OB and natural birth.

mhbraymer · July 2012

To those who are or did give birth at a hospital with an OB when did you start talking to them about wanting a natural birth? I'm reading and doing research now. I wanted a natural with my dd but things changed and I got an epi so I'm hoping for a different expierence this time. Thanks for the advice!

tokenhoser · July 2012

Check out the FAQ in my siggy for some suggestions on how/what to ask to get a feel for your OB's stance on natural birth.

I would have the conversation - at least the basic one - now. Early. If you want to change providers, the sooner the better. It doesn't have to be a full on birth plan, but you can ask about things like eating, intermittent monitoring, and delivering in a not-on-your-back position.

laurenluor · July 2012

I'm a FTM and got recommendations for OBs and then interviewed the 2 I had narrowed it down to. This is when I asked my most general natural birth questions to see if they would be supportive of my wishes. So far I have been extremely happy with my choice and should be discussing more specifics with my OB soon!

mhbraymer · July 2012

tokenhoser:
Check out the FAQ in my siggy for some suggestions on how/what to ask to get a feel for your OB's stance on natural birth.
I would have the conversation - at least the basic one - now. Early. If you want to change providers, the sooner the better. It doesn't have to be a full on birth plan, but you can ask about things like eating, intermittent monitoring, and delivering in a not-on-your-back position.

Thank you that was very helpful.

AmyRI · July 2012

I honestly can't remember when I asked, but I know it was around the mid-point of that pregnancy.

I asked her straight out if she had ever suggested meds to a patient. She said she had - but only once, when the mom was not progressing for many hours and was not tolerating the pain well. She suggested an epidural it as a way to avoid a c-section, and once her body relaxed she did deliver vaginally. It was a good conversation from there - I knew I could trust her not to push unnecessary meds and she made me feel comfortable in trusting her judgement if she did suggest an intervention.

I don't think it's ever too early to have a general conversation about natural birth. You need time to switch providers and be comfortable with a new doc if your current one isn't as on-board as you'd like.

tokenhoser · July 2012

ICarriedAWatermelon:
I feel confident saying yes or no, and I don't feel like I need to be on the defensive or "prepare her" for my desires for delivery.

The thing about being in labour is that it's an intense physical experience. I'd encourage you to talk to your doctor about what you want ahead of time, as it's not easy to be your own best advocate when actually birthing your baby.

AimnJus917 · July 2012

There's really nothing natural about having a baby in a hospital, but I'm assuming you mean unmedicated, intervention-free birth. I had an unmedicated hospital birth but intervention-free was out of the question. My hospital's policies included continuous fetal monitoring and IV prep, no fluids or food (I could have ice chips, woopie!). I had a birth plan and other than the interventions mentioned above, the OB and nurses were pretty much on board and didn't try to coax me into an epi and let me push when I felt the urge. It was my first and I had no experience with pushing in different positions and the nurses were clueless so I ended up pushing on my back, having a 3rd degree tear and episiotomy. It wasn't the worst hospital experience, but I'm going with a midwife practice this time! I told my OB (she didn't deliver my DS) around 36 weeks about giving birth unmedicated and she said, "that way my goal too, but I didn't make it." Yeah, thanks for the vote of confidence, Doc! So really no support from her. Good luck and believe in yourself, if your labor is progressing well and no issues, you can do it!

LollyBug18 · July 2012

I brought it up at my last appointment a couple weeks ago but, someone correct me if I'm wrong, after DD's hospital birth with the same OB, I almost feel like it's more important to get the feel of the hospital staff and how they'll handle med-free/low intervention. My OB didn't really have any part of my birth until I was already pushing, the nursing staff took care of everything up until that point, which really surprised me at the time.

tokenhoser · July 2012

LollyBug18:
I brought it up at my last appointment a couple weeks ago but, someone correct me if I'm wrong, after DD's hospital birth with the same OB, I almost feel like it's more important to get the feel of the hospital staff and how they'll handle med-free/low intervention. My OB didn't really have any part of my birth until I was already pushing, the nursing staff took care of everything up until that point, which really surprised me at the time.

I stayed home until I was 10 cm. Staying home and labouring there is the best way to dodge hospital policy and nursing staff. I don't plan to aim for quite 10 cm next time, but it worked out well for me. Most doctors and nurses will tell you to stay home for as much of labour as you can if you want to go med-free.

The OB still has the right to "give you permission" if you want to do something out of ordinary for the hospital, and most nurses will respect that. It is definitely easier to birth somewhere you don't have to fight with, if that is an option, but not everyone has options.

marshmallows · July 2012

We hired our doula around 20ish weeks so sometime after that. I think they asked in the beginning but I wasn't sure yet. They haven't asked this time yet. Maybe they just assume I will. My ob likes doing natural births so it wasn't an issue.

erb82 · July 2012

I talked with my OB around 32 weeks. This might be a little late for some people, but I already had a good relationship with my doctor since she had already been my gynecologist, and I was sure that it wouldn't be an issue.

AimnJus917:
There's really nothing natural about having a baby in a hospital, but I'm assuming you mean unmedicated, intervention-free birth. !

I really disagree with the statement above. What could be more natural than a mother giving birth in the place that's most comfortable for her? I respect that for you, a hospital birth may feel uncomfortable and unnatural, but that's not true of everyone. I consider my unmedicated, intervention-free hospital births to be very natural, because I was in the place that I wanted to be, surrounded by people I trusted, and free to make the decisions I felt were best for my family. Isn't that what we're all aiming for no matter what our individual decisions are?

cco42 · July 2012

erb82:
I talked with my OB around 32 weeks. This might be a little late for some people, but I already had a good relationship with my doctor since she had already been my gynecologist, and I was sure that it wouldn't be an issue.
AimnJus917:
There's really nothing natural about having a baby in a hospital, but I'm assuming you mean unmedicated, intervention-free birth. !
I really disagree with the statement above. What could be more natural than a mother giving birth in the place that's most comfortable for her? I respect that for you, a hospital birth may feel uncomfortable and unnatural, but that's not true of everyone. I consider my unmedicated, intervention-free hospital births to be very natural, because I was in the place that I wanted to be, surrounded by people I trusted, and free to make the decisions I felt were best for my family. Isn't that what we're all aiming for no matter what our individual decisions are?

Agree on all accounts! 32 weeks is plenty early to discuss birthing with your OB. I wasn't even going to discuss it at all with my OB. I don't want medication, I've already had experience delivering naturally, and if any medical personnel should ask me if I want an epidural while I'm in labor I'll just tell them, '"no and don't ask me again." And that's that. No need for fancy birth plans, no need for lengthy discussions. I trust my body but I also trust my team of medical experts to make the right decisions in a pinch. No one's going to stick a needle in your back without you agreeing to it

tokenhoser · July 2012

No one is going to force you into an epidural, but they can arrange things in ways that make that a much more attractive choice. If you get stuck on continuous monitoring and can't move, you'll want the epi. If you can't push in the position you find most comfortable, you increase the chances of ineffective pushing (and eventually a section) or tearing. If you can't eat or drink, you require IV fluids. If they decide you're not progressing fast enough and crank up some pit, you'll want the epi.

Hospital policy impacts birthing women. Denying that is just being arrogant.

cco42 · July 2012

There is a difference between being educated, knowing your options and desiring a natural birth vs. assuming you know more than your obstetrical team and writing up a 14-page birth plan. One is far more arrogant than the other and, while it is wise to be prepared, no one knows what any given labor and delivery will bring. I didn't intend to come off as arrogant when I stated that I trusted both my body *and* the medical personnel attending my birth.

tokenhoser · July 2012

No one writes a 14 page birth plan and gets taken seriously.

If you spent any time on this board, you would see that we frequently tell people to cut the fluff and get it down to under half a page in bullet points.

Doctors and nurses are experts in emergencies but much of standard OB care is actually not evidence-based. If they want me to buy into their knowledge, they need to back it up with some journal articles and research. And if none of that exists... why, some things might just be bad habits. I'm not going to get taken for a ride because I should just trust the nice doctor to know what's best for me.

lauriedupuis · July 2012

tokenhoser:
Check out the FAQ in my siggy for some suggestions on how/what to ask to get a feel for your OB's stance on natural birth.
I would have the conversation - at least the basic one - now. Early. If you want to change providers, the sooner the better. It doesn't have to be a full on birth plan, but you can ask about things like eating, intermittent monitoring, and delivering in a not-on-your-back position.

This. I started talking to my provider at 12 weeks and by the end of my 16 week appt. I knew that I had no support for what I wanted. It was easier to interview and change providers at that point than it would be later on.

aylafsu88 · July 2012

I just had a natural birth in a hospital with an OB!! You will hear mixed advice on using an OB if you really want a natural birth and some people will strongly suggest using a midwife (our natural childbirth educator). However, you can find OBs who are pro natural birth. The big thing you need to do is start asking them questions about how they feel/approach certian situations. This will give you an idea of how pro natural they are. Always ask questions that are open ended so that they give their answer and are not feeding you the answer they think you want to hear. You will know by talking with your OB how pro natural they are. If you get any uneasy vibes or think they are feeding you answers then defiantly switch to a different practice! Your gut will tell you how pro natural they are, so trust your instinct with the OB!!

GL!!

pc150805 · July 2012

tokenhoser:
No one is going to force you into an epidural, but they can arrange things in ways that make that a much more attractive choice. If you get stuck on continuous monitoring and can't move, you'll want the epi. If you can't push in the position you find most comfortable, you increase the chances of ineffective pushing (and eventually a section) or tearing. If you can't eat or drink, you require IV fluids. If they decide you're not progressing fast enough and crank up some pit, you'll want the epi.
Hospital policy impacts birthing women. Denying that is just being arrogant.

I don't really agree with this and I feel like it's not a fair thing to say to someone who is nervous about birth. I had continuous monitoring because my daughter had a heart condition so I was "stuck" and "couldn't move" but I didn't want the epi. In fact, I did try other positions like standing and it was significantly more uncomfortable. I didn't eat or drink and never required IV fluids. I delivered on my back and didn't have a single tear and she was born in 15 minutes of pushing. So just keep an eye on your body and how you feel. Talk to you doctor early so you can work out a plan but be flexible.

AimnJus917 · July 2012

erb82:

I talked with my OB around 32 weeks. This might be a little late for some people, but I already had a good relationship with my doctor since she had already been my gynecologist, and I was sure that it wouldn't be an issue.

AimnJus917:
There's really nothing natural about having a baby in a hospital, but I'm assuming you mean unmedicated, intervention-free birth. !

I really disagree with the statement above. What could be more natural than a mother giving birth in the place that's most comfortable for her? I respect that for you, a hospital birth may feel uncomfortable and unnatural, but that's not true of everyone. I consider my unmedicated, intervention-free hospital births to be very natural, because I was in the place that I wanted to be, surrounded by people I trusted, and free to make the decisions I felt were best for my family. Isn't that what we're all aiming for no matter what our individual decisions are?

Um, ok. Let me tailor my statement then to explain what I really meant as a response to the original poster's question. There's really nothing natural about having a baby in a hospital attended by an OB who doesn't support/knows very little about natural birth. I had an unmedicated birth, that's what I tell people when they ask. I don't tell them I had a natural birth. Pushing on your back is not "natural." Continuous fetal monitoring is not "natural." An episiotomy is not "natural." The words "natural" and "most comfortable place of birth" aren't synonyms so I guess I don't understand your comment. I guess people have different opinions as to what is natural but personally I think it's used a little loosely regarding birth. Now that I am in my 2nd pg, I learned from my first and recommend women to talk to their Drs. asap about how they feel about unmedicated, natural birth options and then decide if they want switch or not.

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