Hospital protocols vs. Parental preferences — The Bump
November 2022 Moms

Hospital protocols vs. Parental preferences

Hey guys, first time mama here. I was wondering if anyone could fill me in on common hospital protocols for labor & delivery and for baby care post delivery? 
Trying to put together my birth plan so my husband and I can advocate for myself and baby but there is so much I don't know. Can I tell my doctors I would like to wait as long as possible to be given an epidural? I know there is a certain time frame that this can be given. How many centimeters is too far along to be given epidural? Is it just when you get to active labor? Can I tell my doctors to perform an episiotomy sooner rather than later to prevent tearing? Etc. Does baby need to be weighed and measured before I can hold baby for an extended time? Or breastfeed? Can I postpone the timing of necessary shots? If yes, until how long? If baby goes to nursery, can I ask that they do not bottle feed my baby but bring her back to me no matter the time of day? Etc. Please, any advise is appreciated. 

Re: Hospital protocols vs. Parental preferences

  • lilswedlilswed member
    The best people to ask about your specific hospital  and situation would be your ob who probably knows your hospital procedures. We also did a hospital tour and they answered a lot of my questions about what I could put into a plan. 

    Just keep in mind that plans may need to change and you may even find in the moment that what you thought would work for you isn’t. The team I had followed my plan as much as they are able - I.e. a cord wrapped around babe’s neck changes the after birth plan - no guilt if you need to switch it up in the moment.
  • If you can afford it I suggest getting a doula. They are great help at the hospital, the nurses are in and out but a doula is there the whole time to help you through the pain and to help your partner be there for you as a birth partner.   Also taking childbirth Ed and birthing classes with your partner will help a lot, they go through a lot of hospital scenarios and teach you about what your body will go through. 

    Post birth it’s really up to you if they’ll move your baby for all the things they do after.  I think usually They’ll let you hold your baby right away, and then after skin they’ll weigh, measure, do whatever tests and shots if needed/decided. They didn’t let me breast feed right away, I think they just wanted me to wait until I delivered the placenta then I did. But I held him skin to skin until I tried feeding the first time.  
       A lot of the stuff they  can do with your baby laying on your chest. Tell them you want them to do as much as possible while you hold baby if that’s what you want, If you don’t want them to clean off the vernix they don’t have to.  At my hospital they never took the baby to a nursery. He was in my room the whole time, I think if I wanted they would have take him so I could rest but I liked him there.  

    I’ve heard episiotomy is harder to heal than natural tearing, but sometimes It’s necessary for the delivery.  I was actually talking to my Physical therapist about this yesterday, I pushed for so long I kinda wished they’d done an episiotomy but the pt said it can cause more pelvic floor problems in the long run.  Talk to your ob about all these things they will surely know more than me and know what is right did you. 
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  • I think you should ask your providers all these questions. This is all going to vary.

    I would not request an episiotomy. Episiotomies to avoid tearing is not a thing anymore, and they never should have been given routinely in the past. 
  • It’s fair to ask these questions but keep in mind these protocols have been developed for very specific reasons backed by tons of research and clinical practice, so don’t be disappointed if they can’t accommodate what you think your preferences are now.
  • Every hospital is different and I think it is so important to get to know the specific ones that you are interested in delivering at.  I would also suggest taking a birthing course from the hospital and a birth center/ doula group if possible.  The hospital can let you know what the "standard" is but it might also be helpful to hear about the wide array of options so that you can know what is out there. 

    Something else to ask is if they will offer or require a pitocin shot after labor to help with bleeding.  I personally got it and it made a world of difference. I only bring it up because it was not mentioned in any of my classes that it was something that could be needed. 
  • @skugirl2022 +1 that the best person to ask about this is your OB. They should be able to give you specifics on what they typically offer. That doesn't mean that you can't request something different but make sure you are very open to things going awry. I didn't have a birth plan with my first. The only thing I wanted was immediate skin to skin and for them to leave the placenta attached for a few minutes. At birth he came out not breathing. They had to take him away for a few minutes to resuscitate. At the end of the day my baby was born happy and healthy and that's all that matters!

    Also, they had to perform an episiotomy to get him out when he stopped breathing and 0/10 do not recommend. I can still hear and feel the clip and it makes me shudder everytime. I ended up with a 3rd degree tear and had a very uncomfortable recovery. You're way more likely to rear after an episiotomy. 
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