Labor experiences at INOVA Alexandria?

cecilyandgautam

My husband & I completed the maternity ward tour at INOVA Alexandria last night, which is our back up hospital in case labor doesn't progress at Birth Care, and generally, we liked their standard practices & procedures. Vibe-wise, it generally feels like a good hospital option. But I can't shake my worries about their 40+% c-section rate. I asked the tour guide under what conditions they perform c-secitons and she gave the textbook answer. I didn't want to freak the other moms on the tour out or grill her by asking her to account for such a high rate.

Those of you who delivered at Alexandria, can you share your experiences, good or bad? In the unlikely event that I do need to transfer, I want to be informed. Thanks!

RomeRomance06

I had a vaginal birth, medicated. My labor was pretty uneventful so all in all I was happy with my experience. I was diagnosed with Group B strep so I went to the hospital soon after my water broke so I could be hooked up to antibiotics. The admitting went quickly and I was in the delivery room within the hour. This was in the middle of the night. The first nurse I had was OK. She was at the end of her shift so I think she was checking out early. But the nurse I had through most of my labor/delivery was awesome. She was there the whole time and was supportive of me even when I decided to hold off on the epidural. She was great at teaching me how to push and overall I was happy with the experience. 

beano

I'm delivering my first baby at INOVA Alexandria.  My OB, who practices at Alexandria, will be delivering me, and her natural birth rate is 85% (15% C-Section).  I could be wrong, but I don't think it's up to the hospital, rather up to your OB. 

claraj

I delivered at Alexandria hospital and I had a great delivery experience. Like PP said, the call on the C-section is really up to your OB, not the hospital.

Mrs.Handy

I delivered unmedicated at Inova Alexandria. I was at home for most of labor though and arrived at the hospital 9.5 centimeters dilated.

I agree it is up to your OB or MW. I pushed for over 3 hours and my MW was so patient and encouraging. My doula was so impressed since most OBs would have been pushing for a c-section at that point. My MW told me that if I would have had an epidural, I probably would have ended up with a c-section.

Good luck!

BabyHatch

Agree with PP's about it being the OB's decision. I would also consider that there is a NICU and a perinatal clinic at that hospital so that could really be influencing the higher C-section rates.

I came as close as you could get to an emergency c-section after laboring for 28hrs, NICU docs in the delivery, etc. and I still made it through with a vaginal delivery.  And I credit my OB and the AMAZING L&D nurses they have on site for making that happen.

Bluiyez

I mainly lurk here but I did deliver at INOVA Alexandria in April 2010. The labor & delivery rooms were fine. I had a natural birth with a doula and midwife. The hospital staff were fine. Arrived at 7 AM and delivered at 11:20 AM, so I wasn't there long. I hated the room I was transferred to in post partum. The bathroom was tiny and filthy. I took pictures. My baby was a bit jaundiced so I stayed more than the 24 hours I had hoped to. That was my only issue. GL! 

LindseyJW

I transferred from BirthCare in hour 37 of labor to INOVA Alexandria in my first pregnancy. I have also been monitored in L&D at 38 weeks during my second pregnancy following a car accident.

i am 100000000% certain that the treatment you will get there as an OB patient is worlds different from the treatment as an out-of-hospital birth transfer. my last stay there was so atrocious that i filed a written complaint, as did my midwife and the resolution was that L&D needed training in both customer service as well as midwifery care. my MW was asked to do that training. this was a year ago, so perhaps they are less ignorant now. the general attitude that anyone who intentionally chose to birth outside the hospital must be an idiot was pervasive and their treatment of me and my birth reflected as much. i will never go back there. if we have more babies and hospital birth becomes necessary, we will go to VHC.

is Paula McKenzie still the referring OB for BC? she is wonderful. it is likely that if you are transferred during labor, it will be for a surgical birth. her c/s rate is a little on the high-side, but that is b/c she gets BC's transfers and risk-outs. BC sometimes works with Dr. Tchabo at VHC, is this still an option? VHC is more friendly and compasionate in general (from what i understand) to transfer moms.

here are some of the things that i dealt with when i arrived at 10cm for a c/s:

- prolonged delay at the front desk for registration papers (even though i was the only one there checking in). they reprimanded me for not doing my paperwork in advance (um, wasn't planning to come here?). they would not allow me to stand (had to sit in a wheel chair - are you kidding me??? at 10cm dilated???)

- chastisement from the anesthesiologist and L&D nurse for "trying to do this at home"

- post-surgery, i was told that i had to ask for pain meds so that i "wouldn't become addicted." this was policy. i later discovered that this was not their policy, but rather the policy is to bring them every four hours. imagine my pain when i forgot to ask because i was sleeping, or enjoying snuggle time with my new baby. instead of having pain meds on a regular schedule, i had to monitor the clock and remember myself when to ask (b/c if you want until you need them, as i often did, it was way too late). and then they frequently took 20 or even 30 minutes to bring them. the result of making me ask was that i felt like a drug fiend. always begging for my next fix. it was HORRIBLE.

- they did not give me a "cough pillow," which is the standard of care following abdominal surgery. a friend who is a L&D nurse at another hospital made me one when she visited on day 2. i felt WORLDS better after this

- i had an allergic reaction to the epidural which caused severe itching. i swear i thought i was allergic to my own blood. an OB ordered antihistamene into my IV. i endured 24 hours of itching before they discovered that while the meds had been put in the IV, someone forgot to turn it on.

- despite making it clear that our baby was not to be left in the nursery or taken out of my room wihtout DH, the nursing staff made multiple attempts in the middle of the night to take the baby - even once trying to take him OUT OF MY ARMS while we were sleeping together. WTF??????

- my OB (paula) left instructions that i was to have my catheter removed within a few hours. it wasn't removed until her follow up the next day.

- paula left discharge instructions that they did not give us, which we only learned after running into paula at hte grocery store weeks later. she told them to tell me to use the stairs at least once a day, but not more than 3 times and to walk around the block at least once/day. the instruction i was given was to not use the stairs more than once a day, which means i had to stay in my bedroom since we have no bathroom on our main level. i was a prisoner in my own house.

- they discarded my placenta, even though i asked to take it with me (and was given a pacifying "sure" when i asked for it)

- there were all kinds of problems when it was time for me to be discharged. i think we waited 4 or 5 hours after we were told we could be discharged for them to "get the paperwork right." and they never bothered to check if we had a car seat (or had it properly installed), which i think they are supposed to do if you are driving away.

i am absolutely certain that my post-partum experience at INOVA Alexandria contributed to my PPD. it was a terrible experience and i would not wish it on my worst enemy.

i suggest to my students who are homebirthing to go to VHC if they need to transfer. BC MWs don't have hospital priveleges, so it might not matter which hospital you choose to go to. obviously, if it's an emergency, you need to go to the closest hospital. but most transfers aren't emergencies. if you have time, avoid this hospital. it is not friendly to mamas planning to birth outside the hospital.

Artslvr

Every time Lindsey talks about her experience there I just cringe.  I'm so sorry lady - what a freaking nightmare.

I had good experiences there, but I was not a transfer from a birthing center, so I'd take Lindsey's advice with the route you're going.

Good luck!

L'Etincelle

Wow, it was so interesting reading Lindsey's experience. I had a few of the same issues when I delivered at Inova Alexandria in 2008. I came in wanting a natural birth in hospital w/ my midwife and wound up with a C-section. (After much thought and research following this, I now know my C-section was NOT necessary!!!) I had no idea that this hospital's C-section rates are so high   I agree with PP who said the recovery rooms are subpar. Mine was also filthy and we actually saw a large ROACH running across the room during the day. We yelled out to a passing nurse, and she reached her foot into our room and just stomped on the bug with her tennis shoe (she was not at all surprised....)! I also had to ask for pain meds when I needed them for my C-section recovery. I was given a little pillow.

One note about VHC, is that in researching having Dr. Tchabo as my OB for a VBAC, I found out that as it is a teaching hospital, it is chalk full of residents who will likely be walking in and out of your labor room, surgery room, whatever and even more likely participating or performing an exam or procedure on you. I was not comfortable with this thought! Also, FYI, even though Dr. Tchabo is a great option since he is pro-VBAC (compared to most other OBs in our area), the chance of actually having him as the physician on call when you go into spontaneous labor is quite low. He's only on call a few days a week and otherwise delegates to another OB practice.  

Good luck to you! Follow your instincts and insist on the birth you desire!

victoria1212

This is not l&d related but when my husband was at inova fairfax in the cardiac care unit from complications post-spinal surgery the policy was still they don't give pain meds unless they are asked for by name. However, they did not bother to tell either one of this info- just uselessly kept coming in and asking what his pain level was. 20 hours witout any medication was miserable for a man who had 10 screws and 2 metal plates put in his neck plus cut vocal cords and heart issues. I am still pissed about it 8 months later!

mamabear2010

I delivered there in July 2010. I had a medicated vaginal birth, although I had hopes of going natural. I had a doula with me and my birth was 23 hours. We checked in at 2am and everything went smoothly. The nurse assigned to us was amazing. I had a birth plan and she was pretty understanding. I came prepared to argue about my preferences but thankfully I didn't need to with the first nurse. They gave me a heplock and I was allowed to walk around for 40 mins every hour. My doula arrived a few hours later. And my first nurse finisher her shift at 7am.

 The next nurse I got was a b!tch from hell. She was just plain rude and nasty. She hated the fact that I had a doula and she obviously VERY intimidated by her. Even though my doula was very hands off when the nurses were there, she gave them space and didn't interfere. This nurse kept snapping at the doula and at me. She hated the fact that I was not getting an epi. My OB came to check on me in the AM and told me that my baby was facing up (sunny side up), and that if he didn't turn, we would probably have to do a c-section. This scared me and stressed me out a lot, but my doula was amazing. She helped me do lots of exercises to turn the baby. By mid-day, my OB wasn't coming to check on me and I was in a lot of pain. The mean nurse check me to see my progress. It had been almost 12 hours since I checked in and we were hoping I was at least 6-7cm. In the SNARKIEST way possible, she tells me "you haven't progressed. at all. nothing." I was in tears. She was dying for me to get the epi.

 Since I wasn't progressing and the pain was more than I could bear, my family and doula encouraged me to get the epi. Part of me didn't want to get it just because of that nurse. But I did. and when I asked her for it, she had the ugliest smirk on her face. The head nurse came in with the anesthesiologist and I told her I want my first nurse back. Thankfully they brought her back as soon as her shift began and my experience was starting to get better again. This nurse was just amazing, she literally helped turn the baby as I was pushing for more than an hour by massaging his head with baby oil and other stuff. She was so nice and really made the experience amazing. I didn't hesitate to make my opinion of the bad nurse public by filling out the surveys at the hospital and when they called me PP.

 I liked the small size of the hospital and most of the staff. The c-section definitely depends on the OB but the nurses can also have an influence. The fact that this one nurse had such a negative reaction to my doula and my birth plan was so off-putting. But I was SO grateful to have that one nurse who made a world of a difference for us.

If you have to go to Alexandria, go for it. But be vocal about what you want from the beginning and don't hesitate to complain. There are probably a few bad apples, but I would hope you can get through to someone who is more understanding. 

Good luck! (and sorry for the long reply!)

 

 

jefloodphd

I just delivered at INOVA Alexandria in September and overall, had a good experience. I had a very long labor that ended in a c-section....long story, but I don't think it was the hospital's fault (well, other than that the L/D nurse was very inexperienced/new and I'm not sure if my induction could have gone differently with a more experienced nurse...I'll never know). L/D staff was really good overall.

I also had a similar situation described previously about asking for medication...though it was only with one nurse (who told me 12 hrs after the c-section that I wasn't allowed more pain meds and she'd have to speak with the Doctor...um, I just had major surgery, pretty sure they aren't going to deny me pain meds! She made me feel like a drug seeker and I was afraid to ask for them after....) But, I also had some great, supportive nurses, so I think it was just one bad egg.

LindseyJW

thanks for your support ladies. those experiences ultimately empowered me to do all i can to affect change in the birthing world. that's my motivation for my career change. i would not be where i am in my life without them! 

FYI: after speaking with INOVA-A re: my last experience there, and sharing with them my first experience there (my c/s), i was told that:

- IT IS POLICY to administer pain medication to c/s patients on a 4-hr schedule. patients ARE NOT SUPPOSED to be made to ask for it. it is supposed to be brought to them and offered on a 4hr cycle. this is in stark contrast to what i was told when i was there, and to what it appears some of you were told as well. 

also - like PP, you can always ask for a nurse who is partial to unmedicated birth. if there is one on shift at the time, he/she will be thrilled to work with you. and, a nurse who isn't interested in unmedicated patients will gladly trade patients! 

i agree that the OB makes the ultimate suggestion for a c/s, but it is the hospital staff, standard hospital procedures and regulations and the attitudes and degree of support you get from nurses that lead you down the path to where the OB would suggest it in the first place. 

consider PP's experience with the great nurse and then the nurse from hell. i wonder had the great nurse never left, if her labor would have continued progressing (also, pp, it is VERY common for labors to rest for a while. i hope your doula shared that with you. it doesn't mean something is wrong or that you can't continue laboring and birthing normally.).  mom's state of mind does affect her labor. if she is not being supported, or is being made to fight for what she wants or worse, is being degraded during her labor, it is quite likely that there will be an impact to the progression of her labor. obviously i can't say that's what happened in this situation, but it's quite likely. i'm so sorry that happened to you and i'm proud of you for making it publicly known. i was so damaged after my c/s that i couldn't even do that.

cecilyandgautam

Thank you for sharing your experiences, both the good & the less than ideal. I definitely will talk to my husband & doula about asking for another nurse if the one assigned to us isn't on board with our approach. Since the plan is to deliver at Birth Care, I really will only be transfering if there's a problem so my experience will be different from those of you who started out there with your first choice in place. I am planning and hoping for a natural birth but at the same time, am not scared of needing to change plans if hour 30 arrives without much progress.

Your stories help as I prepare for the big day. Many thanks!