I want women to know that hospital births don't have to be filled with intervention and that moms who deliver in hospital settings can and should be active participants in deciding what goes on during their own labor and delivery. I delivered both of my children in the hospital where I am a registered nurse (on the OB unit). I labored in the hot tub, in the shower, on the birthing ball, and spent very little time in the bed. I refused artificial rupture of membranes when I felt it wasn't in my best interest, I delivered my daughter unassisted and without any medication, then got up and gave her her first bath while my son and extended family looked on. My children were immediately placed skin-to-skin, never left my room, etc. While I admit that I largely wouldn't have been challenged because I was cared for by my peers, any proactive mom could have the same experience in my institution. I chose my experience while at the same time delivering in a place that had help, equipment, and experts available should the need arise. As a neonatal/obstetric nurse I am all too aware of the fact that infants are sometimes born who need immediate intervention to ensure their well being. In fact, approximately 10% of infants need some type of resuscitative efforts. Fetal distress can and does present very rapidly, without warning. Some of the worst infants that I have performed resuscitations on have had no identified risk factors during the prental/intrapartum period. For me, delivering in a situation where help is available is a must. Medical professionals like myself don't have to be the enemy. Are there bad MDs and nurses? Sure there are. But moms who are informed and proactive can, to a very large degree, decide what they want for their own birthing experience. Educated women who form partnerships with their physician and nurses can have natural births, even in the hospital setting. As a Certified Childbirth Educator, I stressed to my class participants to be vocal to their care providers. Don't just slide into the bed as they apply the fetal monitor and stay there for the duration of your labor. Speak up! Tell the nurse, MD, or midwife what you want your experience to be like. The experience is yours, no matter where you give birth. Birth is a natural process and the interventions should be minimal and based on need. Be your own advocate, and the advocate for your baby as well. Hospitals aren't the enemy. There are many like-minded healthcare professionals such as myself who want you to have the best experience possible and who would love to help. Just seek us out!

Tags: choices, intervention, minimal, proactive, safety

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I personally feel like to have the kind of birth that you envision you should hire the health care professional that YOU feel the most at ease with and that speaks to your needs. We are all focusing so much on Where, when in my opinion its Who that matters.
I think that villifying anyone is never productive. Hospitals do have many "bad" protocols, in my opinion but I don't think its the staff that is to blame. As consumers we need to become educated and use our voices to demand what we want, this is the only way things will change. This is the birth of our baby and we should feel as educated as possible and then, well its birth so you just never know what will happen;)
As consumers we need to demand the changes that we would like to see. There may be tons and tons of evidence out there stating that immediate cord clamping does nothing but harm; however, until mom's say stop doing this its not gonna change. Putting ourselves against each other isn't going to do anyone any good. I respect the right for women to birth wherever, with who ever they choose. I think that its fantastic actually that we get that choice!!! I liked the moive, Business of Being Born because it showed that there are other options.
*Deep breath*

I last gave birth nearly 9 years ago & this is still a raw topic for me. I read Ina May & Odent & went to La Leche League meetings. I wrote up a birth plan & brought it to my hospital & talked it over with my doctor. I was educated & pro-active & informed. What I wanted to say is that... sometimes, that's just not enough.

I live in a small town. At the last minute, the doctor & ultrasound tech thought there might be a problem, so they airlifted me to a large teaching hospital in the nearest city, where nobody knew me & frankly, they didn't give a damn about my birth plan or what I wanted. They ended up finding nothing wrong, but decided to induce, while I was there, since we were a week "overdue" anyway. The nurse that I had was not good. The doctor that ended up delivering was fresh out of medical school, hadn't read my birth plan, was just covering over the lunch hour (my son chose to be born at 12:12).... I never got one look at him, even though he was perfectly healthy, before they took him for "routine observation". It was wretched.

I was livid, when it was all said and done. Negative experience, through & through. Thing is - it wasn't my fault. There's nothing that I could have done differently. It took me a long time to see that. I had rage & PTSD. It took years for me to forgive myself & my (now ex) husband & see that I couldn't have done anything more than what I'd done.

As a culture, we need the medicalized way we handle the birthing experience to change. It needs to be everyone's responsibility, not just mom's, because she's at her most vulnerable, when she's giving birth.
I only have one child, who was born in a hospital. I had an absolutley fabulous, peaceful experience. The entire birthing process was phenomenal.
I had four natural childbirths in hospitals with no interventions (except a bad doc that cut me in childbirth #1, that didn't happen again). I simply took control. I had no interventions - no IVs, no monitors, no internal exams, nothing. I went home after a couple of hours too.

I think good medical professionals prefer the women that know what they want and that are in control. I know my doc wishes more women would do what I did!

Now, if God blesses me with #5, there's no way I'm getting anywhere near a hospital. I felt it a waste of gas. And a new set of clean sheets shouldn't cost me $3,000, like the hospital bill reflected! No way, no how. If I could've convinced my husband to stay home for the other ones, and if I'd have researched the laws (I was told it was illegal in Ohio to have an unassisted home birth, and I was stupid enough to believe it), all four would've been born safe and sound right in my home.
I am really glad that your experience wasn't horrible but that is not the norm. It is very hard to find a hospital where you can have an intervention free birth without a fight. I mean hospital policy says one thing, and you want to go against it, so the nurses badger you etc. It can get tough.. you should HAVE to fight. You shouldn't have to remind people of your birth plan, etc.

Women are even held down and given forced vaginal exams, and interventions they don't want or need.

Not all hospitals are bad, but for a normal birth.. a woman should really look at all her options. Hospitals aren't needed for low risk births. It shouldn't be the norm, and women shouldn't have to fight to have a normal birth.

I know many women who are very informed, and educated, who were bullied, and badgered and told horrible things at a hospital. Even I had things done against my will, and without consent, from an OB whom I developed a relationship with and whom i believed understood my wishes. Sometimes these professionals get ahead of themselves. It's terrible.
My best friend is a great example of a woman that went in well informed, prepared to speak up and refuse treatments if offered, birth plan in hand...ended up being pressured into every intervention you can think of topped off by a c/sec. I was there and watched it happen. When I tried to speak up for her and encourage her to change her pushing position (she was at her limit mentally by that point) I was told to be quite or they would call security because I was "endangering the life of the patient" (my specific statement was that pushing on your back is not effective and did she want me to help her to a semi sitting position, which she did but the OB ordered her not to and insisted she was in the best position for giving birth).

She was/is traumatized by the experience. Her biggest complaint, she knew better and was prepared with a birth plan and her wishes were ignored, she was made to feel like she was endangering her baby, and was talked to in such a condescending/patronizing way she gave in.
After she began telling her story every woman she talked to was able to guess what hospital she had delivered at.

She was told one thing by her care provider for her entire pregnancy and made to believe that the hospital knew about the wishes of the practice she was with so they would respect and support her decisions to refuse certain interventions. In reality that was not the case. They pulled the "bait and switch." She did her research, and was well informed. She was just no match for the emotional and psychological pressure she faced at the hospital.
Oh, I agree. But I'm a tough woman, and it would've been very impossible for them to force me to do anything after the first birth 15 years ago when I was genitally mutilated.

See, I think this is part of the problem. Women go in thinking the policy is set in stone, or that they can't demand something, and they give in. The word "NO" is very powerful. "Ma'am, we need to do an exam". NO. What can they do at that point? Kick me out? That would be fine!

I spoke with my OB and she worked at three different hospitals, and directed me to the most natural-birth friendly one. The minute I walked in the door, I made sure the nurse and attending doctors knew I didn't need them. If I'd have had any argument, I would've probably left. I can't say enough about the hospital I gave birth in, but I firmly believe that no doctor or nurse in any hospital would've forced me into an IV or exams or anything. That would've been assault at that point, and I would be rich.
I am a strong willed woman like you and I totally agree with you. My right to informed consent/refusal is absolute. Touch me against my wishes and I will sue you for assault & battery. Kick me out of the hospital and I will sue for violating EMTALA. If you don't like it kiss my a@%. But that is not the personality of all women--some just don't have it in them to be that assertive. Well informed, educated women, who are not as outspoken and "aggressive" as you and I easily fall victim to the pressures at the hospital.
I've birthed 6 children so far and have another due in July '07. I had a homebirth with my 6th and the rest were born in the hospital. I've had both medicated and unmedicated births in a hospital setting. The medicated births were with an OB, the unmedicated with a family practitioner who knew and shared my belief in natural birth. I would love more than anything to have another homebirth with this baby but my midwife can no longer do homebirths due to lack of doctor backup.

I don't care where other women choose to have their babies or how. What angers me is the lack of choices in so many areas. My midwife is a CNM with 30 years experience catching babies and yet because her new backup doctors don't like homebirth she can no longer do them. It's ridiculous! I am being denied a choice about where to have my baby unless I want to use a lay midwife, which I don't. I want professional care, in my own home.
I totally agree with you! My husband and I are expecting our first child and I am five and 1/2 months along. I am and have been glued to discovery health shows and just birthing storys and films all together. I am going for a total natural birth and would love to have a water birth (at a birthing center) where medical help will be around (RNs). But the nearest birthing center is atleast a hour and 1/2 away. I went to visit our women and childrens hospital here in Orlando florida which is farely new (3yrs old) and loved the fact that they were so helpful, indeed i asked many questions but all answered nicely. Here in orlando we are aloud to stay in the jaccuzzi tub until our water breaks but after that we are welcomed to roam around. they also allow you to chose water or which ever postion you feel comfortable to give birth in, on all fours on your side or squating which i plan. the only thing i am not to found of is that the baby must go to the nursery atleast two hrs a day for check ups but may be accompanied by me or my husband at all times. I am just scared they are gonna force me into something i dont want like potocin or breaking of my membranes i want it to be totally natural with no intervention i still have about three months for more reasearch. but love the idea of being in a hospital enviorment but with my birth ideas ! ;)
The choice of where one gives birth in the United States is an interesting and difficult dilemna. I have been an obstetrical nurse for going on 35 years and have seen such positive changes in hospitals around the country. These changes are due to new scientific data and consumer demand. I think public knowledge about the process of birth and how it is assisted in hospitals is one of the best ways to facilitate change in hospital management of birth. Prenatal classes, OB appointments are optimum opportunities for the public to be informed and of course documentaries such as, "The Business of Being Born'. I run a committee on perinatal empowerment in my hospital and am sharing with my peers, "Your Best Birth" and "The Business of Being Born".
I would like to see the rate of c- sections go down but insurance companies are paying for scheduled c-sections when there is really no other reason than patient request. I have heard that in some South American countries women prefer to have c-sections because it is a social accolade. I hope that is not happening in the good ole USA. Let us continue to inform the public on the choices they have in the birthing process and increase wise choices of care in the hospital.
Jennifer, you have the right to go home immediately after birth if you and baby are healthy. No way would I ever let them take my baby to a nursery to do God-knows what to. I'm not even sure what "exams" they're talking about - mine had weight and length at birth, and that's it. They were not even permitted to remove the baby from my bed when they did the initial checks after the birth of my four. This is YOUR baby. Go home, or tell them that they will NOT be taking the baby away. They cannot force you. Good luck!

jennifer noel said:
I totally agree with you! My husband and I are expecting our first child and I am five and 1/2 months along. I am and have been glued to discovery health shows and just birthing storys and films all together. I am going for a total natural birth and would love to have a water birth (at a birthing center) where medical help will be around (RNs). But the nearest birthing center is atleast a hour and 1/2 away. I went to visit our women and childrens hospital here in Orlando florida which is farely new (3yrs old) and loved the fact that they were so helpful, indeed i asked many questions but all answered nicely. Here in orlando we are aloud to stay in the jaccuzzi tub until our water breaks but after that we are welcomed to roam around. they also allow you to chose water or which ever postion you feel comfortable to give birth in, on all fours on your side or squating which i plan. the only thing i am not to found of is that the baby must go to the nursery atleast two hrs a day for check ups but may be accompanied by me or my husband at all times. I am just scared they are gonna force me into something i dont want like potocin or breaking of my membranes i want it to be totally natural with no intervention i still have about three months for more reasearch. but love the idea of being in a hospital enviorment but with my birth ideas ! ;)

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