January 2013 Moms

Natural in the hospital: opinions/thoughts wanted

Hi ladies!  I know I don't post often but I'm here everyday.  I will try to keep this short.

Essentially, I feel like giving up on the natural birth in the hospital thing.  I'm feeling very discouraged especially after the recent Scrubs magazine/FB craziness where L&D nurses were asked about the most ridiculous birth plans they have seen and there was tons of patient bashing...blah blah.  Sorry I can't make it clicky but if you want to read some of the drama go here and look for a post from Thursday: https://www.facebook.com/scrubsmagazine?fref=ts

Anyway, I feel like having a doula (which I do) and having a birth plan (even though it is NOT nuts) is going to automatically get me ridiculed by the staff and fast track us to C/S land.  Please tell me this is just because I just inundated myself with one side of the NB in hospital story.  I am terribly afraid now that my DH and doula and I will have to fight against every intervention.  I am afraid I will flip out and b*&$h out the staff makign things worse (and ruin all the hypobabies study I've done).

 Yeah, ok I tried to keep that short.  Anyone feel like reassuring me that I am overreacting and the birth plan and doula are the best things I could have done and that things will be fine? :) 

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Re: Natural in the hospital: opinions/thoughts wanted

  • You'll be fine especially with a doula. Highly recommend this book http://www.amazon.com/gp/aw/d/1558327185 to ease your anxiety
  • The leader of our child birth class (an RN at our hospital in L&D) has no issues with us having a birth plan, planning a natural child birth, and having a doula. I think you are worrying a little prematurely. If your birth plan is pages and pages long then yes you maybe you will get ridiculed but otherwise you should be fine. Fast tracked to a C/S should only be done by your doctor. Hopefully you have discussed your desires with your doctor and as they are on board you should be fine.
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  • Stick with your plan.  It's about you and your baby.  Who cares what the staff thinks of your plan.  Do what's best for you.  
  • I don't know what article you were talking about because it's a link to their basic FB page but I'm sure there are always going to be some nurses who roll their eyes and others who have no problem following a birth plan. What do you care? I sure don't, if I want to give them a list of 1000 things I want them to do and they think I'm crazy, fine. 

    As long as you're aware that the more specific you get the less likely they can follow every "plan" down to the letter, so be it, I'll probably never see the nurses again. I'm thinking about taking a birth plan mostly because DH has no idea what's going on and I want it to be made clear that I want skin to skin, BF, no nursery time if possible, delay shots until she's breast fed... most of it's actually fairly standard these days but I don't want anyone forgetting what I want as long as there are no emergencies.

    I know my hospital has a good reputation for following birth plans and being extremely accommodating. I doubt having a birth plan & doula statistically leads to more interventions because there are more people on your side [not that there are sides - going in there assuming the nurses are against you is probably a GREAT way to turn them against you]

    Be realistic about what you want and I doubt you'll have any problems. 

  • I had a natural hospital birth with DS and we even had the added craziness that he ended up being breech.  Going into the pregnancy, I was just very open with my doctors about what I wanted and what things were most important to me.

    Find out what is common practice at your hospital and leave those things off of your birth plan to keep it as short as possible.  For example if sin to skin is the norm after a delivery then you don't have to stress about having it written in a plan.  One thing that also helped was to keep everything as positive and about you as you can.  For example, instead of saying "I don't want to labor on my back." say "I'd prefer to labor in as many positions as possible."  This way your plan is more about what you do want.  I know it sounds silly, but it can really set the tone for the nurses.

    Another biggie that I would suggest is knowing what you are open to to being flexible with and what points you are adamantly against.  If you don't want an IV, but you are ok with a hep lock then a nurse might see you as easier to "work with."  

    One last piece of advice was given to me by my Bradley teacher.  If it ever comes to the point where they suggest a C-section then ask if you can have a few minutes to discuss it with your husband.  If they give you time, then it is not an emergency.  If they say no, then know that it may be a true emergency.

    I'm sure there is more, but that is all I can think of right now. GL!!

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  • You're ready to give up on something you feel strongly about because of a facebook article you read?
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  • image eatmorecupcakes:

    Find out what is common practice at your hospital and leave those things off of your birth plan to keep it as short as possible.  One thing that also helped was to keep everything as positive and about you as you can.  For example, instead of saying "I don't want to labor on my back." say "I'd prefer to labor in as many positions as possible."  This way your plan is more about what you do want.  I know it sounds silly, but it can really set the tone for the nurses.

    Another biggie that I would suggest is knowing what you are open to to being flexible with and what points you are adamantly against.  If you don't want an IV, but you are ok with a hep lock then a nurse might see you as easier to "work with."  

    One last piece of advice was given to me by my Bradley teacher.  If it ever comes to the point where they suggest a C-section then ask if you can have a few minutes to discuss it with your husband.  If they give you time, then it is not an emergency.  If they say no, then know that it may be a true emergency.

    Thank you!  I feel much better.  Will modify birth preferences to reflect those ideas.  

    image mj0011:
    You're ready to give up on something you feel strongly about because of a facebook article you read?

    Clearly not ready as I posed the question here....but the area where I live seems pretty unfriendly to natural child birth.  In an effort to keep my OP from being a novel I left out some details about interactions with my OB, the hospital etc. You'll just have to trust that it's not JUST about the FB article..

     Also, yes! That book looks great.  Thanks, I will check it out! 

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  • Nurses I know LOVE natural birth, it is a L&D dream come true for a mom to complete a natural birth successfully.

    With that said, the reality is in this litigious society doctors and nurses are obligated to OFFER intervention early and often. Your birth plan does not protect them against malpractice, but your informed consent and denial does so if the situation arises where a change in treatment *may* improve the outcome for you or your baby they have to offfer it and let you decide. It is not a conspiracy, it is professional obligation: a nurse is not ignoring you if she assesses your pain and informs you medication is available if you need it, she is doing her job. If you plan for this, it shouldn't cause too much stress or disappointment: most interventions can be safely refused or delayed.

    No nurse should judge you for sticking with your birth plan.  I am sure there are crazy nurses out there, but your chances of getting one are very low. If it happens, ask DH to get the Charge Nurse and ask if your nurse can be switched, if that doesn't worse ask for the House Supervisor. Hospitals care VERY much about their customer survey scores and they want you to be a happy mama.

    Lastly, my sister had two natural births at a Kaiser Permanente hospital, no IV with the first, no interventions of any kind with either. She labored mostly at home and arrived a couple hours before transition both times, so most of her labor was without nurses. The nursing staff were very respectful, I expect the same when I give birth, and I hope you have the same experience too!

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  • image SanDimasMama:

    Nurses I know LOVE natural birth, it is a L&D dream come true for a mom to complete a natural birth successfully.

    No nurse should judge you for sticking with your birth plan.  I am sure there are crazy nurses out there, but your chances of getting one are very low. If it happens, ask DH to get the Charge Nurse and ask if your nurse can be switched, if that doesn't worse ask for the House Supervisor. Hospitals care VERY much about their customer survey scores and they want you to be a happy mama.

     Thank you!  Especially about the info regarding a plan of action for DH.  Really, really appreciate that info. 

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  • image OliveBeckett:
    image eatmorecupcakes:

    Find out what is common practice at your hospital and leave those things off of your birth plan to keep it as short as possible.  One thing that also helped was to keep everything as positive and about you as you can.  For example, instead of saying "I don't want to labor on my back." say "I'd prefer to labor in as many positions as possible."  This way your plan is more about what you do want.  I know it sounds silly, but it can really set the tone for the nurses.

    Another biggie that I would suggest is knowing what you are open to to being flexible with and what points you are adamantly against.  If you don't want an IV, but you are ok with a hep lock then a nurse might see you as easier to "work with."  

    One last piece of advice was given to me by my Bradley teacher.  If it ever comes to the point where they suggest a C-section then ask if you can have a few minutes to discuss it with your husband.  If they give you time, then it is not an emergency.  If they say no, then know that it may be a true emergency.

    Thank you!  I feel much better.  Will modify birth preferences to reflect those ideas.  

    image mj0011:
    You're ready to give up on something you feel strongly about because of a facebook article you read?

    Clearly not ready as I posed the question here....but the area where I live seems pretty unfriendly to natural child birth.  In an effort to keep my OP from being a novel I left out some details about interactions with my OB, the hospital etc. You'll just have to trust that it's not JUST about the FB article..

     Also, yes! That book looks great.  Thanks, I will check it out! 

    If you are having issues with your OB and hospital, you might still consider switching.  I never had a written birth plan to hand to the nurses at the hospital.  I had a high risk pregnancy with DS and my doctors were wonderful.   I told my OB what I wanted, and the team made sure it happened.  If you have confidence in your doctor and hospital, you shouldn't need a checklist because the OB will already have everything in their notes.  The only person I might give a check list to would be the doula and your H, so they could be a double check.  But really I would focus on the bigger issues (not being induced, not wanting a c-section unless it is an emergency etc, not wanting pain meds), and not worry so much about the smaller ones. For example if you have a good hospital, they will encourage skin to skin and rooming in, so there is no need to stress that.  Its all about communicating with your OB and having a knowledge of your hospital rather than about a list IMO.

    Definitely do not give up on your dream.  Hire the doula, and go in there with a non-combative, relaxed attitude, and I think that will give you a lot of support among the nurses.  No one is really going to care that much that you don't want pain meds. What they are going to care about is if you come in acting like they are the enemy. Fingers crossed you get a really great nurse, and have a wonderful experience.   Oh and what did the OB say to you that has you questioning things?

  • Not to be snarky because I mean this in the nicest way. What nurses generally get upset about is a patient who reads a lot if research and believes they know everything. Yes, research is wonderful and most medicine is evidence based BUT it is difficult to have a patient who is not flexible and has unrealistic expectations.

    I am a nurse but we were also told this in our birthing class. The more positive and educated you enter your birth the better, keeping in mind safety is number one and that is the staffs' job. Malpractice insurance and lawsuits are expensive, as a nurse it is my job to keep you safe.

    With that in mind there is no reason if your requests are safe and reasonable to accommodate within the law and policies you should be fine.
  • There is nothing wrong with having a birth plan. What RNs and other medical profesisonals get annoyed at, however, is when: 1. The birth plan endangers the mother and child and/or goes against hospital policy. 2. The birth plan is extremely complex and interfers with the care of you, your child and others in the hospital. That's it.

    While I am an RN in pediatrics, I have MANY friends who work in L&D and, accross the board, they all say that they have no problems with realistic birth plans and/or natural labor. You have done preparation (I did hypnobabies too!) and I am sure have realistic expectations with the understanding that, ultimately, the important thing is the safety and health of you and your child. Where problems occur is when women absolutely flip the H out when situations occur (such as fetal distress) and refuse to compromise or accept any change from their plan. You can be a strong advocate for yourself and still be polite. Don't go in with the idea that you know everything...you don't and need to listen to medical explanations as they are given to you. Don't go in with the assumption that the medical world is conspiring to give you an unncessary c-section. Question what you don't understand and ask for explanations, but try to have an open mind to what their input is as well.

    Despite popular belief, most nurses do not want their patients to have to go "down the fast track to c-section".  

    When you get admitted, express your intentions to deliver naturally...don't go in with guns blazing anticipating a fight when there might not be one. If things begin happening and you are uncomfortable with the plan or intervention ask for the reasoning behind them. Also, remember that the bottom line is that you have a healthy baby and that you are safe as well. So while things like birth plans and doulas are awesome, paramount to all of that is you and your child's health and safety.

    And quit reading those kinds of stories on the internet! :)

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    First BFP! 9/5/11- M/C 9wk5 1st U/S, no HB.
    Forever loved, little bug.

    Second BFP: 1/13/12. 2/13/12: Blighted Ovum diagnosis. Chromosomal testing showing complete tetraploidy. We'll miss you, little monkey and wish we could have known you. Two babies never to be in our arms, but always in our hearts.

    Third BFP: 5/4/12 EDD: 1/12/2013. Our rainbow baby, W, born 1/16/13 a healthy little boy!!! We love you honeybadger and are so so blessed to have brought you home!

    All "after loss" board ladies (PgAL, TTCAL, PAL, MC/PL) always welcome to post!
  • I just switched about 4 weeks ago from an OB to a CNM and am giving birth in a hospital. My old OB and hospital are not natural birth friendly and I knew it would be difficult to have the birth I wanted if I stayed with them. The hospital I'm now using is known as a very natural birth friendly hospital. I am really happy with my decision! It's never too late to switch.
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  • image FreyaWin2382:
    And quit reading those kinds of stories on the internet! :


    This!!! I know : I'm trying!! Lol. not so great at that.

    And thanks to all who are in the field with the info on how not to go in. I felt like I was really in danger of guns blazing and making assumptions so each of your posts has made me feel better.

    On the subject of the OB let's just say if I hadn't brought up the birth plan it wouldn't have been discussed and she told me tht the doula was ok as long as she didn't get in the way.... Eh.. I trust her and all but I still don't feel like she is very supportive of the natural stuff. Final example, I wrote in the preferences which is short and bullet points that I wanted the squat bar as an option potentially and she said it was too hard to deliver that way. For her. She wouldn't be able to see. Which, TBH , is fine with me for actual delivery since she seems fine with intermittent monitoring and hep lock so i should be both laboring at home and mobile during most of the hospital time which is much more important. I just get a vibe about it? I have considered the switch idea but I would say I really do trust her. Just feeling like maybe I was getting attached to the wrong expectations.

    But!! Anyway! I feel better and I will stop obsessing over this starting now. Thanks all you are so helpful. I appreciate this board so much.
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  • I had a doula, I had a birth plan, I had a natural birth in a hospital.  You can do it!

    It's actually the inductions and epidurals that more often than not land someone on the "fast track to a c-section," so if those are not a part of your birth plan you're already ahead of the game.

    Just remember that YOU are the employer and the doctors/nurses are the employees.  If you don't like the people they assign to you and if you don't feel they are supportive of your plans, you can always switch.

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  • Our hospital seems to push for natural births. I feel a little guilty considering medication to manage pain after our childbirth class at the hospital.
    It's your decision though. Who cares what the nurses think anyway? You're not going to see them again.

     

  • I'm trying to go natural in a hospital with a doula and a birth plan too.  I think as long as you keep your "plan" reasonable, and treat the nurses with respect, they should treat you with the same courtesy.  

     

    All you can do is try the best you can for a natural birth, and by choosing a provider who is supportive, getting a doula, and putting together a thoughtful birthplan, you can be confident that you're doing all you can.  I know for my part that if I do end up with a c/s, I did everything I could do avoid it, and that it was medically necessary.  

     

    Don't give up! 

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  • With my son I had a natural birth in my hospital and had a wonderful experience. The nurse I had was extremely supportive and kept suggesting different positions to try etc.  and her replacement when she was on break was wonderful as well. I had talked about my plan with my doctor ahead of time and she was on board, though I will say that the nurses are probably more important, my doctor checked on me a few times during labor but was mostly only there at the end, the nurses are there the whole time.

    My best advice would be to go in with a good attitude. If the first thing you say to the nurse is "this is my birth plan and I WILL NOT deviate from it so don't try anything lady!" you'll put them on the offensive and it will be unpleasant for everyone involved. I just told my nurse that I wanted a natural birth and was hoping to only have medically necessary interventions and she was supportive and no interventions were needed.

    I had a birth plan but we didn't give it to the nurses, it was more for DH and I so we had talked everything through and knew which things I was and wasn't comfortable with and we just said yes or no to things as they arose. (I did verbally tell my nurse not to offer pain relief unless I asked for it and she respected that)

    A successful natural birth is definitely possible in a hospital, GL to you!

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  • image OliveBeckett:

    Hi ladies!  I know I don't post often but I'm here everyday.  I will try to keep this short.

    Essentially, I feel like giving up on the natural birth in the hospital thing.  I'm feeling very discouraged especially after the recent Scrubs magazine/FB craziness where L&D nurses were asked about the most ridiculous birth plans they have seen and there was tons of patient bashing...blah blah.  Sorry I can't make it clicky but if you want to read some of the drama go here and look for a post from Thursday: https://www.facebook.com/scrubsmagazine?fref=ts

    Anyway, I feel like having a doula (which I do) and having a birth plan (even though it is NOT nuts) is going to automatically get me ridiculed by the staff and fast track us to C/S land.  Please tell me this is just because I just inundated myself with one side of the NB in hospital story.  I am terribly afraid now that my DH and doula and I will have to fight against every intervention.  I am afraid I will flip out and b*&$h out the staff makign things worse (and ruin all the hypobabies study I've done).

     Yeah, ok I tried to keep that short.  Anyone feel like reassuring me that I am overreacting and the birth plan and doula are the best things I could have done and that things will be fine? :) 

     

    I had a birth plan and it essentially went accordingly until b was born (he had pneumothorax so hubbs couldn't cut the cord and i couldn't bf right away or be in the mother baby unit) but i think you would be ok as long as you have an open mind about it. Not everything may go as planned so be prepared to have to stray a little from it. That and when you are giving birth your plan might be the last thing on your mind and it may change. As long as there is no risk to the baby or you (decreasing heart rate, high bp etc etc) you should be ok. But like i said before, keep an open mind and know that the doc is experienced and if s/he feels that there is a risk or a complication that it might be best to listen to the options they present to you. Also, have you talked to your doctor about this and what you expect during labor and delivery? That can help you too. 

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  • I had a natural birth in the hospital and it was a great experience.  I did not have a written birth plan, I just told the nurse I had in the beginning the main points I was going for and she obliged.  I told her I did not want to be offered anything, no. matter. what.  I knew if I wanted pain meds I could ask for them, but I did not want the thought being put into my mind by the nurses more than it already was.  I also wanted to be able to move around as much as possible, and for the baby to be placed on my chest immediately after birth (which was their policy anyway).  

     I think what some of the others have said is important.  The more specific and rigid you are in how you want things to go, the harder you become to work with as a patient because it will most likely not all go exactly like you're picturing.  The most important thing for me was having my H there and involved 100% of the time I was in labor.  He had a clear understanding of what I wanted before we went in and advocated for me throughout labor (although he didn't need to much).  My son's heart rate was dipping more than they liked to see when we first got there, so I spent a lot more time laying in bed on monitors than I would have liked to, but because I didn't have a rigid plan, I just went with it and once they were satisfied with what they were seeing, I was able to get up and move around again.

     It's definitely doable.  :) 

  • Again, thank you all for responding.  I feel a lot better about this and I wanted to just summarize the points that helped ease my mind in case others read this and have the same question:

    - Be realistic about your preferences especially where they clash with hospital policy (consult with the doc/hospital to confirm those things)

    - Don't be too specific/elaborate in the birth "plan" as you will be able to be more flexible

    - Stop reading the internet! There is a bunch of negative stuff out there but it is not helpful to internalize that and assume that you know better or that the staff won't support you.  

    - Who cares what anyone thinks! Never going to have to see them again :) 

      Thanks again for the insights.

     

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  • image PrivacyWanted:
    You'll be fine especially with a doula. Highly recommend this book http://www.amazon.com/gp/aw/d/1558327185 to ease your anxiety

    One of the reasons to have a doula is for her to fight for what you want in the hospital. Nurses have to follow hospital protocol. Just because it is protocol doesn't mean it has to happen, however. DH and I are prepared to fight for what we want in the hospital room, as long as it doesn't violate hospital policies (not being in the bathtub after water breaks, etc).

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  • Have you considered home birth?
  • I had a natural hospital birth, and I hope I can go that route again this time. In fact, most of the nurses pretty much left me alone and I preferred it that way. I don't see why they'd prefer to monitor you-- more work for them!

     That said, I can see that if you are a very needy patient that has many demands, that might be irritating to them (even if it is their job). I would suggest that you use your doula to be your communication person, and seek support mainly from the doula. I think this will ease any pushiness you might sense from the nursing staff. 

     

    Good luck to you! Don't give up on what you want for YOUR labor!

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  • I know that every hospital is going to be different, but I didn't even have a Doula and I had a natural hospital birth that DD. The Hospital didn't seem to have any issues with my requests. My Doctor and I had discussed everything a head of time and he didn't attempt to push for anything that I didn't want. There was a few basic questions that I was asked, regarding medications etc. But I  just refused things I didn't want. The Hospital had no issues and they were great. Relax, you don't want to go into your child birth experience with all of these already built up fears.
  • image claire109:
    Have you considered home birth?


    I wasn't quite ready to go that route. Like I said, my birth plan is not nuts so I didn't think that going that route was necessary. Ideally I would have a birth center with midwives but that doesn't exist here. At all. There are no tubs in the rooms. My doc wasn't even sure there were showers. And I got strange looks for wanting to labor in the tub. Just not done here. Hence the doula. So I can try to labor in my own tub at home for as long as possible.
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