Natural birth in a hospital (and a question about homebirth)

[futuresoccermom]

I want to have as natural as a birth as possible...but in a hospital! I am not worried about nurses/doctors interfering with the bigger issues (like, saying no to induction/epi/offers of pitocin, ect, as I'm pretty confident in stating my wishes regarding those things) I'm more worried about the little things that I dont want to have happen, like, hourly vaginal exams, constant EFM monitoring, birth position (I refuse to birth on my back again!)...not wearing a hospital gown... being extra gentle with the baby when it first comes out, basically, I don't really want the nurses help if I dont absolutely need it...If you've resisted any of the smaller 'routine' tasks from the nursing staff, where they generally accommodating? What was your experience like??

I am curious about actual hospital policies too, I am going to ask my doctor about our hospital..

Also! If you had a home birth, what do you do if your group B strep positive?? I was positive with my first and had to be on IV during my entire labour.. (it ripped out of my arm twice which was a major pain!) I have yet to be tested with this pregnancy, I really dont want to have any IV if I dont need to..

Also, home birth, who stitched you up if you had a bad tear?

Thanks ladies!!

[MaryJane]

If you are wanting to prevent GBS then you should start a preventative regimen now. Best to talk to a midwife or naturopath. It usually consists of garlic and echinacea. Depending on where you are, homebirth midwives usually are able to administer antibiotics and they're definitely able to do sutures if necessary. As for the hospital birth, the willingness of the nurses to cooperate with your wishes depends on the nurse. I've seen some very accommodating nurses and some who were very rude and forceful. Remember that if you aren't happy with your nurse and how you are being treated you can ask for a different nurse. You might also consider hiring a doula. She can help prepare you to advocate for yourself and make sure that your needs and desires are being respected. And remember the words I do not consent to that. Those are the magic words. Also ask what are you doing? Why are you doing it? What are the risks of what you're doing? What are the alternative? What if we wait?

[Bridget]

Since I had tested positive for group b strep in a previous pregnancy, my midwives had me on a probiotic throughout my pregnancy. They shared with me some statistics and studies showing a high success rate women who had previously tested positive. My test was negative during that pregnancy. They would have administered antibiotics had I wanted them and also stitched me up had I needed.

[Coral]

Absolutely hire a doula. They can help run interference for you. And honestly, it's all dependent on your specific nurse/hospital and doctor. Have you talked to like minded people who have birthed there? They should be able to give you a better idea of what your hospital will and wont allow. Also be sure to talk to your doctor ahead of time about your birth wishes. Good luck momma. <3

[preciousnd98]

I opted for a medicated birth, but my hospital didn't do many vaginal exams at all. I was checked when I got there, and then they monitored contractions and waited until the patterns showed signs that I was close to ready before checking again. My hospital also has an "alternative birthing room" which has a tub, queen sized bed, yoga balls, etc so you can create your own "home" birth if that is what you prefer. It was my understanding that there is a lot less involvement if you choose that option and they do what they can to meet your needs, only stepping in if necessary or requested. So I would definitely talk to your doctor about options at your hospital to achieve the birthing experience you want.

[wannabmomof3]

I didn't read the other posts, but the ONE thing (well, one major thing) that helped ensure the birth I wanted was have a nurse that is pro-natural. I had the most AMAZING nurse-who did everything i asked, my every wish. If you have someone from the hospital that's on your side and knows your every wish (not all nurses follow a birth plan), then the chances that it'll happen are great. I can't stress that enough to my friends and family who are opting for a natural birth. When you are in labor, call your hospital before you go in and request for a pro-natural nurse and have DH explain your wishes before hand. Not sure if you are doing a birth plan or not, but at least they will be prepared for you.

[tanyachap]

I agree with everything Mary Jane said. Midwife can give you AX during delivery and stitch you up.

The hospital experience depends on the nurse and doctor. It is great to hire a doula but if you don't want to for whatever reason, DH has to be your advocate. I personally trust my DH 60% with that. LOL.

[Consensus]

Have a birth plan. Hire a doula, though they cannot talk to the staff for you. The hospital I delivered at was pretty pro-natural so most of those things you mentioned automatically; I was only checked 3, maybe 4 times total (once when I came in, a few hours later, right after that when I felt the urge to push and then to verify I was complete - only one contraction between 7 and 10!). And they kept the lights dim and the room was very quiet- I even slept between contractions! Though it turned into a circus when birthing time came, there were probably 10 people in the room, but they handed him right to me after birth and he snuggled on my chest for the first 20 minutes
The doula was great in grabbing the birthing ball and helping me to advocate position. the nurse was very pro-natural too, and I stated that I wanted a pro-natural nurse several times. I wasn't on EFM for my first hour, but a shift change meant a head doctor change and a change in policy so I ended up on it, but I was a vbac so I wasn't surprised. I had no qualms about changing into a hospital gown though, no need to make a bigger mess of my own clothes.

I do think hospital environment is one of the biggest factors though. Hope you get some good answers from your doc. Good luck!

[i.<3.cheesysmiles]

The one thing I could not get my doc to budge on was birthing on my back. For labor, I could do whatever, but they wanted me to deliver on my back. That is something you could probably talk to your doctor ahead of time.


For my second, I hired a doula. It was very helpful. She did advocate and speak for me when I couldn't. Likje when I needed the lights shut off. She was right there, holding a damp cloth on my head and I just told her to shut the lights, and she told the nurse...IDK if that was against doula "rules" but she did speak to the staff for me. I think it might have depended on the nurse, too. I had a young, new nurse who was really friendly, and I think really intrigued by a natural birth. She kinda wanted to sit back and watch. lol. Like others said, I do think it depends on the nurse. With my first, I had a very off-hands nurse, too, but I think it was just because she didn't want to be bothered.

[futuresoccermom]

I dont know, I've never really had a desire for a doula! I've witnessed doula's in action, a friend of mine had one, she is a single mom and hired one. The doula was great for emotional support and knowledge, but the nurses still came in and did their thing! I feel like I have the birthing support that I need (DH and my sister) they are both reading and taking very seriously my hypnobirthing approach.... I think they will be all the help I need (and quite frankly, I dont want anybody else besides them massaging me...my sister massaged my butt for ...I dont even know how many hours when my back labour was bad!) It has to be somebody I am close to...I can't give myself over to a doula like that...I want that person to be Dh. I do plan on staying home for as long as physically possible, hopefully, right up until delivery.
What I need is a pro-natural nurse. I will definitely ask my doctor about the nursing staff. This is the same hospital I delivered my daughter at, but during that birth, the nurses very much ran the show. I felt very much like 'their patient' rather than a mom giving birth. But looking back, I fully appreciate how they handled things because I was a mess and had no idea what I was doing. I know better now.. and so does Dh. I know he will be a good advocate for our wishes, I just hope we have a nurse that complies! And not some old brute who is set in her ways or trying to push things along!

[macksmom]

As the others said most of it will depend on the nurses and hospital policies and how much you advocate for what you want. Have a written birth plan. Talk to your OB about what you want. Make sure you know what is available at the hospital. I thought my hospital was progressive but they had little to no accomodations for natural birthing. No baths, you are barely even allowed in the shower, no roaming the halls (they said you could stand next to your bed ) - although that is because I had an IV and was being induced.

Speaking of...if you do end up needing an induction for whatever reason opt for the epidural! I did an induction with no epidural and it was horrifying. I wanted to go natural but had to be induced for medical reasons. Bad idea.

I hope you get the birth experience you want!!!

Also - I understand what you are saying about a doula. I felt the same way. I think if the people who are with you are trained in how you want to birth you will probably be ok. It sounds like it may get too crowded with a doula in there too. I have only heard good things about them though so it's something to consider.

[JJorn]

I've had two births in the hospital. The first time my labor was 33 hours long and I was in L&D for about 13 hours of that. I really wanted to go all natural and nothing was offered to me until I asked at hour 24 just for some pain relief so I could sleep for a bit. I was so exhausted. So, I think it was a narcotic in the butt and in the IV and I got some rest. Four hours later I was ready to go again and had my DD several hours later. My OB had a medical student with her who thanked me profusely because all the OB patients she had observed had epidurals. I did have my DH's aunt with us and she is a doula. She was a great resource and did help with pain management, how to move my body to help with labor and how to push.

My second birth was only 22 hours long, and I was in L&D for the last about 6 hours. I guess that I was GBS+ at 9 weeks so they made me have two doses of antibiotics before they would even check me (and I was 7 cm and 100% effaced then). I was pretty mad about that since I was negative at 36 weeks and just wanted them to break my water so I could have this baby! They did a hep block so I only had an IV bag attached when I received the antibiotics (about an hour after I arrived and then 4 hours later). Otherwise I was free to move around anywhere I wanted. The next time I was checked was 30 minutes after they broke my water (at my request) when I said that I had to push. I was complete and my DS was born a few pushes later.

I really had no issues (except that crummy GBS+ hospital policy) with my hospital births. My DH really doesn't want me to have a home birth and there isn't' a single birthing center in my state. There might be a law against them. So, my choices were hospital birth or hospital birth.

[babybluesash]

If you are wanting to prevent GBS then you should start a preventative regimen now. Best to talk to a midwife or naturopath. It usually consists of garlic and echinacea. Depending on where you are, homebirth midwives usually are able to administer antibiotics and they're definitely able to do sutures if necessary. As for the hospital birth, the willingness of the nurses to cooperate with your wishes depends on the nurse. I've seen some very accommodating nurses and some who were very rude and forceful. Remember that if you aren't happy with your nurse and how you are being treated you can ask for a different nurse. You might also consider hiring a doula. She can help prepare you to advocate for yourself and make sure that your needs and desires are being respected. And remember the words I do not consent to that. Those are the magic words. Also ask what are you doing? Why are you doing it? What are the risks of what you're doing? What are the alternative? What if we wait?

This also there is something called Hibiclens which you can do six hours before your test and you can also use it during labor as well if a homebirth to prevent any infection.
http://www.drmomma.org/2009/09/chlor...tocol-for.html

[futuresoccermom]

As the others said most of it will depend on the nurses and hospital policies and how much you advocate for what you want. Have a written birth plan. Talk to your OB about what you want. Make sure you know what is available at the hospital. I thought my hospital was progressive but they had little to no accomodations for natural birthing. No baths, you are barely even allowed in the shower, no roaming the halls (they said you could stand next to your bed ) - although that is because I had an IV and was being induced.

Speaking of...if you do end up needing an induction for whatever reason opt for the epidural! I did an induction with no epidural and it was horrifying. I wanted to go natural but had to be induced for medical reasons. Bad idea.

I hope you get the birth experience you want!!!

Also - I understand what you are saying about a doula. I felt the same way. I think if the people who are with you are trained in how you want to birth you will probably be ok. It sounds like it may get too crowded with a doula in there too. I have only heard good things about them though so it's something to consider.

I will definitely find out the specifics, I know we have showers... I feel like i'm in a 'defensive mode' when I think of birthing at the hospital! I may have no reason to feel this way.. I guess I'm just comparing from my first. I'm gonna make a birth plan!

[NHKate]

I had a natural birth at a hospital, and I didn't need to fend off anything. The nurses and doctors were totally on board with me about it. I think they checked my cervix about 2-3 times total. I planned on having a waterbirth, and would have, except that after pushing in the tub for awhile, I just felt like getting out and being in a different position. (Still, the tub was great for my comfort while I was in it.) The hospital I went to is very well known for being mom and baby friendly, and letting you have your birth the way YOU want it, so I'm lucky I had a hospital like that near me.

[futuresoccermom]

I had a natural birth at a hospital, and I didn't need to fend off anything. The nurses and doctors were totally on board with me about it. I think they checked my cervix about 2-3 times total. I planned on having a waterbirth, and would have, except that after pushing in the tub for awhile, I just felt like getting out and being in a different position. (Still, the tub was great for my comfort while I was in it.) The hospital I went to is very well known for being mom and baby friendly, and letting you have your birth the way YOU want it, so I'm lucky I had a hospital like that near me.

That is so awesome! Some hospitals are getting it!! With mine, I think it will have all to do with nurses and how confident I am...I remember with my first, I was so confident with breastfeeding (thanks to APA and the breastfeeding room which I stalked during my entire first pregnancy) I remember one nurse telling me that I should supplement before my milk came up and I wanted to smack her. The next nurse that came in was nothing but supportive and helpful. You'd think they'd all be generally on the same page but when it comes to birth/baby I think most of it is just personal opinion. I have to make sure mine is the loudest!

[CoffeeCat]

I think everyone has said what I was going to say about making your hospital experience more natural-oriented.

About your questions regarding homebirth, if I was GBS+ which I wasn't, my midwife (CPM LM) had an arrangement with a CNM who was homebirth-friendly and would drop in anytime, day or night to start an IV of antibiotics, and my MW had more bags she could hang every however many hours per ACOG protocol.

Homebirth midwives are trained to do tears, but it depends on their experience as to whether they will do them or send you in. Some are trained more intensively than others, so you would need to specifically ask if you were thinking of going the homebirth route and were concerned. My midwife has been in practice a long time, but because they have so many waterbirths and non-augmented labors and the women she cares for rarely are on their backs pushing, they statistically see less tearing to get that practice in on, and have to make specific training trips (in her case to Utah) to get that experience. By law she can't do anything worse than a 2nd degree at home in Vermont. This last time with my 4th baby I had an 11 lb baby in 1.5 hours. He had a 16.25" head circumference. I pushed for less than 5 minutes...cannonball scenario!...but my tear was pretty much the same as when I had my 2nd son. 2nd degree. She was comfortable repairing it at first because it wasn't deep or jagged, but she couldn't visualize the apex of the tear clearly. It was located in a tricky spot I guess, and she thought it would need a heavier guage thread than she carries (she was right). She called L&D, a doc stitched me up and I went back home-took about an hour total, including getting out of bed slowly, getting clothes on, getting baby ready to come with us, getting there which was the shortest part, checking in at the main desk, getting the tear repaired, signing paperwork, driving home. Being a non-emergent transfer it took longer than if we had called an ambulance. In my case the hospital doesn't fuss for an hour because I'm a homebirth transfer, the doc was right there & friendly (we did have a weird misunderstanding because his pager sent him a weird message but that's another story). In some scenarios I could see it taking away from the glorious afterglow with your baby though. Then again anytime you have a home birth you have to be prepared for transfer, and even in the hospital things can happen that interrupt bonding time, so it's really not that different in that respect when dealing with a bad tear that your midwife isn't comfortable with doing herself.

Sounds like you are leaning toward a hospital birth anyway, which is great-I had really good experiences in the hospital the first 2xs as far as how I was treated in labor. We only chose homebirth with #4 because we knew that with my history of late babies who were otherwise very healthy we would be heavily pressured to induce or augment without clinical evidence of fetal distress, because it had happened to us 3 times before. And sure enough he was born at 42 weeks 1 hour, 30 minutes. Right after the hospital "cutoff"

[futuresoccermom]

I think everyone has said what I was going to say about making your hospital experience more natural-oriented.

About your questions regarding homebirth, if I was GBS+ which I wasn't, my midwife (CPM LM) had an arrangement with a CNM who was homebirth-friendly and would drop in anytime, day or night to start an IV of antibiotics, and my MW had more bags she could hang every however many hours per ACOG protocol.

Homebirth midwives are trained to do tears, but it depends on their experience as to whether they will do them or send you in. Some are trained more intensively than others, so you would need to specifically ask if you were thinking of going the homebirth route and were concerned. My midwife has been in practice a long time, but because they have so many waterbirths and non-augmented labors and the women she cares for rarely are on their backs pushing, they statistically see less tearing to get that practice in on, and have to make specific training trips (in her case to Utah) to get that experience. By law she can't do anything worse than a 2nd degree at home in Vermont. This last time with my 4th baby I had an 11 lb baby in 1.5 hours. He had a 16.25" head circumference. I pushed for less than 5 minutes...cannonball scenario!...but my tear was pretty much the same as when I had my 2nd son. 2nd degree. She was comfortable repairing it at first because it wasn't deep or jagged, but she couldn't visualize the apex of the tear clearly. It was located in a tricky spot I guess, and she thought it would need a heavier guage thread than she carries (she was right). She called L&D, a doc stitched me up and I went back home-took about an hour total, including getting out of bed slowly, getting clothes on, getting baby ready to come with us, getting there which was the shortest part, checking in at the main desk, getting the tear repaired, signing paperwork, driving home. Being a non-emergent transfer it took longer than if we had called an ambulance. In my case the hospital doesn't fuss for an hour because I'm a homebirth transfer, the doc was right there & friendly (we did have a weird misunderstanding because his pager sent him a weird message but that's another story). In some scenarios I could see it taking away from the glorious afterglow with your baby though. Then again anytime you have a home birth you have to be prepared for transfer, and even in the hospital things can happen that interrupt bonding time, so it's really not that different in that respect when dealing with a bad tear that your midwife isn't comfortable with doing herself.

Sounds like you are leaning toward a hospital birth anyway, which is great-I had really good experiences in the hospital the first 2xs as far as how I was treated in labor. We only chose homebirth with #4 because we knew that with my history of late babies who were otherwise very healthy we would be heavily pressured to induce or augment without clinical evidence of fetal distress, because it had happened to us 3 times before. And sure enough he was born at 42 weeks 1 hour, 30 minutes. Right after the hospital "cutoff"

I read that about tearing! The chances are decreased when your more relaxed, birthing how you want (I'm assuming home births see a lot less tearing! You've got to be pretty relaxed and confident to birth at home imo!) But transferring, like you said, if something 'tricky' comes up, is something that's got to be expected in some circumstances, its wonderful that midwives can administer the antibiotics and handle tearing, I didn't know that. I am going to have a hospital birth... I need that peace of mind of having the medical staff right there and don't want to pay out of pocket for midwife when we pay a butt load of taxes to have the birthing floor of our hospital readily available to us. Even it it means just utilizing one of their big private birthing rooms, and dirtying up a bunch of their sheets!! (ha ha)
I talked to my doctor yesterday... he assured me that I can have 'the birth that I want' and even said if I come across any nurses that 'push' something I dont agree with, that I can 'push back' and it will all be okay. I really love my doctor, but he's not guaranteed to be the one there when I give birth. I get whoever happens to be working that day/night and there are 6 doctors who work the rotation.... (bummer!) We shall see! I did find a wonderful hypnobirthing 'birth plan' template that I am going to re-type and personalize, I feel better about that now!
Thank you ladies!

[MalvinaB]

Hello there...

I have had both of my girls naturally (no medical intervenions once so ever). I was confronted with a lot of issues about it, from how people viewed me to dealing with a nurse in particular. Here is a link to my latest blog that I wrote in response to my natural birth with my second daughter, which I think wil help you understand how it is to deal with the "little things". http://startwithmom.com/blog/?p=760
The bottom line that I want to point out, which i wish I had known prior, if you are dealing with staff who do not want to compromise with your wishes, you have every right to ask for someone else that will. I wish that I had asked for another nurse who had experience with natural births, and of course, I wish I was better prepared for this birth....Good luck to you, and hope that everything that you desire for your birth happens

Also, if you have chance please fee freel to check out my website that is geared for moms and moms to-be who are seeking solutions to healthy living www.startwithmom.com, and feel free to like us on facebook and participate in awesome discussions! www.facebook.com/startwithmom/

[misfit]

My midwife gave me several options about the Group B. Do nothing. Take antibiotics I think and then retest. And the third I think was IV antibiotics when I went into labor. I tested negative with all 3 of my kids though.

[CorpsmanWife]

I had an amazing hospital birth the second time around. I don't know if it was the fact that I was more comfortable with my demands or my 2nd time around. My OB delivered my first via csection. I planned to have a homebirth the 2nd time, but due to heart problems I had to have a hosp. birth. My OB (who delivered my 1st) sat down with me and listened to my fears. From that day forward we were both on the same page and a birth plan was in place. I lucked up and got a nurse who gave birth to 3 babies unmedicated, so she was a major support. My OB was the only one to check me. I wasn't planning on birthing naked but it just happened that way. I was burning up when I hit transition.
I would talk to your OB about all your concerns. Hope everything goes well!

[CoffeeCat]

I am going to have a hospital birth... I need that peace of mind of having the medical staff right there and don't want to pay out of pocket for midwife when we pay a butt load of taxes to have the birthing floor of our hospital readily available to us. Even it it means just utilizing one of their big private birthing rooms, and dirtying up a bunch of their sheets!! (ha ha)

Totally hear ya. Out of pocket expense was one reason we didn't look into homebirth when we lived in Mass. And midwives aren't certified by the state, so their education and experience varies widely, and there weren't very many who were located close to us-the few that were weren't a good match with us philosophy-wise. I don't believe there were any that carried pitocin/methergine for hemorrhages, unless they did it illegally. In VT all insurances are mandated to cover homebirth, though Blue Cross Blue Shield is trying to get around that.

I think it's awesome that your doc is not only supportive, but has given you permission to push back if necessary-that's really great to have that feeling that he has your back and you are being respected. Even if someone else is on call or your nurse doesn't happen to be natural birth-oriented, knowing he stands behind you will be a good feeling to have. I personally found my second & third times there was a difference in how the nurses interacted with me-they were ALWAYS kind and respectful, but there is a little bit less "SUUUUUURE you don't want an epidural...talk to me in 3 hours!) in their voices, if you know what I mean.

[futuresoccermom]

Thank you ladies!
I do feel a world of difference now with my 2nd pregnancy than I felt with my first. I have a better handle on things. I talked to the mom who passed on the hypnobirthing book to me (she is a fellow mom from my daughters preschool) she delivered at the same hospital and she said the nurses were very understanding to her needs, delayed the cord cutting/ didn't rush the baby to be washed/eye drops/weighed etc for about an hour and half! She wanted to nurse/bond the first hour at least before baby was even looked at. They told her that unless you express anything otherwise, they just do their routine. Which makes sense! ..and I will definitely keep in mind to request a different nurse if need be, as awkward as that may be in the moment... maybe that can be my sisters job ;) I will ask ahead of time for a nurse who understands natural birth. Hopefully I wont have any issues!!

[jazzmom]

I didn't read the other posts, but the ONE thing (well, one major thing) that helped ensure the birth I wanted was have a nurse that is pro-natural. I had the most AMAZING nurse-who did everything i asked, my every wish. If you have someone from the hospital that's on your side and knows your every wish (not all nurses follow a birth plan), then the chances that it'll happen are great. I can't stress that enough to my friends and family who are opting for a natural birth. When you are in labor, call your hospital before you go in and request for a pro-natural nurse and have DH explain your wishes before hand. Not sure if you are doing a birth plan or not, but at least they will be prepared for you.

This...the nurse on duty if you are in a hospital is key. With my first birth, I didn't realize this. The experience wasn't horrible, but it wasn't great, either. It wasn't until DD2 was born and I decided to try my best for a natural birth that I realized how lucky I was to have a nurse who was willing to listen to my wishes and work with me. (I just got lucky!) I didn't realize you could request a nurse of this type, so thanks for that info!