Friday, April 30, 2010

L'Hopital

Jeremy and I decided early on in this pregnancy that I would be seeking prenatal care with an OB and delivering in a hospital. I've been on the wrong end of the not-going-to-happen-in-most-cases statistics to feel wise giving birth in any other way. So I wanted to share my thoughts on preparing for a natural delivery in a hospital (including what I'd do differently if I was doing it again), and my Top 10 best things about delivering in a hospital.


Natural Childbirth in a Hospital

I did not have strong feelings of wanting to deliver naturally this pregnancy. My biggest goal was wanting to go into labor spontaneously. Both of my previous deliveries were inductions, and for the sake of experience, I really just wanted to go into labor on my own. That being said, I thought it was possible that in going into labor spontaneously that the chances of my having a natural delivery were higher.

Everyone's definition of natural delivery is different. It can range from simply delivering without pain medication, to unassisted childbirth--delivering a baby without a trace of medical intervention, including not ever even talking to a doctor or midwife and delivering at home on your own.

In planning for a natural childbirth you need to decide which elements of "natural" are important to you, personally. Then base the care that you seek in a delivery location and medical provider on those points. There are some official policies that the hospital will have-- for example our local hospital does not allow VBACs. But then there are also "standard procedures," that they normally do, but can actually be refused. There are also preferred practices of your doctor or midwife. They actually can call a lot of the shots in the hospital about your delivery (in your favor and not) so it's really important to talk with your provider about your desires.

Two things I talked to my doctor about were not having an IV and delayed cord clamping. He told me the hospital does give an IV standard, but he said I could refuse it. Also, he said I could get just the hep-lock with no IV connected and that would probably make the nurses feel more comfortable, just in case of emergency. But, he said, if I was willing to drink during labor to stay hydrated, he was comfortable with me refusing an IV.

In regards to delayed cord clamping my doctor was also accommodating. He said that based on his personal research into the topic he could see no significant evidence for or against it. So in that case he was willing to do whatever I wanted, and said that he regularly did delay cord clamping as requested.

At my actual delivery I did get the hep-lock. Based on the stage of my labor we got there at Jeremy said I probably wouldn't be moving around much from that point on so he thought I should go ahead and get it. My feelings on the subject were not that strong, so I went ahead and got it. It bugged me a bit, but really towards the end it kind of gave me a physical focus point for my frustration and and discomfort during contractions.

Other interventions I did not have strong feelings against were the external fetal monitoring, and internal cervical checks. In fact I want those things because I'm curious about what's going on with my body. In truth I never looked at the fetal monitors this delivery, because I was too focused on my breathing, but I know Jer watched them, and I've watched them in my previous deliveries. But if I had been in the hospital longer I was going to request intermittent monitoring so I could walk around and also labor in the tub for a while.

Finally, another intervention I agreed with was the artificial rupturing of membranes right before delivery. The baby was right there. Releasing the waters allowed the baby's head to push past the cervix for delivery, and delivery was so imminent that the risk of introducing infection at that point was nil.

My other suggestions for delivering naturally in a hospital would be these:

Wait for labor to come naturally. With an induction you are on an IV and monitors from the start, you're likely to end up with more interventions.

Stay home as long as possible. Also, with this one there is less time on the monitors which means less opportunity for a false alarm problem. Also, at home there is no medication, so you can't ask for it. At the hospital you know the medication is available, that makes it harder to refuse. There was a point at home in my labor where I thought: if it was daytime and I could easily take my boys to someone's house, I'd probably be going to the hospital right now, and if I was at the hospital right now, I'd be really tempted by the epidural. However, you can take this too far. In the end, I was actually wondering at one point when we were heading out the door if we were going to make it to the hospital in time to deliver.

Finally, always question an intervention you weren't planning on. This was something I read preparing for delivery this time. A lot of times when doctors or nurses want to introduce an intervention it's not necessary right this second. So ask: can we wait another hour before trying that etc. In many situations, you can just wait things out. And some women want to speed things along, like use pitocin to get things going, so you really just need to make your preferences known.

I have one thing I would have done differently if I was doing it over again with the goal to go drugless. Once I got to the hospital, I had obviously hit transition. I pretty much laid down in the bed for my nurse to check me, and I stayed there from that point on. I was tired from having gotten no sleep that night, and the contractions were super-intense. I don't know that laying down slowed anything down, but it definitely didn't speed things along. In retrospect, I think I should have asked for the squat bar. They attach to the bed so I wouldn't have really had to go anywhere, but I think being upright may have helped to decrease the time between when I got there and delivered. (Although maybe then my doctor wouldn't have made it!) But at the time it never even crossed my mind, so I didn't squat.

Top 10 best things about delivering in the hospital

10: Cable TV- Although I was actually quite disappointed in the programing while I was there. Maybe we aren't missing anything by not having cable.

9: The great view of an urban landscape out the window-- There was a fireworks show for me the night I delivered.

8: Seeing the other babies--When Wyatt was getting his morning pediatrician check-up I took a little walk to watch through the nursery window. There was at least 4 other cute babies, 3 girls one boy. Mine had the biggest head, but not the most hair.

7: SWAG--There's all kinds of souvenirs to bring home for the baby scrapbook, like a special certificate that say's Congratulations Mom and Dad, your baby can hear!

6: No kids--Ok really I did miss my boys. They visited me for about an hour and a half each day. But for my health it's better for me to just rest, and not feel tempted to get out of bed and take care of my boys.

5: Pee-pee parties-- The celebration of the nurses the first time you empty your bladder post-delivery.

4: Endless supply of ice pellets-- It beats buying a bag at Sonic.

3: The night time nursery-- I haven't slept the last 4 months, and won't for the next 6 months. I've sent all three boys to the hospital nursery at night with no guilt. I deserve to have those two nights of decent sleep.

2: Room service dining- 6:30 am to 7 pm just pick up the phone and get all the doughnuts and chocolate milk I could want. . . oh, and salad.

1: Someone else does the laundry!

5 comments:

Jen said...

People often think that because I've home-birthed that I'm completely against hospital birth...which isn't the case! (Though, I'm against hospital birth for ME...) =)

What I'm against is women not having the birth experiences that they want and not being supported/respected/encouraged in doing everything possible to make those things happen.

It makes me downright GIDDY when I hear of someone having a birth without regret--when the end result left the parents happy and satisfied and proud of what they did.

At home or in the hospital or anywhere in-between (Joe's dad was born in a Studebaker!), I'm just happy when another women gets the birth she wanted.

(That doesn't mean I'm not opinionated about birth in general and have an "ideal" that I support, of course...but don't we all?)

aleatha said...

What a great post! I am glad you had such a good birth :D

I might use this for reference in the future because Ohio isn't very midwife-friendly. I am waffling between doing a home birth and just going to the hospital. But I've got quite a bit of time before I need to start thinking about that. I hope.

When I was at the hospital when Abraham had jaundice, I felt so well cared for by the lovely nurses, day and night. It was awesome.

Anonymous said...

I've told you this, but for the sake of blog readers, just remember: The baby doesn't remember what his/her birth was like--BUT YOU DO!!! Anything that is upsetting to you may haunt you later. I could never have delivered my 4th child in his posterior position (face up) at home. And though he was ultimately delivered safely with forceps and NO ANAESTHETIC, my subconscious body responded to my next pregnancy by going into mental/emotion shut down when the Braxton Hick's started at 7 months. There are always things we wish were different about pregnancy and deliveries, but if the truth be said, we all wish for a safe, painless delivery of a healthy child with no scarring or trauma to our own bodies. DREAM ON!! It ain't never gonna be that way!! :) So take care of Momma, 'cuz the baby won't remember! Nonny

Mindy said...

And the nurses change your baby's gooey black diapers while you're there!
I've always been nervous for people who don't deliver in hospitals because even though it almost always goes okay, I couldn't forgive myself if something went wrong with my precious baby that could have been preventable. Plus, I think hospitals and their maternity wards are always getting nicer and more in touch with what is desirable to the patient.

shelly said...

Okay, Jeanette, I really enjoy your writing. Birth stories and opinions are always so interesting. So, we've only met a couple times, but I'm butting in my two cents again =)

Oh, how I love the hospital!! I've always said it's the food. Like, seriously, that's the closest to a spa experience I've had =) But I'm with you on the pee party. That's hilarious. I love those pictures. He is such a doll! And amen on that pokey iv. I didn't realize it was standard procedure, but with this last one I just asked not to have it and they were nice and let me do whatever I pleased =)

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