Hello! / NB-UNfriendly hospital?

nbad311

Hi ladies!

I have been browsing the F15 boards recently (I am 10w2d with an EDD of mid February) but decided to come here to express my NB questions!

Firstly, I'll start off by saying I have always been attracted to NB because of my mom's experience, which include the births of myself and brother who were both 9 lbs, armed with nothing more than good Lamaze techniques and a blip of Demerol (this was the 1980s -  I'm guessing Demerol is a thing of the past since I haven't seen it's use mentioned in any of my pregnancy books yet).  While no walk in the park, she said it was totally manageable and so glad she opted for no epidurals.  She was 25 and 30 at the times, and had great healthy, complication-free pregnancies;  I am 30 and so far everything has been going as normal for me, so I'm hoping to follow in the footsteps of my mom!  (but will be prepared for anything!)

Secondly, I did some good research on choosing an OBGYN office I felt comfortable with and have had my first (confirmation of pregnancy) appointment with them, and was very happy with my decision leaving that day.  However, I haven't gotten to the point of putting together my birthing plan or discussing doing a drug-free birth with them (Yet!).  But plan to discuss my wishes at length, more than once, with them as things progress!

My worry lies in the fact that the hospital they are affiliated with, and where I will give birth, is notorious for C-sections and I've never talked to a female who's been there and NOT had an epidural (although I think most have been on board with wanting them from the start).  Do I need to be concerned that my birthing plan and NB desires may be compromised?  I know it's best for both myself and DH to be prepared to let our wishes be known both for the next 7 months at when we do end up in the hospital.  DH has not had many requests so far in the pregnancy, but he does want us to have a hospital birth (versus birthing center/home birth) "just in case", which I understand and will honor.  Did anyone go through a similar scenario, with experiences to share?  Thanks!!

Aurora_Borealis

Yes, I think you should be concerned. Not necessarily 'OMG I must change providers right this second' concerned, but more 'I should research alternate hospitals/providers to see if there is a better choice I may not be aware of.'

This isn't to say you wouldn't be able to have a natural hospital birth in the hospital your current providers are affiliated with (labor at home as long as possible, consider a doula), but birthing in an environment that is supportive of your birth preferences makes a difference.

When I had DD, my insurance allowed me the choice of 2 hospitals in my city. One sounds like the hospital you are describing. I actually know of doulas who outright refuse to take clients who plan to birth there. The other is the polar opposite - the midwives and OBs actively discourage epidurals and the hospital has an impressively low c-section rate.

MandMLeona

I will preface this with a note that I have not delivered in a hospital. 

I would at the very least investigate other options, both for hospitals and non hospitals.  If you've read birth stories from hospitals, you know that the nursing staff is who you interact with most.  They are going to be a much bigger impact on a NB than your provider.  If their standards include a lot of interventions...that's what they are going to continually suggest as that's what they have experience and comfort with.  Most nurses in such an environment will have never witnessed a NB, how can they help you achieve one?

Do your research of all options in your area and compare outcomes...talk to your DH so that the decision that you two make is one based on facts and not on fear of the unknown.

Good Luck!

sschwege

I think it's something to be aware of, but based on what you are providing it wouldn't make me hit the panic button yet.  Do they have a Level III NICU?  That will make their c-section rate higher.  All the women you spoke with had epis, but it sounds like most of them wanted it that way.

I would suggest a few things, can you take a tour of the hospital now?  Kind of get a sense of what a birth in that hospital would look like.  Also as you plan to, talk to your doc.  Ask specific questions:

What types of natural forms of pain relief does the hospital have? (birthing ball, tub, etc)

Would you support my decision to hire a doula? (even if you don't plan to, just see what they say)

Would you support me pushing in any position that feels comfortable to me/mother directed pushing?

Provided everything looks good with mom and baby, how long past my EDD do you recommend induction?

Provided everything looks good can we opt for intermittent monitoring? 

Simply asking, "Do you support natural childbirth?" will not give you an accurate picture of the doctor's attitude, but rather his/her response to specific questions should give you a better idea.  If they are vague or keep repeating things like, "I'm just worried about having a healthy mom and baby." "Let's wait and see" I would take that as a red flag.

I had both my babies in the hospital, but the hospital and my MWs were totally on board.  As with any hospital birth it is always best to labor at home as long as possible and consider a class and/or doula.    

MsMacual

Congrats!  I agree that you could be just fine delivering at that hospital.  My experience has been that my care provider being on board with my desire for a NB was more important than the hospital.  I would bring up your plans for a drug free/low medical intervention birth sooner than later with your care provider so you can get a feel for how supportive s/he is.  I'd be ready to switch to a more supportive provider if s/he isn't on board.  Also, it isn't too early to start educating and preparing yourself.  Your level of knowledge will be invaluable so it isn't too early to start.  Finally, there are a lot of little things that you can do to prepare for labor and once you are in labor to help increase your chances of having a NB.  This includes yoga and simple stretching exercises, seeing a chiro (webster certified if possible), seeing an acupuncturist, laboring at home as long as possible, etc.  

annagrya

Just a note of caution: I went to a hospital for my last birth with two doulas and the hospital staff literally made it impossible for me to have a natural birth.  In fact, they made fun of me for having doulas at all.  I ended up with a failed epidural, an overzealous spinal, and a c section.  Not to scare you but the hospital staff has so much say in what you "can" and "can't" do.  I think it matters even more than the ob or midwife in a hospital setting because the nurses call the shots alot of the time.  

JCWhitey

I agree with everyone above.  Research other options.  I looked at the three hospitals in my area.  One had a c-section rate of 39% (inflated due to it being the only hospital with a level 1 NICU in the area, so the other two hospitals transfer there if that will be needed), one was at 30%, and the third was at 18%.  I went with the one that had the 18% rate.  18% is a conceivable "true emergency" rate, IMO, so I knew at least they didn't rush to c-sections.  I had a completely med-free and intervention-free L&D.  I wasn't even required to have a hep-lock or IV.  I asked for one halfway through labor because I felt dehydrated and the nurse was definitely surprised to hear me ask for it.

conradraging

My state overall has an extremely high c section rate, and the hospital does too. But I wouldn't run for the hills yet. It is key to have your doctors and nurses on board, knowing your plans, etc.

I second what a pp said about taking a hospital tour. When I did, the nurse actually talked a bit about the nurses being your advocate and said if a patient told her no drugs, she would never ever mention the drugs. Obviously that's based on what she said not my actual experience yet, but based on my interaction at the tour, I am comfortable being my own advocate and not allowing anyone to push me to get an epi or whatever. I of course remain flexible in my plan because I can't foresee what complications may arise. But I also am not on board with people saying that the hospital has so much say in what you do. If you don't want drugs, tell them upfront. Make sure your H and anyone else there is also on board with your plan and they can help you to refuse any interventions.