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Natural Birth
OB Policies vs. Hospital Policies
I have been planning on having a natural child birth since we got pregnant. I was close to my OB prior to TTC, so I decided to stick with her when I got pregnant. She had both of her kids naturally and from everything we have discussed so far we are on the same page for what I want for my birth experience. She requires a hep-lock, but does not require IV fluids unless you get extremely dehydrated. This was exactly what I wanted, but we went for our hospital tour today and found out that the hospital has a different policy. Even if you only have a hep-lock they still only allow ice-chips. Has anyone else every had experience with OB policies differing from hospital policies? Can you go against hospital policy? I know you can refuse procedures, but can you do anything about policies like this? TIA!
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Re: OB Policies vs. Hospital Policies
In my experience, the water drinking one isn't the hugest deal to most nurses. (not that it should be!). I can guarantee that they wouldn't yank a bottle of water out of your hands! I for one firmly disagree with the no food/drink policy, and pack both in my hospital bag, with no qualms about having them both should I feel like it.
And yes, I think it is normal for their policies to differ, but most Drs will digress to the hospital policies in the end, because they are not there the whole time to fight your battles.
So I was talking to our doula about eating during labor. She said that officiallly our hospital doesn't allow you to eat, but that she's had no problem sneaking in snacks.
I was concerned because I heard that my hospital forces you to get into bed at 9-10 cm. I told my DH and he said that I should just refuse, what are they going to do? Strap me down? When I mentioned this to the doula, she said that it is actually enforced...and in terms of what they can do to me, the ob can refuse to deliver my baby. But she assured me that at that time I might want to be in the bed anyways because most women feel too weak to stand at that point and that in bed doesn't mean flat on back and in stirrups. I could be on all fours, on my side, or using the squat bar that is above the bed.
I've also heard that hospital policies can be enforced (or not enforced) by the ob in charge that day....
Actually, not all hospitals don't bring you food. My hospital brought food to my friend while she was in labour and the nurses made me toast and jam while I was in labour (I laboured at night, she was during the day). I also went though probably 3 or 4 500 ml water bottles during labour, and my nurses would refill the water bottle for me so my husband wouldn't have too.
Daughter #1 - February 12, 2010
natural m/c March 11, 2011 at 8 1/2 weeks
Daughter #2 - January 11, 2012
Ectopic pregnancy discovered November 6, 2012 at 6 weeks
Daughter #3 - January 19, 2014
Started our exploration into the world of international adoption June 2012. We have no idea what this is going to look like but we are excited to find out!
My OB had agreed to my whole birth plan, which included laboring in the shower and on the birthing ball, walking, and trying lots of different positions. When I got admitted to the hospital, they told me that I couldn't get in the shower or even out of the bed because my water had broken and that was hospital policy. I agreed to not get in the shower, but there was no way I was staying in the bed and I was able to refuse. It was a little intimidating to tell them no, but I knew there was no way I would have made it without meds otherwise.
My OB had also agreed to intermitten monitoring, but the nurse insisted that I had to be hooked up to external monitoring. When they kept slipping, she talked me in to internals that also kept getting moved. As often as she came in to fix them, she could have just done the intermitten. It was frustrating.
i wonder if "most women feel too weak to stand" at 9-10cm b/c they haven't had more than ice chips to eat for 24+ hours?
i walked around just fine 9-10cm in both of my labors. in my first labor, i'd been laboring 30hrs before i reached that dilation. i'd also not starved myself! it's so important to eat during labor.
i can't recall offhand what it is exactly, but the % chance of needing an emergency c/s coupled with the % chance of those women vomiting during the surgery combined with the % chance of those women aspirating their vomit is sooooo ridiculously small that i can't believe it's such a standard policy.
there is a local doctor who is known for bucking hospital policy when it comes to the well-being of his natural birth laboring mamas. and the hospital staff defer to his patients. "oh, you are dr. ____'s patient. you can do what you want."
too bad others don't get the same preferences.
hide your snacks. if someone sees them, just say they are for your husband.
Exactly! This blows my mind. I can't go 3 hours without eating these days, and I'm doing a whole lot of sitting on my butt. Ice chips only while I'm laboring? Riiiight.
Someone mentioned that an OB could refuse to deliver your baby if you don't follow policies. That is just not true. An OB cannot just sit outside your room while you're having a baby and refuse to deliver it. They may not be happy about it, may give you a hard time, but barring anything crazy like a precipitous birth or the OB being otherwise occupied, when you push a baby out, an OB will be there.
Thanks for the information ladies! I'm with all of you, I can't imagine going through labor without water! I can't make it more than like 15 minutes these days without it and I know labor will be much more work than sitting here at my desk. We plan to labor at home for as long as possible, so the food part doesn't seem as bad. I'll just snack at home and then take a few light snacks to the hospital, but the water part really got me.
I knew there were some things we were going to have to fight by having this baby naturally in a hospital, but I really couldn't believe this was one of them. Luckily we have a doula and DH is completely on board with the no meds or procedures unless completely necessary, so I will have both of them to help me fight my battles. Just makes me anxious for how the whole experience will work out in the end. Thanks again for the information!
Just one more note, I was not hungry at all during labour. The thought of eating almost made me vomit, so just beware that you may not want to eat at all. I did eat the toast and jam my nurses brought me (they actually made me eat it because I hadn't eaten much), but by that point I was hungry, but for the 24 hours prior to that, I had no desire to eat at all.
Daughter #1 - February 12, 2010
natural m/c March 11, 2011 at 8 1/2 weeks
Daughter #2 - January 11, 2012
Ectopic pregnancy discovered November 6, 2012 at 6 weeks
Daughter #3 - January 19, 2014
Started our exploration into the world of international adoption June 2012. We have no idea what this is going to look like but we are excited to find out!
I am in a similar situation as you are, with an OB who's policies differ from the hospital I plan to deliver at.
What I have been told is that these hospital policies can be overturned with a doctor's orders. Therefore, if I want to eat, drink, move around, etc., during labor all I need to do is have my doctor say OK and it's no problem.
I'm in the process of drafting up a birth plan right now, but have already talked to my doctor about most aspects of it. I plan on having her sign the birth plan to show that she has read and agreed with my preferences, and then bringing it to the hospital so that the nurses can see that these things are OK. If they need to, they can also call her to get confirmation.
It does make me a little nervous to get going against policy on so many things, but my doctor has assured me that it's not unusual for mothers to have these preferences, and the hospital will have plenty of experience with them.
BFP#2: EDD 2/11/14, MMC confirmed 7/15/13 (growth stopped at 6 weeks), D&C @ 12 weeks 7/25/13
In my experience, there's a delicate power balance between an individual OB's policies and a hospital's policies. Sometimes an OB will say a patient does not need to follow a certain policy and the OB's wishes will win out (i.e. letting you have a heplock instead of routine IV). Other times, the OB would be willing to let you do something but can't because it goes against hospital policy.
Part of the reason for this is "hospital policy" is not just one blanket thing. The policy may be hospital-wide, it might be specific to a certain department or a certain supervisor. It may be the result of insurance policy, legal advice, or medical studies. It may have very ardent defenders or may be one that people are willing to overlook. So for this reason, an OB might be allowed to get around certain policies but not others. If going around a policy will put the OB into conflict with another hospital department (anesthesia for example) or with the legal interests of the hospital, they will probably encounter a lot more resistance and might decide it's not worth the fight.
I ran into some of this with my own delivery. The hospital didn't do water births but my OB was able to do them by bringing in her own tub. The hospital wanted routine IVs, but my OB let her patients have heplocks. On the other hand, when I asked about eating in labor, she told me upfront that while she would be ok with it, the anesthesia department would be very upset with her so she couldn't OK it. And I wasn't allowed to labor in the tub while on Pitocin because it was a hospital-wide policy that if you were on IV medication, you couldn't get into a tub. So she had to comply with that.