low/no intervention hospital birth

SSCmomma

I have a midwife but my insurance will only cover a hospital delivery. I have hired a doula but I am still nervous about the hospital staff. How do I keep the number of hospital staff to a minimum ans out of my room? Also can I refuse to sign anything other than say billing forms? I just don't trust them and I don't want to sign anything that would compromise my rights. I am so afraid of the hospital staff I am tempted to try to deliver at home but I know my midwife won't come to my house so I'd be stuck with just me and DH. Of this whole experience the only part that I find really terrifying is going to the hospital but I cannot afford an out of pocket birthing center. Help!

marriedinaugust

Have you toured the hospital and talked to the nurses/OBs or your midwife about how natural friendly they are? I had an amazing natural birth at a hospital last time. Everyone was on board with what we wanted. And a lot of our birth plan was actually standard practice for them.

margaritachikita

Stay home as long as possible. Your doula should be able to help you gauge when it is the right time to go in. Generally the longer you stay home, the fewer interventions.

SSCmomma

The next hospital tour is in Dec. (I'm due 1/17) and I will be attending.  What has really gotten me worked up was actually the birthing class I took.  The only one available in my area was provided through the hospital.  They really just went over the medical procedures and touched on breathing, etc.  They informed us that MOST woman get the epidural and that we shouldn't wait to get it because it can take them over an hour to get it to you.  They also informed us that if you ended up having a c section and you weren't put under general anesthesia they would be TYING your hands down to avoid risk of contaminating the field.  They don't have a tub and if you want to use the shower it needs to be brief so they can keep you monitored.  They cited insurance concerns for most of these policies.

This whole thing now feels like something that is just going to happen TO me instead of me participating in.  As for the parade, I understand I am stuck with the on call OB because I chose to use a midwife practice for my care.  That is one person. If that person feels they need an entourage, I would question their capabilities.  Medical students are not an option.  I am not a guinea pig.  I wouldn't get my hair cut by a cosmetology school, so this would definitely not be a place I'd be letting students practice.  My main reason for not getting an epidural is so I can try to get up and leave if I need to escape.  I am genuinely afraid of these people.

I have an appointment with my MW in mid November.  The following week I am scheduled to meet one of the hospital OB's.  They claim it's a required "meet and greet" in case I need a c section but that the person I meet likely won't be the doctor on call anyway.  I'm sure its just to bill out an extra office visit.

I am sorry if this all seems whiney but as I started to type this is all kind of pouring out.  I'm really afraid of these people and never realized that if I got pregnant that I would be this trapped.  I know there really isn't an "answer".   I keep trying to remind myself that it is only a temporary problem and that once I get out of there, I'll have my beautiful baby to take home.  I appreciate those who have listened and offered words of support.  Thanks,

stephl3055

My main reason for not getting an epidural is so I can try to get up and leave if I need to escape.

That part concerns me.  Do you mean try to leave the hospital?  Are you really that afraid of a hospital birth?  If you have a genuine, true fear I'm worried you won't relaxed enough to let your body do what it needs to do.  If you are stressed and worried, labor will not be easy for you and it could stall.  This is something you really need to discuss with your doula or your OB.  

I had a somewhat un-medicated hospital birth (induced due to GD, so I had an IV) but my water broke on it's own and I didn't get an epidural.  It was a great experience and I would do it again (hopefully minus the induction next time).  I was worried about policies, but the nurses were wonderful.  On the tour I could tell they were more focused on the "typical" experience (epidurals and C/S), but I talked to one of the nurses after and she said help locks were recommended, but not required, and that they could do intermittent monitoring.   

As far as the birthing class, my doula typically doesn't recommend the hospital ones because they are geared towards what most women want: pain relief.  I took a few classes online and spoke with her instead of attending any birthing classes.  The nurses were actually more NB friendly than my supposedly NB friendly OB.  They helped with positions and let me walk laps around the hospital even though I was supposed to be hooked up to monitors, etc.  

JCWhitey

OP in many ways I understand where you are coming from.  I actually had a big fear of hospitals.  I have no idea where it came from but when I was around 12 I started having panic attacks when I'd be in one.  I was sick a lot and in and out of the hospital when I was a child and the therapist my parents brought me to suspected something bad happened to me, but I neither remembered it nor was I able to recall over the years.  Hospitals just make me nervous.  Then I used to be OK with L&D since they seemed like a happier place, but then I became a NILMDTS photographer and find that I'm able to visit the hospital to do my work, but knew I wouldn't be able to deliver a child in the hospital I did the photography at.  Even though I know the cases I got called in for were really rare, I couldn't handle being in the same room that I had worked in and that was pretty much all of their L&D rooms by the end.  

So instead I sought out a different hospital for my son's birth.  Depending on where you live you probably have more than one option for hospitals, even if it means driving a bit of a ways.  With my son we were living in CA when I got pregnant and were planning to deliver at a hospital about 20 miles away.  Then we moved and I picked a hospital that was an hour and 20 minutes away.  For me the drive was worth it because I found a hospital where I felt very comfortable.   This time I will be delivering at a hospital just a few blocks from my house (we moved again) and I am excited for that.  It's a totally NB hospital, they don't even offer inductions, epidurals, or C-sections.  It's basically a birthing center but not.  If you need any of those things they will transfer you, and at that point it's usually an emergency so I could care less what they do as long as the baby is OK.

Then once you find a place where you feel comfortable educate yourself on their policies.  Hospital birth is not all doom and gloom like some people make it out to be.  I really, really, really enjoyed my hospital birth and cannot wait to have another one!   My hospital made it clear that as the mother you could refuse any treatments on yourself.  I asked for only intermittent monitoring and ended up with about 10 minutes of monitoring when I got there and then just in between pushing.  Otherwise I didn't see that monitor at all!  I also requested a hep lock instead of an IV, but the nurse just said she'd have me go without since she could insert an IV quickly if I needed one.  I asked for one halfway through labor to help with hydration and after 20 minutes of fluids asked for it to be removed and they took it right out.  Then I spent time freely in the tub (which was miserable for me and I quickly got out), the shower, on the toilet, on the ball, etc.  I moved around freely and my awesome nurse just went along for the ride.  I never had anything pushed on me or anything.  I know my birth plan was read and taken seriously by the staff because everyone I interacted with referenced it in some way. 

Also, you shouldn't have to wait for a big tour to go see the L&D.  Just all a few days ahead of schedule and say you are researching hospitals and wanted to come take a quick tour.  A nurse should be able to show you around and answer basic questions.  Those big scheduled tours tend to be more for registering and getting more information rather than seeing the place and meeting the nurses.  Which, btw, the nurses are the most important thing in a hospital birth!  You may see your doctor for an hour or two total over the course of your labor, but the nurse(s) you will see constantly and are you main go-to point during labor.  Being comfortable with the nurses is more important than your OB, IMO.  Some will disagree and have their reasons, that was just my experience.

The biggest thing I'm grateful for when it comes to my hospital birth is that it got me over my fear of hospitals.  I no longer have any feelings of anxiety when I go to one.

JCWhitey

Oh and to add but not build onto my novel above... I didn't sign a darn thing when I went into the hospital, not even consent to treat!  Not on purpose, I just went into labor early and didn't make my appointment to do that (which was four days after I delivered).  I labored at home until I was in active labor and by the time I got to the hospital I was way too deep into labor to even hold a pen.  The nurse asked for verbal permission, but had to ask for verbal permission for everything which was fine with me since she didn't ask for much.  You may actually be better off getting the paperwork now and reading it over and then handing in what you decide to sign when you go into labor, if they'll let you do that.  Not having anything signed can be a big PITA if you don't want people constantly asking you questions.

sschwege

I was going to try to address some of your concerns and offer some suggestions, but after reading your second post I decided against it.  You seem genuinely terrified and beyond the usual concerns most mothers express, I think you need to speak with your MW about your feelings and also perhaps a therapist.  Even if you could find a way to make a HB or BC happen, the reality is, you could still need a transfer to the hospital, these are feelings you need to work through.  

SSCmomma

I appreciate the suggestions.  I am going to try to talk to my MW and doula to see if they have any ideas.  I may have to just go it alone (with DH) at home since neither will attend a home birth.  I could probably deal with having to go to the hospital AFTER the fact.  I'm going to have to do a little research with the insurance company as well and see what would happen if I just didn't go in until afterward.   I'm going to have to give it some thought and weigh the risks vs. the benefits.  If I thought I could just keep the hospital staff out unless I decide it's an emergency and I need help then I would go but I'm pretty sure the hospital would have objection to that for legal/insurance reasons.  Really all I want is a clean room and absolute dire emergency intervention.  Other than that I don't want any treatment or assistance from the hospital staff.  I just know that isn't going to be an option and I will not have a good experience if I go to the hospital.  Those who mentioned it are correct in saying I probably wouldn't be able to relax enough to even labor safely if I go to the hospital.  I'll be too worked up.  I wish I had realized all this before I got pregnant.  Anyway, thanks for listening and being supportive.

soulcupcake

OP, it is very possible to have a low/no intervention hospital birth, but you must do your research on nearby hospitals and OB/MW practices. Do you know of a hospital or obstetric practice in your area that is supportive and encouraging of low intervention birth? Are there any attached birth centers in your area? Check with your insurance company and see what providers are in your network.

I was able to have a great low intervention/med-free hospital birth with my second daughter. I had a supportive midwife and great nurses, but I really lucked out that particular day/night with that staff. The hospital I birthed at isn't known for its low intervention practice, and the vast majority of labors/births are medicated. I did, however, want a homebirth with her, but it wasn't an option then. There weren't any homebirth midwives in the area I lived at the time. 

I did plan a homebirth with #3 and 4, and am doing the same this time. I wasn't sure a homebirth would be possible this time. With my current insurance I was limited as far as choices. I would have gladly birthed at the free-standing birth center near me, but they're no longer in my network, as of the beginning of the year due to the ACA changes being implemented. There was only one OB practice within 30 minutes of me that's in my network that favors low intervention care/practice. They're very supportive of med-free and natural birth, but ultimately, I really wanted a homebirth. So I transferred my care at 23 weeks.

I absolutely support a woman's right to UC. I know many mamas that have successfully UC'd, but they didn't UC their first. My midwife with #4 discourages FTPs attempting a UC. Those I know that have, have previously birthed at home with an attendant, and they're well-researched, prepared and versed on situations that can arise, complications and how to address them. I've had to prepare for a UC due to my history of precipitous births, but I ultimately want the care of a midwife.

JCWhitey

Where are you from?  Is a birth center an option?  That's a happy medium between hospital and home birth that your insurance may cover or at least partially cover.  And you an always pay OOP for a home birth/home birth MW.

MommyAtty

I highly recommend you talk to your midwife not about having an unattended home birth (which is really a dangerous option) but about the possibility that you have pregnancy-induced anxiety. I had 2 hospital births. No pain meds. And at a hospital where over 90% of women get an epidural. I got very little flak about going natural. (I did get a little with my first delivery but my OB shut the nurse down cold, which is why I went to him for #2.) I was in the zone for both deliveries, and honestly they could have sent a freaking marching band in the room and I wouldn't have had a clue. I did agree that a nursing student could observe the second time, in part because I wanted her to see a non-medicated birth so she would be supportive of other mothers in the future. The students don't do anything. They just watch. But seriously, pregnancy can screw with your head. People know about PPD and PPA but many still don't know the symptoms can start during pregnancy. Please, for your safety and that of your baby, talk to your midwife.

SSCmomma

There aren't any birthing centers around and the next nearest hospital is 45 minutes without traffic or Pennsylvania weather. I only have the midwife and no OB. She uses whatever doctor is on call as her backup during deliveries but doesn't have anyone specific.
Without going into detail, I did have a VERY bad experience at a hospital years ago. Different hospital but as d day approaches the anxiety is building. I was doing ok until I went to the birthing class (the only available around here).
I also realize that a home birth would not be a good idea but I really just feel the tension building and know that when the moment comes I will be in a complete state of terror and need to be sedated just to go to the hospital. I am hoping that if I go into labor during my MW's office hours I can go there to labor until she is available to head to the hospital (she has done this in the past). From previous reviews I have heard she does not show up at the hospital until last minute so I don't want to go ahead of her. I really am trying to come up with reasonable ideas and solutions but it seems like roadblocks at every turn. I will be continuing to try to research and come up with a plan.

SSCmomma

danisgossipgirl said:

Trying to plan is just distracting you from dealing with your mental health.

Not really sure what you mean by "dealing with my mental health". Are you suggesting I seek help from the medical profession when the medical professionals are my problem?

JCWhitey

SSCmomma said:

Trying to plan is just distracting you from dealing with your mental health.

Not really sure what you mean by "dealing with my mental health". Are you suggesting I seek help from the medical profession when the medical professionals are my problem?

I thought your problem was the hospital itself?  Or is it all doctors/nurses?  Therapists rarely see patients in a formal hospital or even clinic-like setting.   My first one (to deal with my random hospital anxiety attacks) was in a classroom in an unused portion of a school.  My second (to help deal with a young family member's passing) was in an office building.  Both wore usual business casual clothes and didn't feel clinical at all.

Also, 45 miles isn't far at all.  May be worth at least going to check out the alternates you have just so you don't feel stuck with what you have.  I'm due in the middle of winter in Northern MN and if I'm considered high risk for any reason at all the hospital here won't deliver you (very small rural community hospital with limited resources).  Most of the pregnant women here end up delivering in the next town with a hospital with an L&D wing which is about 130 miles away.  Only once every 3-4 years does someone not make the hospital.  As a FTM you will likely have more than enough time to travel there if you find you'll be more comfortable.  

Cunningbottom

Trust your instincts. After my first birth in a hospital I learned alot. One is not to sign anything. Write up a birth plan and anyone who does not sign your birth plan is not allowed in your room. Go in as late as possible. And yes your fears are real and true. It sounds like your hospital does have a high csection rate and does not follow mother friendly practices. What happens to you during labor and how you are treated will stay with you forever. Many women end up with depression or PTSD after the unsupportive treatment they received in L and D. Healthy mom, healthy baby is not all that matters.

SSCmomma

I'm sure I will end up at the hospital to deliver.  I realize I will not have a choice because I cannot afford a birthing center out of pocket and can't find a nearby provider willing to do a home birth.  Based on past experience, I won't trust the hospital staff/policies. That is never going to change.  I will have my doula come to the house to help me know when I absolutely can't wait any longer to go to the hospital and with any luck my MW will be in her office when I go into labor and I can go there to labor until she is ready to go to the hospital.  My birth plan is to minimize my time at the hospital and minimize my interaction with the staff there.

If something happens where I have to go under the care of the drs or hospital staff for the safety of my baby they will probably have to sedate me.  Hopefully this won't happen but if it does that is how I will have to deal with it.  All I can do at this point is hope for the best.

Cunningbottom

That sounds like a good plan. Also take a birth plan that states why you have anxiety with the hospital. Maybe that will change how they treat you.

JCWhitey

Cunningbottom said:

That sounds like a good plan. Also take a birth plan that states why you have anxiety with the hospital. Maybe that will change how they treat you.

Even meeting with them ahead of time.  The midwife should be able to arrange something considering the circumstance.  Meeting the nurses ahead of time seems like a good move.

MsMacual

I quickly read the advice given by the other ladies- I think they said some super helpful things.  I have had two mw assisted hospital births- both were pain med free.  My first required a vacuum assist so I did have some medical intervention with his birth.  My mw was very professional and brought the idea up about an hour before she felt that we needed to make a decision.  We could have said no to the vacuum, but at that point we were moving onto hour 4 of pushing.  My second was a water birth and the only medical intervention was when the mw caught him as I delivered.  I was very careful to choose care providers who were supportive of my desire to have as natural of a birth as possible.  I also had an ongoing conversation about my ideal birth plan so we were on the same page about how I was hoping things would go.

It sounds like you have a great care team which will be invaluable.  Have you considered taking a hypno birthing course or something similar?  That might help, too.  Unfortunately the curriculums for the hospital based birth classes provide the full spectrum and aren't always designed to only discuss unmedicated/low intervention births. 

Good luck as you continue to prepare. You'll do great!

mrsmopar67

I think your best weapon of defense is being EXTREMELY informed. Research ALL drugs and intervention possibilities, so if you decide to decline you can cite all of your reasons. I had to fight my OB every step of the way for my first birth, but because I was informed, I knew it was my decision. No, I don't want IV antibiotics immediately. My water has only been broken for a few hours.

No, I don't want continuous monitoring, I plan to labor in whatever position and room is comfortable.

No, I do not want to be checked 146621 times. I'm not interested in the infection risk.

The second time around, I had planned a home birth and at the 48 hour labor mark I was only a 3. When I got to the hospital and was checked by the midwife and was a 6, I refused to even speak with most of the staff. My MW there was wonderful, and my team of two doulas and my husband kept every hospital staff person away from me except the nurse with the Doppler however often that had to happen.

The MAGIC WORDS in hospitals are "I DO NOT CONSENT." And let your doula know and your husband know any time you seem uncomfortable and seen to be struggling to say, "what I'm hearing her say is that she DOES NOT CONSENT."

YOU truly have the power over your body and your care in the hospital. It's YOUR choice what interventions you do or don't want in every circumstance. Your veryyyyyy best bet, like I said, is to be entirely informed. And don't be afraid to ask the staff to leave the room to allow you to discuss it privately. It's your body, your baby & your birth. Especially for someone who feels strongly about it (and oh girl, do I understand completely. I felt very similarly to you.)

You have the ability to refuse treatment from any provider you don't like, also. Fire nurses & whoever comes in your room that is not respecting your decisions or your right to make those decisions. Be vocal, be unapologetic.

Alllllll of that being said: my first was born as soon as my awful OB left. She announced that she was going to bed and that I would be in labor for at least 8 hours more. She did not make it back for delivery lol. Whatever random doctor that was around delivered and they did so little since DS came so fast, they literally caught and handed him right to me.

With #2, the mw at the hospital helped me have my HB at the hospital. The only intervention I got was IV fluid because I asked for it. I was exhausted and dehydrated after 2 days of laboring. The staff cheered me on and truly made me feel like a super hero after DS2 was born because I had delivered him after 52 hours of labor. She also didn't give me the "routine" pit shot afterwards either. She had no problem with me delivering my placenta before the umbilical cord was touched. DS2 nursed for an hour and a half straight after he was born. No one bothered me. Every time I said no, it wasn't questioned.

I knew I had the right to decline & I asked for paperwork instead of answering questions. I also signed out AMA after DS 2. They had a social worker come in to talk to me (lol).the SW shared that she had her babies at the local birth center whose policy was to keep mothers no longer than 6 hours after birth, so she had no issues with me leaving, but that she was required to talk to me anyway.

Once you realize you really do hold the power and that you can deny consent to any and everything, it's freeing.

SSCmomma

I think one of my concerns is that once I sign the mountains of forms they throw at you then I won't have the option of declining treatments. They write the stuff to be just vague enough to sound harmless but then they own you.

sschwege

SSCmomma said:

I think one of my concerns is that once I sign the mountains of forms they throw at you then I won't have the option of declining treatments. They write the stuff to be just vague enough to sound harmless but then they own you.

You could always ask to see the paper work ahead of time, perhaps that would help?  You can still decline no matter what you sign provided you are able to make a conscious choice.  Ask questions or have your support person do so, and remember the phrase, "I do not consent."  You always, always have the right to refuse no matter what you sign, so no, they don't 'own you'.  Now when your baby is born that is a little different, if they don't think you are acting in the best interest of the child they can step in. 

SSCmomma

sschwege said:

SSCmomma said:

I think one of my concerns is that once I sign the mountains of forms they throw at you then I won't have the option of declining treatments. They write the stuff to be just vague enough to sound harmless but then they own you.

You could always ask to see the paper work ahead of time, perhaps that would help?  You can still decline no matter what you sign provided you are able to make a conscious choice.  Ask questions or have your support person do so, and remember the phrase, "I do not consent."  You always, always have the right to refuse no matter what you sign, so no, they don't 'own you'.  Now when your baby is born that is a little different, if they don't think you are acting in the best interest of the child they can step in. 

With the baby, the only thing I plan to decline as of now is the Hep B vaccine.  Hopefully that won't be a huge issue.  When I was at my child birth class that was provided through the hospital a few other women had asked if they could pick up the paperwork beforehand or if there was access to print the forms online but the nurse said no and that you had to just go in and fill them out.  I have a friend who is an attorney so I may just have them call to request copies of all the registration forms  I'm sure they can't actually deny you the right to have the forms reviewed my an attorney nor would they want the publicity that denying the request would bring.

JCWhitey

SSCmomma said:

I think one of my concerns is that once I sign the mountains of forms they throw at you then I won't have the option of declining treatments. They write the stuff to be just vague enough to sound harmless but then they own you.

What mountain of forms?  I signed six (all AFTER the birth of my son since I was pretty much in transition when Zi arrived and the nurse proclaimed that I was not in a condition to read and sign medical forms, so all she did was ask for verbal permission to treat), and the nurse went over each one and explained what they do, none were very vague in fact they were pretty straight to the point.  There wasn't a vague mountain by any means.  And again, if this is worrying you, register now and read over the forms, ask questions when you need to.  You are really creating a mountain out of a mole hill here.  Absolutely nothing gives the hospitak permission to do whatever they please and "own you".

MsMacual

I'd check with your hospital- I was encouraged to pre register, which I didn't do with my first and registering while in labor is a PITA.  I completed most of the forms when I pre registered with the hospital before I gave birth to my second.  I was notified at that point that there would be 2 forms to sign when I arrived to give birth- one for me and one for the baby.  I didn't ask to see those in advance, but I believe that my hospital would have given me a copy of both had I asked.  I didn't really read either, to be honest (I was in transition and really wanted to get up to the L&D floor so I could give birth!), but I was told that they both were giving the hospital consent to bill our insurance.  With both of my kids- we were asked permission before they gave the common treatments (eye goop, vit k, hep c, bathing, etc).  My second birth didn't require any intervention so my mw and nurse weren't in a situation where I needed to be asked before something was done.  I was asked to consent before each "intervention" with my first- including putting in a hep lock so they could give me a bag of fluid.  I really think a lot comes back to your care provider and her being aware of your desire to not have any interventions.  Your doula and partner also can be great advocates for you while you are in labor and can step in if an intervention is brought up.

megorlando

I'm in a similar situation. I totally understand where you're coming from. It's what drove me to a freestanding birth center back in Florida, when I had my first baby five years ago.

Look into a doula - if you find one you like, she will literally sit and be your mouthpiece, to the extent of her legal ability, as well as help you every step of the way. She will also take the pressure off your husband, because it's a lot to ask of someone who loves you and the baby SO MUCH to try to fight the hospital for you, especially if what the doctor is saying makes sense to him. She's the neutral party that can help explain if it really is a needed intervention, or deflect them if it's not.

Also, research Hypnobabies - Not Hypnobirthing - I did Hypnobirthing the first time and that was a pile of pooooooooo, IMHO. However, I was pleasantly surprised, five years later, with this second pregnancy, to read all the amazing reviews on Hypnobabies from other women who hated Hypnobirthing, like I did. There's part of the Hypnobabies program that's fear-clearing sessions, and, the instructions even say that if you exhibit certain symptoms or reactions to the fear-clearing session, you should try a local in-person hypnotherapist, because you have a deep-seated fear that CAN be cleared away with some assistance. I'm sure you're aware that the very fear and distrust of hospitals can affect your ability to progress during labor, and put you into the very situations that you're dreading. It's a vicious cycle, but one that you CAN break out of, and arm yourself to be prepared for. Oh, and you don't have to pay full price - stalk it on ebay used, then you can resell it after baby and not even be out any money in the end. Also, many doulas are trained under Hypnobabies, so they know the language and prompts to use.

Having had a baby in a birth center, I can confidently state that, although I have this innate dread of the hospital setting as a whole, I am SO looking forward to the benefits of it. For instance, back in Florida, I couldn't even find a board-certified pediatrician to accept my daughter after she was born - something about the liability of not being born in a hospital, thus seen by a staff pediatrician immediately? And there were other things that make me REALLY happy to be in a hospital setting, like the fact that the people responsible for me won't have been awake for the previous 36 hours, which means that they probably won't do things like miss tears...

For an opposing, somewhat refreshing look at the whole debate, look up The Skeptical OB. She's got a blog that's made me feel much better about the fact that in Alabama I can pretty much have an unassisted homebirth, or a hospital birth with an OB, and, of those two, I personally prefer the hospital, even though I'm confident that I could safely do a homebirth if I had to, having had one baby already, and done TONS of research. Her presentation of her side of the debate may help you mentally, too. It's easy for us to get caught up in the more emotionally compelling presentations of the no-intervention argument - but when she points out that Ina May Gaskins lost one of her own babies after refusing to go to the hospital for assistance - well, that's sticking to a dogma that I'm NOT okay with. I was even thinking that my backup plan, if I REALLY couldn't deal with a hospital birth, would be to drive a few hours up to the Farm in Tennessee about a week before the guess date and have baby with them - then I read that, and realized, you know, I'm going to have to watch out one way or another, either for someone at the hospital trying to get me to do interventions, or for a midwife trying to convince me that no, baby and I are fine, no need to rush to the hospital for this or that - and literally running the risk of death, one way or another - but, that risk might just be higher with the zero-possibility-of-intervention method. It's a double-edged sword. So, I've hired a doula locally who has GREAT reviews, and am doing the Hypnobabies program, and I feel confident in my decision to deliver at the hospital, knowing that I can trust my doula and husband to watch out for me and baby, and release the fears that the hospital staff will, I don't know, try to sneak in and pump me up with Pit, or cut the cord the moment baby's born, you know, all these things that I know aren't going to happen, but am still afraid of. 

My OB practice is fine with drug-free births, and their standard is delayed cord cutting. Really the only thing I don't want that they're hesitant on is no pitocin after delivery, and, probably, an actively managed placenta delivery. I'd rather avoid pitocin unless I actually have PPH, and, with a drug-free labor, the risk of PPH is lower if the expectant management of the placenta is used instead - to my understanding, at least. But, I know that I'm no doctor, and I don't have access to - or, possibly, the capability to fully understand - medical information. Yes, they'll act on outdated data sometimes, but they truly do want the best for you, and you're far more likely to end up with a positive outcome for both you and baby in a hospital setting. For me, ultimately, reading The Skeptical OB - and all the comments on her posts - comforts me. I'll be fine if I get pitocin at the very end - if the doc says hey, that's a lot of blood - pit me up. A skilled midwife would do that, too - and an injection of 10 IUs of pit isn't something I would have handy at an unassisted home birth, but it's a literal life saver, if needed! Also, the midwife for my first baby actively managed my placenta that time, but I know that's because, frankly, I forgot about it! Like, okay, baby's here, all done - oh, one more thing? oops!

Also, I'm mentally open to, okay, if labor stalls for hours, and trying different positions and nipple stim and whatever else doesn't work, start a pit drip - you have control over even the rate of it. They'll appreciate you having in your birth plan "IF I need pitocin, I request a titrated dose of 2 IU over every 30 minutes, only upped if it's not enough, and lowered if it works, to see if that's enough" - there's a stigma about hospitals and nurses, but they generally do appreciate a knowledgeable person. For me, accepting that there's a small chance I'll end up needing something like that is important. I'm doing all I can on my end to avoid the necessity, but, ultimately, I'll give Pit a shot if it helps to avoid a C-section. Or, if baby is in distress, skip the Pit and just section me. I want both of us alive and healthy, and it takes a lot for me to let go of my desire to have full control of the situation. It's birth - it's literally bringing another little soul into the world - someone else that you'll never have control over, because they're another separate person - so, on a spiritual level, as a second-time mom, I find it fitting that there can be surprises in a baby's birth. That baby will go on to surprise you every day of its life with how amazing and wonderful and messy and complicated he or she is. You mention even being horrified at the hospital class saying they'll tie your hands if you have an epidural c-section - I'm with you - who in her right mind would try to reach into her own belly?? SO weird! But they way I deal with things like that is to say - I'm not getting an epidural, because, while I don't have a needle phobia per se, I'm NOT interested in anything going into my spine - so, if I'm getting a section, they're knocking me out, period. It'll suck to have to be away from baby till I wake up, but it's a hiccup I can deal with, if that if-then scenario comes to be.

By concerning yourself with giving your baby the best birth you can, you're already a great mom. Now, I recommend really digging in and working to figure out how you can make the best of the situation you're not in love with. Motherhood is going to throw these things at you over and over again anyway, trust me. 

If you're like me - and it really sounds like you are - these things get implanted in your head, you start focusing on them, you can't even sleep at night, you get on the internet and start reading all kinds of horrors - it's hard to stop the spiraling, but seriously, look into Hypnobabies, see if you can hire a doula, and talk to your OB once you've got some things together. You can change OBs if you don't like the one you're with. But seriously, read the Skeptical OB before you decide on a homebirth, especially an unassisted one. The dangers are real, and much more terrifying than a nurse bothering you about refusing an epidural. Even if freestanding birth centers were allowed under the law in Alabama, I'd still choose the hospital for this second baby. I was fortunate to have very few complications the first time, but hindsight, and more research, makes me realize the risks I really was taking then.

sschwege

SSCmomma said:

sschwege said:

SSCmomma said:

I think one of my concerns is that once I sign the mountains of forms they throw at you then I won't have the option of declining treatments. They write the stuff to be just vague enough to sound harmless but then they own you.

You could always ask to see the paper work ahead of time, perhaps that would help?  You can still decline no matter what you sign provided you are able to make a conscious choice.  Ask questions or have your support person do so, and remember the phrase, "I do not consent."  You always, always have the right to refuse no matter what you sign, so no, they don't 'own you'.  Now when your baby is born that is a little different, if they don't think you are acting in the best interest of the child they can step in. 

With the baby, the only thing I plan to decline as of now is the Hep B vaccine.  Hopefully that won't be a huge issue.  When I was at my child birth class that was provided through the hospital a few other women had asked if they could pick up the paperwork beforehand or if there was access to print the forms online but the nurse said no and that you had to just go in and fill them out.  I have a friend who is an attorney so I may just have them call to request copies of all the registration forms  I'm sure they can't actually deny you the right to have the forms reviewed my an attorney nor would they want the publicity that denying the request would bring.

That shouldn't be a problem.  We declined Hep B with both babies, like you it was the only thing.  We just said, "We will take care of that with our regular pedi." and they had no problems.  The first pedi said something like, "She will just need it before she starts school." and the second said "No problem!"  We do it at the two week appointment once we have BFing well established.

SSCmomma

Headed to the MW tomorrow so I'm going to try to discuss some of these concerns with her.  Of course it didn't help that I ran into a girl I know who just had a baby at the same hospital I'll be headed to and she gave me a series of horror stories.  Yay  Realllllly wish I could afford to give birth in a birth center or anywhere beside the hospital that my insurance covers.

Amber6486

You know, if it is that important to you, and it sounds like it is, you just need to come up with the money, work overtime, find way to make extra money, dip into savings, take out a loan ect. While I, personally, would not go into debt over this, I think you need to go with what your gut tells you and have the birth you envision. If it is not worth it to you, then start focusing on what you CAN do (researching, reading up on natural pain relieving methods, practicing using a firm tone, saving for at least a doula, rounding up a friend to simply act as a 'mouth piece' ect) instead of what you cannot control. I have also had trauma centered around a hospital and when my insurance said they wouldn't cover a doula, hospital midwife or home birth, I even went so far as to tell my husband I no longer wanted to try conceiving. We agreed to see what happens in 2015, but I know one thing and I hope you figure this out too: You have to be strong and in charge.. No amount of complaining is going to help you or your baby get the results you want. Research research research - knowing everything you can about your rights and your baby and your body will get you so much farther than just being ridden with anxiety. You can do it girl. Read up. Soak it all in. And be a warrior.

SSCmomma

Amber6486 said:

You know, if it is that important to you, and it sounds like it is, you just need to come up with the money, work overtime, find way to make extra money, dip into savings, take out a loan ect. While I, personally, would not go into debt over this, I think you need to go with what your gut tells you and have the birth you envision. If it is not worth it to you, then start focusing on what you CAN do (researching, reading up on natural pain relieving methods, practicing using a firm tone, saving for at least a doula, rounding up a friend to simply act as a 'mouth piece' ect) instead of what you cannot control. I have also had trauma centered around a hospital and when my insurance said they wouldn't cover a doula, hospital midwife or home birth, I even went so far as to tell my husband I no longer wanted to try conceiving. We agreed to see what happens in 2015, but I know one thing and I hope you figure this out too: You have to be strong and in charge.. No amount of complaining is going to help you or your baby get the results you want. Research research research - knowing everything you can about your rights and your baby and your body will get you so much farther than just being ridden with anxiety. You can do it girl. Read up. Soak it all in. And be a warrior.

I have 8 jobs and work over 50 hours a week.  If I could figure out a way to work more and save more I would.  Also, with 8 part time jobs, I won't be getting any maternity leave so I have had to make sure I have some earmarked to be home for 6-8 weeks.  I'm not going to get into detail on the financial woes, just wanted it out there that I'm not crying poverty while sitting on my ass eating bon bons.

That said, I've hired a doula (out of pocket) and have been reading everything I can find. I'm also looking into hypnobabies as suggested.   I talked to my midwife and discussed my concerns so she is at least aware of them.  I've realized that regardless of how I feel, one way or another, a baby will be coming out of me in January.  If things go south they'll knock my ass out and take it out but one way or another it's happening so i just have to make the best of a bad situation (the hospital part, not the baby part).

ajpcv

       You always have to option to decline treatment. I am a nurse, though not an L&D nurse, and people refuse treatment they 'signed' for all the time. The general consent isn't just permission for procedures, it's also permission for assessments and things, so you have to sign it or you can't be admitted. The interventions are small ones (IV, catheters, etc) and you still have the right to refuse them. People refuse IVs all the time. If you do refuse interventions, no one is going to throw you out onto the street, they are simply going to chart 'patient educated on the need for *insert intervention here* and patient refused.' I've had patients refuse life saving medication and procedures simply because it restricts their ability to smoke, and these are procedures that provide separate consents (so they signed twice) and they still have the right to refuse. Their charts may be full of angry nursing scrawl, but they are still in their hospital beds and we are still doing the best we can. Don't let them tell you for insurance purposes they have to, no they don't. They have to offer it to you, educate you, but ultimately it's your choice. Some nursing staffs, floors, hospitals in general are better than others, but in my general experience L&D nurses are always the nicest.

      It does seem that you have some pretty serious hospital anxiety, which is nothing to be ashamed of. I have hospital anxiety and I work in one three nights a week! Have you looked into hypnosis, not for birth but for your fear of hospitals? I'm considering it for my dreadful fear of flying. Also, I'm seeing a midwife and am planning a low intervention hospital birth. She told me flat out to avoid the hospital classes. She told me they were great, but that they are geared towards women seeking epidurals, etc and I should look for something else. I'm taking the hypnobabies home-study instead. Going to the hospital as late as possible is exactly what you should do, it's what I learned in my L&D class in nursing school. No one wants to be in the hospital, so staying at home with your doula is a great idea. 

      Finally if you really don't like the hospital near you, you really should look into another one. I chose one 30-45min away (and even more if I go into labor during rush hour!), but I'm confident we'll make it. A friend of mine when to a birth center 90 min away (without traffic!) and she made it both times. Good luck!

jennypolkadots

I think you need to explore your options a bit more and learn about how consent works. Ask your doula which hospitals in your area are most natural birth friendly. Ask her how she helps you through labor in that hospital environment. Get your partner involved. See if opening an FSA is a possibility to help you afford your birth. Ask your home birth midwives if they could work out a payment plan or reduced fee for you. Most midwives work with an insurance billing company that can contact your insurance on your behalf and see what they will pay. Many times the midwife can bill things differently to get at least partial coverage - for example, billing as out of network for prenatal visits and a global birth fee. Try to connect with other mothers in your area that had great natural births at the hospital you are planning on. Research a lot, but also make sure your partner is fully informed so he can support you through the birth.

I really liked the book "Natural Hospital Birth: The Best of Both Worlds" and "natural birth the bradley way". I know making all of these decisions and feeling like your options are limited is scary, but it will all work out if you really explore your options and find the best thing for you! You can only do what you can do. 

Most every hospital allows you to pre-register and that is when you sign most of your forms. You can take them home and mull through all of them. If the nurse won't let you do that, question her about it and ask to speak to her manager or someone in legal. There is now way that is the policy. I think a lot of your fears are unfounded and it would be best to debunk many of them before labor because fear can stall your labor. You and your doula can also stay home (or a hotel close to the hospital) as long as needed before the birth. 

I'm sorry you've heard so many horror stories, you need to tune those out and not engage. Don't let people share their pain with you... there is plenty of time to talk delivery stories after your baby comes. I have had a couple of times that I walked away from a conversation or interrupted saying something like "I'm really sorry that was your experience, but if you don't mind I'm trying hard to stay positive and get over my anxiety about birth. So maybe we could talk about all of this after January?" and I've never had someone be upset by that. 

I also really think you could benefit from learning meditation or possibly hypnobirthing. Not just to use in the delivery room but to start controlling your negative thoughts and calming yourself. 

gcurson1991

As an RN I am so sorry to hear that you feel like this. I am not an OB nurse so I can not tell you how emergency situations work outside of the minimal rounding experiences I have had, I can tell you with the emergency c section I am aware of she wanted no drugs, the doctor gave her a local anesthetic and told her when the pain got to be too much the would give her the general. Also, please be assured your nurses want you to have the best experience possible and you need to talk with them about your expectations. They can limit the staff to a minimum. NURSES CANNOT GIVE YOU MEDICATION WITHOUT YOUR CONSENT. Unless you cannot talk for yourself you can always refuse any treatment. I would not suggest refusing vital signs because they do need to monitor the baby, they can catch things early that may require a simple change in body position instead of needing a full on section. If you don't like your nurse, or your personalities don't mesh, you can always request a new one. Sometimes that can't always happen but most of the time we try to be accommodating. You need to have a discussion with the OB and the nurses and tell them specifically what you do and don't want. I am so sorry you have such an awful fear of health care staff. I will also say that the mothers who are the most relaxed and go with the flow have the best experiences. I always caution people from having home births because how are you going to address an emergency? In the hospital, if they deem you are in an emergency they have 30 min to get baby out or they run a risk to you and baby. Can you recognize an emergency and get to the hospital in 30 min? Also I would like to add, just so you aren't suprised, a duela (sp) cannot replace nursing care in the hospital. What is mean is, the nurse cannot legally delegate tasks. But you have total control of who is in your room and what happens to your body. Tell your nurse about these fears as soon as you get there. And you can refuse students, although they don't do anything anyways. I really hope you have a wonderful experience and can have as natural of a birth as possible.

Kaelynn91

I had an absolutely wonderful natural hospital birth! My advice is to tour the hospital ahead of time. Ask as many questions as you can so that you can get an idea of their normal operating procedures. Then if you have any preferences that go against the norm make sure you include them in your birth plan. For me it was super helpful to pre-register with the hospital. That allowed me to give them a few of my preferences ahead of time. They knew that I wanted a natural birth as soon as I checked in! 

runswithscissors86

I also had a student present during the birth of my first. I don't mind students present in almost any situation( I taught at an Aveda Institute and love that student teacher environment). Bc the nursing student was present, my mother was able to stay at my head and coach me while my husband held one leg and the student held the other. It was also cool to see how excited the nursing student was to be participating in the "real thing."

SSCmomma

runswithscissors86 said:

I also had a student present during the birth of my first. I don't mind students present in almost any situation( I taught at an Aveda Institute and love that student teacher environment). Bc the nursing student was present, my mother was able to stay at my head and coach me while my husband held one leg and the student held the other. It was also cool to see how excited the nursing student was to be participating in the "real thing."

Glad that it was a good experience for you but I just really don't want any extra people there.  You are the kind of person a student should get to learn on, not a miserable bitch like me who will be yelling at them to GTFO.  I'm not even 100% on DH being there.  I'd love to just have the midwife deliver the baby and that's it.  I know that isn't realistic but a girl can dream.

malisaann

This exactly. I had a birth plan and when my midwife looked it over, many of the things I wanted were standard procedure. I loved not having to worry about giving direction or permission while in labor/ right after delivery.