or anything else that got in their way. Experiencing horrendous back labor while midwives and nurses shook their heads and discussed my inevidable c/s, being polite and smiling was not a priority for me.

The next time an even more educated, stronger back-boned individual showed up for help and received nothing but incredibly abusive and punishing behavior by an OB and staff that were in no mood for strong, self-confident laborning mothers like me. The result was coersed unnecessary surgery, threats to take my baby away, and being reported to various agencies for threatening the welfare of my child.

What did I do to deserve this? I had BACKBONE and EDUCATION. I spoke up, I tried to advocate for myself and my baby, I showed up with "threatening types" in tow (midwife, doula, dh). I tried to fight for what should have been my basic right - humane treatment.

Perhaps if I had smiled more, written a more eloquent birth plan and brought "cute" signs to my births, things would have been different.

I think most of the time it is just plain LUCK that when one achieves a "good birth" in a hospital. You can run around putting adorably firm signs wherever you wish, hire the world's greatest super-doula, write incredibly detailed birthplans worthy of literary praise, but if the staff is not in the mood to be "tolerant" of your particular mode of behavior, you'll get what they dish out. period. And if you attempt to fight, you may very well be punished. It happens every single day.

Unless there's a medical reason to be in the hospital, stay home because getting a "good birth" in a hospital is a crap shoot.

J

[Arwyn]

I appologize for how that sounded to you, Pauline. I probably could have worded it better.

However, I do think that, going by the numbers, it is fair to say that a woman who gives birth without unnecessary intervention in a hospital is lucky, when epidurals, narcotics, Pitocin, AROM, episiotomy rates are all well, well over 50%, even, and this is in my experience, for women attempting, planning, and working hard for natural birth in a hospital. I would be very wrong if I suggested that she was lucky to escape with her baby or herself alive - the odds are extremely in favor of a woman AND her baby making it through birth no matter the setting. The only times I hear "you were lucky you had a good experience" in reference to homebirth are talking about survival, which is ridiculous. There is a certain element of luck when talking about transfers, also, but since about 88% of all planned homebirths take place at home, the odds are against needing a transfer, and the stress of all that.

Again, I am very sorry that I offended, and I wish I could think of a better way to say it, but I do think the numbers on a wide scale, and my experiences (hearing about others' birth stories) on an anecdotal scale, support my assertion that having a good, natural, non-interventive hospital birth is largely, though certainly not entirely, a matter of luck. Luck in having a good hospital near you for you to choose, luck in having a birth-supportive practitioner near you for you to find, and luck in getting L&D nurses who don't sabotage your experience (or introduce labor-stopping stress by having to fire them). If you do have all those things, and you are willing to put in the work, then yes, a good, positive, wonderful, empowering, natural, non-interventive hospital birth is possible, and I am so glad that both you and Aimee got to experience that, and I support you in supporting other women toward finding and creating that.

[Arwyn]

I also disagree that no one ever talks about bad homebirth experiences - I certain do see those conversations (here, on MDC), although they do largely take place on the UC board!

[PGNPORTLAND]

thanks Arwyn. I appreciate what you're saying. I think this topic affects me really personally. I think it affects all of us really personally depending on what our experience is, home or hospital, positive or negative. I think my (sophia's) birth was so beautiful and empowering and special to me that I can't imagine it happening anywhere else and I feel hurt when it's suggested that it could have been "better" somewhere else . Does that make sense? Anyway, thanks for your response.

pauline

[NYCVeg]

Of course there are some good hospital births, Aimee. My point about posting the thing that I learned from my Bradley instructor was precisely that these WERE incredibly educated, prepared, assertive mamas who knew the procedures inside and out and were willing to fight for what they wanted. And 59/60 had interventions--NOT c/s (though I'm sure there were some), but interventions (like epidurals and Pitocin) that they had planned on avoiding. And among the students working with midwives/out of hospital, very few ended up with interventions--not none, but relatively few. Like Cigilteach said, it's not just a matter of "oh, educate yourself and get a backbone and it won't happen to you". Hospitals have "procedure" and "policy" and in many cases will do whatever it takes, when you are at your most vulnerable, to do things according to "standard practice" (which in most hospitals, includes epidurals, Pitocin, continuous fetal monitoring, lithomy position birth, and so on).

ETA: Oh, and Arwyn...the percentages for the things you listed are way, way higher. I think that OVER 90% of women who birth in hospitals get epidurals.

[ericswifey27]

Originally Posted by 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??

People "hire" obs because they have been culturally conditioned to do so- they don't know how twisted a hospital birth can be, so they just never think to explore other options.

I know that's what happened to me. My mother birthed my twin sister and I (I was born first, breech) vaginally. Honestly, I was expecting to go in to the hospital and do the same. I had a birth plan. I was determined to not have pain medication, that I was going to have what I considered a normal, healthy birth experience.

What I was not prepared for was the steamrolling that occurred. I am a planner, and I am used to standing up for myself and getting what I need. But somehow everything that I explicitly said I did not want to happen, happened.


Fool me once, shame on you. Fool me twice, shame on me.

I was deceived. Plain and simple.

I won't be fooled again.

I am having an HBAC.