Labor/birth/aftermath discussion with your Ob/Gyn

marvan5

I have read stories like this before, this is nothing new (but still a good read):

https://www.adbusters.org/magazine/80/industrial_childbirth.html

I am deciding to give birth in my hospital's birthing center, but I have concerns that my doctor may try and rush things along, or recommend a c-section if labor is "too long." I want to trust her since this is my first child, but I also want to trust my body to be able to "do its own thing." My next appointment is next week and I want to start talking labor and delivery with her, and what happens after the child is born (baby in my arms immediately, do they really pull out the placenta, etc). I want to know what to expect, of course, and I also want to let her know I want to do this as naturally as possible. Do you have any tips for talking about this without being incredibly pushy or seeming like a know it all when really, I don't know much... SHE is the doctor, not me. And/or previous experiences that might help with this conversation? This article along with other stories and statistics I have heard about make me worry that I will be over medicated and have unnecessary procedures performed and the first moments with my child which are crucial for bonding may be taken away.

Beauxbaton

Well, they may be the doctor, but don't let them push you around. If you are worried about them being pushy then do a little research. Like when is it REALLY necessary to do a csection. Is it normal for fetal heart rate to vary throughout labor? What should concern you and what shouldn't.

When I had DS the OB resident was a BITCH. She tried to get me to stay in the fetal monitors the whole time. Tried to convince me that me walking around would be harmful because they could monitor the heart rate. Tried to push pitocin. Just was overall unpleasant. Luckily the nurse was awesome, my husband was awesome, and I'm pretty good for sticking up for myself. Being educated on your labor choices is going to be the most critical thing for you. See if there are any doulas or midwives in your area that teach classes.

As fat as talking to your doctor. Don't act like they know more than you. Don't give them all the power. Tell them what you want. Typically OBs response to things is "we can try." Just know that that is them saying they'll try, but nothing is a guarentee, which is pretty true with labor and delivery anyway.

The after birth stuff I'd tour your hospital. At the hospital I'm delivering at it is THEIR policy (not the doctors) that you get 1 hour at least, of skin-to-skin immediately following the delivery. If you don't want then wiped off before they are handed to you, then they don't do it. I'd also express your wishes to the nurses that are in your delivery room. And just be very up front. And have anyone else who is going going o be there as support to you be aware of what you want.

All in all just be confident in what you want, and know when/if intervention is necessary. And don't be afraid to deviate from what you originally wanted if your mind changes

kcrusius

My best suggestion is to express your wishes as clearly as possible. Then tell your labor nurse. That is the person that can make or break your experience- they are your best advocates. They know how to speak to docs in "their language" and get them to think it's their idea to follow yor wishes. Most (good) docs really do want you to have the best experience possible, barring complications. I hope your conversation goes well- maybe try writing down your plan before you go so you have it to refer to in case you get nervous.

elleswarth

What did you even google to find that article? I had to stop reading it halfway through. It's obnoxious. Her time table seems ridiculously off and exaggerated. Here in the US, the eye drops and K shots are given right when the baby is delivered, not hours later. She also didn't advocate for herself, as she clearly stated she said "okay" any time they suggested something. This article seems to be a complaint about not getting to breastfeed and apparently her needs being ignored. You are your own advocate. The end.

Stargirlb

Powerful article.

This articulates a big part of why I chose an unassisted birth for my first. When I started asking my doctor questions (at about 25 weeks,) he treated me in a patronizing way and basically dismissed what I wanted for my birth as 'trying to be a hero.' When I told him I wanted an all natural delivery, he looked amused and said I would change my mind. Barf. I walked out of his office that day and never returned. I chose to take him at his word-- that he did not respect what I wanted.

If my sovereignty over my body (and my guardianship over my newly produced child,) was not going to be recognized, then I would not let him manage the experience for me and deliver on that lack of respect that I sensed. I could care less if he had attended 5 births or 5 million.

I was 18 and unmarried, which would tend to make people treat me as a dumb/immature pregnancy vessel. I was never raised to accept any less that full respect for my personhood and decision-making capacity at any age, so I did not find it difficult to stand up for myself and walk out. The thought of going things alone is always the default in my mind, and not a source of fear. Not everyone feels the same.

The way you word your post suggests that you are worried about how your caretaker perceives your concerns/reservations based on your lack of experience or education. While I'm sure that makes you a nice person to interact with, these things have no bearing on your right to make decisions for your body. In fact, your inexperienced and vulnerable position creates all the more reason for the care provider to be the one to treat you with the extra care in communicating everything, and to ensure boundaries are not overstepped. Very much how it should be if you were having sex for the first time with an older seasoned partner. You should not have to be primarily concerned, as the vulnerable party, with expressing your concerns/considerations in a way that won't offend them or make them hostile. That dynamic smells a lot like rape culture and blaming the victim ahead of time. "Don't you trust me? You did agree to do this, after all.."

It makes me said to hear of experiences like the one this woman had. And I wish I knew how to help others avoid having bad experiences without being accused of advocating for "dangerous things". I also do not like seeing these experiences as being written off as a failure to self-advocate.

I do think that if this article resonates with you, that you should mentally prepare yourself to deliver alone, even if you don't plan to actually do that. Educate yourself on the process, what it would entail, what you would have to monitor for and how you could react to various emergencies. This knowledge will give you a lot more confidence and understanding of your own power and authority as a woman and as an individual living human being. You will be forced to consider how you will own and address your fears, which is a prerequisite to being able to fully consent to someone intervening or assisting you in any manor.

I don't think that training your mind to think like this is a prerequisite to a positive outcome, but it will certainly help empower you to face anything that comes your way. And ask the hard questions without a shred of fear of what the response may be.

“You may not control all the events that happen to you, but you can decide not to be reduced by them.” ― Maya Angelou

AggieMom0809

I wouldn't bring it up as "this is what you want to happen," but ask what she expects the process to be and express your concerns. Most don't force c-sections just because it's been too long. It's a lot more complicated than that. The pain meds are up to you. You can deny all meds. I personally didn't want the baby placed on me until they were cleaned, but that's the standard at my hospital. Then you push the placenta out while they go clean up the baby.

ECATX

emmyg65 said:

I would approach it like an information-gathering conversation, which it is. Don't make assumptions—care providers differ widely in their approaches and perhaps yours is already totally on board with your preferred approach. Start with open-ended questions. Here's a list to give you some ideas.

I agree with this. When I was pregnant with DD, I brought it up to my dr. after I finished the birth class (which her practice recommended and was offered by the hospital where I'd be delivering). She wasn't exactly a huge supporter of natural birth, but it's not like she was going to push pain meds on me, either (and she didn't). She outlined the reasons she might do a C-section or induction and emphasized it was only in instances where it was necessary for safety reasons. There were a few things we didn't agree on, but they weren't deal breakers for me and were all things that didn't end up making a difference at all.

It's also important to find out what the hospital's policies/procedures are. The hospitals in my area are super supportive of skin-to-skin contact, breastfeeding, etc - and a lot of the after-labor stuff comes down to the hospital. rather than the ob-gyn.

I hope your conversation goes well! There are a lot of good dr's out there, and no one can force anything on you that you don't want. Good luck!

2000cougar

That story sounds like the experience I had with my first. My epidural was still working when it came time for me to push. On the second push, the resident said that I wasn't moving the baby far enough and I'd need a C-section. Because of a pre-exitsting condition of mine, C-sections are quite dangerous. Even the vascular surgeon who was in the delivery room thought the OB was being premature and told me to give it another try. I was fortunate to have another Dr on my side during the delivery. I've switched doctors and at their practice, one of the doctors from the office delivers the baby assuming they have some notice. My first was a scheduled induction and no doctor from my office showed up. 

I don't think it's unreasonable to ask about the labor & delivery procedure. Did they give you any information about creating a birth plan? I'd also keep in mind that what you want is the "best case scenario" and keep yourself open to the idea that complications and special circumstances may arise that change your plan. There was a woman in my area that just delivered in a supermarket. I doubt that's what she had in mind as her plan. In the end, the only outcome I want is for both of us to be fine. 

marvan5

Thank you ladies sooo much for your insight and advice. This gives me a really good place to start. That article was shared by a friend of mine on facebook. I have no idea where she found it. It definitely is not a story from my country (nor hers, she's Canadian), but it highlights a lot of pressures from hospitals and doctors that I fear could happen to me. I want to be aware of typical procedures and up front with my doctor about expectations (once I am more aware of procedures and options). I just pray that things will go to plan, and it doesn't all go out the window. If something goes wrong I know I might not get what I had hoped for and then at that point all I want is my baby to be healthy (and me, too!).

@laziestdaisy I haven't been with my doctor for very long, I only met her last summer when I became pregnant and I started having issues... that ended in a blighted ovum. She was and has been very kind, patient, and open with me and thoroughly answers all my questions so far and makes me feel comfortable about continuing to do so.
@Stargirlb I will definitely be researching how to personally prep myself as if I were to give birth without assistance, that just makes so much sense! The only reason I'm not doing an at home water birth is I want the emergency facilities close by just in case something does go wrong. I hope with future pregnancies I will be able to do that with a midwife. I have a couple of books sampled on my Kindle to read this fall to help me with expectations and being prepared that I found on a previous thread in our birth club. Of course if you have any resources you can suggest that would be most appreciated
@emmyg65 Thank you for that list! I will definitely be using that as a list for an opening conversation with my doctor to help understand what her process is. I also hope to gather information from her about the hospital's birthing center or the best way to do so. I am sure a tour will be involved.

aerotigergirl

When I was pregnant with DS, I had similar concerns. I had heard horror stories (we all get these from so many directions) about doctors pushing women into lots of different kinds of labor/delivery augmentations and I really wanted to avoid all of that as long as it was medically safe to do so. I learned as much as I could on my own, chose a care provider carefully, and asked questions very early on to make sure our expectations were similar. 

I'd advise reading a lot about natural birth, learning what you really want and where you're willing to compromise (and you have to honestly realize - rather than just pay lip service- that you are going to have to be flexible, because things don't always go according to plan), and then having a very frank discussion with your care provider. If it becomes obvious, through that conversation, that you're on drastically different pages, it's not too late to change your care to a different care provider who is more aligned with the type of birth experience you're looking for. 

sfgiantsgamerbabe

My mom HATED having my oldest brother in a hospital. She had my other older brother and me at home (with a doula and midwife present, of course). We lived in a small town so the hospital was nearby incase anything went wrong.

My OB practice is really good about respecting women's decisions on childbirth. I already made it clear I don't want to be induced or have a c-section unless it's absolutely medically necessary. I was assured don't do c-sections unless it's medically necessary. They also have a deal with the hospital that we can have certain foods like jello, popsicles, and clear broth during labor. My SIL had a good experience at the hospital when she had my niece so, hopefully, I will have a good experience.