STM: Unmedicated hospital birth = pipedream?

darjeeling · February 2013

Hi ladies,

I hope this post isn't too redundant, I'm looking for some feedback.

I've read a lot of birth stories over the last couple years, so I know it's possible, but I'm feeling a bit discouraged about preparing to have an unmedicated birth at a hospital. Maybe I'm just being a negative nelly lately.

Right now I am reading, among other books, Natural Hospital Birth and although it has a lot of great information, I feel it paints a picture that you will be fighting your providers every step of the way. Does this seem accurate?

I'm wondering if it's just the personal slant of the authors of these books, or if it is really going to be that difficult. I'm starting to question my decision to deliver at a hospital. There are a couple midwifery practices nearby, but the idea of a possible transfer makes me feel unsafe.

So...for the hospital moms: I realize birth is unpredictable, but were you able to have the birth you wanted at a hospital? Did you feel the staff helped you or did you feel like you were fighting them the whole time? Is it just a matter of attitude - like if you believe you can get what you want, then you get it?

And for the midwife moms: how did you mitigate concerns about possible emergencies that required hospital care?

TIA for your viewpoints.

hamiltks10 · February 2013

I totally understand your feelings and felt that way myself leading up the the birth of my son. But I was able to have the natural birth that I wanted in a hospital.

I think a few things played into my experience. My doctor/midwife group is fantastic. They are very open and supportive of natural childbirth. My hospital, too, has changed over the last few years to become more mom and baby friendly...for example, making kangaroo care standard practice and keeping your baby with you in your room for your entire stay. So that helped a lot.

Also, I think that laboring at home for as long as you can eliminates many of the concerns that you have going into labor. I was able to eat and drink, I went in my tub and in the shower, I wasn't hooked up to monitors or IV's, etc.

I got to the hospital ready to push....so other than asking that they unhook my IV after I got antibiotics (group b strep), I didn't have to "fight" for anything. Also...I brought my own bottle of water and when I got thirsty while pushing, I just asked my husband for a drink of water. I don't know if they would have allowed me to drink anything otherwise or if they would have gotten me water if I had asked. But they didn't stop my husband from giving me the water we brought. That may have just been a battle that they didn't care to fight. : )

Anyway...it is absolutely possible to have the birth you want in the hospital. We spend so much time preparing for all the "what-if's". Hopefully for you, things go smooth and you won't even have to deal with any of those concerns.

tokenhoser · February 2013

Yes, I had the birth I wanted in the hospital. I'm planning another hospital birth. Things I did and will do again:

-hire a doula. Not to fight with the hospital, to give you confidence and help you time your hospital arrival to work best for you.

-hospital arrival: I arrived fully dilated. It was perfect for my first birth, as it still took about 90 minutes for DS to arrive. I'll be aiming to be there a bit sooner, but I do not want to linger for hours subject to silly hospital restrictions on food, drink, monitoring, movement, etc. I guess if I'm GBS+, this may have to change.

-doctor choice: I went with my family doctor and found that indeed, she was pretty willing to work with me. OB's tend to be the most technology driven and midwives tend to be most physiological driven, with family docs somewhere in the middle. Of course, there are exceptions in any group of caregivers - great OBs and terrible midwives. Still, it helps to trust your provider as much as possible in advance of the birth.

I can say I got everything I wanted on my birth plan, minus the private recovery room. Wink A lot of that is luck of the draw, but if you don't have those desires articulated in the first place, then there's little chance of achieving them.

Aurora_Borealis · February 2013

It all depends on your provider and your hospital.

I had an unmedicated hospital birth. My prenatal care was through a clinic affiliated with the hospital and low-risk moms have the option of midwife care as the clinic has both midwives and OBs. I purposely chose the clinic because the hospital is known in my area as one that promotes natural, low-intervention birth.

A midwife delivered DD and then I was put under the care of an OB due to a post-birth complication. I did not have to 'fight' with any of my providers about anything during my in-clinic prenatal or in-hospital maternity care.

I also labored at home for as long as I could. And probably longer than I should have as I arrived to the hospital fully dilated and pushing.

So my advice would be to find a hospital and care provider that support natural birth. If there are none in your area and you do not want to use a midwife, I would hire an experienced doula and study techniques to allow you to manage your own labor and labor at home for as long as you feel comfortable doing so.

RMama2012 · February 2013

I think the book is meant to give you lots of tools in the event that you do get push back. I gave birth unmedicated in a hospital with 90% epi rate and 30%+ csection. My biggest issue was the heart rate monitor as when I squatted I would move it and they would come and fix it. They weren't rude but they did eventually ask if I could stand for my contractions (!!!???!!!) and the second time i said NO! and they left me alone. Pretty much no1 bothered me again until transition when one nurse offered me some suggestions for positions but then also said "Some people think you cant get the epi at this point (I was over 8) but you can." There was no way I was going to give in at 9cm! So I will say, no one was rude, belittling, etc. I would recommend bringing your own support though. I had DH (he was actually not helpful) and my MIL (Godsend and she was originally not part of my plan and then as the day progressed I told her to stay for delivery).

AmyRI · February 2013

Well, I have done it twice and didn't have to fight anyone. The nurses weren't that helpful, but they weren't against me. I didn't fight the intermittent monitoring or hep lock and they didn't press meds and let me out of bed even during monitoring.

My second birth ended up with a breech baby, my MW transferred my care to the hospital's on call OB, and he let me deliver vaginally and in the normal Labor and Delivery room even though that required a whole second team waiting in the OR.

I did go into labor spontaneously both times and had a baby in my arms less than 5 hours after I walked in, but I never felt like I was fighting them.

jellybeanjean · February 2013

Yes, I've had an unmedicated hospital birth.

My situation's a little different, as I am an L&D RN at the hospital that I deliver, so I my nurses are my friends and I truly know my OB's. It can be done. I think a lot of it will be the luck of the draw, as some PP's have said. Some of my coworkers are more 'natural-birth friendly' than others. It won't hurt your chances to ask if someone who's pro-natural birth can take you, but if the floor's busy, that may obviously be impossible. If you don't start off defensive and have unreasonable requests, I would hope that most OBs and most RNs will work with you. Lots of pleases/thank yous will go a long way in every area of life...this is no different.

Sidenote -- a lot of my less pro-natural birth friends/coworkers are NOT that way to make their own lives easier. I've seen countless posts that have either implied or outright stated that. It is really, really hard to see someone in pain for a long time. Not everyone prepares well, not everyone handles it well, and not everyone has the same research backing up their reasons for wanting a natural birth. Of course, regardless of the reason/preparation/support/attitude, I will try my hardest to get you the birth you want...but it is emotionally HARD to see someone not handling it well for hours on end. That, of COURSE, is not at all a sweeping statement...but when it happens, it's really hard to watch/coach.

aylafsu88 · February 2013

Yes I had the birth I wanted in the hospital. The staff was amazing and did everything they could to respect my birth plan. I walked in to the hospital and told them I wanted an intervention free birth and to refrain from offering any meds. They did and only checked me when I felt to urge to push. My OB was amazing, he was very supportive of a natural birth and I pushed in the side position. The OB sat on the end of the bed and never once told me to push, or counted while I was pushing. He let me set the pace and push when I wanted to. He also massaged my perineum as LO had a nuchal hand to prevent a big tear. I do think a large part of going natural is your mental preparness and the support system you ahve around you. My doula/H told me how great I was doing the entire time. By hearing them say that I believed it. I was also prepared to the intensity and the pain of contractions. When I was preg I told myself that L&D would be hard and it would hurt. By mentally preparing for the pain I was not surprised when it was difficult and downright painful at times. I had a realistic expectation of L&D which I think helped tremendously.

ETA: Like other posters I made sure I found an OB that supported natural birth this way I never had to worry about fighting for certain things (like no internal checks, no IV etc).

Amanda&EricB · February 2013

darjeeling:

So...for the hospital moms: I realize birth is unpredictable, but were you able to have the birth you wanted at a hospital? Did you feel the staff helped you or did you feel like you were fighting them the whole time? Is it just a matter of attitude - like if you believe you can get what you want, then you get it?

I was definitely able to have the birth I wanted. My very first step to achieving this was to have an OB that I could trust, and that I felt had my best interests in mind. I needed a doctor that would be honest and forthcoming, who would respect my wishes but would ALWAYS put my health and that of my baby first.

I never once had to argue or fight to get the birth I wanted. They let me know what was going on, offered random things but when I declined, they never pushed. It was never brought up again.

I also never went into it with the attitude that I knew more than they did. Sure, this is my body, but my body had never birthed a baby before. So I was really clueless. I knew what I wanted, but I was open to other options if the need arose.

At one point, after pushing for almost 3 hours, I cried and asked my OB if I was going to need a c section. She said absolutely not, that I could do this and she had faith in me. And that gave me a boost, and shortly thereafter I delivered my son.

alitria · February 2013

My situation is a bit different because I showed up about half an hour before my son was born (long story) so I mostly was in labor at home but even in a crisis they were respectful of not wanting medication. The hospital was set up to be very NB friendly with more midwives than OBs on staff and rooms available for water birth. However, I live in the Pacific NW which seems to be generally more NB friendly than many places and my hospital is near several midwifery schools so they're used to working with them. While the NICU didn't volunteer more "natural" practices, when I asked I was absolutely allowed to do skin to skin and try to nurse and have family time. I did quite a bit of research before I picked my hospital and didn't regret my decision.

blush64 · February 2013

I had the birth I wanted with both of my sons. I didn't have to fight for anything. Not one person tried to push anything at me. With my first I was completely med-free and other than being told the epidural was available no one said anything. The hospital I will deliver at this time will mention that pain relief is available but won't push it. (according to nurses on the maternity floor and from people who have had babies there, and my doctor) Walking around and moving around was encouraged and they don't even want you to go to the hospital until you are well into labour.

With my second I choose to have an epidural but no one actually asked. I asked them.

sschwege · February 2013

So much of it depends on your provider and the hospital you are delivering at. But with that being said even if you trust your provider it is still better to labor at home. My MWs have a low c-section rate 13% and an epi rate of 30% and I still stayed away from the hospital until late in the game.

I am fortunate to live in a big city where I had my pick of hospitals. So both times I was delivered by a CNM at a hospital known for being pro-natural childbirth. I had a med-free birth without a problem both times. The first time I arrived at the hospital 6cm, did 20 minutes of continuous monitoring, then spent the next 4 hours in the bath (nurse came every 15 min to listen with the underwater doppler), got out pushed for an hour and DD was born. Second time did continuous monitoring for 10 min, they checked me I was fully dilated, pushed for 2 minutes and DS was born. Both times I could move as I wanted, eat/drink, didn't even have a Saline-Lock. So because of where I was at, it wasn't a fight at all. The only 'problem' I encountered was when I got to triage with my son, the nurse wanted to me lay down for the NST and I told her I didn't think I could. She told me it was better if I did and that's when my mom stepped in and said, 'Why don't we try it with her standing by the bed and if it doesn't work she will lay down." The nurse reluctantly agreed to it and it worked fine.

abell77 · February 2013

I think it really depends on the hospital. I researched all the hospitals in my area, and ultimately chose to deliver at the one furthest away from me (30-60 mins depending on traffic) because they used midwives and were very supportive of natural birth. I had great birth experiences and it was totally worth the drive for me. When I toured the nice, new, fancy hospital that was only a five minute drive away, I got lukewarm, almost patronizing responses when I inquired about unmedicated birth, so I knew it was not the right place for me.

ridesbuttons · February 2013

The more I read on this board, the more grateful I am for my little, rural hospital. No OB/GYN practices locally. If you are high risk, you must go 45-60minutes south to a larger center.

The GPs are pragmatic. I had GD with my first, and my GP watch watchful but not overly concerned. I kept weekly appointments with the diabetes clinic and kept a log of my sugar.

2 hospital births. 2 good experiences. Not once did I have to turn down an intervention (in fact they give you it straight ahead of time: even if you want an epidural you might not get one because of staffing and other factors).

Nurses, doctors all encouraging, good suggestions. I had my own GP, an ER doc and an on-call doc attend various points of both labours/deliveries.

Perhaps the univeral mentality of keeping costs down works in our favour on this platform, who knows.

A37licia · February 2013

I think a lot of it really, really depends on the hospital and the staff. It varies so widely. Some, you hardly have to push back, and some you are fighting tooth and nail.

darjeeling · February 2013

Thank you so much for your feedback ladies, it's very reassuring to hear your stories.

Celyn · February 2013

My second time around, I had a fabulous nurse who was really emotionally supportive. I delivered at a hospital with a terrible track record for natural birth (although with a doctor who had a fabulous rep as a natural birth advocate -- I'd give him more credit in my experience if he was there for more than just the last few minutes

[Deleted User] · February 2013

abell77:
I think it really depends on the hospital. I researched all the hospitals in my area, and ultimately chose to deliver at the one furthest away from me (30-60 mins depending on traffic) because they used midwives and were very supportive of natural birth. I had great birth experiences and it was totally worth the drive for me. When I toured the nice, new, fancy hospital that was only a five minute drive away, I got lukewarm, almost patronizing responses when I inquired about unmedicated birth, so I knew it was not the right place for me.

I'm pretty sure we delivered at the same hospital Wink

I loved my hospital birth, but it did not feel like the typical hospital birth. I chose it because it had the lowest c/s and epidural rates in the area, and when I met with the midwives who would do my prenatal care, they were all very caring and nice. I didn't have to fight for anything. I got a tub room, no IV or heplock (I didn't have to refuse, none was offered) automatic intermittent doppler monitoring, I could eat and drink whatever/whenever, and no one said the word epidural to me once.

Had I delivered at the hospital 10 minutes away, I would not have been treated that way. Choose the most supportive hospital you can find, even if you have to drive a little longer.

stever · February 2013

I gave birth to both my sons without medication. I had not MW or doula but gave birth at a "baby friendly" hospital with very helpful nurses and great OB's.

It's definitely possible.

luvmyducks · February 2013

I suggest talking to your care provider about the hospitals you could be delivering at and also schedule a hospital tour earlier than later.

I had no problem getting the natural birth I wanted at my hospital with my OB. The staff was amazing and a lot of things I had on my birth plan were already standard procedures at the hospital.

lindslalala · February 2013

For the most part I had the birth I wanted at the hospital. I was able to go epi-free, but had to get Pitocin which I wasn't thrilled with. My midwife delivered DS at the hospital, which I believe is fairly common although maybe not in your area? She has an OB "backing" her in case an emergency c-section is needed and for other things of an emergency nature. For our next baby I plan to see the same midwife and also deliver at the hospital, I felt like it was the best of both worlds.

aibrean · February 2013

I fully intend to go med-free as much as possible. The only part where I wouldn't is if they have to induce me (GD-related although my numbers and baby size look good right now) or if I have to have a c-section (opting for a spinal block and not an epidural unless they knock me out).

babywisher · February 2013

Hospital birth here. My Dr and the staff were amazing. I made the decisions and they were good with whatever I decided.

happywife2b · February 2013

Have you done your hospital tour yet? I would recommend writing out your birth plan and then sharing it with your OB for feedback, as well as taking it with you for your hospital tour so you can discuss it with the staff and get their feedback, as well. That way you will have a very good idea of the prevalent attitudes and practices at your particular hospital.

And yes, lots of those books and movies are heavily biased.

PansyPants · February 2013

I didn't feel like I was fighting the staff or my providers, but I also was very careful to choose a midwife/doctor who were very supportive. I had to switch providers both pregnancies but its worth city for the peace of mind.

I also had great luck with the hospital and nurses, one was a little pushy but I just stashed calm and ignored her mostly.

pinkiemo · February 2013

I'm doing another hospital birth this time around. I had complications during my first that made it impossible to go med free, but I don't blame the docs or the hospital. I didn't have to fight at all with them and actually avoided a c-section because I asked for an extra half hour to labor on and they gave it to me.

The only part I wasn't happy with was than it was mandatory for the anesthesiologist to talk to me. But this was more her attitude than anything else. I was fine with her talking even though I said from the beginning I was going natural. She came in to talk to me while I was in transition and vocalizing a lot. After trying to wait in between contractions to talk and not getting anywhere, she got annoyed and said "I'm just going to talk over your screams."

That just made me "scream" louder. Wink

mlrafiki · March 2013

jellybeanjean:
Sidenote -- a lot of my less pro-natural birth friends/coworkers are NOT that way to make their own lives easier. I've seen countless posts that have either implied or outright stated that. It is really, really hard to see someone in pain for a long time. Not everyone prepares well, not everyone handles it well, and not everyone has the same research backing up their reasons for wanting a natural birth. Of course, regardless of the reason/preparation/support/attitude, I will try my hardest to get you the birth you want...but it is emotionally HARD to see someone not handling it well for hours on end. That, of COURSE, is not at all a sweeping statement...but when it happens, it's really hard to watch/coach.

I just want to say that this was a really helpful perspective to hear.... I've often wondered if nurses seem to push meds not so much because its convenient for them or that's what they're used to, as that it must just be hard to deal with that much suffering. Even though I haven't given birth yet, the nurses I had when I was in the hospital with kidney stones really reacted when I started crying, and it made me feel like that aspect of the job has to be so tough. Respect!

darjeeling · March 2013

We actually went on our hospital tour last Monday, and it went better than I expected. Although I did find out from my doctor that they do constant fetal monitoring which I'm not too thrilled about, I think I might be able to avoid most of that by laboring at home.

I was really surprised - they actually encourage women to walk around or rock in rocking chairs during labor, skin to skin right after the baby is born, and the nurses help with breastfeeding. And they pass out warm cookies to the dads at certain times of day. (hopefully they are organic, j/k

The biggest surprise was the bathrooms have jacuzzi tubs you can labor in!

We registered for our hypnobabies classes, and I'm over halfway through interviewing doulas (2/3), so am feeling a bit more prepared.

Thanks again for everyone's helpful insights!

Dman85 · March 2013

I had a natural birth in the hospital. I was in labor for 25 hours and with the exception of one nurse my wishes were accepted. The one nurse suggested pitocin a few times, but nothing bad that I felt was out of line. I am going back to the same hospital to deliver this baby and am confident that it can be done again. THe hospital is very natural friendly though.

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