the absurdity of attempting a "natural birth" in a hospital setting - Page 3

[mammamoon]

Easy for you all to say.
I want a HB as much as everyone but am unable to have one (and that is a long story) without going unassisted. It has been devastating coming to terms with that. And Finaly I am just starting to realize that it's what you make of it.

I had a hospital birth with my son bc my intuition told me he was not well, and he ended up being born with a congenital heart defect that required emergency bypass surgery. But the birth was amazing and I had absolutely no intervention besides the doc catching the baby. The wonderful memory of the birth is what got me through the trauma of my sons suffering. It was our strong connection that was enhanced by having such a powerful birth experience that helped save my son and my own spirits.

You can be strong and demand the birth you need at the hopital, refusing any treatment that they are trying to push on you. Educating yourself about hospital births gives you power so hospital births can be as sacred and divine as any homebirth, Just look at that beautiful baby you gave birth to and remeber what this is about. It's Not about our ideals, but our divine connection to this soul that just came through you, no one can take that away from you.

Women who chose or are forced into a hospital birth need to be strong, but remeber one of the greatest lessons of motherhood and that is surrender
(and I don't mean the medical staff), then after that...acceptence, and above all love.
This response is really for me, to empower mysef through this birth that isn't so ideal, but beautiful all the same. I'm sure alot of you women have strong feelings opposing hospitals(as I did, especially being a doula) but my new perspective needs to be honored too.
Thanks for listening!

[Momma Aimee]

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.

I agree

why are home births always such a great thing -- and hosptial births are always such a bad thing?

as if thoese of us choose to birth i a hosptial are the ones who are "the poor uninformed" and if we would jsut stay home things would be so much better.

I have had -- well menaing I am sure -- p eople tell me if I had a home birth then the medical things would not have happned. possible, but when a home birth mom has a issue no one jumps to tell her if she'd been in a hosptial she would not have faced the same challange.

I see hm as a vaild opintion -- but not one to be chosen out of fear.

A

[PGNPORTLAND]

ITA - I would NEVER criticize someone else's birth choice. Especially unsolicited, especially after the fact.
Again, I just don't think any of us can say what's right for another woman. I mean, If someone were to say "oh, I had a terrible hospital experience. It was horrible and now I am preggo again and what should I do?" I would say "have you thought about a homebirth?" Sure. But if someone has a good/great experience with their hospital - I would never say, "well, I guess you got lucky". That really, to me, takes away from someone's birth experience. It takes all their hard work (which you have no matter where you birth) and chalks it up to fate.

Yes, it's the dichotomy that bothers me too. But I don't believe in All or Nothing philosophies. They have never served me well on any topic.

pauline

[saratchka]

I think there's certainly an element of luck in most things, and birth is no exception. I do think that there are many of us who walked into a hospital birth well prepared and not lacking in backbone, who still ended up with unnecessary interventions that we did not want because it's really, really hard to buck the system when you're in labor and immediately post delivery. Most of the time I could stand up to a doctor telling me they were going to take my baby to the NICU for little to no reason. At that point, I simply wasn't able to evaluate the situation as I normally would. And even DH, also well prepared, was so shaken up by the whole experience that he didn't have the confidence to insist the DD stay with me. There are things about labor that you can't understand until you experience it, and the change in my mental processes was one of those for me.

I'm not trying to say that homebirth is right for everyone, or even right for everyone with low risk and a desire for an intervention-free birth. And I'm certainly not trying to question anyone's decisions regarding their own birthing needs. What I am saying is that to achieve an intervention-free birth in a hospital requires both hard work and some luck. (And I'm speaking as one of the lucky ones, really. I had no medication prior to delivery and afterward, I had only local anisthetic for my stitches and some ibuprofen for swelling. DH stayed with DD even when she was taken to NICU. So overall, I had a very natural birth by most people's standards.)

Especially for first timers, it's really hard to be truly prepared, even if you are well educated. I read about putting up signs, for example, but was told by other women who had delivered in the hospital I was using that this caused the nursing staff there to become hostile, so I didn't do it. Having been through the experience, I think my wishes might have been respected more thoroughly (if grudgingly) had I done so, but it took experience, not just education, to come to that conclusion.

Of course, there's some luck to a successful homebirth as well. I just think that if your wish is to have an intervention-free birth, the deck is stacked in your favor at home, while the opposite is true in most hospitals.

[doctorjen]

I think this thread is fascinating, and useful to me in thinking about how I attend my own clients. I hope you won't mind me poking my (hospital-birth-attending) self in here.

One thing I think is important in thinking about whether you can have a natural birth in the hospital, is understanding where your providers are coming from and what their standard practices are.

Whenever you ask someone to go against their standard practices, there is a set up for conflict. Also, a provider may even want to accomodate you, but not really understand how and therefore end up not realizing that what is going on is "normal" since they haven't seen it before.

For example, when I first started in practice, I had read about, and even personally experienced myself birthing in an upright position - but I had only ever attended births where the mom pushed the baby out semi-sitting or flat on her back. There was a learning period where many of the women I attended still ended up on their backs because I didn't know how to help them be upright. When pushing was taking a while, or a woman asked me for suggestions on positioning, I didn't know what to do, and the nurses were most comfortable with mamas on their backs, and so we naturally gravitated that way.

Now that I've attended dozens of births where the mom was upright, I'm more comfortable and I've come up with bunches of ways to birth a baby upright in a hospital setting - including with mom squatting on the floor and me under the bed. Now, I rarely see women birth on their back because we naturally have the habit of encouraging and supporting upright positioning.

Same when I was trying to learn not to do episiotomies. The first time out in practice that I saw a baby crowning for a long time, I interpreted that she wasn't able to stretch, and I would want to do something (perineal massage, stretching, coached pushing, even an episiotomy) I saw something normal going on, but since I had no experience, to me it seemed abnormal. Now that I've given up doing them entirely and seen numerous births were the mama naturally backed off pushing hard when the baby started to distend the perineum, and where the baby was visible for quite a while before being born entirely, I realize that everyone will eventually stretch to allow the baby out if you just wait long enough. I'm much less interventionalist in this area now that I know what I'm doing.

What I'm saying is that it's not always even that hospital providers have the intent to go against what you want, but when you are asking folks to practice outside their experience and comfort, even if they want to be helpful they may not be able to.

Add in the standard hospital setting where it's not just one provider, but possibly a number of provider's where you get whoever's on call, the nurses, the hospital personal you may have to go through before you are even admitted (a triage nurse or a resident or student or whatever) and there is a lot of room for having to take someone outside their comfort zone. That's a lot of folks you have to hope are willing to try to bend and step out of their experience. That's not to say it never happens - I had a lovely, lovely hospital birth with #3 in a tertiary care center complete with residents, but it does mean there's a lot more variables to how it can get crossed up.

Unfortunately, there are also providers out there who are on power trips who will actively try to show a laboring woman with her own ideas that s/he is in control and force the laboring woman into a postition of very unequal power. I've have witnessed that personally, where a woman's wishes are discounted only because they are her wishes and the staff can't let go of power.

In any birthing setting I think it's important to know what your provider's experience and standard practices are - best not to have to fight for you wishes at all if you can choose a provider who standardly does what you want. If they don't match up with your expectations, then at least you need to make sure that the person attending you is going to be good natured about trying to do what you want if it isn't their standard practice.

I do think it is important to continue to try to improve the birthing culture around us, and important for those affected badly to continue to speak out. For those of us whose experience has been positive, whether in hospital or at home, it's important that we don't therefore discount the experience of women who have been hurt. It's always wrong to coerce, threaten, and bully - and especially during such a vulnerable time. Acknowledging that this occurs doesn't negate the fact that some hospital births are wonderful.

[huggerwocky]

Originally Posted by Aimee21972

I agree

why are home births always such a great thing -- and hosptial births are always such a bad thing?

as if thoese of us choose to birth i a hosptial are the ones who are "the poor uninformed" and if we would jsut stay home things would be so much better.

I have had -- well menaing I am sure -- p eople tell me if I had a home birth then the medical things would not have happned. possible, but when a home birth mom has a issue no one jumps to tell her if she'd been in a hosptial she would not have faced the same challange.

I see hm as a vaild opintion -- but not one to be chosen out of fear.

A

I will disagree, I still think a homebirth is always first choice.

[Momma Aimee]

one has to be realistic, and thus better able to make the imporvements that are needed int eh system as a whole.

Unfortunately, there are also providers out there who are on power trips who will actively try to show a laboring woman with her own ideas that s/he is in control and force the laboring woman into a postition of very unequal power. I've have witnessed that personally, where a woman's wishes are discounted only because they are her wishes and the staff can't let go of power.

and this is when you kindly the first time, then with more force, ask for them to be replaced. you are the consumer -- and can always go up the chain of cammand.

heard nurse -- nurseing director for the hosptial -- hosptial director. (I have had to do it for MIL in ICU). not fun, but necessary to protect others fromt he same negitive person.

Doc-jen --- I found your comments wonderful. Thanks for the insight from your great point of view -- momma and provider.

AImee

[PGNPORTLAND]

Originally Posted by huggerwocky

I will disagree, I still think a homebirth is always first choice.

The first choice for you, maybe. But not for everyone.

[PGNPORTLAND]

Dr. Jen, I had a wonderful resident attend my birth too. Sometimes they are better because they are still learning and more openminded. Sometimes not, I 'm sure. It all depends on the individual.

[Momma Aimee]

I still think a homebirth is always first choice.

I think my friend who just gave birth 10 weeks early, after being on bed rest since week 8 of her pregancy would disagree;

I think my siter who gave birth at week 34 after 2 weeks of early labor -- in the hosptial -- and 3 months of bed rest, would also disagree.

yes, HB is nice -- for no-risk, healthy moms and babies -- however there are a lot of moms and babies who would die without the hosptial option.

Aimee

[lolar2]

It is the complications that make the second choice-- hospital birth-- necessary.

[saratchka]

Originally Posted by doctorjen

What I'm saying is that it's not always even that hospital providers have the intent to go against what you want, but when you are asking folks to practice outside their experience and comfort, even if they want to be helpful they may not be able to.

This is exactly what I assumed to be the case with my care providers, and most of those I hear about. Thank you for stating it so clearly!

Originally Posted by doctorjen

I do think it is important to continue to try to improve the birthing culture around us, and important for those affected badly to continue to speak out. For those of us whose experience has been positive, whether in hospital or at home, it's important that we don't therefore discount the experience of women who have been hurt. It's always wrong to coerce, threaten, and bully - and especially during such a vulnerable time. Acknowledging that this occurs doesn't negate the fact that some hospital births are wonderful.

Thank you for sharing your great insights with all of us. It's easy to get angry about the negative experiences we've had and heard about and sometimes it's very helpful to be reminded of the other side of the story. You have a great perspective on the whole issue. Do you have any ideas/suggestions for things we as consumers of healthcare can do to help improve the birthing culture?

[torio]

Originally Posted by mammamoon

You can be strong and demand the birth you need at the hopital, refusing any treatment that they are trying to push on you. Educating yourself about hospital births gives you power

No question--educating oneself is a source of power; being strong and having backbone (as an earlier poster said) is important in all aspects of life. However, even when one is in a hospital for illness (pregnancy w/o complications isn't an illness) it's often a battle to hang onto the right to true informed consent and the right to refuse treatment. I may be out of line posting here as I have yet to deliver a baby. However, my experience with hospital staff after a miscarriage made me certain that it's not a place I want to deliver a child unless there is a medical emergency.

I'm not planning a homebirth out of fear of hospitals, but because like the OP said, they're not selling what I want to buy. Provided my pregnancy is without complication I want a HCP (in our case a midwife) who is trained and experienced in healthy, normal birth.

I have too many friends and family members who chose hospitals and later told stories of the reasons for the interventions they'd hoped to avoid. In a sad majority of the cases, the situations were ones that a well-trained and experienced midwife could've handled w/o drugs, instrumental delivery or transfer for c/s.

Yes, some births require the assistance of medical technology. But it shouldn't require 'backbone' to avoid unnecessary interventions.

[Cigilteach]

You'd think that would work but in reality....

and this is when you kindly the first time, then with more force, ask for them to be replaced. you are the consumer -- and can always go up the chain of cammand.

heard nurse -- nurseing director for the hosptial -- hosptial director. (I have had to do it for MIL in ICU). not fun, but necessary to protect others fromt he same negitive person.

This chain of command thing is almost impossible to do when in hard labor. When it is attempted, unless you get up and seek the people out, you don't have much chance of seeing them. No one is going to go and fetch these "busy important people" unless you raise bloody hell - then you're the nutcase of course and treated as such.

I tried this, both times but more so the second and it got me nothing but more anguish.

Head nurse - no where to be found during labor, when I did meet with her she lectured me, lied to me and did NOTHING.

Nursing Director - same exactly scenario.

Hospital DIrector - no one would help me contact this woman at the time, threats and abuse just became more strenuous and vindictive the more I attempted to go up the "chain of command". Since I was in hard labor, I couldn't very well stalk off in search of these people. When doula attempted to do so she was thrown out. MIdwife - same. Poor DH - waylayed in the hallway by various people telling him his baby was going to die (baby was absolutely FINE the entire time, I have the hospital records) and meanwhile worrying what they were doing to me in his absense.

I wrote and called EVERYONE after the event (2nd baby) and got no response whatsoever but did have to deal with policemen, welfare agencies and "investigators" at MY door and criminal charges brought against my midwife for uh...existing.

I am a very normal, compitent and loving mother, NOTHING had taken place to instigate these people "reporting" me but me opening my mouth too much about the horrendous way I was treated.

It is very easy to advocate being the responsible consumer in the hospital. Try doing it when the sh*t is hitting the fan.

I agree that the outcome of birth, wherever it occurs is always unpredictable.
It is pretty predictable, however, that the interests of a laboring woman will be secondary to that of the hospital/OB and that is what leaves her treatment/outcome to chance NOT the natural occurances of birth.

J

[moonfirefaery]

I think my friend who just gave birth 10 weeks early, after being on bed rest since week 8 of her pregancy would disagree;

I think my siter who gave birth at week 34 after 2 weeks of early labor -- in the hosptial -- and 3 months of bed rest, would also disagree.

yes, HB is nice -- for no-risk, healthy moms and babies -- however there are a lot of moms and babies who would die without the hosptial option.

I know plenty of women IRL and have read of many women on this forum, who were high risk and had very healthy babies, even preemies, at home even after long labors. Situations in which a baby would assuredly die at home, but not in the home, are not as doctors and hospitals have convinced people they are. You don't have to birth in a hospital birth just because you have been on bedrest or in labor for 2 weeks, nor do you need to do so just because you have birthed early. That your friends felt more comfortable there or that the hospital convinced them that it was safer doesn't mean that home birth would not have been more comfortable or safer. Being premature by a few weeks doesn't mean you would die if not born in the hospital, nor does having a long labor or even gestational diabetes. There are so many situations where women are just sure that without the hospital & their birth attendants, they or their child would surely have suffered or perished. Many of those situations could have been handled without such drastic intervention, and even more are caused by unnecessary intervention that is much easier to avoid when you home birth. Feeling certain about something does not make it true. My mother is against homebirth because her son was born with his cord so tightly around his neck that he was blue and not breathing. She thinks the doctor saved him, that he'd have died if he was born at home. That's not necessarily true, because a midwife could have just as easily given him oxygen, too, or even resuscitated him without it.

I think a birth that is as free from intervention as possible is best, and I agree that the most likely environment for avoiding unnecessary intervention is the home. If you've found a hospital that you know will respect your birth plan then by all means deliver there. I disagree that homebirth should be a first choice, nor do I think that hospital birth should be the first choice. I think a first choice should be an intervention free birth, wherever the mother is most comfortable. If a mother would be more comfortable in the hospital and still manage to avoid intervention, that's great. If she'd be more comfortable at home, awesome. The point of this thread isn't to bash hospital birth. It is to point out that it is usually (not always) a lot more difficult, you have to fight a lot more harder, to get a natural, intervention-free birth. Just chose a place where you will be most comfortable, feel most safe, and have your wishes respected.

p eople tell me if I had a home birth then the medical things would not have happned. possible, but when a home birth mom has a issue no one jumps to tell her if she'd been in a hosptial she would not have faced the same challange.

I don't see how telling you the fact that home birth is safer and proven to have a lower rate of medical intervention is jumping on you, nor do I understand the analogy between that and telling a homebirth woman that 'x' wouldn't have happened in the hospital...because the number of things which happen in the hospital & wouldn't have happened at home is quite a bit higher than the number of unwanted things which occur at a homebirth that would have been handled better at a hospital. When you chose to birth in the hospital you are chosing to expose yourself to a higher risk of medical intervention, unless you have chosen one of the few hospitals that actually honor birth plans. When you chose to birth at home the risk of dangerous complication is usually very low, as is the risk of unnecessary medical intervention. The challenges we face at home are things like handling the pain, remaining patient, etc. Of course we wouldn't face them in the hospital because we would have pain medication and then an emergency C-section when labor wasn't going fast enough for the OB. Instead, we'd be trading off those minor inconveniences for the dangers of medication & abdominal surgery. :/

[Cigilteach]

Thanks

Dr. Jen and Arwyn, your posts were tremendous.

I do not wish to bash anyone's birth or choice.

But I do feel it very important to be firmly grounded in reality when it comes to exactly what is happening to many many women who attempt to birth in hospitals. I've know countless women who really thought they had their "ducks in a row" only to get a good slap in the face with reality when the time came. It should not be happening.

I think we need to step out of this system and create another from scratch with Arwyns and sage Dr. Jens and midwives and mothers and fathers at the helm. From inside angry defensive hospitals under the consumer gun? That's definitely not an atmosphere in which I'd like to birth, would you?

J

[philomom]

This thread saddens me. I had two amazing hands off midwife births in a hospital. Not one thing was done without my consent.

I did not even know that a person could give birth at home until my midwife told me that they (midwife team) all quietly attend each other at home. Yes, I was college educated and had taken Bradley classes, but it did not occur to me that this was something people do. Please don't try to make me feel bad for making the best empowered choice I could at the time.

[Momma Aimee]

You don't have to birth in a hospital birth just because you have been on bedrest or in labor for 2 weeks, nor do you need to do so just because you have birthed early.

That maybe true, and I know i read in one of Dr Sears books that thei had their down's baby at home.

however -- in the two cases I am personally involved with and sited abopve -- both babies were in NICU for 7+ weeks and neither was breathing at birth. Thus a home birth, even with teh best care and 911 service, would have at elast resulted in brain damage if not death.

There is a differnce in birthing early -- as I did with DS -- and delievering at 30 week and 34 weeks. And ther eis a difference in being on bedrest as my other sister was for high blood pressure and early contractions, and being in and out of the hosptial the whole pregancy with pre-term labor as these two women were.

my point in -- while it is importnat not to discount HB as a OPTION it is important to remember that hosptial births have their place (for thoese like me who choose them) and are also a real need for some (my sister and freind).

Again -- I think it is important to work within the system to effect change for the better for all -- including my daughters and daters-in-laws. I will fight the good fight if it means my grandchildren can be born with less stress to their parents. If no one complains, or bucks the system -- the system marches on.

Aimee

[ladybugg423]

Originally Posted by Aimee21972

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 know some women who have done their homework and prepared themselves and had great natural births in hospitals, but for me it does feel like I would be putting on armor to have a baby. Even if I wasn't fighting the entire time, if I am having to go into the hospital and contradict everything that is their norm (even if it is done by signs and support people), I don't feel that is natural. I think it's unnatural for a woman to have to defend herself while she is in labor and birthing. Even if there is no obvious fighting, the fighting for rights is still there. To me, it's not about fear necessarily. It's making an informed decision if you know what kind of environment you want and the hospital doesn't provide it. If I went to a hospital, I know that my choices are far too alternative for them to consider--besides all the other reasons that I believe homebirth is safer.

Oh and Wednesday, I love your analogy about McD's! That rings so true to me! As far as money is concerned, I'll tell you what I told my sister who is wanting to have a VBAC and has been informed that if she schedules her cesarean the birth will be completely paid for, but if she attempts VBAC, her insurance will not pay a dime: Money should not be a reason for making a life choice. This is an experience that is priceless. I would have to pay for my own homebirth here. If that was what I felt most at peace with, money would come together even if I had to take a loan out. People take loans of much higher amounts of money for things that are far less important.

[Momma Aimee]

When you chose to birth at home the risk of dangerous complication is usually very low, as is the risk of unnecessary medical intervention.

True -- there is less chance of a slippy-slope at home. and no un-needed interventions.

however our interventions were not un-necessary

-- and the physical issues i had with deliever would have exsitsted at home as well as at teh hsoptial -- I just would have ended up with a amblance ride, an unknown ER doc and an emerencgy C-section in the ER.

I just am bothered byut eh assumption that my birth would have "of course" been better at home. It was not perfect at the shoptial, but the bad things about it were not the fault of the hosptial -- thgus being at home (or a birth center) would not have "fixed it" and when I grievee for the issues in my first birth -- on the days i feel like a failur -- and i hear "well have a home birth next time" as if THAT is the whole answer -- it is a simplistic answer, a pat responce, and bothers me.

HB is a great options, i agree, but i do not think it should be put up on a pedistal and made while and idealized while the hosptial is vilified (sp?) as always eveil.

Aimee