Natural Birth at a hospital and with an OB
MrsMom148
member
Can it be done? I know I should ask my OB what his opinions are regarding natural birth and maybe taking a tour of the hospital and seeing/asking what support systems they have for moms who would like to give birth naturally. Problem is I'm not sure what questions I should ask, etc.
These are the general parameters of what my birth plan is starting to look like:
I would like to avoid being induced unless it is absolutely medically necessary and pain management options not be offered to me unless I ask for them. Who should I ask about skin on skin bonding immediately after the birth: the hospital or my doc? Natural pain relieving methods (yoga ball, different positions, etc)?
Thank you in advance for your responses. Looking forward to your advice and even some encouraging natural birth at a hospital stories, if you would like to share them.
ETA: how long should I labor for at home before going to the hospital? We live 2 miles away from the hospital, no more than a 10 minute drive.
Re: Natural Birth at a hospital and with an OB
I've done it twice so far. The third I was induced (41w6d with decreasing fluid) and the epidural was my choice.
My first two were completely fine. I was offered drugs with my first by the nurses and that made it hard (took one shot of nubane at the end that I did not feel at all) so I made sure to let the nurses know with my second not to offer, that I would ask. I think that's something that should be directed toward your nursing staff mostly, not so much your OB.
Induction should be discussed with your OB. What is his standard time limit for induction, what are his methods of induction (depending on how far along you may be), etc.
The natural pain methods was all the nursing staff. I asked at our hospital visits if they provided the birthing balls (which they all did) and I knew that there were showers and/or tubs available, so all that was asked for once we got to the hospital knowing that they were provided/available. I guess you could ask your dr. how "NB-friendly" the hospital staff generally is so you know what you might be up against.
I've never asked about the skin-on-skin bonding but I would suppose that would be talked about with your dr. and then put in your written birth plan so that the nurses are aware of it as well. Maybe have DH remind the staff during the final stages of pushing so that it's remembered.
Add me to the been-there-done-that list. So, yes.
Ask about what the potential reasons for induction are. If the answer is "41 weeks, because you're overdue" or "because you're measuring big" it might be a problem. If the answer is baby in distress based on a NST, or pre-eclampsia, then those are valid reasons.
I don't like the phrase "pain management options not be offered." I would say pain medications not be offered - and like PPs said, this is going to be directed at your nursing staff. I asked my OB if she had ever recommended someone get an epidural. She said yes - once - when the woman was facing a c-section after a very long labor. She suggested it because the woman was very tense. As soon as she got the epi, her body relaxed and baby moved down and she delivered vaginally. I was happy with that answer. My nurses asked me what my "pain management plan" was when I arrived - I said no meds. They still offered up techniques for managing the pain, but they came in the form of offering a shower, suggesting positions, trying the birthing ball, breathing techniques. It was helpful to have their suggestions, but they never offered drugs.
As far as my doc was concerned, she had a lot of mamas say they wanted to go med-free, but ended up asking for an epi. She sort of doubted that I could do it, but made it known that I was welcome to try and she would help me. So, from her experience, she wanted to make sure we discussed the medicated options. I took the hospital birth course, we had a brief discussion on "what if" (I wanted an epi over IV narcotics), and that was it. Never discussed it again.
I would talk to your doc about skin-to-skin, and if your doc isn't present at the birth, make sure the on-call OB and nursing staff knows your wishes because whoever catches the baby is ultimately responsible for this one. Usually it is the OB.
I went to the hospital after only 4 hours of labor, but my contractions picked up quickly, were only 3 minutes apart, and I was starting to get scared. I was only 4cm on admission, but I have birth less than 4 hours later, so I don't regret listening to my body. But as long as you are comfortable at home, stay at home.
many do it, so I definitely think it's possible! My SIL has done it 4 times, at 3 different hospitals with different OBs. She was even induced twice and still had success going med free.
to prepare myself I've read lots of books, including Ina Mae's Guide to Childbirth and Natural Hospital Birth. I have also hired a doula, which I think will be key for me as I need the support from someone with training.
talk to your doctor about it early and often to make sure they are the right provider for you.
Gretchen Evie, born 7/8/2012 at 35w5d
I've done it twice, at different hospitals with different doctors...Actually, the first was without a doctor.
With my first, my labor did not progress in a traditional way, so when we called the hospital, they said it wasn't real labor and told me not to come in. Eventually, a friend of the family, who had had five children, came over and said, "Oh my god. Why aren't you at the hospital already?" We made the 30 minute drive to the hospital and pulled into the ER 13 minutes before the baby was born.
With my second, I went to my OB's office and was told that I was in labor. I checked into the hospital a couple hours later, had my water broken (my choice) and the baby was born an hour and a half later...
I think the best way to know whether or not your OB is really into natural birth is to either look into or ask about his stats. How many births has he attended, how many of those were vaginal vs how many were c-sections? How many unmedicated births has he attended?
I personally love having a birth plan - keeping it short & to the point and only putting the most important requests on the birth plan is my advice. I went over it w/ my midwife ahead of time; she put it in the chart. Then when we arrived at the hospital we politely handed it to the nurses and midwife on duty. I was SO impressed; without asking they got the equipment out I had on my birthplan (birthing ball, etc). Too bad I was already 9.5 cm when I arrived and started pushing immediately so none of it was needed :-) Regarding skin to skin contact, it was on the birth plan but we didn't rely on the staff remembering the birth plan - we just voiced our preference politely "would you mind waiting to weigh him until he has breastfed and has had some skin to skin contact?" They were very supportive and came back HOURS later to do all the weighing and stuff.
Regarding other preferences we had (no hep B shot, etc) we told them and then made sure that either myself or my husband were w/ the baby 100% of the time. When he went to the nursery to do a car seat check (he was a premie so they have to check their O2 levels in the carseat) my husband sat w/ him the entire hour. Never unattended. They also wrote it on his bassinet that we didn't want pacifiers, bottles, etc so that in case a new nurse came in the middle of the night there was no confusion.
Basically don't be afraid to communicate your wishes clearly but politely. I was so ready to go in "ready to fight" and it was just the opposite, everyone was so supportive.
Regarding when to go to the hospital, the later you wait, the less they can do to you :-) I really really thought I was having braxton hicks (but I think it's bc I was 36 weeks adn just hadn't prepared for the idea of a premie!) but still waited until I felt rectal pressure to go to the hospital - we're 15 minutes away. I was 9.5 cm dilated and started pushing pretty much by the time they settled me in my room. It was WONDERFUL. They didn't even have time to check my chart! Next time I plan on waiting as long as possible once again. I don't believe in going off of how close your contractions are; everyone is so different w/ contraction timing. Our bradley course instructor told us we should listen to our body and when you no longer feel safe at home, head to the hospital. That was perfect timing for me.
It can be done! I did it 2 weeks ago
I asked my OB very early on what her "non-negotiables" were with L&D so I knew what we were working with. I was pleasantly surprised by how pro-natural birth she ended up being. (She let me have a water birth even though it was "against" hospital policy to actually deliver in the tub!) If it turns out that your OB isn't so receptive to your natural birth plans, you might try asking some doulas in your area about their experiences with OBs.
If you are interested in my (long) birth story, click on the "Baby Vlog" link in my signature and I tell my story in a 4 part video.
It can absolutely be done, I did it.
My advice is to research the hospital you're going to be delivering at and also make sure you ask your OB their feelings on natural birth (be sure to define natural birth when talking to them so you're both on the same page).
Labor at home for as long as you feel comfortable. I know this kind of answer sucks when you're pregnant but.... You'll know when it's time. Trust your body, trust your instincts, and when you think it's time to go; get going. I wanted to go before it would be too painful to ride in a car and arrived at the hospital after roughly 7 hours of labor at was at 4 cm.
Definitely schedule a hospital tour and talk to them about EVERYTHING. Don't be afraid to ask every tiny question you can think of. What kind of birth aids do they have (yoga ball, squat bar, birthing stool, birth peanuts, other), do they routinely do Skin to Skin for the first hour and if not can you request it, can you delay cord clamping, can you bring your own juice to drink (my hospital had nasty juice so I wanted my own), can you wear your own clothes, can your husband do a dance. Honestly, ask them everything. If you're worried they might not be completely supportive; tour twice. The nurse you tour with might have her own opinions and that may not reflect the whole staff.
During the tour, ask for a copy of the hospital policies regarding labor and delivery. Make sure you read them to know what you can and can't do so you don't get bullied during labor. I had an incident where they said I couldn't get in the tub because my water had broken and my doula challenged it because she knew their hospital policy better than the nurse and my OB. I ended up in the tub and it was a life saver.
If at any point you're uncomfortable with the answers you're getting and you're afraid your wishes won't be granted (provided that there isn't a medical reason to go against them), don't be afraid to switch OB's and hospitals. I switched at 18 weeks and was very happy with the outcome. There's no reason to go into your labor with any hesitation about the environment or your support team.